Third Ventriculostomy in Dog with Hydrocephalus

The options for treatment of hydrocephalus and associated symptoms have been limited in dogs. A recent procedure at the Southern Animal Referral Centre may provide a new option for its treatment.

Jesse, a 6 month old Lab-X presented to the Southern Animal Referral Centre with a history of seizures likely related to hydrocephalus. A CT scan was performed with a diagnosis of hydrocephalus. Jesse’s owners were keen to treat and actively explored the options for intervention.

Our initial intent was to place a peritoneal shunt. Accordingly surgery was delayed until Jesse was mature to avoid her outgrowing the shunt. During the intervening months, I discovered a procedure which is routinely performed in humans with a high success rate for the same condition. The procedure involved making a hole in the third ventricle to allow for drainage of cerebrospinal fluid.

In the interim Jesse had been on escalating doses of prednisolone and phenobarbitone which were required to control her seizures. She had a pendulous abdomen as well as other clinical signs attributable to iatrogenic Cushing’s Disease.

Jesse’s owners opted to proceed and Jesse was readmiitted for surgery

Jesse was anaesthetised and placed in ventral recumbency. A small hole was trephined in her skull and a 2.7 mm endoscope was placed in the dilated lateral ventricle. The floor of the third ventricle was identified and a 5 fr balloon catheter was used to make a hole to allow passive drainage of excessive cerebrospinal fluid. The surgery took about 15 minutes and just 3 hours later she was ambulatory.

Our intent is to follow with repeated scans to assess the progression of the disease and to slowly reduce medications. This procedure has the potential to be life-saving. Jesse certainly could not have been maintained on this level of prednisolone for an extended period of time.

This procedure has never been clinically reported in dogs to our knowledge. We invite other cases which may be appropriate.

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