Subarachnoid‐peritoneal shunt to treat a diffuse thoracolumbar arachnoid diverticulum in a dog

Abstract

A 2‐year‐old, male German shepherd dog presented with a chronic history of hindlimb gait abnormalities, urinary and faecal incontinence. Magnetic resonance imaging of the area revealed a diffuse subarachnoid diverticulum (from T6 to L2), and a novel subarachnoid‐peritoneal shunting technique was considered. Surgery involved a T11–T13 dorso‐lateral hemilaminectomy and placement of a lumbar catheter into the diverticulum via durectomy. The catheter was then inserted into the peritoneal cavity via a left lateral incision to the abdomen. The dog recovered well from the surgical procedure and showed a resolution of its clinical signs at the follow‐up appointment (2 weeks after surgery). The patient represented 7 months later for recurrence of urinary and faecal incontinence and mild pelvic limb ataxia. Repeated diagnostic imaging revealed kinking of the lumbar catheter. Revision surgery was performed and the patient showed a resolution of the pelvic limb ataxia the following day. Patient lost to long‐term follow‐up.

Lumbar spinal arachnoid diverticulum in a cat

“…1,2,5 Various surgical options are described, including durotomy, with or without marsupialisation, durectomy, subarachnoid shunt placement or even subarachnoidpleural or peritoneal shunt. 6,7 In cats, SAD are a rare finding and no breed predisposition has been reported. According to the veterinary literature, only eight case reports describe this condition.…”

“…Surgery is suggested when neurological signs occur and persist, aiming at spinal decompression 1,2,5 . Various surgical options are described, including durotomy, with or without marsupialisation, durectomy, subarachnoid shunt placement or even subarachnoidpleural or peritoneal shunt 6,7 . In cats, SAD are a rare finding and no breed predisposition has been reported.…”