Feline Hydrocephalus (Water on the Brain): Vet Guide 2025 🐱🧠💧

Hello caring cat families! I’m Dr Duncan Houston BVSc 🩺. Hydrocephalus—commonly called “water on the brain”—occurs when cerebrospinal fluid (CSF) builds up in the brain’s ventricles, putting dangerous pressure on delicate tissue. Though rare in cats, especially kittens, it demands careful diagnosis, treatment, and lifelong support. This 2025 guide covers everything you need: from recognizing signs to treatment options, including surgery, and a reassuring plan for home care 😊.

🔍 What Is Hydrocephalus?

Hydrocephalus is the abnormal accumulation of CSF in the brain’s ventricles and/or subarachnoid space, leading to increased intracranial pressure and ventricle expansion :contentReference[oaicite:3]{index=3}. It’s categorized by:

• Congenital (birth defect): due to developmental abnormalities or genetic predisposition in breeds like Siamese :contentReference[oaicite:4]{index=4}.
• Acquired: caused by infections (e.g. FIP), tumors, trauma, hemorrhage, or obstruction to CSF flow :contentReference[oaicite:5]{index=5}.
• Subtypes include obstructive (blockage), communicating (absorption issues), or compensatory (following brain loss) :contentReference[oaicite:6]{index=6}.

⚠️ Why It Matters

Raised intracranial pressure compresses the brain, risking permanent damage or death if untreated :contentReference[oaicite:7]{index=7}. Early detection and intervention are critical for a better outcome.

👶 Signs to Watch (Congenital)

• Domed, enlarged head with soft fontanelle still open :contentReference[oaicite:8]{index=8}.
• Smaller stature, slower learning than littermates :contentReference[oaicite:9]{index=9}.
• Circling, head tilt, incoordination, spastic gait :contentReference[oaicite:10]{index=10}.
• Head pressing, mental dullness, strabismus (“downward‑looking” eyes), seizures :contentReference[oaicite:11]{index=11}.

🧓 Signs in Older or Acquired Cases

• Circling, incoordination, head pressing, vision loss :contentReference[oaicite:12]{index=12}.
• Seizures, restlessness, changes in consciousness or behavior :contentReference[oaicite:13]{index=13}.
• Signs linked to underlying cause—ear problems, infections, or tumors.

🔬 Diagnostic Approach

1. Clinical exam: Evaluate head shape, fontanelle, gait, vision, mental state :contentReference[oaicite:14]{index=14}.
2. Imaging:
   • Ultrasound: useful in young kittens with open fontanelle :contentReference[oaicite:15]{index=15}.
   • X‑rays: may show domed skull or enlarged ventricles but limited detail.
   • CT/MRI: gold standard—confirms fluid buildup, evaluates obstruction, identifies tumors/infections :contentReference[oaicite:16]{index=16}.
3. CSF tap & EEG: sometimes to rule out infection or seizure disorders :contentReference[oaicite:17]{index=17}.

🏥 Treatment Options

1. Medical Management

• Corticosteroids: reduce brain swelling and inflammation :contentReference[oaicite:18]{index=18}.
• Diuretics: medications like furosemide, acetazolamide reduce CSF production :contentReference[oaicite:19]{index=19}.
• Antiepileptics: for seizures—phenobarbital, levetiracetam, zonisamide.
• Antibiotics/antivirals: if infections (e.g. FIP) are involved.
• Medical management is palliative—not curative—and may only provide temporary relief :contentReference[oaicite:20]{index=20}.

2. Surgical Intervention – Ventriculoperitoneal (VP) Shunt

• Placement of a shunt drains excess CSF from ventricles to the abdomen :contentReference[oaicite:21]{index=21}.
• Success rates up to 80%, especially in congenital cases :contentReference[oaicite:22]{index=22}.
• Risks include infection, blockage, overdrainage—may require shunt revisions :contentReference[oaicite:23]{index=23}.
• High cost and need specialist neurosurgeon.

📈 Prognosis & Follow‑Up

• Mild congenital: can live quality lives with medical care, but brain deficits may be permanent :contentReference[oaicite:24]{index=24}.
• With shunt: many improve dramatically, but lifelong monitoring and shunt management needed :contentReference[oaicite:25]{index=25}.
• Acquired types: prognosis depends on underlying disease—tumors, infections, trauma have variable outcomes :contentReference[oaicite:26]{index=26}.

🏡 Home Care & Monitoring

• Continue medications, monitor appetite, energy, and neurologic signs via **Ask A Vet app** 📱.
• Create safe, padded spaces—soft bedding and low obstacles.
• Record head pressing, circling, disorientation—report changes early.
• Arrange regular vet checkups, blood tests, and imaging to monitor progression or complications.

📝 Key Takeaways

• Hydrocephalus in cats is rare but serious due to CSF buildup in the brain.
• Signs vary but often include a domed head in kittens and neurologic symptoms at any age.
• Diagnosis via imaging is essential; medical treatment relieves symptoms, while surgery offers longer-term control in selected cases.
• Prognosis depends on severity and whether surgery is possible; many cats improve with proper care.
• At-home monitoring, symptom tracking, and a supportive environment are vital for quality of life.

📞 When to Contact Ask A Vet

If you notice head pressing, circling, incoordination, seizures, vision loss, or changes in behavior—open the **Ask A Vet app** 💬 without delay. Early intervention can make all the difference.

✨ Final Thoughts

Hydrocephalus can be a deeply challenging diagnosis, but with a compassionate veterinary team, thoughtful medical or surgical planning, and loving home care, many cats go on to live meaningful, joyful lives. Your vigilance and advocacy make a world of difference ❤️🐾.