Theoretically, the goals of treating a dog with hydrocephalus are to decrease the amount of cerebrospinal fluid (CSF) being produced, increase the amount of CSF being absorbed and/or shunt excess CSF to some other bodily cavity. The overriding practical goal is to relieve the build-up of pressure on nerves (neurons), blood vessels and other affected brain tissues. Unfortunately, given the current state of medical knowledge, it is difficult if not impossible to artificially increase the brain’s absorptive capabilities through some form of medical manipulation. The veterinarian’s selection of a treatment protocol will depend upon a number of different things, such as the dog’s presenting symptoms, size and physical condition, as well as the underlying cause of hydrocephalus if it can be determined within a relatively short period of time. Many dogs with hydrocephalus show no outward signs of the condition; these dogs probably will not require medical treatment unless or until symptoms develop.
Pharmaceutical treatment of dogs with the acute onset of hydrocephalus is primarily designed to decrease the amount of cerebrospinal fluid that is being produced. Corticosteroids, such as prednisone or dexamethasone, have been used for this purpose. Other drugs, including acetazolamide, omeprazole and furosemide, have also been used by some veterinarians in an attempt to reduce the overproduction of CSF in hydrocephalic dogs. Administration of diuretics may also be recommended to reduce the pressure inside the dog’s skull (intracranial pressure) by promoting the elimination of fluids in the urine. If the dog is having seizures, anticonvulsive medications may be recommended. Unfortunately, drug therapy usually provides only temporary improvement in clinical signs.
Surgery may be necessary, especially if medical management does not relieve the dog’s symptoms within several weeks. The goal of surgical treatment is to shunt the excess cerebrospinal fluid from the cerebral ventricles to other locations in the body - often to the peritoneal cavity or to the right atrium. The peritoneal cavity is a space between the layers of membranes that line the abdomen and the pelvic cavity. The right atrium is one of the four chambers of the heart. There are several different procedures and techniques to accomplish this re-routing of fluid; the treating doctor will decide which he or she thinks is most appropriate and most likely to be successful in a given case. Surgical treatment of hydrocephalus is almost always done by referral to a specialized veterinary neurologist.
Of course, owners should rely on their treating veterinarian for advice about the best and most current treatment protocols for any disease or disorder, including hydrocephalus.
The outlook for dogs with hydrocephalus can be quite variable, ranging from quite good to grave. If the condition is congenital and the dog has obvious neurological symptoms with accompanying irreversible brain damage, the prognosis is probably guarded to poor. However, if the condition is congenital with no or only mild symptoms, or if it is acquired by trauma-induced inflammation or by a treatable infection, the prognosis can be quite good, depending upon whether the underlying cause can be identified, corrected or cured before significant brain damage occurs from the increase in intracranial pressure.