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Wyatt S, Fenn J, Beltran E. Transcerebellar ventriculoperitoneal shunt for management of presumed arachnoid diverticulum in the fourth ventricle of a dog. Vet Surg 2024. [PMID: 38519448 DOI: 10.1111/vsu.14090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 02/25/2024] [Accepted: 03/03/2024] [Indexed: 03/25/2024]
Abstract
OBJECTIVE To describe the approach for placement of a transcerebellar fourth ventriculoperitoneal shunt for management of presumed fourth ventricle arachnoid diverticulum and secondary obstructive hydrocephalus of a dog. To describe the outcome of this procedure. STUDY DESIGN Case report. ANIMALS Male entire English springer spaniel, 3 years 9 months of age. METHODS The dog was initially presented for management of acute, progressive, and multifocal brainstem and forebrain dysfunction. Magnetic resonance imaging revealed internal obstructive hypertensive hydrocephalus. The dog was managed via ventriculoperitoneal shunting from the left lateral ventricle and made an excellent recovery. The dog acutely deteriorated 18 months after initial discharge and follow-up magnetic resonance imaging confirmed the ventricular shunt remained in situ with normal-sized lateral ventricles but revealed a cystlike lesion within the fourth ventricle, presumed to be a fourth ventricle arachnoid diverticulum. The diverticulum was causing mass effect and resultant compression of adjacent neuroparenchyma. A second ventriculoperitoneal shunt was subsequently placed into the fourth ventricle via the caudal cranial fossa and cerebellum. This was attached to a three-way connector, to which the existing shunt (within the left lateral ventricle) was also attached, and then secured to the existing medium-pressure valve. RESULTS Postoperatively, the dog immediately developed mild vestibular-cerebellar ataxia, with a marked improvement after 3 months. There were no shunt-associated complications. Long-term follow up at 40 months after the second surgical procedure revealed a normal neurological examination. CONCLUSION Transcerebellar ventriculoperitoneal shunt placement for treatment of a presumed fourth ventricle arachnoid diverticulum was performed and was associated with a favorable long-term outcome.
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Affiliation(s)
| | - Joe Fenn
- Royal Veterinary College, Hatfield, UK
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2
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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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YAMAMOTO H, KIMURA K, HORIKIRIZONO H, TAMURA Y, KAMBAYASHI S, BABA K, OKUDA M, MIZUNO T, IGASE M. Effect of tolvaptan on hyponatremia in a dog with syndrome of inappropriate secretion of antidiuretic hormone. J Vet Med Sci 2023; 85:1047-1051. [PMID: 37587049 PMCID: PMC10600542 DOI: 10.1292/jvms.23-0243] [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: 06/10/2023] [Accepted: 08/08/2023] [Indexed: 08/18/2023] Open
Abstract
A 1-year-old spayed female Miniature Schnauzer had chronic hyponatremia, accompanied by polyuria and polydipsia. Blood tests and urinalysis revealed severe hyponatremia, low plasma osmolality with euvolemia, and increased sodium excretion in urine. Hypothyroidism and hypoadrenocorticism were ruled out as causes. These findings led to the diagnosis of syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Magnetic resonance imaging (MRI) showed dilation of the lateral ventricles, indicating severe hydrocephalus. Tolvaptan, a vasopressin V2 receptor antagonist commonly used in human SIADH, was administered along with water restriction. This treatment resulted in a consistent increase in plasma sodium levels without any adverse effects. This case report represents the first documented evidence of the therapeutic efficacy of tolvaptan in treating SIADH in a dog.
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Affiliation(s)
- Hiroka YAMAMOTO
- Laboratory of Molecular Diagnostics and Therapeutics, Joint
Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Kyoga KIMURA
- Laboratory of Veterinary Internal Medicine, Joint Faculty of
Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Hiro HORIKIRIZONO
- Laboratory of Veterinary Radiology, Joint Faculty of
Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
| | | | - Satoshi KAMBAYASHI
- Laboratory of Veterinary Internal Medicine, Joint Faculty of
Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Kenji BABA
- Laboratory of Veterinary Internal Medicine, Joint Faculty of
Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Masaru OKUDA
- Laboratory of Veterinary Internal Medicine, Joint Faculty of
Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Takuya MIZUNO
- Laboratory of Molecular Diagnostics and Therapeutics, Joint
Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Masaya IGASE
- Laboratory of Molecular Diagnostics and Therapeutics, Joint
Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
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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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5
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Beckmann K, Kowalska M, Meier V. Solitary intraventricular tumors in dogs and cats treated with radiotherapy alone or combined with ventriculoperitoneal shunts: A retrospective descriptive case series. Vet Med (Auckl) 2022; 37:204-215. [PMID: 36382395 PMCID: PMC9889607 DOI: 10.1111/jvim.16583] [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: 06/23/2022] [Accepted: 10/31/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Intraventricular tumors are rare, optimal treatment is not defined. Symptomatic patients often exhibit life-threatening hydrocephalus. With several months time-to-effect after radiotherapy (RT), increased intracranial pressure is concerning. This increase in pressure can be overcome by ventriculoperitoneal shunting (VPS). OBJECTIVES Retrospective evaluation of outcome and complications in dogs and cats with intracranial tumors treated with either RT or VPS/RT. ANIMALS Twelve client-owned cats and dogs. METHODS Dogs and cats with symptomatic intraventricular tumors treated with definitive-intent RT or VPS/RT were included in a retrospective, descriptive case series. Complications, tumor volume evolution, time-to-progression, and survival time were determined. RESULTS Twelve animals were included: 1 cat and 5 dogs treated with single-modality RT and 4 cats and 2 dogs treated with VPS/RT. Neurological worsening seen in 4/6 animals during single-modality RT and 2/6 died during RT (suspected brain herniation). All dogs with VPS normalized clinically by the end of RT or earlier. Complications occurred in 4/6 animals, all but 1 were successfully managed surgically. Imaging follow-up in 8 animals surviving RT showed a marked decrease in tumor volume. Median survival time was 162 days (95% confidence interval [CI]: 16; infinity) for animals treated with RT and 1103 days (95%CI: 752; infinity) for animals treated with VPS/RT. Median time-to-progression was 71 days (95%CI: 7; infinity) and 895 days (95%CI: 704; infinity) for each group, respectively. Two dogs died because of intraventricular metastasis 427 and 461 days after single-modality RT. CONCLUSIONS AND CLINICAL IMPORTANCE Ventriculoperitoneal shunting led to rapid normalization of neurological signs and RT had a measurable effect on tumor volume. Combination of VPS/RT seems to be beneficial.
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Affiliation(s)
- Katrin Beckmann
- Department for Small Animals, Division of Surgery, Section of NeurologyVetsuisse Faculty, University of ZurichZurichSwitzerland
| | - Malwina Kowalska
- Section of Epidemiology, Vetsuisse FacultyUniversity of ZurichZurichSwitzerland,Ophthalmology Section, Equine DepartmentVetsuisse Faculty, University of ZurichZurichSwitzerland
| | - Valeria Meier
- Department for Small Animals, Division of Radiation OncologyVetsuisse Faculty, University of ZurichZurichSwitzerland
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Bahr Arias MV, Conceição RT, Guimarães FC, Cardoso GS, Rocha NLFC. Preliminary evaluation of a non-invasive device for monitoring intracranial pressure waveforms in dogs. J Small Anim Pract 2022; 63:624-631. [PMID: 35244213 DOI: 10.1111/jsap.13460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 07/02/2021] [Accepted: 10/31/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The objective of this study was to compare waveforms obtained with a new device for the non-invasive monitoring of intracranial pressure (ICP) in dogs with and without neurological disease. MATERIALS AND METHODS This prospective study was conducted on both neurologically normal dogs and dogs with neurological diseases. First, non-invasive ICP waveforms were recorded in normal dogs using the Braincare® BcMM 2000 monitor while the dogs were under general anaesthesia induced for procedures unrelated to this study. The dogs were positioned in lateral recumbency, and the sensor was placed over the skin of the parietal region. Secondly, non-invasive ICP waveforms were monitored in dogs with brain and spinal disease until waveforms with characteristic peaks were acquired. All the recorded signals were amplified, filtered and digitalized, by the device, and then transferred to a computer for analysis. RESULTS Normal pulse waveforms indicating normal brain complacency were observed in eight neurologically normal dogs. In six dogs with brain disease, abnormal pulse waveforms were observed suggesting increased ICP and decreased brain complacency. Four dogs with spinal disease undergoing myelography, had normal waveforms before contrast medium injection and abnormal pulse waveforms during contrast medium injection, indicating a potential increase in ICP. CLINICAL SIGNIFICANCE Based on these preliminary observations, this method was capable of detecting abnormal pulse waveforms that suggested increased ICP.
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Affiliation(s)
- M V Bahr Arias
- Department of Veterinary Clinics, Universidade Estadual de Londrina, Londrina, Paraná, 86051-970, Brazil
| | | | - F C Guimarães
- Department of Veterinary Surgery and Anesthesiology, UNESP, School of Veterinary Medicine and Animal Science, Botucatu, São Paulo, Brazil
| | - G S Cardoso
- Department of Veterinary Clinics, Universidade Estadual de Londrina, Londrina, Paraná, 86051-970, Brazil
| | - N L F C Rocha
- Department of Veterinary Clinics, Universidade Estadual de Londrina, Londrina, Paraná, 86051-970, Brazil
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7
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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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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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11
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Olszewska A, Farke D, Schmidt MJ. Spontaneous hemispheric ventricular collapse and subarachnoid haemorrhages in a dog with congenital hydrocephalus internus. Ir Vet J 2020; 73:5. [PMID: 32226604 PMCID: PMC7098093 DOI: 10.1186/s13620-020-00159-x] [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: 09/16/2019] [Accepted: 03/18/2020] [Indexed: 11/10/2022] Open
Abstract
Background Overdrainage and collapse of the hemispheres is a potential severe complication after surgical treatment of internal hydrocephalus using ventriculoperitoneal shunts. Here we describe a case of a spontaneous hemispheric ventricular collapse in an untreated dog with congenital hydrocephalus internus. Case presentation A twelve-week-old, male, intact Golden Retriever was presented with a history of peracute obtundation, impaired vision, and progressive gait abnormalities of all limbs for three days. Neurological examination revealed a dome shaped skull, a broad-based stance and a moderate cerebellar ataxia. The postural responses were markedly delayed in all limbs. Moderate ventro-lateral strabismus, vertical nystagmus and absent menace response were observed bilaterally. Clinical signs indicated multifocal localisation (forebrain, cerebellum). Magnetic resonance imaging (MRI) showed dilation of all cerebral ventricles, irregular thinning of the periventricular white and grey matter, consistent with internal hydrocephalus. In addition, the hemispheres were collapsed at the right temporal and left frontal lobe with haemorrhage filling the adjacent subarachnoid space. The dog underwent left frontal and right temporal craniotomy for removal of the haemorrhage. The dog improved on all neurological signs and was discharged after seven days. A repeat MRI three months postsurgical intervention showed reexpansion of the cerebral hemispheres. Subarachnoid haemorrhages were markedly reduced. Conclusions Collapse of the hemispheres can occur spontaneously in dogs with hydrocephalus internus. Removal of the haemorrhage can improve clinical signs.
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Affiliation(s)
- Agnieszka Olszewska
- Department of Veterinary Clinical Sciences, Small Animal Clinic, Neurosurgery, Neuroradiology and Clinical Neurology, Justus-Liebig-University, Frankfurter Strasse 108, 35392, Giessen, Germany
| | - Daniela Farke
- Department of Veterinary Clinical Sciences, Small Animal Clinic, Neurosurgery, Neuroradiology and Clinical Neurology, Justus-Liebig-University, Frankfurter Strasse 108, 35392, Giessen, Germany
| | - Martin Jürgen Schmidt
- Department of Veterinary Clinical Sciences, Small Animal Clinic, Neurosurgery, Neuroradiology and Clinical Neurology, Justus-Liebig-University, Frankfurter Strasse 108, 35392, Giessen, Germany
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12
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Castel A, Doré V, Vigeral M, Hecht S. Magnetic Resonance Imaging Findings in 13 Neurologic Pot-Bellied Pigs. Front Vet Sci 2020; 7:21. [PMID: 32076601 PMCID: PMC7006440 DOI: 10.3389/fvets.2020.00021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 01/10/2020] [Indexed: 12/03/2022] Open
Abstract
This study reports the magnetic resonance imaging (MRI) findings in 13 pot-bellied pigs presented to our institution with neurological deficits. Nine pigs had abnormal MRI findings (7 with spinal cord localization and 2 with brain localization), with three of them having histopathological confirmation of the diagnoses. MRI diagnoses included a myopathy suspected to be secondary to Erysipelothrix rhusiopathiae, a round cell neoplasia involving the vertebral canal, myelomalacia, a cervical cyst like extradural lesion, pelvic fracture with secondary cauda equina involvement, two cases of fibrocartilaginous embolism or acute non-compressive nucleus pulposus extrusion, multifocal brain infarcts, and a cystic fourth ventricle dilation resulting in obstructive hydrocephalus and syringomyelia. Four pigs had normal MRI studies, with one of them ultimately diagnosed with idiopathic vestibular disease. This retrospective study illustrates the wide variety of diagnoses achieved with MRI of the head or vertebral column in pigs, several of them having never been described in this species. Some of the conditions identified had a good outcome. This justifies using MRI as an ante-mortem diagnostic tool as it can provide relevant information about the prognosis which can significantly influence treatment recommendations. Our findings suggest that MRI should be considered as a valuable imaging modality, when feasible, in pigs with neurological deficits.
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Affiliation(s)
- Aude Castel
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, QC, Canada
| | - Vincent Doré
- Faculty of Veterinary Medicine, CHUV, Farm Animal Hospital, University of Montreal, Saint-Hyacinthe, QC, Canada
| | - Mariana Vigeral
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Knoxville, TN, United States
| | - Silke Hecht
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Knoxville, TN, United States
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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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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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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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Marinho C, Bacha F, Santos G, Braz P. Hidrocefalia congênita bilateral total em felino: relato de caso. ARQ BRAS MED VET ZOO 2018. [DOI: 10.1590/1678-4162-10363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO O objetivo deste trabalho foi relatar um caso raro de hidrocefalia em um felino doméstico, da raça Persa, de 30 dias de idade. O animal foi atendido com histórico de impossibilidade de manter-se em estação, incoordenação motora, inabilidade para se alimentar sozinho e sustentar o peso da cabeça. No exame clínico, foi observada presença de fontanela aberta, aumento de calota craniana, ataxia, estrabismo unilateral e secreção ocular. A realização de ultrassonografia do crânio levou à confirmação do diagnóstico de hidrocefalia. O paciente permaneceu internado, sendo o protocolo de tratamento empregado constituído de corticosteroide, diurético e protetor gástrico em alta dose, além de alimentação por via oral e fluidoterapia. O animal veio a óbito após 24 horas, sendo encaminhado para realização de necropsia.
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Affiliation(s)
- C.P. Marinho
- Universidade Federal de Mato Grosso do Sul, Brazil
| | - F.B. Bacha
- Centro Universitário da Grande Dourados, Brazil
| | - G.A. Santos
- Centro Universitário da Grande Dourados, Brazil
| | - P.H. Braz
- Instituto Federal de Educação, Ciência e Tecnologia Farroupilha, Brazil
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20
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Boccanera C, Stabile F, Corvi R, Mariscoli M, Mandara MT. Hydrocephalus, supratentorial diverticulum and agenesis of the interthalamic adhesion and corpus callosum in a cat: MRI findings, treatment and follow‐up. VETERINARY RECORD CASE REPORTS 2018. [DOI: 10.1136/vetreccr-2016-000416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Cinzia Boccanera
- Medicina VeterinariaUniversita degli Studi di PerugiaPerugiaItaly
| | - Fabio Stabile
- Department of Neurology/ NeurosurgeryThe Animal Health TrustNewmarketUK
| | - Roberta Corvi
- Universita degli Studi di Teramo Facolta di Medicina VeterinariaTeramoAbruzzoItaly
| | - Massimo Mariscoli
- Department of Veterinary Clinical SciencesUniversity of TeramoTeramoItaly
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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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22
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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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DeJesus A, Turek BJ, Galban E, Suran JN. IMAGING DIAGNOSIS-MAGNETIC RESONANCE IMAGING OF A NEURONAL HETEROTOPIA IN THE BRAIN OF A CAT. Vet Radiol Ultrasound 2016; 59:E17-E21. [PMID: 27896903 DOI: 10.1111/vru.12456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 09/29/2016] [Indexed: 11/27/2022] Open
Abstract
A domestic shorthair kitten was presented for evaluation and further treatment of seizures. Magnetic resonance imaging of the brain revealed a large multilobulated mass in the third ventricle extending into the right lateral ventricle with secondary obstructive hydrocephalus. The mass was homogeneously isointense to gray matter on T2W, T2-FLAIR, T2* W, T1W, and ADC images, and hyperintense on DW-EPI. There was no appreciable contrast enhancement. Seizures were managed medically and with subsequent ventriculoperitoneal shunt placement. Clinical status later deteriorated and the cat was euthanized. Histopathology confirmed that the mass was the result of neuronal heterotopia. To the authors' knowledge this is the first report of neuronal heterotopia in a cat.
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Affiliation(s)
- Antonia DeJesus
- BluePearl Veterinary Hospital, 410 W55th St, New York, NY, 10019
| | - Bradley J Turek
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey Street, Philadelphia, PA, 19104
| | - Evelyn Galban
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey Street, Philadelphia, PA, 19104
| | - Jantra Ngosuwan Suran
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey Street, Philadelphia, PA, 19104
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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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Bittermann S, Precht C, Henke D, Forterre F, Karli P. Slit ventricle syndrome and subdural haemorrhage due to suspected overshunting in a dog with hydrocephalus internus. VETERINARY RECORD CASE REPORTS 2016. [DOI: 10.1136/vetreccr-2015-000284] [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)
- Sophie Bittermann
- Division of Neurological SciencesDivision of Clinical NeurologyDepartment of Clinical Veterinary MedicineVetsuisse FacultyUniversity of BernBernSwitzerland
| | - Christina Precht
- Division of Clinical RadiologyDepartment of Clinical Veterinary MedicineVetsuisse FacultyUniversity of Bern, SwitzerlandBernSwitzerland
| | - Diana Henke
- Division of Neurological SciencesDivision of Clinical NeurologyDepartment of Clinical Veterinary MedicineVetsuisse FacultyUniversity of BernBernSwitzerland
| | - Franck Forterre
- Division of Small Animal SurgeryDepartment of Clinical Veterinary MedicineVetsuisse FacultyUniversity of Bern, SwitzerlandBernSwitzerland
| | - Philemon Karli
- Division of Neurological SciencesDivision of Clinical NeurologyDepartment of Clinical Veterinary MedicineVetsuisse FacultyUniversity of BernBernSwitzerland
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Kaiser S, Driesen A, Malberg S, Kramer M, Thiel C. Treatment of a periorbital cyst in a dog by creation of a permanent drainage opening. TIERAERZTLICHE PRAXIS AUSGABE KLEINTIERE HEIMTIERE 2015; 43:421-6. [PMID: 26526863 DOI: 10.15654/tpk-140927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 03/27/2015] [Indexed: 11/13/2022]
Abstract
An inflammatory periorbital cyst with secondary pressure atrophy of the maxilla was treated by surgical creation of a drainage opening to the nasal cavity in a 4-year-old Yorkshire Terrier. Following treatment, clinical signs resolved and computed tomography 5 weeks after surgery confirmed the permanence of the drainage opening. Eight months later, the dog showed no clinical abnormalities. Therefore, the procedure described in this report may offer a suitable treatment option in cases where the cyst's size or localization prevents complete excision.
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Affiliation(s)
- S Kaiser
- Dr. Susanne Kaiser, Small Animal Clinic, Department of Veterinary Clinical Science, Justus Liebig University, Frankfurter Strasse 108, 35392 Giessen, Germany,
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Kolecka M, Ondreka N, Moritz A, Kramer M, Schmidt MJ. Effect of acetazolamide and subsequent ventriculo-peritoneal shunting on clinical signs and ventricular volumes in dogs with internal hydrocephalus. Acta Vet Scand 2015; 57:49. [PMID: 26337283 PMCID: PMC4558722 DOI: 10.1186/s13028-015-0137-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 08/08/2015] [Indexed: 12/03/2022] Open
Abstract
Background Acetazolamide is recommended for the reduction of cerebrospinal fluid production in canine internal hydrocephalus. The efficacy of the drug in terms of alleviation of the clinical symptoms and the restoration of normal ventricular volume has not been documented. We hypothesize that acetazolamide inadequately improve clinical signs and has no effect on the ventricular volume. Six dogs with internal hydrocephalus underwent neurological examination and were examined by magnetic resonance imaging, on the day of the diagnosis, after treatment with acetazolamide directly before surgery, and 6 weeks after implantation of a vetriculo-peritoneal shunt due to lack of improvement after medical therapy with 10 mg/kg acetazolamide three times daily (TID). The ventricular volume in relation to the total brain volume was determined on each occasion. The changes in relative ventricular volume and of the neurological status were assessed and compared. Results McNemar’s test revealed no significant differences in clinical symptoms before and after medical treatment (P > 0.05). However, clinical symptoms changed significantly after surgical treatment (P = 0.001). The ventricle-brain ratio was not significantly changed after therapy with acetazolamide (P > 0.05); however, after subsequent shunt implantation, it was significantly reduced (P = 0.001). Conclusion Acetazolamide (10 mg/kg TID) showed no effects on clinical signs or ventricular volume in dogs with internal hydrocephalus. After subsequent ventriculo-peritoneal shunting, the dogs had a significantly reduced cerebral ventricular volume and five out of six dogs had no abnormal findings in neurological examination.
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Bazelle J, Caine A, Palus V, Summers BA, Cherubini GB. MRI characteristics of fourth ventricle arachnoid diverticula in five dogs. Vet Radiol Ultrasound 2014; 56:196-203. [PMID: 25385344 DOI: 10.1111/vru.12218] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Accepted: 07/23/2014] [Indexed: 10/24/2022] Open
Abstract
Intracranial arachnoid diverticula (cysts) are rare accumulations of cerebrospinal fluid (CSF) within the arachnoid membrane. The purpose of this retrospective study was to describe magnetic resonance imaging (MRI) characteristics of fourth ventricle arachnoid diverticula in a group of dogs. The hospital's medical records were searched for dogs with MRI studies of the brain and a diagnosis of fourth ventricle arachnoid diverticulum. Clinical characteristics were recorded from medical records and MRI studies were reinterpreted by a board-certified veterinary radiologist. Five pediatric dogs fulfilled inclusion criteria. Clinical signs included cervical hyperaesthesia, obtundation, tetraparesis, and/or central vestibular syndrome. In all five dogs, MRI findings were consistent with obstructive hydrocephalus, based on dilation of all ventricles and compression of the cerebellum and brainstem. All five dogs also had cervical syringohydromyelia, with T2-weighted hyperintensity of the gray matter of the cord adjacent to the syringohydromyelia. A signal void, interpreted as flow disturbance, was observed at the mesencephalic aqueduct in all dogs. Four dogs underwent surgical treatment with occipitalectomy and durotomy. A cystic lesion emerging from the fourth ventricle was detected in all four dogs during surgery and histopathology confirmed the diagnosis of arachnoid diverticula. Three dogs made excellent recovery but deteriorated shortly after surgery and were euthanized. Repeat MRI in two dogs revealed improved hydrocephalus but worsening of the syringohydromyelia. Findings from the current study supported theories that fourth ventricle arachnoid diverticula are secondary to partial obstruction of the central canal or lateral apertures and that arachnoid diverticula are developmental lesions in dogs.
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Affiliation(s)
- Julien Bazelle
- Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull, West Midlands, B90 4NH, UK
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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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