A de novo mutation in CACNA1A is associated with autosomal dominant bovine familial convulsions and ataxia in Angus cattle

Bovine familial convulsions and ataxia (BFCA) is considered an autosomal dominant syndrome with incomplete penetrance. Nine Angus calves from the same herd were diagnosed with BFCA within days of birth. Necropsy revealed cerebellar and spinal cord lesions associated with the condition. Parentage testing confirmed that all affected calves had a common sire. The sire was then bred to 36 cows across two herds using artificial insemination, producing an additional 14 affected calves. The objective of this investigation was to identify hypothesized dominant genetic variation underlying the condition. Whole-genome sequencing was performed on the sire, six affected and seven unaffected paternal half-sibling calves and combined with data from 135 unrelated controls. The sire and five of the six affected calves were heterozygous for a nonsense variant (Chr7 g.12367906C>T, c.5073C>T, p.Arg1681*) in CACNA1A. The other affected calves (N = 8) were heterozygous for the variant but it was absent in the other unaffected calves (N = 7) and parents of the sire. This variant was also absent in sequence data from over 6500 other cattle obtained via public repositories and collaborator projects. The variant in CACNA1A is expressed in the cerebellum of the ataxic calves as detected in the transcriptome and was not differentially expressed compared with controls. The CACNA1A protein is part of a highly expressed cerebellar calcium voltage gated channel. The nonsense variant is proposed to cause haploinsufficiency, preventing proper transmission of neuronal signals through the channel and resulting in BFCA.

Seizures in 3 juvenile dogs after intravenous anesthetic drug withdrawal during weaning from mechanical ventilation suspected to be a sign of iatrogenic withdrawal syndrome

OBJECTIVE

To describe seizure activity in juvenile dogs successfully weaned from long-term mechanical ventilation.

CASE SERIES SUMMARY

Three juvenile dogs (all approximately 3 months old) underwent long-term mechanical ventilation with IV anesthesia for suspected noncardiogenic pulmonary edema. Within 24 hours of extubation and within 10 hours of discontinuing midazolam continuous infusions, all dogs experienced seizures, which is 1 sign of iatrogenic withdrawal syndrome. Each dog was treated with an anticonvulsant protocol, and none experienced seizures after being discharged.

NEW OR UNIQUE INFORMATION PROVIDED

Each dog received IV anesthesia, including fentanyl, dexmedetomidine, midazolam, and propofol, during mechanical ventilation and subsequently experienced seizures after successful weaning from mechanical ventilation. Juvenile dogs may be at risk for seizures after weaning from mechanical ventilation and IV anesthesia. Neurological monitoring and further research into an appropriate weaning protocol may prove beneficial in juvenile dogs requiring prolonged anesthesia.

Serum concentrations of complement C3 and C4 in dogs with idiopathic epilepsy

BACKGROUND

High concentrations of complement factors are presented in serum of animal epilepsy models and human patients with epilepsy.

OBJECTIVES

To determine whether complement dysregulation occurs in dogs with idiopathic epilepsy (IE).

ANIMALS

The study included 49 dogs with IE subgrouped into treatment (n = 19), and nontreatment (n = 30), and 29 healthy dogs.

METHODS

In this case-control study, the serum concentrations of the third (C3) and fourth (C4) components of the complement system were measured using a canine-specific ELISA kit.

RESULTS

Serum C3 and C4 concentrations were significantly higher in dogs with IE (C3, median; 4.901 [IQR; 3.915-6.673] mg/mL, P < .001; C4, 0.327 [0.134-0.557] mg/mL, P = .03) than in healthy control dogs (C3, 3.550 [3.075-4.191] mg/mL; C4, 0.267 [0.131-0.427] mg/mL). No significant differences were observed in serum C3 and C4 concentrations between dogs in the treatment (C3, median; 4.894 [IQR; 4.192-5.715] mg/mL; C4, 0.427 [0.143-0.586] mg/mL) and nontreatment groups (C3, 5.051 [3.702-7.132] mg/mL; C4, 0.258 [0.130-0.489] mg/mL). Dogs with a seizure frequency >3 times/month had significantly higher serum C3 (6.461 [4.695-8.735] mg/mL; P < .01) and C4 (0.451 [0.163-0.675] mg/mL; P = .01) concentrations than those with a seizure frequency ≤3 times/month (C3, 3.859 [3.464-5.142] mg/mL; C4, 0.161 [0.100-0.325] mg/mL).

CONCLUSIONS AND CLINICAL IMPORTANCE

Dysregulation of classical complement pathway was identified in IE dogs. Serum C3 and C4 concentrations could be diagnostic biomarkers for IE in dogs with higher seizure frequency.

A retrospective study of the efficacy of zonisamide in controlling seizures in 57 cats

BACKGROUND

Evidence-based recommendations for antiepileptic drug selection in cats beyond phenobarbital are limited, and additional studies are needed for cats where seizures remain inadequately controlled by administration of phenobarbital alone or for cats that cannot safely receive phenobarbital.

OBJECTIVE

To compare seizure frequency in cats before and after oral administration of zonisamide and describe adverse clinical or clinicopathologic effects in this cohort.

ANIMALS

Fifty-seven cats with a history of seizures.

METHODS

Multicenter, retrospective study. Median number of seizures per month and number of seizure days per month were compared before and after administration of zonisamide in all cats, a subgroup of cats with idiopathic epilepsy (IE), and a subgroup of cats receiving zonisamide as sole therapy. Clinical and clinicopathologic adverse effect data were also reported.

RESULTS

A median decrease of 1 (P = .001, 95% confidence interval (CI) [-1.0, -0.5]) seizure per month, and 1 (P = .003, 95% CI [-1.5, -0.2]) seizure days per month was found across all cats after oral administration of zonisamide. The subgroup with IE showed median decreases of 1 (P = .03, 95% CI [-2.0, -0.5]) and 2 (P = .01, 95% CI [-2.5, -1.0]), respectively. The most common clinical adverse effects were sedation (17%), ataxia (11%), hyporexia (17%), and emesis (5%). One cat developed mild nonregenerative anemia, 2 cats developed mild metabolic acidosis, and 6 cats showed mild increases in ALT and ALP.

CONCLUSION

Zonisamide was well tolerated and efficacious in controlling seizure activity in most cats.

Surgical treatment of feline intracranial meningiomas: a retrospective study of 26 cases

BACKGROUND

Surgical excision is the treatment of choice for feline intracranial meningioma.

OBJECTIVES

To report clinical findings, complications, and outcomes following surgery for feline intracranial meningioma.

METHODS

Medical records (01/2000-01/2017) of cats that underwent surgical excision of an intracranial meningioma at our institution were reviewed. Patient data included signalment, clinical signs, surgical technique, complications, histopathologic diagnosis, survival time, and owners' answers to a satisfaction questionnaire. Survival was assessed using the Kaplan-Meier method and log-rank test.

RESULTS

Twenty-six cats were included in this study. The exact cause of death was known in 17 cases and was not related to meningioma in 9/17 cases. Overall median survival time was 881 days (95% confidence interval 518; 1248). The age of the cat did not influence survival (p = 0.94) or the occurrence of complications (p = 0.051). Complications occurred in 13/24 cats, including dramatic complications in 4/24 cats. Most complications appeared in the first 24 hours post-surgery (12/13). Males had more postoperative complications (p = 0.042), including more seizures (p = 0.016). Cats with cranioplasty had fewer complications (p = 0.021). Clinical recurrence was confirmed in 3 out of 17 cats. Recurrence-free survival time was 826 days. Most owners (12/14) were satisfied with the outcome.

CONCLUSIONS

Surgical treatment of intracranial meningioma in cats was associated with a long median survival time but also with a high rate of minor and major postoperative complications, including early postoperative seizures. Cranioplasty may reduce complications. Age at the time of surgery had no effect on outcomes.

Clinical outcomes for 20 cats with congenital extrahepatic portosystemic shunts treated with ameroid constrictor ring attenuation (2002-2020)

OBJECTIVE

To report the clinical perioperative, short-term, and long-term outcomes for cats undergoing ameroid ring constrictor (ARC) attenuation of a congenital extrahepatic portosystemic shunt (EHPSS).

STUDY DESIGN

Retrospective case series from a single veterinary teaching hospital (2002-2020).

ANIMALS

Twenty client-owned cats with EHPSS.

METHODS

Data collected from medical records included signalment, history, physical examination, clinicopathologic testing, medications, diagnostic imaging, intraoperative findings, perioperative complications, and postoperative clinical outcomes. Long-term clinical outcome was obtained from a standardized owner interview or medical records.

RESULTS

Perioperative complications were reported in five cats out of 20, including blindness (two cats), ascites (one cat), head pressing (one cat), and seizures and death (one cat). Short-term clinical outcome was excellent in 14/18 cats, good in 2/18 cats, and poor in 2/18 cats that were available for follow up, and long term clinical outcome was excellent in 15/18, good in 1/18 cats, and poor in 2/18 cats that were available for follow up.

CONCLUSION

Long-term clinical outcome was good or excellent in 16/18 of cats available for follow up. Perioperative complications were reported in five cats.

CLINICAL SIGNIFICANCE

Surgical attenuation of EHPSS with an ARC can result in resolution of clinical signs and biochemical abnormalities in the majority of cats. The perioperative complication rate for feline patients with EHPSS attenuated with an ARC was lower than reported historically. Seizures may persist in the long term despite normal bile acid stimulation test results, complete blood count, and biochemistry analysis.

Successful use of intravenous and oral levetiracetam in a goat to control refractory seizures secondary to suspected polioencephalomalacia

OBJECTIVE

To assess the clinical efficacy and plasma concentrations of levetiracetam in a goat with seizures.

ANIMAL

A 5-month-old doeling.

CLINICAL PRESENTATION, PROGRESSION, AND PROCEDURES

The goat was referred because of progressive anorexia and lethargy over 3 days. Clinical signs consisted of weakness, obtundation, opisthotonos, anisocoria, and cortical blindness. Initial evaluation was most consistent with polioencephalomalacia.

TREATMENT AND OUTCOME

Neurologic improvement occurred within 4 hours of thiamine administration, with appetite returning over 12 hours. On day 3 of hospitalization, the goat suffered acute onset repetitive seizures that were incompletely responsive to standard interventions over 3 hours. Administration of IV levetiracetam (60 mg/kg) produced resolution of seizure activity within 20 minutes. Levetiracetam was continued twice daily IV, then PO after day 6. Plasma concentrations were above or within therapeutic ranges (5 to 45 μg/mL) as previously established for other species, following both IV and PO levetiracetam. Oral administration (60 mg/kg, PO, q 12 h) resulted in plasma levetiracetam concentrations of 48.1 μg/mL 2 hours after a dose and 23.4 μg/mL 2 hours prior to the next dose.

CLINICAL RELEVANCE

Levetiracetam is a newer anticonvulsant commonly used in humans and small animals due to its efficacy, cost, and wide safety margin. Its use has not previously been reported in domestic small ruminants. In this case, levetiracetam showed excellent clinical efficacy in the face of refractory seizures, with no apparent side effects. Plasma concentrations during oral administration were at the high end of the therapeutic range, indicating absorption in a nonmonogastric species. Further studies are warranted to determine optimal dosing in small ruminants.

Basic triage in dogs and cats: Part I

Background

Emergency cases can present at any time of the day or night. All small animal practitioners need to have the skills to triage and stabilize common emergency cases even if they ultimately aim to refer the patient to another facility.

Objectives and procedures

The first part of this 3-part review article series covers respiratory distress and seizures. A stepwise approach to categorize and stabilize these cases is outlined, along with helpful tips to optimize the referral experience, if indicated.

Results

Having a strong methodical approach to animals in respiratory distress optimizes treatment. Similarly, achieving cessation of seizures, along with having a good understanding of the causes of seizures, allows for patient stabilization.

Conclusion and clinical relevance

Do NOT refer emergent cases before completing basic stabilization. Many emergency cases do not require emergent referral and can be worked up by the primary veterinarian or sent to a referral clinic on an appointment basis after appropriate stabilization steps are completed.

Juvenile idiopathic epilepsy in Egyptian Arabian foals, a potential animal model of self-limited epilepsy in children

BACKGROUND

Juvenile idiopathic epilepsy (JIE) is categorized as a generalized epilepsy. Epilepsy classification entails electrocortical characterization and localization of epileptic discharges (ED) using electroencephalography (EEG).

HYPOTHESIS/OBJECTIVES

Characterize epilepsy in Egyptian Arabian foals with JIE using EEG.

ANIMALS

Sixty-nine foals (JIE, 48; controls, 21).

METHODS

Retrospective study. Inclusion criteria consisted of Egyptian Arabian foals: (1) JIE group diagnosed based on witnessed or recorded seizures, and neurological and EEG findings, and (2) control group of healthy nonepileptic age-matched foals. Clinical data were obtained in 48 foals. Electroencephalography with photic stimulation was performed under standing sedation in 37 JIE foals and 21 controls.

RESULTS

Abnormalities on EEG were found in 95% of epileptic foals (35 of 37) and in 3 of 21 control asymptomatic foals with affected siblings. Focal ED were detected predominantly in the central vertex with diffusion into the centroparietal or frontocentral regions (n = 35). Generalization of ED occurred in 14 JIE foals. Epileptic discharges commonly were seen during wakefulness (n = 27/37 JIE foals) and sedated sleep (n = 35/37 JIE foals; 3/21 controls). Photic stimulation triggered focal central ED in 15 of 21 JIE foals.

CONCLUSIONS AND CLINICAL IMPORTANCE

Juvenile idiopathic epilepsy has a focal onset of ED at the central vertex with spread resulting in clinical generalized tonic-clonic seizures with facial motor activity and loss of consciousness. Electroencephalography with photic stimulation contributes to accurate phenotyping of epilepsy. Foals with this benign self-limiting disorder might serve as a naturally occurring animal model for self-limited epilepsy in children.

Prevalence of nonconvulsive seizures and nonconvulsive status epilepticus in dogs and cats with a history of cluster seizures: A retrospective study

BACKGROUND

Nonconvulsive seizures (NCS) and nonconvulsive status epilepticus (NCSE) are frequently observed in human patients. Diagnosis of NCS and NCSE only can be achieved by the use of electroencephalography (EEG). Electroencephalographic monitoring is rare in veterinary medicine and consequently there is limited data on frequency of NCS and NCSE.

OBJECTIVES

Determine the prevalence of NCS and NCSE in dogs and cats with a history of cluster seizures.

ANIMALS

Twenty-six dogs and 12 cats.

METHODS

Retrospective study. Medical records of dogs and cats with cluster seizures were reviewed. Electroencephalography was performed in order to identify electrographic seizure activity after the apparent cessation of convulsive seizure activity.

RESULTS

Nonconvulsive seizures were detected in 9 dogs and 2 cats out of the 38 patients (29%). Nonconvulsive status epilepticus was detected in 4 dogs and 2 cats (16%). Five patients had both NCS and NCSE. A decreased level of consciousness was evident in 6/11 patients with NCS, 3/6 also had NCSE. Mortality rate for patients with NCS (73%) and NCSE (67%) was much higher than that for patients with no seizure activity on EEG (27%).

CONCLUSION AND CLINICAL IMPORTANCE

Prevalence of NCS and NCSE is high in dogs and cats with a history of cluster seizures. Nonconvulsive seizures and NCSE are difficult to detect clinically and are associated with higher in hospital mortality rates. Results indicate that prompt EEG monitoring should be performed in dogs and cats with cluster seizures.

Serum C-reactive protein concentrations in dogs with structural and idiopathic epilepsy

BACKGROUND

C-reactive protein (CRP) is an acute-phase protein produced by the liver during systemic inflammation. In humans, some epilepsies are associated with increased serum CRP (sCRP) concentrations, but this has yet to be proven in veterinary studies. Dogs with structural epilepsy (SE) and normal interictal neurological examination are hard to distinguish from dogs with idiopathic epilepsy (IE) without the use of advanced imaging.

METHODS

The study included eight dogs with SE and 12 dogs with IE from a referral hospital population. This was a retrospective observational cohort study. The Mann-Whitney test was used to compare the sCRP concentrations within 24 hours of the last epileptic seizure between dogs with SE or IE.

RESULTS

Dogs with SE had higher sCRP concentrations than dogs with IE (8.9 [range <2.2-53.2] mg/L vs. <2.2 [range <2.2-6.9] mg/L; p = 0.043). Five of the eight (62%) dogs with SE had an sCRP concentration above the reference interval, compared with none of the 12 dogs with IE.

LIMITATIONS

The small sample size was the major limitation of this study. Other inflammatory causes were also not exclusively ruled out, although further clinical investigations were not indicated.

CONCLUSIONS

This study found that sCRP concentrations were higher in this cohort of dogs with SE than in those with IE. Further studies with larger cohorts of dogs are warranted to validate if sCRP can be used as an additional biomarker for SE.

A retrospective evaluation of phenobarbital-induced hematologic changes in 69 cats

BACKGROUND

Phenobarbital (PB) is used as a first-line treatment for recurrent epileptic seizures in cats. While hematologic abnormalities are well-known side effects of antiepileptic therapy with PB in humans and dogs, little is known about such alterations in cats.

OBJECTIVES

The aim of this retrospective study was to investigate the prevalence and clinical relevance of cytopenia during PB treatment in cats.

METHODS

In this single-center, retrospective clinical study, 69 cats-with suspected idiopathic epilepsy admitted to the Small Animal Clinic of the University of Veterinary Medicine in Vienna (VMU)-were included. A complete blood count for each patient was performed, and changes in hematocrit, leukocytes, neutrophils, and thrombocytes were documented and graded.

RESULTS

Fifty-three out of 69 cats (76.8%) showed cytopenias with a reduction of at least one cell fraction during PB treatment. The most frequent change was neutropenia (60%), followed by leukopenia (49.3%), thrombocytopenia (24.1%), and anemia (20.3%). Most of the changes were mild or moderate; only one patient (1.5%) showed severe leukopenia and neutropenia, and one was a life-threatening neutropenia (1.5%) with a serum PB concentration within or even below the therapeutic range. These patients did not present with clinical symptoms other than those related to epileptic episodes. Cats who received combination therapy showed lower hematocrits than those who received monotherapy. A tendency for leukocytes and neutrophils to decrease during PB treatment was also seen.

CONCLUSIONS

Blood cytopenias may frequently occur in cats on chronic PB therapy, even when serum drug levels are within the therapeutic range. However, clinical signs are typically mild to moderate and rarely severe.

A rare finding of double Barr bodies and X-monosomy/X-trisomy mosaicism in a dog with presumed idiopathic epilepsy

A 4-year-old spayed female Border Collie dog presented to the Neurology and Neurosurgery service for an approximately five-month history of seizures. A complete neurodiagnostic workup was performed and did not reveal any significant abnormalities. The patient's seizures were well controlled with a combination of anticonvulsants. During a manual blood smear review at a follow-up appointment, double Barr bodies were identified in segmented neutrophils. Karyotyping revealed that the patient is mosaic for X-monosomy and X-trisomy, a finding that has never been reported in a dog and is rarely reported in people. This case demonstrates how the identification of abnormal neutrophil nuclear appendages may correlate with chromosomal abnormalities in dogs.

The efficacy and safety of cannabidiol as adjunct treatment for drug-resistant idiopathic epilepsy in 51 dogs: A double-blinded crossover study

BACKGROUND

Approximately 30% of dogs with idiopathic epilepsy (IE) are drug-resistant. Recent studies have suggested cannabidiol (CBD) may be an effective anticonvulsant in dogs with IE.

OBJECTIVE

To evaluate the addition of CBD to antiseizure drugs (ASDs) on seizure frequency and to report adverse events in dogs with drug-resistant IE.

ANIMALS

Fifty-one dogs. Dogs having at least 2 seizures per month while receiving at least 1 ASD were included in the trial.

METHODS

Double-blinded placebo-controlled crossover study. The 5 mg/kg/day dosage met futility requirements after 12 dogs, and a dosage of 9 mg/kg/day was used in the next 39 dogs. Dogs were randomly assigned to receive CBD or placebo for 3 months, with a 1-month washout period between oils. Total numbers of seizures and seizure days were recorded. Diagnostic testing was performed periodically throughout the trial.

RESULTS

At the 9 mg/kg/day dose, the decrease in total seizure frequency was significant compared with placebo. A 24.1% decrease in seizure days occurred in dogs receiving CBD and a 5.8% increase occurred in dogs receiving placebo (P ≤ .05). No significant difference was found in the number of responders (≥50% decrease in total seizures or seizure days). Liver enzyme activities increased at both dosages. Decreased appetite and vomiting were more common in the CBD phase (P ≤ .05).

CONCLUSIONS AND CLINICAL IMPORTANCE

Cannabidiol decreased total seizures and seizure days compared to placebo when administered to dogs PO at 9 mg/kg/day. Liver enzymes should be monitored with administration of CBD in dogs.

Long-term outcome of epileptic dogs treated with implantable vagus nerve stimulators

BACKGROUND

The long-term effect of implantable vagus nerve stimulators (VNS) on seizures has not been evaluated in epileptic dogs.

OBJECTIVES

Report seizure frequency in medication-resistant epileptic dogs before and after VNS implantation.

ANIMALS

Twelve client-owned dogs with idiopathic epilepsy and >1 seizure day per 3 weeks despite 3 months of appropriate use of 2 antiseizure medications and seizure diaries maintained 6 months before and >12 months after VNS implantation.

METHODS

Uncontrolled, open-label, before and after study. Mean monthly seizures and inter-seizure periods obtained from contemporaneous seizure diaries in the 6 months before implantation were compared with 0 to 6 months, 7 to 12 months, and subsequent 12-month periods after implantation. The number of dogs with >50% decrease in seizure frequency, >3 times increase in inter-ictal period interval, and seizure freedom for >3 months at the time of death or last follow-up were recorded.

RESULTS

Five of 12 dogs were euthanized <12 months after implantation. All 7 remaining dogs showed >50% decrease in seizure frequency until last follow-up, starting at a median of 37 to 48 months after implantation (range, 0-6 to 61-72 months) and a >3-fold increase in mean inter-seizure interval starting a median of 25 to 36 months after implantation (range, 0-6 months to 49-60 months), 3/7 dogs were seizure-free at death or last follow-up.

CONCLUSIONS AND CLINICAL IMPORTANCE

Monthly seizure frequencies decreased and inter-seizure intervals increased in all dogs 2 to 3 years after VNS implantation, but a high proportion were euthanized before this time point. Prospective clinical trials are required to establish causality and the magnitude of this association.

Outcome and quality of life after intracranial meningioma surgery in cats

OBJECTIVES

The present study aimed to evaluate the postoperative quality of life (QOL) after surgery for the treatment of intracranial meningioma in cats.

METHODS

The study included 14 cases that underwent craniotomy from May 2009 to March 2021. Owners were contacted via telephone after a median time of 967 (range 227-4209) days after surgery and surveyed with a specially designed questionnaire that consisted of three domains, subdivided into different items. Physical behaviour, including general condition, food intake, mobility and overall impression, was evaluated from 0, reflecting the worst status, to 10, reflecting the best. The development of preoperative existing clinical signs, seizures and concurrent medication were evaluated individually for each patient. The time span necessary for the improvement of each item was recorded. Finally, satisfaction about the decision for surgery was ranked from 0 to 10.

RESULTS

Thirteen questionnaires were completed. Three cats were evaluated twice owing to revision surgery. Owners reported a statistically significant (P <0.001) improvement from immediately after the operation to 240 days after surgery. Preoperative clinical signs resolved in 95% of cases. All questioned owners would opt for surgery again.

CONCLUSIONS AND RELEVANCE

QOL after surgery for intracranial meningioma in cats seems encouraging regarding our study. Nevertheless, limitations, such as small sample size, recall bias, lack of a control group and validation of the questionnaire, need to be kept in mind when interpreting the results.

Diagnostic utility of serum bile acids in dogs presenting with epileptic seizures consistent with a tier 1 confidence level diagnosis of idiopathic epilepsy

BACKGROUND

The International Veterinary Epilepsy Task Force consensus guidelines recommend performing fasting serum bile acid (SBA) and/or serum ammonia measurements as part of a tier 1 diagnosis of idiopathic epilepsy in dogs. The aim of this retrospective study was to determine the diagnostic utility of fasting SBA in this population.

METHODS

Dogs that met the tier 1 confidence level diagnosis of idiopathic epilepsy, with the additional requirement of both fasting and 2-hour postprandial SBA measurements, were included. The incidence of significant hepatopathies and usefulness of dynamic SBA testing and minimum database results were analysed.

RESULTS

A total of 233 dogs were included. All dogs diagnosed with clinically significant hepatopathy had elevations in postprandial SBA, with eight of 14 (57.14%) showing elevations in fasting SBA. The prevalence of clinically significant hepatopathies that could have been missed without using postprandial SBA measurement was 1.29%.

LIMITATIONS

The further investigations performed were not uniform and there were limitations in the ability to control sampling techniques due to the retrospective nature of this study. Investigations into hepatopathy were not standardised across this study population.

CONCLUSIONS

This study documents the importance of postprandial SBA measurements in the detection of hepatopathies and reveals that non-dynamic blood sampling has a negative predictive value of 91% for detecting elevated postprandial SBA, specific to dogs meeting the tier 1 confidence level diagnosis of idiopathic epilepsy.

Efficacy evaluation of a commercially available MCT enriched therapeutic diet on dogs with idiopathic epilepsy treated with zonisamide: a prospective, randomized, double-blinded, placebo-controlled, crossover dietary preliminary study

BACKGROUND

Idiopathic epilepsy (IE) is a common, chronic brain dysfunction in dogs. Recently, the effect of feeding a diet enriched with medium-chain triglycerides (MCTs) on seizure frequency has been evaluated in several studies in dogs with IE. However, most dogs with IE in previous studies were treated with phenobarbital as the main antiseizure medication (ASM). In Japan, zonisamide (ZNS) is the most prescribed ASM for dogs with IE. The interaction between ZNS and various nutrients including MCTs and the potential effects on treatment efficacy resulting from combining these therapies have not been previously studied. A prospective, randomized, double-blinded, placebo-controlled, crossover dietary study was conducted. Dogs (n = 7) treated with ZNS were fed either a placebo diet (PL) or Purina ProPlan Veterinary Diet NeuroCare (NC) for 3 months, after which treatments were crossed over and continued for another 3 months. Seizure frequency (seizures/month; sz/m), blood tests including concentrations of ZNS and β-hydroxybutyric acid, and owner's visual analogue scale score were collected from all dogs for both treatment periods.

RESULTS

There was no significant difference in the seizure frequency between PL (2.95 ± 0.80 sz/m) and NC (1.90 ± 0.57 sz/m) during the 6 months of trial. Three of 7 dogs showed ≥ 50% seizure reduction, and 1 of those 3 dogs achieved seizure freedom in NC period. However, 2 of 7 dogs had no changes in epileptic seizure frequency, 2 of 7 dogs had a deterioration in seizure frequency in the NC period. Feeding the MCT diet concurrent with ZNS showed no apparent adverse effects and did not affect ZNS concentration.

CONCLUSIONS

This study indicated that the commercially available MCT-enriched diet (NC) can be safely used concurrently with ZNS for dogs with IE.

Once-a-day oral treatment with phenobarbital in cats with presumptive idiopathic epilepsy

OBJECTIVES

Phenobarbital (PB) q12h is the most common treatment recommendation for cats with recurrent epileptic seizures. Medicating cats may be challenging and result in decreased quality of life for both cat and owner. The aim of this retrospective study was to evaluate treatment with oral PB q24h in cats with presumptive idiopathic epilepsy.

METHODS

Nine cats with presumptive idiopathic epilepsy, receiving oral PB q24h, were included in a retrospective descriptive study.

RESULTS

Seizure remission was achieved in 88% (8/9) of the cats and good seizure control in 12% (1/9) of the cats, treated with a mean dose of oral PB of 2.6 mg/kg q24h (range 1.4-3.8 mg/kg). No cats required an increase of their PB frequency at any time during a mean follow-up period of 3.5 years (range 1.1-8.0 years). No cats displayed side effects or issues with compliance at the last recorded follow-up.

CONCLUSIONS AND RELEVANCE

Once-a-day administration of PB for feline epilepsy was safe and resulted in satisfactory seizure control for the nine cats included in this study. The results of this study justify exploring this topic further in larger prospective studies.

Flumazenil Treatment for Diazepam-Associated Neurological Signs in a Cat With a Portosystemic Shunt

A 7-month-old female spayed domestic short hair cat was presented for evaluation of inadequate clinical response to medical management for hepatic encephalopathy (HE). An abdominal computed tomography (CT) was to be performed but the cat developed 2 grand mal seizures shortly after presentation. Minimal handling and no drugs had been administered before the seizures. A single dose of diazepam (0.3 mg/kg, IV) was administered after each seizure. Another seizure occurred 24 hours after hospitalization and diazepam (0.5 mg/kg, IV) was once again administered. Seizures ceased but neurological signs worsened and included head pressing, loss of menace response, and a stuporous mentation. Due to unresponsiveness to treatment that included administration of intravenous fluids, levetiracetam, ampicillin/sulbactam, and retention enemas (water with lactulose), a dose of flumazenil (0.01 mg/kg) was administered IV and resulted in immediate but transient improvement of clinical signs. The stuporous state returned after 60 min post-treatment and an additional dose of IV flumazenil (0.01 mg/kg) was administered with the same outcome. Based on this positive clinical response, IV infusion of flumazenil was initiated at 0.01 mg/kg/h following a loading dose of 0.005 mg/kg. Due to minimal improvement in neurological signs, flumazenil IV infusion was increased gradually until reaching the effective dose of 0.1 mg/kg/h. Flumazenil IV infusion was continued for 24 hours with improvements in neurological signs, which did not return upon gradual decrease of the flumazenil dose. This is the first report describing the use of a flumazenil IV infusion to improve neurological signs in a cat with a PSS and HE treated with diazepam.

Orthotics and prosthetics by 3D-printing: Accelerating its fabrication flow

Orthoses and socket prostheses are rarely used orthopaedic devices in veterinary medicine. Recently, more pet owners have sought these treatments for pets with orthopaedic conditions. However, veterinarians often lack substantial scientific evidence on device outcomes and may expect high costs, the main limiting factor, if human orthopaedic market prices are assumed. This discrepancy creates an imbalance between pet owners' expectations, veterinarians' recommendations, and actual patient benefits. To address economic constraints and enhance knowledge about these devices, this study used 3D technology-namely 3D scanning and printing via fused deposition modelling-to design, modify, and manufacture orthoses and socket prostheses for ten patients, including nine dogs and one calf. An equation was devised and applied to all printed devices to streamline the resizing process for sockets and orthoses. The 3D-printed devices were fitted to the patients, and their adaptation was assessed using three novel scales based on prior scientific literature in the small animal orthopaedic field. The orthoses were well-tolerated, with successful and straightforward adaptation. Although socket prostheses were tolerated, the dogs' adaptation was suboptimal, while the calf demonstrated excellent and immediate adaptation.

The role of neuroinflammation in canine epilepsy

The lack of therapeutics that prevent the development of epilepsy, improve disease prognosis or overcome drug resistance represents an unmet clinical need in veterinary as well as in human medicine. Over the past decade, experimental studies and studies in human epilepsy patients have demonstrated that neuroinflammatory processes are involved in epilepsy development and play a key role in neuronal hyperexcitability that underlies seizure generation. Targeting neuroinflammatory signaling pathways may provide a basis for clinically relevant disease-modification strategies in general, and moreover, could open up new therapeutic avenues for human and veterinary patients with drug-resistant epilepsy. A sound understanding of the neuroinflammatory mechanisms underlying seizure pathogenesis in canine patients is therefore essential for mechanism-based discovery of selective epilepsy therapies that may enable the development of new disease-modifying treatments. In particular, subgroups of canine patients in urgent needs, e.g. dogs with drug-resistant epilepsy, might benefit from more intensive research in this area. Moreover, canine epilepsy shares remarkable similarities in etiology, disease manifestation, and disease progression with human epilepsy. Thus, canine epilepsy is discussed as a translational model for the human disease and epileptic dogs could provide a complementary species for the evaluation of antiepileptic and antiseizure drugs. This review reports key preclinical and clinical findings from experimental research and human medicine supporting the role of neuroinflammation in the pathogenesis of epilepsy. Moreover, the article provides an overview of the current state of knowledge regarding neuroinflammatory processes in canine epilepsy emphasizing the urgent need for further research in this specific field. It also highlights possible functional impact, translational potential and future perspectives of targeting specific inflammatory pathways as disease-modifying and multi-target treatment options for canine epilepsy.