Peer-reviewed veterinary case report
Risk factors and treatment for dogs and cats with brain swelling
By Farke, Daniela et al.·Published in Journal of veterinary internal medicine·2023·Department of Veterinary Clinical Sciences, Germany·View original on PubMed →
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Original publication title: Risk factors, treatment, and outcome in dogs and cats with subdural hematoma and hemispheric collapse after ventriculoperitoneal shunting of congenital internal hydrocephalus.
Plain-English summary
A group of 75 dogs and 7 cats developed serious neurological issues after surgery to treat congenital internal hydrocephalus, specifically due to overshunting from a ventriculoperitoneal shunt. Symptoms included sudden worsening of their neurological status, leading to conditions like subdural hematoma (a type of bleeding in the brain). In 10 of these animals, the subdural hematoma was surgically removed, and they showed quick improvement afterward. The study found that certain factors, like having biventricular hydrocephalus, increased the risk of these complications, but surgical decompression was effective in treating the problem.
People also search for: dog hydrocephalus treatment · cat brain surgery recovery · dog subdural hematoma symptoms
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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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/37675951/