Canis ISSN: 2398-2942

Ventriculoperitoneal shunt placement

Contributor(s): Rodney Bagley, Laurent Garosi

Introduction

  • Placement of a ventriculoperitoneal catheter allows flow of CSF from the ventricles to the peritoneal cavity preventing build up of pressure in the brain.
  • Shunt systems which have been designed for use in humans seem to work well for animals.
  • Surgical treatment offers the possibility of long-term control of the clinical signs in dogs with hydrocephalus.
  • They have a valve which is designed to reduce the siphon effect of gravity-induced hydrostatic pressure in the distal catheter, thereby, maintaining physiological ventricular pressures.

Uses

Advantages

  • Can provide long-term relief of increased intracranial pressure associated with hydrocephalus.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Ventriculoperitoneal and VA shunts are the treatment of choice for communicating and non-communicating hydrocephalus, with normal or increased pressure, in humans.
  • Successful treatment has also been achieved in dogs with these conditions.
  • One study with VA shunt placement in 40 dogs reported a 75% success rate.
  • Reported success rates vary between 50 and 90% in dogs, with shunt revision rates between 30 and 70%.
  • Experimental evidence suggests that reconstitution of the cerebral hemispheres after shunting occurs only in the white matter.
  • Reconstituted white matter is characterized by myelin destruction, remyelination, and reactive astrocytosis.
  • Because neuronal loss and cortical laminar destruction are irreversible, hydrocephalus should be aggressively treated as early as possible.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Biel M, Kramer M, Forterre F et al (2013) Outcome of ventriculoperitoneal shunt implantation for treatment of congenital internal hydrocephalus in dogs and cats: 36 cases (2001-2009). JAVMA 242 (7), 948-958 PubMed.
  • de Stefani A, de Risio L, Platt S R et al (2011) Surgical technique, postoperative complications and outcome in 14 dogs treated for hydrocephalus by ventriculoperitoneal shunting. Vet Surg 40 (2), 183-191 PubMed.
  • Shihab N, Davies E, Kenny P J et al (2011) Treatment of hydrocephalus with ventriculoperitoneal shunting in twelve dogs. Vet Surg 40 (4), 477-484 PubMed.
  • Filgueiras Rda R, Martins Cde S, de Almeida R M et al (2009) Long-term evaluation of a new ventriculoperitoneal shunt valve system in a dog. J Vet Emerg Crit Care 19 (6), 623-628 PubMed.
  • Kitagawa M, Kanayama K & Sakai T (2005) Subdural accumulation of fluid in a dog after the insertion of a ventriculoperitoneal shunt. Vet Rec 156 (7), 206-208 PubMed.
  • Piatt J H Jr. (1995) Peritoneal cerebrospinal fluid shunt insertion - a technique for protection of the abdominal catheter. Technical note.​ J Neurosurg 82 (2), 305-306 PubMed.
  • Kriebel R M, Shah A B & McAllister J P 2nd (1993) The microstructure of cortical neuropil before and after decompression in experimental infantile hydrocephalus. Exp Neurol 119 (1), 89-98 PubMed.
  • Hale P M, McAllister J P 2nd, Katz S D et al (1992) Improvement of cortical morphology in infantile hydrocephalicanimals after ventriculoperitoneal shunt placement. Neurosurgery 31 (6), 1085-96 PubMed.
  • Yamada H, Yokota A & Furuta A et al (1992) Reconstitution of Shunted Mantle in Experimental Hydrocephalus. J Neurosurg 76 (5), 856-862 PubMed.
  • McAllister J P 2nd, Cohen M I, O'Mara K A et al (1991) Progression of experimental infantile hydrocephalus and effects of ventriculoperitoneal shunts - an analysis correlating magnetic resonance imaging with gross morphology. Neurosurgery 29 (3), 329-340 PubMed.
  • Lockhart C, Selman W, Rodziewicz G et al (1984) Percutaneous insertion of peritoneal shunt catheters with use of the Veress needle. Technical note.​ J Neurosurg 60 (2), 444-446 PubMed.

Other sources of information

  • Oliver J E & Hoerlein B F (1987) Cranial Surgery. In:Veterinary Neurology. Oliver J E, Hoerlein B F, Mayhew I G, eds. W B Saunders, Philadelphia. pp 486-88.


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