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Maltese Hydrocephalus - A Brain Disease

What this Is

This is a canine neurological disease where there is an excessive buildup of fluid on a dog’s brain. Normally both the brain and spinal cord are surrounded by a fluid called cerebrospinal fluid (CSF). With hydrocephalus, this fluid leaks inside a dog's skull. 

Though this can be very serious and fatal in some cases, if this is caught early treatment can be successful. 

What Causes This

Toy breeds like the Maltese are more prone to this than larger dogs; though it can happen to any breed. There are two types and therefore two reasons that hydrocephalus develops:

Congenital: This is a genetic birth defect in which a dog is born with an obstruction, usually in the middle brain area (mesencephalic). A very young puppy may have no obvious signs that anything is wrong. 

Acquired: This when hydrocephalus develops due to an underlying condition or injury. The most common causes include tumor, prenatal infection, parvo infection, brain hemorrhage, severe vitamin A deficiency, certain brain diseases, and severe trauma. 

Signs and Symptoms

There are physical signs including:
  • The head may show a bulge and/or appear misshapen (more common with young puppies)
  • Eyes appear set incorrectly or become cross-eyed
  • Abnormal gait
  • Odd motions of arching the back whilst extending all four legs 
  • Abnormal breathing
  • Vision trouble, including blindness
And behavioral signs may include:
  • Wetting or soiling in the house
  • Excessive sleepiness
  • Excessive vocalization
  • Hyper-excitability
  • Walking in circles or pacing
  • Odd and repetitive tilting of the head
  • Head pressing (pressing of the head up against a wall or other object)
  • Restlessness
In later stages:
  • Seizures
  • Coma


With young puppies that clearly have swelling, this is often all that is needed to recognize hydrocephalus. If, however, it is just suspected, or to learn of the extent of this, some or all of these tests will be performed:
  • A neurological evaluation
  • Blood work to check for kidney and liver function
  • X-rays of the cranium
  • MRI
  • Ultrasound
  • EEG
  • Spinal tap 


The objective in treatment is to reduce the chances of brain damage or prevent brain damage all together by improving the flow of the CSF fluid. Treatment will vary depending on the severity of the dog’s condition:

Medications are given. This includes anti-inflammatory medication (cortisone or prednisone), medications to help the body reabsorb excess fluid ( furosemide, acetazolamide, or omeprazole), and/or anti-seizure medications. 

Owners will be instructed to prevent their Maltese from jumping as this can cause a rapid pressure change in the brain. Dog steps or ramps should be put against any furniture that a Maltese may go up and down on.

Veterinarian follow-up checkups are very important to make sure that a dog is healing well.

In serious cases, surgery may be required. This involves running a tube from the brain to the abdomin (called a ventriculoperitoneal shunt). This type of procedure is currently only performed at certain universities and veterinary specialty hospitals. Though there are considerable risks, success rate is near 80%. 


Without treatment, this is often fatal. With proper treatment, a Maltese can live at home in stable condition for years, and may even reach his full life expectancy. 
Other Articles of Interest:

Maltese Colitis - For both acute and chronic, signs, diagnosis, and treatment options. 
Maltese Runny Nose Issues - Top reasons why a Maltese may develop a runny nose. 

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