title: Vagus Nerve Stimulator Placement in Dogs: Surgical Implantation Technique, Complications, Long-Term Follow-Up, and Practical Considerations.
abstract: OBJECTIVE
  To describe a modified implantation procedure of a vagus nerve stimulation (VNS) device in dogs and to report short- and long-term complications.
  
  
  METHODS
  Descriptive, experimental study.
  
  
  METHODS
  Healthy, adult Beagle dogs (n = 10).
  
  
  METHODS
  A VNS Therapy(®) System was implanted in the left cervical region of anesthetized dogs. During and within 48 hours after surgery, electrocardiography (ECG) and impedance testing of the system were performed. Dogs were monitored daily and the impedance of the system was determined regularly until VNS devices were surgically removed 3 years after implantation.
  
  
  RESULTS
  The implantation procedure was successful in all dogs without intraoperative complications. ECG monitoring and impedance tests were within normal limits during and within 48 hours after surgery. Postoperative seroma formation was common (70%). One dog developed an irreversible Horner's syndrome leading to removal of the device 5 months after implantation. Another dog developed trauma-induced damage of the lead requiring surgical revision. The device could be safely removed in all dogs; however, electrodes were left in place to avoid nerve damage. At removal, the anchor tether was dislodged in 40% of dogs and the lead was twisted in 50% of dogs.
  
  
  CONCLUSIONS
  Implantation of a VNS Therapy(®) System is safe and feasible in dogs; however, seroma formation, twisting of the lead, and dislodgement of the anchor tether were common. Practical improvements in the technique include stable device placement, use of a compression bandage, and exercise restriction. Regular evaluation of lead impedance is important, as altered values can indicate serious complications.
authors.affiliation: Faculty of Veterinary Medicine, Department of Small Animal Medicine and Clinical Biology, Ghent University, Merelbeke, Belgium.
authors.forename: Valentine
authors.initials: V
authors.lastname: Martlé
authors.affiliation: Faculty of Veterinary Medicine, Department of Small Animal Medicine and Clinical Biology, Ghent University, Merelbeke, Belgium.
authors.forename: Luc M L
authors.initials: LM
authors.lastname: Van Ham
authors.affiliation: Faculty of Medicine and Health Sciences, Department of Neurology.
authors.forename: Paul
authors.initials: P
authors.lastname: Boon
authors.affiliation: Faculty of Medicine and Health Sciences, Department of Neurosurgery, Ghent University Hospital, Ghent, Belgium.
authors.forename: Jacques
authors.initials: J
authors.lastname: Caemaert
authors.affiliation: Faculty of Veterinary Medicine, Department of Small Animal Medicine and Clinical Biology, Ghent University, Merelbeke, Belgium.
authors.forename: Mulenda
authors.initials: M
authors.lastname: Tshamala
authors.affiliation: Faculty of Medicine and Health Sciences, Department of Neurology.
authors.forename: Kristl
authors.initials: K
authors.lastname: Vonck
authors.affiliation: Faculty of Medicine and Health Sciences, Department of Neurology.
authors.forename: Robrecht
authors.initials: R
authors.lastname: Raedt
authors.affiliation: Faculty of Veterinary Medicine, Department of Small Animal Medicine and Clinical Biology, Ghent University, Merelbeke, Belgium.
authors.forename: Ingeborgh
authors.initials: I
authors.lastname: Polis
authors.affiliation: Faculty of Veterinary Medicine, Department of Small Animal Medicine and Clinical Biology, Ghent University, Merelbeke, Belgium.
authors.forename: Sofie
authors.initials: S
authors.lastname: Bhatti
mesh_terms: D000818:Animals; D020878:Device Removal; D004285:Dogs; D004827:Epilepsy / Q000628:therapy / Q000662:veterinary*; D005500:Follow-Up Studies; D011183:Postoperative Complications / Q000601:surgery*; D019736:Prostheses and Implants; D012086:Reoperation; D014630:Vagus Nerve / Q000601:surgery*; D055536:Vagus Nerve Stimulation / Q000295:instrumentation / Q000662:veterinary*