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Schmidt MJ, Farke D. Surgical management of primary and idiopathic internal hydrocephalus in dogs and cats. Front Vet Sci 2024; 11:1435982. [PMID: 39027907 PMCID: PMC11254760 DOI: 10.3389/fvets.2024.1435982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Accepted: 06/18/2024] [Indexed: 07/20/2024] Open
Abstract
Ventriculoperitoneal shunt placement is an effective method to treat internal hydrocephalus in dogs and cats. Although it has a long history in veterinary medicine, the technique continues to evolve. Despite continuing attempts to reduce the incidence of associated complications, shunt failure remains a major problem, and often leads to multiple hospital admissions. This review gives an overview about current knowledge of ventriculoperitoneal shunting techniques in animals, applicable shunt hardware as well as shunt-associated complications and their prevention and treatment.
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Affiliation(s)
| | - Daniela Farke
- Department of Veterinary Clinical Sciences, Neurosurgery, Neuroradiology and Clinical Neurology, Small Animal Clinic, Justus-Liebig-University, Giessen, Germany
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Farke D, Siwicka AK, Olszewska A, Czerwik A, Büttner K, Schmidt MJ. Risk factors, treatment, and outcome in dogs and cats with subdural hematoma and hemispheric collapse after ventriculoperitoneal shunting of congenital internal hydrocephalus. J Vet Intern Med 2023; 37:2269-2277. [PMID: 37675951 PMCID: PMC10658535 DOI: 10.1111/jvim.16861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 08/24/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND Overshunting and hemispheric collapse are well-known complications after ventriculoperitoneal shunt (VPS) implantation. Risk factors that predispose to overshunting, treatment options, and prognosis after therapeutic intervention have not been described. HYPOTHESIS/OBJECTIVES To identify preoperative risk factors for overshunting, the effect of surgical decompression, and their outcomes. ANIMALS Seventy-five dogs and 7 cats. METHODS Retrospective case cohort study. Age, breed, sex, body weight, number of dilated ventricles, ventricle brain ratio, intraventricular pressure, and implanted pressure valve systems were evaluated as possible risk factors. RESULTS Overshunting had a prevalence of 18% (Cl 95% 9.9-26.66). An increase of 0.05 in VBR increased the risk of overshunting by OR 2.23 (Cl 95% 1.4-3.5; P = .001). Biventricular hydrocephalus had the highest risk for overshunting compared to a tri- (OR 2.48 with Cl 95% 0.5-11.1) or tetraventricular hydrocephalus (OR 11.6 with Cl 95% 1.7-81.1; P = .05). There was no influence regarding the use of gravitational vs differential pressure valves (P > .78). Overshunting resulted in hemispheric collapse, subdural hemorrhage, and peracute deterioration of neurological status in 15 animals. Subdural hematoma was removed in 8 dogs and 2 cats with prompt postoperative improvement of clinical signs. CONCLUSIONS AND CLINICAL IMPORTANCE Biventricular hydrocephalus and increased VBR indicate a higher risk for overshunting. The use of differential valves with gravitational units has no influence on occurrence of overshunting related complications and outcomes. Decompressive surgery provides a favorable treatment option for hemispheric collapse and has a good outcome.
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Affiliation(s)
- Daniela Farke
- Department of Veterinary Clinical Sciences, Small Animal ClinicJustus‐Liebig‐University, Frankfurter Strasse 11435392 GiessenGermany
| | - Anna K. Siwicka
- Department of Veterinary Clinical Sciences, Small Animal ClinicJustus‐Liebig‐University, Frankfurter Strasse 11435392 GiessenGermany
| | - Agnieszka Olszewska
- Department of Veterinary Clinical Sciences, Small Animal ClinicJustus‐Liebig‐University, Frankfurter Strasse 11435392 GiessenGermany
| | - Adriana Czerwik
- Department of Veterinary Clinical Sciences, Small Animal ClinicJustus‐Liebig‐University, Frankfurter Strasse 11435392 GiessenGermany
| | - Kathrin Büttner
- Unit for Biomathematics and Data Processing, Faculty of Veterinary MedicineJustus Liebig‐University‐GiessenGiessenGermany
| | - Martin J. Schmidt
- Department of Veterinary Clinical Sciences, Small Animal ClinicJustus‐Liebig‐University, Frankfurter Strasse 11435392 GiessenGermany
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Keadwut K, Lewchalermwong P, Inpithuk N, Choochalermporn P, Pongpradit A, Koatsang N, Suwanna N. Evaluation of Overshunting between Low and Medium Pressure Ventriculoperitoneal Shunts in Dogs with Severe Hydrocephalus Using Frameless Stereotactic Ventricular Shunt Placement. Animals (Basel) 2023; 13:1890. [PMID: 37370401 DOI: 10.3390/ani13121890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/30/2023] [Accepted: 06/01/2023] [Indexed: 06/29/2023] Open
Abstract
Hydrocephalus is a neurological disorder characterized by an abnormal accumulation of cerebrospinal fluid (CSF) within the ventricular system of the brain, leading to cerebral ventricular dilation, brain parenchyma compression, and neuronal cell loss. Surgery is an effective method of draining excessive amounts of CSF. Ventriculoperitoneal shunt (VPS) allows excess CSF to divert into the abdomen; this device is the most commonly used in the treatment of hydrocephalus both in veterinary and human patients. This study aims to describe the application of two types of VPS, low-pressure valve and medium-pressure valve, using a frameless stereotactic neuronavigational system in eight severe hydrocephalus in dogs and, in particular, analyze the prevalence of postoperative overshunting. Non-communicating hydrocephalus was found in seven dogs, whereas the rest of them had communicating hydrocephalus caused by traumatic brain injury with a skull fracture. The criteria for pressure valve selection depended on the intraoperative intraventricular pressure (IVP) that was determined by the adaptive manometer, according to the human protocol. Low-pressure valve placement was performed in five dogs, and the others received medium-pressure valve placement. The follow-up period was 2 weeks, 4-12 weeks, and 12 weeks to 12 months. Pre- and postoperative information including neurological signs, CT-Scan or MRI, medical treatment, complications, and ventricular volume were compared in all dogs. Seven dogs showed neurological improvement within 2 weeks after surgery. Overshunting was seen in four dogs who received low-pressure valve placement. Three of them had shunt infections within 4 to 6 weeks after surgery. One dog underwent shunt revision from a low-pressure valve to a medium-pressure valve caused by severe overshunting and progressive neurological signs. In addition, cognitive and learning improvements were evaluated based on the owners' feedback, and neurological signs were examined during the follow-up period in two dogs that received low-pressure valve placement. We conclude that a medium-pressure valve is recommended for overshunting prevention. However, low-pressure valve placement seems to improve cognitive function and learning ability, which is related to an increase in the brain parenchyma observed during long-term monitoring. Moreover, we also report our experience and surgical procedure for frameless stereotactic ventricular shunt placement (FSVSP) in VPS surgery in dogs affected by hydrocephalus.
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Affiliation(s)
- Kanokwan Keadwut
- Kasetsart University Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Kasetsart University, Bangkok 10900, Thailand
| | - Pakthorn Lewchalermwong
- Kasetsart University Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Kasetsart University, Bangkok 10900, Thailand
| | - Nathanat Inpithuk
- Kasetsart University Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Kasetsart University, Bangkok 10900, Thailand
| | - Piyathip Choochalermporn
- Kasetsart University Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Kasetsart University, Bangkok 10900, Thailand
| | - Ananya Pongpradit
- Kasetsart University Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Kasetsart University, Bangkok 10900, Thailand
| | - Nattika Koatsang
- Kasetsart University Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Kasetsart University, Bangkok 10900, Thailand
| | - Nirut Suwanna
- Department of Companion Animal Clinical Sciences, Faculty of Veterinary Medicine, Kasetsart University, Bangkok 10900, Thailand
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Mahon E, Eiras-Diaz A, Mason S, Stabile F, Uriarte A. Case Report: Ventriculoperitoneal Shunting and Radiation Therapy Treatment in a Cat With a Suspected Choroid Plexus Tumor and Hypertensive Hydrocephalus. Front Vet Sci 2022; 9:828083. [PMID: 35400094 PMCID: PMC8989464 DOI: 10.3389/fvets.2022.828083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 02/14/2022] [Indexed: 11/13/2022] Open
Abstract
A 14-year-old male neutered domestic short-hair cat was presented for a history of behavioral changes and episodes of urinary retention. Neurological examination was consistent with a multifocal intracranial neuroanatomical localization, with suspected right sided lateralisation and suspected raised intracranial pressure (ICP). Brain magnetic resonance imaging (MRI) revealed an intraventricular multilobulated well-defined T2W-hyperintense and T1W-isointense, markedly contrast enhancing mass lesion within the dorsal aspect of the III ventricle extending into the left lateral ventricle, causing hypertensive obstructive hydrocephalus. A ventriculoperitoneal shunt (VPS) was placed within the left lateral ventricle, followed by a radiation therapy (RT) course of 45 Gy total dose in 18 daily fractions. Six-months post-RT, computed tomography revealed mild reduction in mass size and resolution of the hydrocephalus. The patient was neurologically normal with no medical treatment. Raised ICP causes severe clinical signs, can lead to brain ischaemia and herniation, and significantly increases anesthetic risk during RT. Placement of a VPS in cats with hypertensive obstructive hydrocephalus may allow improvement of neurological signs due to raised ICP, and therefore making the patient a more stable candidate for anesthesia and radiation therapy.
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Affiliation(s)
- Elizabeth Mahon
- Department of Neurology and Neurosurgery, Southfields Veterinary Specialists, Essex, United Kingdom
| | - Aldara Eiras-Diaz
- Department of Internal Medicine, Southfields Veterinary Specialists, Essex, United Kingdom
| | - Sarah Mason
- Department of Oncology/Radiation Therapy, Southfields Veterinary Specialists, Essex, United Kingdom
| | - Fabio Stabile
- Department of Neurology and Neurosurgery, Southfields Veterinary Specialists, Essex, United Kingdom
| | - Ane Uriarte
- Department of Neurology and Neurosurgery, Southfields Veterinary Specialists, Essex, United Kingdom
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Lee DN, Ha M, Kwak I, Amhed S, Kang K, Woo SH, Oh JS, Yoon J, Yeon SC. Severe hydrocephalus in a raccoon dog (Nyctereutes procyonoides). J Vet Med Sci 2021; 83:1086-1089. [PMID: 33980788 PMCID: PMC8349822 DOI: 10.1292/jvms.20-0607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Hydrocephalus is one of the most common central nervous system malformations in domestic dogs, yet they are poorly documented and studied in wild carnivoran
mammals. A pup of raccoon dog (Nyctereutes procyonoides) was rescued and brought to Wildlife Center. The pup showed generalized ataxia, a domed skull, and an
open bregmatic fontanelle. Ultrasound and MRI showed severe enlargement of the lateral ventricle with the loss of septum pellucidum resulting in a single large
ventricle and cervical syringohydromyelia. Although treatment was attempted, the animal was euthanized due to poor prognosis. At necropsy, macroscopic findings
were identical to the diagnostic imaging, where marked enlargement of the calvarium, and attenuated gyri and sulci were observed. Finally, hydrocephalus was
confirmed. Here, we describe a case of hydrocephalus in a raccoon dog (Nyctereutes procyonoides).
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Affiliation(s)
- Do Na Lee
- College of Veterinary Medicine and the Research Institute for Veterinary Science, Seoul National University, Seoul 08826, Republic of Korea
| | - Minjong Ha
- College of Veterinary Medicine and the Research Institute for Veterinary Science, Seoul National University, Seoul 08826, Republic of Korea
| | - Insik Kwak
- College of Veterinary Medicine and the Research Institute for Veterinary Science, Seoul National University, Seoul 08826, Republic of Korea
| | - Sohail Amhed
- College of Veterinary Medicine and the Research Institute for Veterinary Science, Seoul National University, Seoul 08826, Republic of Korea
| | - Kyuyong Kang
- College of Veterinary Medicine and the Research Institute for Veterinary Science, Seoul National University, Seoul 08826, Republic of Korea
| | - Sang-Ho Woo
- College of Veterinary Medicine and the Research Institute for Veterinary Science, Seoul National University, Seoul 08826, Republic of Korea
| | - Jeong-Seop Oh
- College of Veterinary Medicine and the Research Institute for Veterinary Science, Seoul National University, Seoul 08826, Republic of Korea
| | - Junghee Yoon
- College of Veterinary Medicine and the Research Institute for Veterinary Science, Seoul National University, Seoul 08826, Republic of Korea
| | - Seong-Chan Yeon
- College of Veterinary Medicine and the Research Institute for Veterinary Science, Seoul National University, Seoul 08826, Republic of Korea
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Ito D, Ishikawa C, Jeffery ND, Kitagawa M. Cerebrospinal fluid flow on time-spatial labeling inversion pulse images before and after treatment of congenital hydrocephalus in a dog. J Vet Intern Med 2021; 35:490-496. [PMID: 33421205 PMCID: PMC7848343 DOI: 10.1111/jvim.16020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 12/15/2020] [Accepted: 12/16/2020] [Indexed: 11/30/2022] Open
Abstract
A 3-month-old male cross-breed dog presented with signs of progressive diffuse brain disease. Noncommunicating congenital hydrocephalus concurrent with cervical syringomyelia was diagnosed on magnetic resonance images. On time-spatial labeling inversion pulse (Time-SLIP) images CSF flow through the mesencephalic aqueduct was poorly defined and there was flow into the syrinx across the craniocervical junction. After percutaneous ventricular drainage and ventriculoperitoneal shunting, CSF flow through the aqueduct was clearly detected and flow into the syrinx disappeared. In addition, CSF flow in the subarachnoid space at the pons and ventral aspect of the cervical subarachnoid space was restored. Signs of neurological dysfunction improved after ventriculoperitoneal shunting and the cerebral parenchyma was increased in thickness on 2-year follow-up computed tomography images. Patterns of CSF flow on Time-SLIP images before and after CSF drainage or ventriculoperitoneal shunting aid in clarifying disease pathogenesis and confirm effects of CSF drainage.
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Affiliation(s)
- Daisuke Ito
- Laboratory of Veterinary Neurology, Department of Veterinary Medicine, College of Bioresource, Nihon University, Kanagawa, Japan
| | - Chieko Ishikawa
- Laboratory of Veterinary Neurology, Department of Veterinary Medicine, College of Bioresource, Nihon University, Kanagawa, Japan
| | - Nick D Jeffery
- Veterinary Medicine and Biomedical Science, Department of Small Animal Clinical Sciences, Texas A&M University, Texas, USA
| | - Masato Kitagawa
- Laboratory of Veterinary Neurology, Department of Veterinary Medicine, College of Bioresource, Nihon University, Kanagawa, Japan
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Pohlin F, Boustead KJ, Grace JF, Zeiler G. Isoflurane maintenance of neuroanaesthesia in two dogs with hydrocephalus and syringohydromyelia undergoing ventriculoperitoneal shunt surgery. VETERINARY RECORD CASE REPORTS 2020. [DOI: 10.1136/vetreccr-2020-001235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Friederike Pohlin
- Department of Companion Animal Clinical StudiesUniversity of PretoriaOnderstepoortSouth Africa
- Anaesthesia and Critical Care ServiceValley Farm Animal HospitalPretoriaSouth Africa
- Research Institute of Wildlife EcologyDepartment of Interdisciplinary Life SciencesUniversity of Veterinary Medicine ViennaViennaAustria
| | - Keagan John Boustead
- Department of Companion Animal Clinical StudiesUniversity of PretoriaOnderstepoortSouth Africa
- Anaesthesia and Critical Care ServiceValley Farm Animal HospitalPretoriaSouth Africa
| | - Justin Frederick Grace
- Department of Companion Animal Clinical StudiesUniversity of PretoriaOnderstepoortSouth Africa
- Anaesthesia and Critical Care ServiceValley Farm Animal HospitalPretoriaSouth Africa
| | - Gareth Zeiler
- Department of Companion Animal Clinical StudiesUniversity of PretoriaOnderstepoortSouth Africa
- Anaesthesia and Critical Care ServiceValley Farm Animal HospitalPretoriaSouth Africa
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Farke D, Kolecka M, Czerwik A, Wrzosek M, Schaub S, Kramer M, Failing K, Schmidt MJ. Prevalence of seizures in dogs and cats with idiopathic internal hydrocephalus and seizure prevalence after implantation of a ventriculo-peritoneal shunt. J Vet Intern Med 2020; 34:1986-1992. [PMID: 32918850 PMCID: PMC7517859 DOI: 10.1111/jvim.15890] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 08/07/2020] [Accepted: 08/18/2020] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Seizures are considered a clinical sign in dogs with internal hydrocephalus but are not found in recent studies. Seizure prevalence due to ventricular enlargement and the prevalence of postoperative seizures in animals is not known. OBJECTIVES To determine seizure prevalence in dogs and cats with idiopathic internal hydrocephalus, to identify risk factors for seizure development, and to determine seizure prevalence in a 2-year period after ventriculo-peritoneal shunting (VPS). ANIMALS Records and MRIs of 197 animals from 2001 to December 2019 were investigated. A total of 121 animals (98 dogs and 23 cats) were included in the study. METHODS A retrospective multicenter case cohort study was conducted. Databases were searched for dogs and cats with internal hydrocephalus. MRI and CSF examinations were evaluated for signs of additional underlying disorders. Prevalence of seizures was estimated for animals showing only hydrocephalus internus. Risk factors were evaluated according to age, morphometric and morphological findings in the brain. All animals that underwent surgery were reexamined 2 years after surgery. RESULTS One hundred twenty-one animals (98 dogs and 23 cats) with internal hydrocephalus met the inclusion criteria. Seizure prevalence in dogs and cats with internal hydrocephalus was low (1.7%; <5.8% CI 95%). Seizures were not observed in the 2-year period after surgery. CONCLUSION AND CLINICAL IMPORTANCE Seizure prevalence in dogs and cats diagnosed with hydrocephalus internus is low. Seizures in association with VPS do not seem to be a complication of the procedure.
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Affiliation(s)
- Daniela Farke
- Department of Veterinary Clinical Sciences, Small Animal ClinicJustus‐Liebig‐UniversityGiessenGermany
| | - Malgorzata Kolecka
- Department of Veterinary Clinical Sciences, Small Animal ClinicJustus‐Liebig‐UniversityGiessenGermany
| | - Adriana Czerwik
- Department of Veterinary Clinical Sciences, Small Animal ClinicJustus‐Liebig‐UniversityGiessenGermany
| | - Marcin Wrzosek
- Department of Internal Medicine and Clinic for Horses, Dogs and Cats, The Faculty of Veterinary MedicineWrocław University of Environmental and Life SciencesWrocławPoland
| | - Sebastian Schaub
- Department of Veterinary Clinical Sciences, Small Animal ClinicJustus‐Liebig‐UniversityGiessenGermany
| | - Martin Kramer
- Department of Veterinary Clinical Sciences, Small Animal ClinicJustus‐Liebig‐UniversityGiessenGermany
| | - Klaus Failing
- Unit for Biomathematics and Data Processing, Faculty of Veterinary MedicineJustus Liebig‐University‐GiessenGiessenGermany
| | - Martin Jürgen Schmidt
- Department of Veterinary Clinical Sciences, Small Animal ClinicJustus‐Liebig‐UniversityGiessenGermany
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Gillespie S, Gilbert Z, De Decker S. Results of oral prednisolone administration or ventriculoperitoneal shunt placement in dogs with congenital hydrocephalus: 40 cases (2005-2016). J Am Vet Med Assoc 2020; 254:835-842. [PMID: 30888275 DOI: 10.2460/javma.254.7.835] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate signalment, clinical findings, and outcomes of dogs with congenital hydrocephalus treated medically with orally administered prednisolone or surgically by ventriculoperitoneal shunt placement. DESIGN Retrospective case series. ANIMALS 40 client-owned dogs. PROCEDURES Medical records from 2005 to 2016 were searched to identify dogs with congenital hydrocephalus confirmed by MRI examination. Patients were categorized by treatment (medical vs surgical). Signalment, clinical signs, neurologic examination findings, results of diagnostic tests, duration of hospitalization, complications potentially related to treatment, and follow-up information were recorded. Outcome was categorized on the basis of clinical (neurologic) signs as improved, stabilized, or deteriorated. Variables of interest were compared between groups by Fisher exact or Mann-Whitney U tests. RESULTS 28 and 12 dogs had surgical and medical treatment, respectively; 3 medically treated dogs subsequently underwent ventriculoperitoneal shunt placement. No significant differences were noted in clinical or imaging findings between surgically and medically treated dogs. Median follow-up time was 9 months and 15.5 months for medically and surgically treated dogs, respectively. Of 12 medically treated dogs, 6 improved and 6 deteriorated. Of 26 surgically treated dogs with data available, 14 (54%) improved, 1 (4%) stabilized, and 11 (42%) deteriorated; 4 (15%) had known postoperative complications. CONCLUSIONS AND CLINICAL RELEVANCE Approximately half of the dogs treated with prednisolone in this population had neurologic improvement at last follow-up; results of surgical treatment were comparable to those in previous studies. Further research is needed to assess factors associated with acceptable outcomes for dogs with congenital hydrocephalus.
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Orlandi R, Vasilache CG, Mateo I. Palliative ventriculoperitoneal shunting in dogs with obstructive hydrocephalus caused by tumors affecting the third ventricle. J Vet Intern Med 2020; 34:1556-1562. [PMID: 32472726 PMCID: PMC7379019 DOI: 10.1111/jvim.15818] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 05/12/2020] [Accepted: 05/13/2020] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Hypertensive or obstructive hydrocephalus is a common complication in dogs with tumors affecting the third ventricle for which few therapeutic options are available. OBJECTIVES To describe signalment, neurological status, and pre- and postsurgical findings, complications and survival time in 4 dogs with obstructive hydrocephalus caused by third ventricle tumors that were palliatively treated using ventriculoperitoneal shunting (VPS). ANIMALS Four client-owned dogs with obstructive hydrocephalus caused by tumors affecting the third ventricle. METHODS Medical records were reviewed for dogs diagnosed with third ventricular tumors. Inclusion criteria were complete medical record, advanced diagnostic imaging for review, and VPS as sole surgical treatment. RESULTS At the time of diagnosis, all patients displayed acute onset and rapidly progressive diffuse intracranial clinical signs. On advanced imaging, all dogs had a homogeneously enhancing mass occupying or collapsing the third ventricle as well as obstructive hydrocephalus. All of the dogs underwent VPS of the most dilated lateral ventricle. In 2 of the patients, intracranial hypertension followed by normotension after VPS placement was confirmed intraoperatively by means of direct intracranial pressure monitoring. Excellent clinical improvement was observed in all dogs immediately after surgery. Three patients required a second VPS in the contralateral lateral ventricle 3, 7 and 11 months after the first surgery, all of them with renewed improvement in clinical signs. CONCLUSION AND CLINICAL IMPORTANCE Ventriculoperitoneal shunting is a rapid and effective treatment for patients with obstructive (hypertensive) hydrocephalus caused by tumors located within the third ventricle.
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Affiliation(s)
- Rocio Orlandi
- Servicio de Neurología, Hospital Veterinario VETSIA, Madrid, Spain
| | | | - Isidro Mateo
- Servicio de Neurología, Hospital Veterinario VETSIA, Madrid, Spain.,Servicio de Neurología, Hospital Clínico Veterinario, Universidad Alfonso X el Sabio, Madrid, Spain
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Lehner L, Czeibert K, Nagy G. Two different indications of ventriculoperitoneal and cystoperitoneal shunting in six dogs. Acta Vet Hung 2020; 68:95-104. [PMID: 32384064 DOI: 10.1556/004.2020.00010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 02/14/2020] [Indexed: 11/19/2022]
Abstract
In this study we described two different indications of ventriculo- and cystoperitoneal shunting (VPS, CPS) procedures in six dogs, including their clinical data and magnetic resonance imaging (MRI) examinations. One dog had moderate and two dogs had severe congenital hydrocephalus, one was presented with intracranial pressure elevation due to meningoencephalitis of unknown origin (MUO) associated with congenital hydrocephalus, and two with quadrigeminal cysts (QC). VPS procedures were done in four and CPS in two dogs, using low-pressure valve systems. The follow-up period ranged from 1 to 6 months and control MRI scans were also made. Significant improvement was detected in five cases during the short-term follow-up period (1 month) and in four cases in the medium-term follow-up (2-6 months). Major complications were found in two cases: one dog with acute-hypertensive hydrocephalus died one week after surgery, and in another case development of a chronic subdural haematoma and hygroma caused death 3 months after the surgery. Minor complications (e.g. subdural hygroma) were found in two cases. In cases of severe hydrocephalus or intracranial cysts, higher-pressure valve systems are recommended in order to prevent subdural hygroma. Transient postoperative clinical signs usually resolve within one week after the surgery.
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Affiliation(s)
- László Lehner
- 1FeliCaVet Veterinary Referrals Clinic and Hospital, Rétköz utca 16, Budapest, H-1118, Hungary
| | - Kálmán Czeibert
- 2Department of Ethology, Institute of Biology, ‘Eötvös Loránd’ University, Budapest, Hungary
| | - Gábor Nagy
- 3National Institute of Clinical Neurosciences, Budapest, Hungary
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Brückner M. Laparoscopic repositioning of an obstructed ventriculoperitoneal shunt catheter with laparoscopy-assisted partial omentectomy and omentopexy. Vet Surg 2019; 49 Suppl 1:O71-O75. [PMID: 31814142 DOI: 10.1111/vsu.13362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 10/21/2019] [Accepted: 11/13/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To describe the use of laparoscopy for repositioning of a ventriculoperitoneal shunt (VPS) catheter. STUDY DESIGN Case report. ANIMAL One 11-month-old male cairn terrier weighing 5.5 kg. METHODS The dog had placement of a VPS system for primary hydrocephalus at 4 months of age. Poor functioning of the shunt system was suspected because of deteriorating neurological signs. A contrast study of the VPS system provided evidence of a distal shunt obstruction, and repeated brain computed tomography (CT) was consistent with persistent hydrocephalus. RESULTS Laparoscopy was used to free the abdominal catheter of the shunt system and perform a partial omentectomy and omentopexy of the remaining omentum. Concurrently, the dog was sterilized. Recovery was routine, and follow-up CT 1 year after repositioning revealed that the hydrocephalus had substantially improved. Results of a contrast study of the VPS system also provided evidence that it was functional. CONCLUSION Ventriculoperitoneal shunt systems are placed in dogs with primary and secondary hydrocephalus, and complications are quite common, including obstruction, bleeding, infection, and overshunting or undershunting. This is the first published clinical case report in which the repositioning of a VPS catheter with partial omentectomy and omentopexy in a dog are described. CLINICAL SIGNIFICANCE Future studies may be performed to determine whether laparoscopy can be considered as a treatment to assist with safe placement of VPS systems, avoiding misplacement of the shunt system and iatrogenic damage to the viscera and vessels.
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Affiliation(s)
- Michael Brückner
- Evidensia Specialistdjursjukhuset Helsingborg, Helsingborg, Sweden
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13
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Kolecka M, Farke D, Failling K, Kramer M, Schmidt MJ. Intraoperative measurement of intraventricular pressure in dogs with communicating internal hydrocephalus. PLoS One 2019; 14:e0222725. [PMID: 31560704 PMCID: PMC6764652 DOI: 10.1371/journal.pone.0222725] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 09/05/2019] [Indexed: 12/14/2022] Open
Abstract
Collapse of the lateral cerebral ventricles after ventriculo-peritoneal drainage is a fatal complication in dogs with internal hydrocephalus. It occurs due to excessive outflow of cerebrospinal fluid into the peritoneal cavity (overshunting). In most shunt systems, one-way valves with different pressure settings regulate flow into the distal catheter to avoid overshunting. The rationale for the choice of an appropriate opening pressure is a setting at the upper limit of normal intracranial pressure in dogs. However, physiological intraventricular pressure in normal dogs vary between 5 and 12 mm Hg. Furthermore, we hypothesise that intraventricular pressure in hydrocephalic dogs might differ from pressure in normal dogs and we also consider that normotensive hydrocephalus exists in dogs, as in humans. In order to evaluate intraventricular pressure in hydrocephalic dogs, twenty-three client owned dogs with newly diagnosed communicating internal hydrocephalus were examined before implantation of a ventriculo-peritoneal shunt using a single use piezo-resistive strain-gauge sensor (MicroSensor ICP probe). Ventricular volume and brain volume were measured before surgery, based on magnetic resonance images. Total ventricular volume was calculated and expressed in relation to the total volume of the brain, including the cerebrum, cerebellum, and brainstem (ventricle-brain index). Multiple logistic regression analysis was performed to assess the influence of the covariates "age", "gender", "duration of clinical signs", "body weight", and "ventricle-brain index" on intraventricular pressure. The mean cerebrospinal fluid pressure in the hydrocephalic dogs was 8.8 mm Hg (standard deviation 4.22), ranging from 3-18 mm Hg. The covariates "age", (P = 0.782), "gender" (P = 0.162), "body weight", (P = 0.065), or ventricle-brain index (P = 0.27)" were not correlated with intraventricular pressure. The duration of clinical signs before surgery, however, was correlated with intraventricular pressure (P< 0.0001). Dogs with internal hydrocephalus do not necessarily have increased intraventricular pressure. Normotensive communicating hydrocephalus exists in dogs.
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Affiliation(s)
- Malgorzata Kolecka
- Department of Veterinary Clinical Sciences, Small Animal Clinic – Neurosurgery, Neuroradiology and Clinical Neurology, Justus-Liebig-University, Giessen, Germany
| | - Daniela Farke
- Department of Veterinary Clinical Sciences, Small Animal Clinic – Neurosurgery, Neuroradiology and Clinical Neurology, Justus-Liebig-University, Giessen, Germany
| | - Klaus Failling
- Unit for Biomathematics and Data Processing, Faculty of Veterinary Medicine, Justus Liebig-University-Giessen, Giessen, Germany
| | - Martin Kramer
- Department of Veterinary Clinical Sciences, Small Animal Clinic – Neurosurgery, Neuroradiology and Clinical Neurology, Justus-Liebig-University, Giessen, Germany
| | - Martin J. Schmidt
- Department of Veterinary Clinical Sciences, Small Animal Clinic – Neurosurgery, Neuroradiology and Clinical Neurology, Justus-Liebig-University, Giessen, Germany
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Martin S, Shivapour S, Beltran E. Supracollicular fluid accumulation type 3 with concurrent hydrocephalus in a five‐month‐old crossbreed dog. VETERINARY RECORD CASE REPORTS 2019. [DOI: 10.1136/vetreccr-2018-000800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
| | - Sara Shivapour
- Department of Clinical Science and ServicesRoyal Veterinary CollegeNorth MymmsHatfieldUK
| | - Elsa Beltran
- Department of Clinical Science and ServicesRoyal Veterinary CollegeNorth MymmsHatfieldUK
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Schmidt MJ, Hartmann A, Farke D, Failling K, Kolecka M. Association between improvement of clinical signs and decrease of ventricular volume after ventriculoperitoneal shunting in dogs with internal hydrocephalus. J Vet Intern Med 2019; 33:1368-1375. [PMID: 30957934 PMCID: PMC6524126 DOI: 10.1111/jvim.15468] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 02/14/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND One of the remaining questions in treating dogs with internal hydrocephalus is the association between the decrease of ventricular volume and re-expansion of cerebral parenchyma with clinical improvement. HYPOTHESIS A decrease in ventricular volume and re-expansion of brain tissue occur after ventriculoperitoneal shunting (VPS). Clinical improvement defined by resolution of ≥1 clinical signs is associated with decreased size of cerebral ventricles and that the extent of change in ventricular size is associated with clinical improvement. ANIMALS Forty-five client-owned dogs with newly diagnosed communicating internal hydrocephalus. METHODS Ventricular volume, brain volume, and clinical status of dogs that underwent VPS were measured before and 3 months after surgery. Multiple logistic regression analysis was performed to assess the influence of decrease in ventricular size in addition to the covariates "age of the animal" and "duration of clinical signs before surgery" on improvement of clinical signs. RESULTS Decreased volume of cerebral ventricles was associated with resolution of ≥1 preoperative clinical sign (P < .003). The covariates "age of the animal" and "duration of clinical signs" were not associated with improvement of clinical signs. The percentage decrease in ventricular size was associated with resolution of ataxia (P = .008) and obtundation (P = .011). CONCLUSION AND CLINICAL IMPORTANCE The decrease in ventricular volume and increase in brain parenchyma after VPS are associated with improvement in clinical signs.
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Affiliation(s)
- Martin J. Schmidt
- Department of Veterinary Clinical Sciences, Small Animal ClinicJustus‐Liebig‐UniversityGiessenGermany
| | | | - Daniela Farke
- Department of Veterinary Clinical Sciences, Small Animal ClinicJustus‐Liebig‐UniversityGiessenGermany
| | - Klaus Failling
- Unit for Biomathematics and Data Processing, Faculty of Veterinary MedicineJustus Liebig‐University‐GiessenGiessenGermany
| | - Malgorzata Kolecka
- Department of Veterinary Clinical Sciences, Small Animal ClinicJustus‐Liebig‐UniversityGiessenGermany
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16
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Gradner G, Kaefinger R, Dupré G. Complications associated with ventriculoperitoneal shunts in dogs and cats with idiopathic hydrocephalus: A systematic review. J Vet Intern Med 2019; 33:403-412. [PMID: 30747447 PMCID: PMC6430919 DOI: 10.1111/jvim.15422] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 01/09/2019] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Several case series and case reports have been published about idiopathic hydrocephalus treatment in dogs and cats using ventriculoperitoneal shunts (VPS). OBJECTIVES To determine the risk and type of complications in dogs and cats after VPS placement. ANIMALS Sixteen papers were included. Sixty dogs and 13 cats with idiopathic hydrocephalus treated by VPS placement were identified. METHODS The databases CAB, Scopus, and Medline were used. Idiopathic/congenital hydrocephalus, feline/canine patients, ventriculoperitoneal shunting, complications, and outcomes were inclusion criteria. The focus was on complication type and time frame within which they arose. RESULTS Complications in dogs (n = 60) were shunt obstruction (6/60; 10%), pain (4/60; 5.5%), shunt infection (3/60; 4.1%), disconnection (3/60; 4.1%), excessive shunting (2/60; 2.7%), and kinking (1/60; 1.6%). Complications in cats (n = 13) were coiling of the shunt in the SC tissue (2/13; 15.4%); kinking (1/13; 7.7%); and shunt obstruction (1/13; 7.7%). Complications were most likely during the first 6 months after shunt placement. CONCLUSION AND CLINICAL IMPORTANCE Ventriculoperitoneal shunting is considered a viable treatment option for patients with hydrocephalus. Potential complications should be discussed with the owner. Early diagnosis of complications is essential.
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Affiliation(s)
- Gabriele Gradner
- Department of Small Animal SurgeryClinic of Small Animal SurgeryViennaAustria
| | - Rose Kaefinger
- Department of Small Animal SurgeryClinic of Small Animal SurgeryViennaAustria
| | - Gilles Dupré
- Department of Small Animal SurgeryClinic of Small Animal SurgeryViennaAustria
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LAPAROSCOPIC-ASSISTED INSERTION OF A VENTRICULOPERITONEAL SHUNT IN A RESCUED ASIATIC BLACK BEAR (URSUS THIBETANUS) IN LAOS. J Zoo Wildl Med 2017; 48:897-901. [PMID: 28920775 DOI: 10.1638/2016-0147.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A 3-yr-old Asiatic black bear (Ursus thibetanus), weighing 68 kg, underwent a laparoscopic-assisted placement of a ventriculoperitoneal shunt for hydrocephalus in the Lao People's Democratic Republic. Rescued as a young cub with a notably domed head, the bear's condition had deteriorated with age, but euthanasia was not a viable option because of cultural issues. Surgery was attempted as a palliative measure. The bear had ventrally orientated crossed eyes (abducens nerve palsy and dorsal midbrain syndrome), papilledema, severe rhinorrhea, depressed mentation, lethargy, a very poor appetite, and was stunted. Hydrocephalus was confirmed via intraoperative 2.0-5.0 MHz head ultrasound, as no magnetic resonance imaging was available in the country. Surgery was planned via 3D modeling of museum skulls and brain cavity, and ultrasound examination of formalin-preserved brains of other carnivores with hydrocephalus. The bear demonstrated a notable improvement in mentation, appetite, and behavior, maintained for 4 yr following surgery.
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18
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Schmidt MJ, Kampschulte M, Enderlein S, Gorgas D, Lang J, Ludewig E, Fischer A, Meyer-Lindenberg A, Schaubmar AR, Failing K, Ondreka N. The Relationship between Brachycephalic Head Features in Modern Persian Cats and Dysmorphologies of the Skull and Internal Hydrocephalus. J Vet Intern Med 2017; 31:1487-1501. [PMID: 28833532 PMCID: PMC5598898 DOI: 10.1111/jvim.14805] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 06/01/2017] [Accepted: 07/13/2017] [Indexed: 01/06/2023] Open
Abstract
Background Cat breeders observed a frequent occurrence of internal hydrocephalus in Persian cats with extreme brachycephalic head morphology. Objective To investigate a possible relationship among the grade of brachycephaly, ventricular dilatation, and skull dysmorphologies in Persian cats. Animals 92 Persian‐, 10 Domestic shorthair cats. Methods The grade of brachycephaly was determined on skull models based on CT datasets. Cranial measurements were examined with regard to a possible correlation with relative ventricular volume, and cranial capacity. Persians with high (peke‐face Persians) and lower grades of brachycephaly (doll‐face Persians) were investigated for the presence of skull dysmorphologies. Results The mean cranial index of the peke‐face Persians (0.97 ± 0.14) was significantly higher than the mean cranial index of doll‐face Persians (0.66 ± 0.04; P < 0.001). Peke‐face Persians had a lower relative nasal bone length (0.15 ± 0.04) compared to doll‐face (0.29 ± 0.08; P < 0.001). The endocranial volume was significantly lower in doll‐face than peke‐face Persians (89.6 ± 1.27% versus 91.76 ± 2.07%; P < 0.001). The cranial index was significantly correlated with this variable (Spearman's r: 0.7; P < 0.0001). Mean ventricle: Brain ratio of the peke‐face group (0.159 ± 0.14) was significantly higher compared to doll‐face Persians (0.015 ± 0.01; P < 0.001). Conclusion and Clinical Relevance High grades of brachycephaly are also associated with malformations of the calvarial and facial bones as well as dental malformations. As these dysmorphologies can affect animal welfare, the selection for extreme forms of brachycephaly in Persian cats should be reconsidered.
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Affiliation(s)
- M J Schmidt
- Department of Veterinary Clinical Sciences, Clinic for Small Animals, Justus-Liebig University, Giessen, Germany
| | - M Kampschulte
- Department of Diagnostic and Interventional Radiology, University Hospital Gießen, Gießen, Germany
| | - S Enderlein
- Department of Veterinary Clinical Sciences, Clinic for Small Animals, Justus-Liebig University, Giessen, Germany
| | - D Gorgas
- Vetsuisse Faculty Berne, Clinical Radiology, Berne, Switzerland
| | - J Lang
- Vetsuisse Faculty Berne, Clinical Radiology, Berne, Switzerland
| | - E Ludewig
- Department of Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria
| | - A Fischer
- Section of Neurology, Clinic of Small Animal Medicine, Ludwig-Maximilians-University, Munich, Germany
| | - A Meyer-Lindenberg
- Clinic of Small Animal Surgery and Reproduction, Ludwig Maximilians-University, Munich, Germany
| | - A R Schaubmar
- Unit for Biomathematics and Data Processing, Faculty of Veterinary Medicine, Justus Liebig-University, Giessen, Germany
| | - K Failing
- Unit for Biomathematics and Data Processing, Faculty of Veterinary Medicine, Justus Liebig-University, Giessen, Germany
| | - N Ondreka
- Department of Veterinary Clinical Sciences, Clinic for Small Animals, Justus-Liebig University, Giessen, Germany
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Bennett SE, Behr S. Retrograde migration and subcutaneous coiling of the peritoneal catheter of a ventriculoperitoneal shunt in a cat. JFMS Open Rep 2017; 2:2055116916646387. [PMID: 28491419 PMCID: PMC5362877 DOI: 10.1177/2055116916646387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2016] [Indexed: 11/25/2022] Open
Abstract
Case summary Ventriculoperitoneal shunt placement is the most commonly utilised surgical treatment for hydrocephalus in human and veterinary patients. Migration of the peritoneal catheter is an uncommon but well-documented complication in people, usually occurring within the first 3 months postoperatively, although only a single feline case report exists. A ventriculoperitoneal shunt was placed in a domestic shorthair cat, aged 4 years and 10 months, following a diagnosis, with MRI, of unilateral, non-communicating hydrocephalus. Diarrhoea, increased vocalisation and pruritus were reported within the first 3 months postoperatively. A shunt-associated seroma developed, which was aspirated under ultrasound guidance. Within 3 days, the entire peritoneal catheter was subcutaneously coiled at the level of the seroma. The peritoneal catheter was replaced within the abdomen via a new subcutaneous tunnel. No further complications had occurred 24 months following revision surgery. Relevance and novel information This is the second report describing peritoneal catheter migration in a cat. Repetitive head and neck movements during self-grooming, raised intra-abdominal pressure secondary to vocalisation and tenesmus, and negative pressure exerted during seroma aspiration may have contributed to ventriculoperitoneal shunt migration. Excessive loose skin and increased activity may further increase the risk of migration in cats. Diagnostic imaging should be offered prior to and following aspiration of shunt-associated swellings, and minimal negative pressure should be exerted. Attempts to reduce the frequency of postoperative self-grooming, prevention and prompt treatment of conditions predisposing to raised intra-abdominal pressure and moderate exercise restriction, particularly within the first 3 months, may help reduce the risk of peritoneal catheter migration.
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20
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Schmidt MJ, Rummel C, Hauer J, Kolecka M, Ondreka N, McClure V, Roth J. Increased CSF aquaporin-4, and interleukin-6 levels in dogs with idiopathic communicating internal hydrocephalus and a decrease after ventriculo-peritoneal shunting. Fluids Barriers CNS 2016; 13:12. [PMID: 27357498 PMCID: PMC4928270 DOI: 10.1186/s12987-016-0034-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 05/30/2016] [Indexed: 12/03/2022] Open
Abstract
Background Studies in animal models, in which internal hydrocephalus has been induced by obstructing the cerebrospinal fluid pathways, have documented an up-regulation of the concentrations of aquaporin-4 (AQP4) in the brain. In this study, the concentrations of aquaporin-1 (AQP1), AQP1, AQP4 and interleukin-6 (IL-6) were determined in the CSF of dogs with idiopathic communicating hydrocephalus before and after the reduction of intraventricular volume following ventriculo-peritoneal shunt (VP-shunt) treatment. Results The concentrations of AQP4 and IL-6 were increased in the cerebrospinal fluid of dogs with hydrocephalus compared to controls. Both parameters significantly decreased after surgical treatment, accompanied by decrease of ventricular size and the clinical recovery of the dogs. AQP1 was not detectable in CSF. Conclusions Brain AQP4 up-regulation might be a compensatory response in dogs with hydrocephalus. Future determination of AQP4 at the mRNA and protein level in brain tissue is warranted to substantiate this hypothesis.
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Affiliation(s)
- Martin J Schmidt
- Department of Veterinary Clinical Sciences, Small Animal Clinic, Justus-Liebig-University, Frankfurter Strasse 108, 35392, Giessen, Germany.
| | - Christoph Rummel
- Institute for Veterinary Physiology and Biochemistry, Justus-Liebig-University, Frankfurter Strasse 100, 35392, Giessen, Germany
| | - Jessica Hauer
- Department of Veterinary Clinical Sciences, Small Animal Clinic, Justus-Liebig-University, Frankfurter Strasse 108, 35392, Giessen, Germany
| | - Malgorzata Kolecka
- Department of Veterinary Clinical Sciences, Small Animal Clinic, Justus-Liebig-University, Frankfurter Strasse 108, 35392, Giessen, Germany
| | - Nele Ondreka
- Department of Veterinary Clinical Sciences, Small Animal Clinic, Justus-Liebig-University, Frankfurter Strasse 108, 35392, Giessen, Germany
| | - Vanessa McClure
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Private Bag X04, Onderstepoort, Pretoria, 0110, Republic of South Africa
| | - Joachim Roth
- Institute for Veterinary Physiology and Biochemistry, Justus-Liebig-University, Frankfurter Strasse 100, 35392, Giessen, Germany
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22
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Affiliation(s)
- Mark Lowrie
- Davies Veterinary SpecialistsManor Farm Business ParkHigham GobionHertfordshireSG5 3HRUK
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23
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Affiliation(s)
- James A Lavely
- Department of Neurology and Neurosurgery, VCA Animal Care Center of Sonoma, 6470 Redwood Drive, Rohnert Park, CA 94928, USA.
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Driver CJ, Pinilla MJ, Loderstedt S, Kenny PJ. Intra-abdominal blockage of a ventriculoperitoneal shunt by a suspected mesenteric pseudocyst in a dog. Aust Vet J 2013; 91:418-421. [DOI: 10.1111/avj.12101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2013] [Indexed: 12/01/2022]
Affiliation(s)
- CJ Driver
- The Queen Mother Hospital for Animals, Department of Veterinary Clinical Sciences; The Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Hertfordshire AL97TA UK
| | - MJ Pinilla
- Department of Pathology and Infectious Diseases; The Royal Veterinary College; North Mymms Hatfield Hertfordshire UK
| | - S Loderstedt
- The Queen Mother Hospital for Animals, Department of Veterinary Clinical Sciences; The Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Hertfordshire AL97TA UK
| | - PJ Kenny
- The Queen Mother Hospital for Animals, Department of Veterinary Clinical Sciences; The Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Hertfordshire AL97TA UK
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De Decker S, Davies E, Benigni L, Wilson H, Pelligand L, Rayner EL, Shihab N, Volk HA. Surgical Treatment of an Intracranial Epidermoid Cyst in a Dog. Vet Surg 2012; 41:766-71. [DOI: 10.1111/j.1532-950x.2012.01010.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Steven De Decker
- Department of Veterinary Clinical Sciences, Royal Veterinary College; University of London; England
| | - Emma Davies
- Department of Veterinary Clinical Sciences, Royal Veterinary College; University of London; England
| | - Livia Benigni
- Department of Veterinary Clinical Sciences, Royal Veterinary College; University of London; England
| | - Helen Wilson
- Department of Veterinary Clinical Sciences, Royal Veterinary College; University of London; England
| | - Ludovic Pelligand
- Department of Veterinary Basic Sciences, Royal Veterinary College; University of London,; England
| | - Emma L. Rayner
- Department of Veterinary Clinical Sciences, Royal Veterinary College; University of London; England
| | - Nadia Shihab
- Department of Veterinary Clinical Sciences, Royal Veterinary College; University of London; England
| | - Holger A. Volk
- Department of Veterinary Clinical Sciences, Royal Veterinary College; University of London; England
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