Association between improvement of clinical signs and decrease of ventricular volume after ventriculoperitoneal shunting in dogs with internal hydrocephalus

Schmidt, Martin J.; Hartmann, Antje; Farke, Daniela; Failling, Klaus; Kolecka, Malgorzata

doi:10.1111/jvim.15468

Cited by 18 publications

(30 citation statements)

References 41 publications

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“…Case selection criteria were the same as for previous studies [18] Client-owned dogs that presented between October 2017 and May 2019 in the Clinic for Small Animals at the Department for Veterinary Clinical Sciences, Justus-Liebig-University, Giessen, Germany, with newly diagnosed, communicating internal hydrocephalus were prospectively enrolled in the study. A detailed history was obtained for each dog to assess the duration of clinical signs.…”

Section: Methodsmentioning

confidence: 99%

“…MRI examinations were performed using a 3.0-T superconductive system (Siemens Verio) and sensitivity-encoding coil. A standardized MRI protocol was used as described in detail previously [18]. Sagittal, dorsal and transverse T2-weighted (TE = 120 ms, TR = 2900 ms), transverse FLAIR sequences (TE = 120ms, TI = 2400ms, TR = 7000ms) and transverse T1-weighted sequences (TR = 491 ms, TE = 8 ms) before and after contrast were acquired in all animals pre-operatively.…”

Section: Methodsmentioning

confidence: 99%

“…In order to evaluate a possible relationship between ventricular size and IVP, total ventricular volume and brain volume was calculated from MR-images and expressed as the ventricle-brain index (V/B-index). Image processing for volume rendering was achieved using specialised graphical software, as described previously [18, 23] (AMIRA ® , Mercury Computer Systems, Berlin, Germany). This program allows accurate manual image segmentation on a slice-by-slice basis.…”

Section: Methodsmentioning

confidence: 99%

“…We therefore use valves with an opening pressure of 15 cm H 2 0 (approximately 11 mm Hg) that allows egress of CSF at mildly increased IVP. The reduction of ventricular volume and associated improvement of clinical signs in a large cohort of operated dogs was somewhat variable [18]. This raises the question whether the selected opening pressure may not adequately address the requirements in each individual animal, and a valve with a lower pressure may be needed to reduce ventricular volume.…”

Section: Introductionmentioning

confidence: 99%

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Intraoperative measurement of intraventricular pressure in dogs with communicating internal hydrocephalus

et al. 2019

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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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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Intraoperative measurement of intraventricular pressure in dogs with communicating internal hydrocephalus

et al. 2019

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“…The choice of treatment is generally dictated by the physical status, the age of the animal, and the cause of the hydrocephalus (Thomas 2010, Estey 2016. Ventricle-peritoneal shunts have been commonly used to divert the flow of CSF from the ventricles of the brain to the peritoneal cavity in human patients with hydrocephalus, and have proved to be an effective surgical treatment for hydrocephalus in dogs and cats (Kim et al 2006, Kitagawa et al 2008, Schmidt et al 2019. Surgery does not decrease the damage to the nervous tissue secondary to the increased intracranial pressure (ICP) that have already occurred at the moment of diagnosis; in addition, surgery might be indicated with criteria because of the risk of the anesthesia, the risk of neurological and systemic complications intraoperative, and the risk of postoperative complications of shunt placement (Platt & Olby 2004, Dewey 2008, Gradner et al 2019.…”

Section: Introductionmentioning

confidence: 99%

Medical therapy using omeprazole in 12 hydrocephalic dogs: clinical, diagnostic, and therapeutic findings

et al. 2019

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According to experimental studies with healthy dogs, omeprazole might decrease the CSF production by about 26%; therefore, book texts have been suggested the usage of omeprazole in medical protocols for hydrocephalus treatment. However, to the best knowledge of the authors, the usage and medical response of the omeprazole with substantial group of illness dogs, such as hydrocephalic animals, was lacking. This report describes clinical, diagnostic, and therapeutic findings in 12 dogs with hydrocephalus in which omeprazole were used for medical treatment. The diagnosis of hydrocephalus was accomplished by transcranial sonography (TCS) and/or computed tomography. The ventricular measurement was assessed periodically by TCS during medical treatment. Six dogs were diagnosed with non-obstrutive hydrocephalus and in the other 6 cases hydrocephalus occurred with other concomitant anomalous encephalic disease often related with obstructive hysdrocephalus, such as quadrigeminal cist, arachnoid cyst, chiary-like malformation, and syringomyelia. All of them had medical improvement after the use of omeprazole and the most of the cases had ventricular size reduction. In 10 dogs, the omeprazole was used as single drug, and in 2 dogs medical treatment with steroids and/or diuretics was previously being performed, and omeprazole was added because conventional treatment was resulting in mild to unsatisfactory medical control of the neurological status. The results of this paper shown that omeprazole may be used to ameliorate the neurological status in symptomatic hydrocephalic dogs. This work may represent the first description about the use of omeprazole in order to treat a substantial group of affected dogs with suspected increased intracranial pressure by hydrocephalus, probably due to limitation of CSF production.

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Lateral Ventricular Fenestration

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Advanced Techniques in Canine and Feline Neurosurgery

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Association between improvement of clinical signs and decrease of ventricular volume after ventriculoperitoneal shunting in dogs with internal hydrocephalus

Cited by 18 publications

References 41 publications

Intraoperative measurement of intraventricular pressure in dogs with communicating internal hydrocephalus

Intraoperative measurement of intraventricular pressure in dogs with communicating internal hydrocephalus

Medical therapy using omeprazole in 12 hydrocephalic dogs: clinical, diagnostic, and therapeutic findings

Lateral Ventricular Fenestration

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