Case Report: Ventriculoperitoneal shunt for management of syringomyelia and Chiari-like malformation in a Cavalier King Charles Spaniel.

Abstract

A 1-year-old male Cavalier King Charles Spaniel (CKCS) was presented with spinal hyperesthesia, reluctance to exercise, and phantom scratching. MRI revealed a Chiari-like malformation (CM) with brachycephaly, cerebellar herniation, ventriculomegaly, and syringomyelia extending from the odontoid peg to L5, with a maximum transverse syrinx width of 7.0 mm at C2-C3. Medical management (meloxicam and gabapentin) failed to resolve clinical signs. Due to significantly increased lateral ventricles and concern for syrinx progression, a ventriculoperitoneal shunt was placed. Aside from transient post-operative pneumocephalus, the procedure was successful. The dog showed significant clinical improvement, and follow-up MRI demonstrated syrinx reduction and resolution of lateral ventricles. At 6 months post-op, the syrinx measured 2.3 mm. Eight months after the surgery, the dog experienced a brief episode of a suspected movement disorder like but recovered fully. The patient remains pain-free and neurologically normal. This case describes the clinical and imaging outcomes of ventriculoperitoneal shunting (VPS) in a dog with Chiari-like malformation, syringomyelia, and ventriculomegaly.