Craniotomy in Dogs

To perform surgery on the brain, a portion of the skull must be opened, removed and then replaced after the procedure. This operation is called a craniotomy. The piece that is removed and put back is often referred to as a “bone flap”. This surgery is most commonly used to remove tumors in and around the brain. 

Brain tumors or other damage can be confirmed by use of MRI or CT scan images. Craniotomies are the surgery of choice when treating large tumors or performing surgeries on the brain tissue. These operations are complex and should only be attempted by an ACVS board-certified veterinary surgeon. 

The dog will need to undergo blood work to assess whether it is a good surgical candidate or not. Either CT scans or MRI images will be needed to help the surgeon locate all lesions and plan the surgery accordingly. If surgery is appropriate, the dog will need to fast before the operation takes place. An IV will be placed and the dog's fluid levels will be topped up. The head will be clipped and cleaned before the operation begins. Some dogs also require oxygen supplementation prior to the operation.

An incision will be made to the skin on the dog's head, exposing the skull. The skull will then be punctured using a drill. If only an aspiration biopsy is needed, the hole made can be very small. Tissue will be harvested through this hole and sent for full evaluation. If the opening in the skull is for tumor excision or other surgical procedures, either a lateral, transfrontal, suboccipital or rostrotentorial cut will be made. Once the procedure is complete, the bone portion is replaced and secured with the use of permanent metal wiring. The skin can then be sutured closed.

Craniotomies themselves are actually associated with decent survival rates despite being high-risk surgeries. Due to the ailments that are treated by a craniotomy, the dog's overall life expectancy is lengthened on average only nine months. Only 39% of dogs who received a craniotomy for cancer treatment were alive one year post-surgery. If a craniotomy is being used for a biopsy, approximately 95% of these procedures are successful. 

The dog must be monitored as it regains consciousness. This is to determine if limb movement, pupil dilation and other signs of neurological soundness are present. Pain medication can begin at this time, and will likely continue for several days after the surgery. The dog will stay in the hospital for three to five days. A prescription for antibiotics will be given to help protect the brain from infection. 

Once the dog is discharged, all activity should be reduced. A follow-up appointment will be needed to assess recovery and to remove sutures from the head. If any metal implants have been used, these will permanently stay in the skull. A full recovery is to be expected by 8 weeks. If the dog has been diagnosed with cancer, a treatment regime will be started as the dog heals from surgery.

Any surgery involving the brain requires a skilled and experienced surgeon. Advanced imaging is required to plan for the operation, adding significantly to the overall price. Owners can expect to pay somewhere between $5,000 to $25,000 depending on who performs the surgery and what other treatments are implemented. Some forms of mild cancer may be managed using radiation therapy alone, however medical treatment without surgery is often unsuccessful.

All surgeries that use general anesthesia carry risks to the dog. Operations that open the skull can rarely result in complications like pneumocephalus or cervical subarachnoid pneumorrhachis. If any infection begins in the incision site, damage to the brain tissue may be devastating to the animal. Tumor removal alone may not prevent new tumors from forming. The owner should determine whether the overall prognosis of the dog merits a high-risk and expensive surgery. 

Issues of the brain can be prevented in some cases. Traumatic injury can be avoided by keeping your dog on a leash at all times when outdoors. Ensure that your backyard is secure and that there are no areas your dog may escape from. When obtaining a pet, always be sure to request its full family health history. 

Do not expose your dog to toxins known to cause cancer, such as cigarette smoke. Eliminating this from your home will benefit your human family as well. Feed your dog a diet free of harmful preservatives. This can decrease the chance of your dog developing cancer, although some forms are hereditary and little can be done to halt their progression.