Need insight: Sprite dx with hydrocephalus
 

Our Sprite, 3.5 years old, started having seizures approx 4 months ago. She had numerous blood tests and after inconclusive results was referred to a neurologist. In the meantime she was placed on Kepra to help control the seizures. On Friday the neurologist performed an MRI which indicated hydrocephalus with COM (caudal occipital malformation) syndrome. Her left ventricle is almost 3x the size of the right. The neurologist has put her on prednisone and omeprazole in addition to kepra, but this will only help short term. She needs a ventriculoperitonneal shunt inserted to save her life. Does anyone have experience with this procedure? We are devastated and need to make a decision very quickly about whether to treat her palliatively or proceed with having the shunt inserted. Our regular vet has no experience with this procedure so can't really guide us in terms of the right decision. Any help would be very appreciated.

I don't but I've read about it and would go forward if this was my dog.

I don't have experience with this condition. But always ask about the risks n benefits of surgery, and also how effective Palliative care might be.

I am so sorry you are going through this. I do hope you have informed your breeder of this vey serious health condition.

I had a hydrocephalus pup but his did not warrant surgery; so I really am not certain what I would do. I usually tend to do whatever is possible for a pup; but I always rely on my vet and specialists to guide me. I think if there was a good chance of a positive outcome for Sprite and she were mine, I would go for it.
If seizures are the only indication of a shunt, it sort of sounds to me like she might do well. I hope that is the case.
Please keep us posted on whatever you decide to do. I will keep little Sprite and you in my thoughts and prayers.

This is a congenital condition she was apparently born with and has gradually worsened until the point where she started having seizures. She was very difficult to housetrain, and from time to time walked with a funny little gait, almost like prancing, but we had no idea these were signs of hydrocephalus. Her vision is fine and her head doesn't appear enlarged, so no obvious external signs. Since we learned she had this disorder we have been able to look back and see some of the signs, but they weren't obvious at the time. She started suddenly having seizures up to 4 times a day, had difficulty with balance, and was very lethargic and not eating well. She has had so many tests trying to find out what was wrong. The surgery has it's own risks as they must insert a shunt (drainage tube) from her brain to her abdomen to drain the fluids and relieve the pressure. If we don't have the surgery we can give her meds for a short while but eventually she will suffer a hemorrhage from the pressure. Because her condition is severe now, it will be fatal without surgery. We will ask the neurologist more questions this week, but at our appointment I was too upset by the news to think of questions about what happens after surgery etc. thank you all for your responses and suggestions.

I meant to add that we will definitely notify her breeder, and that palliative care as far as I understood from the neurologist is giving her lots of love, meds to help reduce pain, inflammation and production of cerebrospinal fluids, which will only be effective for a short while, and then inevitably euthanasia. Very sad.

It doesn't sound like you have many options. I know what you're going through on some level having done two MRIs on dogs and having to rule out these kinda of things for our dogs. I didn't have the bad news you have had. But you've come this far, and if the procedure would give a quality of life that she can't have without it, then to worth trying it if you can handle it emotionally and financially IF the neurologist thinks it's worth it. I think it would be ok to decide not to do it too. It's hard, I know I would go for it. I was ready to do brain surgery in my 13 year old of needed but it wasn't.

Yes, we really only have 2 options, surgery or euthanasia. We are still waiting for some test results to determine whether she can even go ahead with the surgery but should have those results by Tuesday. Cost is definitely an issue that needs to be considered. We have an idea for the surgery cost, but don't know about ongoing care expenses afterwards. As you can imagine we haven't slept well the last couple of days trying to figure all this out.

Hopefully there won't be that many costs after the surgery. Speak with the neurologist about that.

I will pray for your baby. I hope you can swing the surgery...she is young and may do really well after it is repaired.

The little one I had was also congenital...he had many other neuro issues but he did really well until he had to be euth for a different condition. He was estimated to be around 12 so he had a full life.

I'm so sorry to hear of Sprite's condition. I'm saying prayers for her and also for you and your husband. Hopefully, the neurologist can give you more solid information this week that will make your decisions a little easier for you.

I am so very sorry for your little Sprite. I will pray for her well being and to give you and your husband the strength and guidance to to deal with this horrific decision you are faced with.(((hugs))))

Thank you all for your support. It is really helping me get through this difficult time. We are looking forward to speaking with the neurologist again because we don't have enough information yet to make a fully informed decision. Our regular vet has a large practice with 3 vets on staff and none of them have ever come across a dog that has had the shunt installed, so that tells me that either this procedure is rarely done or hydrocephalus is very rare, or both. He was very concerned about what the ongoing expenses would be post surgery and also her quality of life. Hopefully we can get those questions answered tomorrow. We are still waiting for test results to make sure there is no infection in the cerebrospinal fluid and that her liver is functioning properly. She's doing a lot of head pressing now, so she must be having a whopper of a headache in spite of the pain meds. I will post an update after I speak to the neurologist.

Here is a link to one of Sammy's threads. You will see all of the neurological issues he had that he did fairly well with. The thing that got him in the end was a perineal hernia because his bladder kept getting trapped in it and multiple repairs did not help. The neurologists see more of the neuro things than regular vets do....yes, they are rare, but not so rare that they don't know how to treat them! It just is something a regular vet does not see and have the experience handling. I am certain you will get better information from the neurologist regarding after care. I think there are videos of Sammy in that thread somewhere...I will look for them later. If not, I think I have them on You Tube and will post for you to see. The neurologists assured me he was not in pain!

http://www.yorkietalk.com/forums/sic...ro-issues.html

Maybe the thread will give you some hope that after surgery Sprite could do well .. that is IF the neurologist feels that the seizures can be minimized by the surgery. Sammy was a trooper in spite of all of his neuro issues. He was such a joy! :)

Thinking of you and praying for Sprite...

Actually, I don't think it is rarely done in the large specialty hospitals. I know it is done at Angell and I found this photo borrowed from TX A&M on their website. Neurology Service. I also found this story of a puppy there who had it done Blind Puppy Suffering from Congenital Brain Disease Abandoned at Supermarket

I can tell from your posts that you and your husband love Sprite and want to truly do the best for him and my heart is breaking for you to be facing such a huge decision regarding his care. It's great that you are trying to gather as much information possible from both YT members and through your vet as well as a neurologist. I have no personal experience with hydrocephalus and cannot offer you anything more than my comfort for what you are faced with in making a proper choice. If the neurologist feels after your consult that Sprite can recover and live a fulfilled life then I say go for it. If you decide that the outcome will not truly benefit him with surgery there is nothing wrong with making a decision to offer comfort until the end. Please keep us posted on what the neurologist consult offer you in answers to his treatment.