Palliative ventriculoperitoneal shunting in dogs with obstructive hydrocephalus caused by tumors affecting the third ventricle

• Published in: Journal of veterinary internal medicine Vol. 34; no. 4; pp. 1556 - 1562
• Main Authors: Orlandi, Rocio, Vasilache, Cornel G., Mateo, Isidro
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01-07-2020; Wiley
• Subjects: Animals; Blood pressure; Brain cancer; Brain Neoplasms - complications; Brain Neoplasms - surgery; Brain Neoplasms - veterinary; canine; Catheters; cerebrospinal fluid; choroid plexus tumor; Dog Diseases - surgery; Dogs; Edema; ependymoma; Female; Hydrocephalus; Hydrocephalus - surgery; Hydrocephalus - veterinary; Intracranial pressure; Magnetic resonance imaging; Male; Medical records; Palliative Care; Pressure transducers; SMALL ANIMAL; surgical; Third Ventricle - surgery; Tomography; Tumors; Ventriculoperitoneal Shunt - methods; Ventriculoperitoneal Shunt - veterinary; Japan; ependymoma; surgical; canine; choroid plexus tumor; cerebrospinal fluid
• ISSN: 0891-6640; 1939-1676
• DOI: 10.1111/jvim.15818

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.