Application of ventriculoperitoneal shunt placement through fontanelle in a hydrocephalus dog: a case report

Abstract

A two and a half year old Chihuahua intact male dog weighing 1.7 kg was referred to our Animal Medical Centre presenting with ataxia, seizure, nystagmus, tremor, and tilt. Additionally, it was not able to stand and sit. Physical examination, palpation, neurology examination, complete blood count (CBC), serum chemistry test, radiographs (X-ray), ultrasonography (US), and magnetic resonance imaging (MRI) were all performed. Open fontanelle, domeshaped calvarium, a thinning of bone structure, and asymmetrically enlarged lateral ventricles on the right were found on diagnostic imaging. Accordingly, the dog was diagnosed with hydrocephalus. A VP shunt placement was performed as surgical treatment. The ventricular catheter was placed into the right lateral ventricle through the fontanelle insertion site and the distal catheter was placed in the abdomen using the percutaneous technique. After surgery, anorexia, seizure, tremor, and nystagmus disappeared. Also, the dog could stand and walk without support; however, gait was slow and not completely normal and the tilt remained.

Complications associated with ventriculoperitoneal shunts in dogs and cats with idiopathic hydrocephalus: A systematic review

“…Two dogs had preoperative as well as postoperative seizures . Three dogs with preoperative seizures had no further seizure activity after VPS placement . Median follow‐up time was 11 months (range, 2‐42 months) with 2 nonsurvivors (Table ).…”

“…It is also difficult to distinguish between shunt‐related complications and disease progression. The data regarding diagnostic imaging is very sparse and therefore was not included in our results: only 6 MRI studies have been repeated: 3 showed a reduction of ventricle size (median 129 days after surgery; range, 60‐208 days) . One had a slit‐like ventricle because of overshunting 2 months later on .…”

Magnetic Resonance Imaging as a Useful Tool for the Selection of Pharmacological and Surgical Treatment Options for Canine Hydrocephalus

“…MRI is a highly useful technique especially when pharmacological treatment is not successful in alleviating or eliminating clinical symptoms. The reviewed sources clearly indicate that surgical treatment of hydrocephalus with the involvement of ventriculoperitoneal shunting delivers much better results than pharmacological therapy (6). However, even after surgery, the long-term outcome is guarded regardless of the cause of hydrocephalus (2).…”

Laparoscopy-assisted ventriculo-peritoneal shunt implantation in a dog: a case report

“…In the absence of pharmacological treatment that increases CSF absorption, surgery is the only life-saving modality. Ventriculo-peritoneal shunting is the standard procedure in dogs (Woo et al, 2009;Thomas, 2010;De Stefani et al, 2011). According to the author's knowledge, a ventriculo-peritoneal shunting procedure with laparoscopically controlled insertion of the catheter into the abdominal cavity has not been described to date in dogs.…”

“…Patients who receive medical treatment and show no clinical signs are also given a guarded prognosis because their condition may deteriorate. Surgical procedures which may be undertaken in the treatment of hydrocephalus are the ventriculo-atrial shunt and the ventriculo-peritoneal shunt, both of which are considered to be modalities of choice (Kim et al, 2006;Woo et al, 2009). …”