Indications, complications, and mortality rate following craniotomy or craniectomy in dogs and cats: 165 cases (1995–2016)

Abstract

OBJECTIVE To determine the most common indications for cranial surgery and identify risk factors associated with the occurrence of complications and death in the perioperative period following cranial surgery. ANIMALS 150 dogs and 15 cats. PROCEDURES For this multi-institutional retrospective case series, medical records of dogs and cats that underwent cranial surgery at any of the 4 participating institutions between 1995 and 2016 were reviewed. Variables were evaluated included species, sex, age, neurolocalization, history of preoperative seizures, surgical approach, histological results, perioperative complications, and outcome. Logistic regression analysis was performed to assess for risk factors for complications. RESULTS The most common neurolocalization was the forebrain (110/165 [66.7%]), with 94 (57.0%) animals having had seizures preoperatively. The rostrotentorial (116/165 [70.3%]) and caudotentorial (32/165 [19.4%]) surgical approaches were most commonly reported. The most common indication was the treatment of meningioma (75/142 [52.8%]). Complications arose in 58 of the 165 (35.2%) cases within 24 hours and in 86 (52.1%) cases 1 to 10 days postoperatively. Perioperative complications included hypotension (38/165 [23.0%]) and anemia (27/165 [16.4%]). During the postoperative period, the most common complications were neurologic deficits, seizures, postoperative anemia, and aspiration pneumonia. The mortality rate with death or euthanasia perioperatively or ≤ 10 days postoperatively was 14.5% (24/165). Long-term complications occurred in 65 of the 165 (39.4%) animals, with seizures and neurologic deficits being the most common. CLINICAL RELEVANCE Cranial surgery was performed most commonly for the removal of neoplastic lesions in dogs and cats, and most complications were not life-threatening.

Otogenic intracranial abscessation secondary to an inflammatory polyp with chronic otitis media/interna in a cat

“…Surgical debridement of intracranial abscesses in feline patients occurs more commonly with forebrain abscesses in cases of cat bite injuries, where treatment success was reported in nine of 10 cases by Martin et al 4 . Craniotomy in the caudal fossa has been associated with a higher mortality rate in dogs; however, it may be associated with fewer complications when performed at the level of the cerebellum as opposed to the brainstem 6,7 …”

“…5 Surgical debridement of intracranial abscesses in feline patients occurs more commonly with forebrain abscesses in cases of cat bite injuries, where treatment success was reported in nine of 10 cases by Martin et al 4 Craniotomy in the caudal fossa has been associated with a higher mortality rate in dogs; however, it may be associated with fewer complications when performed at the level of the cerebellum as opposed to the brainstem. 6,7 Intracranial extension is an uncommon and lifethreatening complication of OMI; however, prompt diagnosis with advanced imaging may facilitate a more favourable outcome. Further studies are needed to determine if lesion localization (i.e.…”

Surgical treatment of feline intracranial meningiomas: a retrospective study of 26 cases

“…Surgical treatment of intracranial tumors in small animals is also associated with relatively high perioperative and postoperative complication rates. Complications following craniotomy or craniectomy in dogs and cats usually occur in the early postoperative period: within 24 h in 35% of cases and between 1 and 10 days post-surgery in 52% of cases [ 12 ]. Between 32% and 47% of dogs experience major complications, such as death, seizures, worsening of neurological status and aspiration pneumonia, after surgical removal of intracranial tumors [ 12 13 14 ].…”

“…Complications following craniotomy or craniectomy in dogs and cats usually occur in the early postoperative period: within 24 h in 35% of cases and between 1 and 10 days post-surgery in 52% of cases [ 12 ]. Between 32% and 47% of dogs experience major complications, such as death, seizures, worsening of neurological status and aspiration pneumonia, after surgical removal of intracranial tumors [ 12 13 14 ]. However, there are few reports investigating postoperative complications following meningioma excision in cats, nor reconstruction using cranioplasty.…”

“…One study reported immediate postoperative complications and long-term recurrence [ 7 ], and another study investigated perioperative mortality [ 13 ]. A third study reported postoperative complications after brain surgery in dogs and cats [ 12 ].…”