Abstract 130: Induced Neural Stem Cell Treated Stroke Pigs Show Improved White Matter Integrity and Brain Metabolism Post-ischemic Stroke

Recent studies in rodent stroke models have shown that induced pluripotent stem cell derived neural stem cells (iNSCs) can lead to a significant decrease in lesion size, immune response and improvement in functional deficits. These improvements are linked to the iNSC potential dual mode of action as they can perform as a cell replacement therapy and produce neuroprotective and regenerative signaling. These results are promising yet the vast majority of therapies developed in rodent stroke models have failed to translate in clinical trials; suggesting that iNSC therapy should be tested in a more human like model such as the pig. We hypothesize that iNSC treatment will lead to improved white matter integrity, brain metabolism and cerebral blood flow (CBF) as determined by magnetic resonance imaging and spectroscopy (MRI and MRS) in stroked pigs. Eight male landrace pigs underwent middle cerebral artery occlusion stroke surgery. After 5 days, 4 pigs received iNSCs intraparenchymal injections and 4 pigs received vehicle only injections. Pigs underwent MRI and MRS assessment at 24 hrs post-injury and 1, 4 and 12 wks post-injection. MRI results at 24 hrs showed that all pigs had an ischemic stroke. At 1 wk post-injection, fractional anisotropy measurements of white matter integrity showed the affected side of the brain was 71% and 52% of normal, non-treated and treated respectively. At 12 wks, iNSC treated pigs showed a significant improvement in FA at 93% of normal, while non-treated pigs showed no improvement. MRS results demonstrated a significant decrease in NAA, Cr and Cho at 1 wk post-injection in treated and non-treated pigs. However, treated pigs showed a significant improvement in NAA, Cr and Cho at 12 wks post-injection, while non-treated pigs showed no improvement. At 12 wks, ischemic tissue in iNSC treated pigs had trending increases in CBF, while non-treated pigs showed no improvement. These results demonstrated that iNSC treated stroke pigs show improved white matter integrity, brain metabolism and CBF post-ischemic stroke and that iNSCs may one day be a viable clinical option for human stroke patients.

Abstract TP109: Quantitative Gait Analysis Demonstrates Significant Changes in Motor Function Post-ischemic Stroke and Simulated Intraparenchymal Therapeutic Delivery in a Porcine Model

Severity of stroke and subsequent recovery can be measured through gait changes of affected individuals. Recent failures of therapies tested in rodents to support safety and efficacy in human clinical trials has led to the development of a novel porcine ischemic stroke model with more comparable brain anatomy and physiology. Assessment of motor function changes is essential for determining the feasibility of the pig stroke model, the effect of therapies and the potential effects of modes of therapeutic delivery such as intraparenchymal injection. We hypothesized permanent occlusion of the middle cerebral artery (MCA) and the intraparenchymal injection process would lead to significant alterations in motor functions such as increased stride duration and decreased two limb support and stride swing time. Gait data was collected on 3 adult male Landrace pigs at 3 pre-stroke time points. Ischemic stroke was induced by permanent middle cerebral artery occlusion (MCAO) and pigs were evaluated at 1, 3 and 5 days post-stroke. Stride duration increased by >50% and percent swing time and percent two limb support decreased by >30% 1 day post-stroke. Increased stride duration and decreased relative swing time and two limb support phase persisted 3 and 5 days post-stroke. At 5 days post-stroke, pigs received PBS intraparenchymal injections and were recorded at 1 and 3 days and 1, 2, 4, 6, 9 and 12 weeks post-injection. Stride duration significantly increased between 5 days post-stroke and 1 day post-injection demonstrating injection had a negative effect on motor function. All other parameters showed no significant changes between 5 days post-stroke and 1 day post-injection. Despite significant changes in gait parameters at early time points post-stroke, by 12 weeks post-injection, pigs showed spontaneous recovery with no detectable changes in motor function as compared to pre-stoke time points. Collectively, these results demonstrate MCAO stroke and intraparenchymal injection led to gait impairments and show that gait analysis is a highly sensitive method to detect changes in motor function.

A Placebo-Controlled, Prospective, Randomized Clinical Trial of Polyethylene Glycol and Methylprednisolone Sodium Succinate in Dogs with Intervertebral Disk Herniation

BACKGROUND

Acute intervertebral disk herniation (IVDH) is a common cause of spinal cord injury in dogs and currently there is no proven medical treatment to counter secondary injury effects. Use of methylprednisolone sodium succinate (MPSS) or polyethylene glycol (PEG) as neuroprotectants is advocated but controversial because neither treatment has been tested in placebo-controlled, randomized, blinded trials in dogs.

HYPOTHESIS

Polyethylene glycol will improve the outcome of severe spinal cord injury caused by IVDH compared to MPSS or placebo.

ANIMALS

Client-owned dogs with acute onset of thoracolumbar IVDH causing paralysis and loss of nociception for <24 hours.

METHODS

Dogs were randomized to receive MPSS, PEG, or placebo; drugs appeared identical and group allocation was masked. Drug administration was initiated once the diagnosis of IVDH was confirmed and all dogs underwent hemilaminectomy. Neurologic function was assessed 2, 4, 8, and 12 weeks postoperatively using an open field gait score (OFS) as the primary outcome measure. Outcomes were compared by the Wilcoxon rank sum test.

RESULTS

Sixty-three dogs were recruited and 47.6% recovered ambulation. 17.5% developed progressive myelomalacia but there was no association with group. There was no difference in OFS among groups. Although full study power was not reached, conditional power analyses indicated the futility of continued case recruitment.

CONCLUSIONS

This clinical trial did not show a benefit of either MPSS or PEG in the treatment of acute, severe thoracolumbar IVDH when used as adjunctive medical treatment administered to dogs presenting within 24 hours of onset of paralysis.

IMAGING DIAGNOSIS-VERTEBRAL POLYOSTOTIC LYMPHOMA IN A GERIATRIC DOG

A 9-year-old spayed female Scottish terrier presented with an 8-day history of progressive paraparesis. Neurological examination suggested a painful T3-L3 myelopathy. Multifocal uniform contrast-enhancing masses involving the vertebral bodies, pedicles, laminae, and spinous processes of two vertebrae and compressing the spinal cord were present on MRI. Fluoroscopic-guided fine needle aspiration of one of the vertebral lesions revealed a predominantly lymphoblastic population of cells compatible with a diagnosis of lymphoma. To the authors' knowledge, this represents the first published case of canine lymphoma with vertebral involvement, characterized with MRI.

Denervation of the Tensor Veli Palatini Muscle and Effusion in the Tympanic Cavity

An English springer spaniel was presented for right-sided atrophy of the muscles of mastication, analgesia and paralysis of the face, and vestibular dysfunction. Neurological signs were consistent with a lesion involving the pons and rostral medulla resulting in deficits in the function of the trigeminal, facial, and vestibular nerves. MRI disclosed a right-sided extraparenchymal mass consistent with a trigeminal nerve sheath neoplasm that was compressing and invading the pons and medulla. Atrophy of the muscles of mastication, innervated by the trigeminal nerve, was also observed on MRI. Additionally, effusion was present in the ipsilateral tympanic cavity. Gross and microscopic evaluation of the right tensor veli palatini muscle (TVPM) was consistent with neurogenic atrophy. Effusion in the tympanic cavity was likely the result of an inability to open the auditory tube as a consequence of paralysis of the TVPM. Without the ability to open the auditory tube, gases present within the auditory tube and tympanic cavity may be absorbed, creating a negative pressure environment that leads to fluid transudation and effusion build up. To the authors' knowledge, this is the first report to document neurogenic atrophy of the TVPM with concurrent effusion in the ipsilateral tympanic cavity.

Correlation of diffusion tensor imaging parameters in the canine brain

The goal of this study was to determine the degree to which ex vivo diffusion tensor imaging (DTI) parameters correlate to one another in white matter regions on very high resolution MR scans. Specifically, we hypothesized that radial diffusivity (RD) and apparent diffusion coefficient (ADC) would correlate more closely than either would correlate with fractional anisotropy (FA). We performed post mortem DTI imaging on three canine brains on a 7 T MR scanner (TR = 100 ms, NEX = 1, gradient amplitude = 600 mT/m, b = 1492-1,565 s/mm²) and generated maps of FA, RD, and ADC. We measured RD, FA and ADC within 14 regions of interest representative of various portions of white matter. We compared the three combinations of values, i.e., FA vs ADC, FA vs RD and ADC vs RD, using linear regression models. Linear regression demonstrated that RD was significantly correlated with FA (p << 0.01; R² = 0.3053) and also with ADC (p << 0.01; R² = 0.6755), but to a much greater degree. However, ADC was not significantly correlated with FA (p = 0.526; R² = 0.101). Our findings suggest that both RD and ADC reflect similar cytoarchitectural features, most likely that of myelination, whereas FA values likely reflect both myelination and additional microstructural features that constrain the diffusion of water in white matter.

Evaluation of nanoparticle delivered cisplatin in beagles

Intracranial neoplasia is a significant cause of morbidity and mortality in both human and veterinary patients, and is difficult to treat with traditional therapeutic methods. Cisplatin is a platinum (Pt)-containing chemotherapeutic agent approved by the Food and Drug Administration; however, substantial limitations exist for its application in canine brain tumor treatment due to the difficulty in crossing the blood-brain barrier (BBB), development of resistance, and toxicity. A modified Pt(iv)-prodrug of cisplatin, Platin-M, was recently shown to be deliverable to the brain via a biocompatible mitochondria-targeted lipophilic polymeric nanoparticle (NP) that carries the drug across the BBB and to the mitochondria. NP mediated controlled release of Platin-M and subsequent reduction of this prodrug to cisplatin allowed cross-links to be formed with the mitochondrial DNA, which have no nucleotide excision repair system, forcing the overactive cancer cells to undergo apoptosis. Here, we report in vitro effects of targeted Platin-M NPs (T-Platin-M-NPs) in canine glioma and glioblastoma cell lines with results indicating that this targeted NP formulation is more effective than cisplatin. In both the cell lines, T-Platin-M-NP was significantly more efficacious compared to carboplatin, another Pt-based chemotherapy, which is used in the settings of recurrent high-grade glioblastoma. Mitochondrial stress analysis indicated that T-Platin-M-NP is more effective in disrupting the mitochondrial bioenergetics in both the cell types. A 14-day distribution study in healthy adult beagles using a single intravenous injection at 0.5 mg kg(-1) (with respect to Platin-M) of T-Platin-M-NPs showed high levels of Pt accumulation in the brain, with negligible amounts in the other analyzed organs. Safety studies in the beagles monitoring physical, hematological, and serum chemistry evaluations were within the normal limits on days 1, 7, and 14 after injection of either 0.5 mg kg(-1) or 2 mg kg(-1) or 2.2 mg kg(-1) (with respect to Platin-M) of T-Platin-M-NPs. At all doses over the 14-day period, no neurotoxicity was observed based upon periodic neurological examinations and cerebrospinal fluid analysis. These studies demonstrated the translational nature of T-Platin-M-NPs for applications in the treatment of brain tumors.

Differential Host Immune Responses after Infection with Wild-Type or Lab-Attenuated Rabies Viruses in Dogs

METHODOLOGY/PRINCIPAL FINDINGS

The experimental infection of dogs with TriGAS induced high levels of VNA in the serum, whereas wt RABV infection did not. Dogs infected with TriGAS developed antibodies against the virus including its glycoprotein, whereas dogs infected with DRV-NG11 only developed rabies antibodies that are presumably specific for the nucleoprotein, (N) and not the glycoprotein (G). We show that infection with TriGAS induces early activation of B cells in the draining lymph nodes and persistent activation of DCs and B cells in the blood. On the other hand, infection with DRV-NG11 fails to induce the activation of DCs and B cells and further reduces CD4 T cell production. Further, we show that intrathecal (IT) immunization of TriGAS not only induced high levels of VNA in the serum but also in the CSF while intramuscular (IM) immunization of TriGAS induced VNA only in the serum. In addition, high levels of total protein and WBC were detected in the CSF of IT immunized dogs, indicating the transient enhancement of blood-brain barrier (BBB) permeability, which is relevant to the passage of immune effectors from periphery into the CNS.

CONCLUSIONS/SIGNIFICANCE

IM infection of dogs with TriGAS induced the production of serum VNA whereas, IT immunization of TriGAS in dogs induces high levels of VNA in the periphery as well as in the CSF and transiently enhances BBB permeability. In contrast, infection with wt DRV-NG11 resulted in the production of RABV-reactive antibodies but VNA and antibodies specific for G were absent. As a consequence, all of the dogs infected with wt DRV-NG11 succumbed to rabies. Thus the failure to activate protective immunity is one of the important features of RABV pathogenesis in dogs.

An additional middle cuneiform?

Additional cuneiform bones of the foot have been described in reference to the medial bipartite cuneiform or as small accessory ossicles. An additional middle cuneiform has not been previously documented. We present the case of a patient with an additional ossicle that has the appearance and location of an additional middle cuneiform. Recognizing such an anatomical anomaly is essential for ruling out second metatarsal base or middle cuneiform fractures and for the preoperative planning of arthrodesis or open reduction and internal fixation procedures in this anatomical location.

Pharmacokinetic evaluation of immediate- and extended-release formulations of levetiracetam in dogs

OBJECTIVE

To compare the pharmacokinetics of various formulations of levetiracetam after oral administration of a single dose to healthy dogs.

ANIMALS

6 neurologically normal mixed-breed dogs.

PROCEDURES

A crossover study design was used. Blood samples for serum harvest were collected from each dog before and at various points after oral administration of one 500-mg tablet of each of 2 generic extended-release (ER) formulations, 1 brand-name ER formulation, or 1 brand-name immediate-release (IR) formulation of levetiracetam. Serum samples were analyzed to determine pharmacokinetic properties of each formulation by means of ultra-high-performance liquid chromatography with tandem mass spectrometry.

RESULTS

No dogs had clinically important adverse effects for any formulation of levetiracetam. All ER formulations had a significantly lower maximum serum drug concentration and longer time to achieve that concentration than did the IR formulation. Half-lives and elimination rate constants did not differ significantly among formulations. Values for area under the drug concentration-versus-time curve did not differ significantly between ER formulations and the IR formulation; however, 1 generic ER formulation had a significantly lower area under the curve than did other ER formulations.

CONCLUSIONS AND CLINICAL RELEVANCE

All ER formulations of levetiracetam had similar pharmacokinetic properties in healthy dogs, with some exceptions. Studies will be needed to evaluate the clinical efficacy of the various formulations; however, findings suggested that twice-daily administration of ER formulations may be efficacious in the treatment of seizures in dogs.

Ischemic stroke in Greyhounds: 21 cases (2007-2013)

OBJECTIVE

To determine the prevalence of ischemic stroke in Greyhounds and determine whether affected dogs had coagulation abnormalities and hypertension.

DESIGN

Multi-institutional, retrospective study.

ANIMALS

21 dogs.

PROCEDURES

Medical records (including diagnostic testing results) and MRI images of the brain were reviewed for Greyhounds with ischemic stroke that had been evaluated at 4 institutions. The proportion of Greyhounds with ischemic stroke was compared with the proportion of non-Greyhound dogs with ischemic stroke. Demographic information for dogs evaluated at each institution was obtained to determine the proportion of Greyhounds in the hospital populations.

RESULTS

21 Greyhounds with ischemic stroke were identified. Abnormalities in coagulation were not identified in the 14 Greyhounds that underwent such testing. Systemic hypertension was identified in 6 of 14 Greyhounds that underwent such testing. No other abnormalities were identified by means of other routine diagnostic tests for Greyhounds. For all institutions combined, the prevalence of ischemic stroke in Greyhounds was 0.66% (21/3,161 Greyhounds). Greyhounds were significantly more likely to be evaluated because of ischemic stroke, compared with all other dog breeds combined (OR, 6.6; 95% confidence interval, 4.2 to 10.2).

CONCLUSIONS AND CLINICAL RELEVANCE

Results of this study suggested that Greyhounds were predisposed to ischemic stroke, compared with all other breeds combined. Coagulation abnormalities did not seem to contribute to ischemic stroke. Hypertension may have contributed to the development of ischemic stroke. Greyhounds with ischemic stroke should undergo measurement of systolic arterial blood pressure. Antihypertensive treatments may be warranted for such dogs.

Psychological factors and personality traits associated with patients in chronic foot and ankle pain

BACKGROUND

The impact of psychosocial factors and personality traits in chronic pain is well established. However, there has been limited literature analyzing the influence of psychological issues in chronic foot and ankle pain. The aim of our study was to identify the association of certain psychosocial factors and personality traits in individuals with chronic painful foot and ankle disorders.

METHODS

Patients with chronic foot and ankle pain were recruited from the specialist foot and ankle clinic. The Eysenck Personality Questionnaire-Revised (EPQ-R), Dysfunctional Attitude Scale (DAS), and Hospital Anxiety Depression (HAD) scale were administered in the form of questionnaires. An age- and sex-matched cohort of healthy volunteers served as the control group. Sample size was determined after power calculation, and a total of 90 participants were recruited with informed consent with 45 participants in each arm. Results were analyzed and statistical analyses were performed using SPSS.

RESULTS

Patients with chronic foot and ankle pain had significantly higher neuroticism scores than the control group (P < .05). The study also revealed greater prevalence of anxiety and depression in patients with chronic pain (P < .05).

CONCLUSION

The study showed a significant association of anxiety, depression, and neuroticism in patients presenting with chronic foot and ankle pain. Clinicians should recognize the influence of these specific psychological issues to provide a more holistic approach to the clinical problem.

LEVEL OF EVIDENCE

Level III, case control study.

Chiari-like malformation and syringomyelia in American Brussels Griffon dogs

Background

Although Chiari‐like malformation (CM) and syringomyelia (SM) have been described in many small breed dogs, the prevalence and clinical manifestations of this complex have not been documented in a large cohort of American Brussels Griffon (ABG) dogs.

Objectives

To characterize the clinical and magnetic resonance imaging (MRI) features of CM and SM in the ABG breed.

Animals

Eighty‐four American Kennel Club registered ABG dogs were recruited.

Methods

Prospective study. Complete histories and neurologic examinations were obtained before MRI. Images were blindly reviewed and calculations were made by using OsiriX. All analyses were performed by Student's t‐test, Spearman's correlation, ANOVA, and chi‐square test where appropriate.

Results

Chiari‐like malformation and SM were present in 65% and 52% of dogs, respectively. Twenty‐eight percent of dogs had neurologic deficits and 20% had neck pain. Mean central canal (CC) transverse height was 2.5 mm with a mean length of 3.6 cervical vertebrae. Neurologic deficits were significantly associated with a larger syrinx (P = .04, P = .08) and syrinx size increased with age (P = .027). SM was associated with a smaller craniocervical junction (CCJ) height (P = .04) and larger ventricles (P = .0001; P < .001).

Conclusions and Clinical Importance

Syringomyelia and CM are prevalent in American Brussels Griffon dogs. Syrinx size is associated with neurologic deficits, CM, larger ventricles, a smaller craniocervical junction height, neurologic deficits, and cerebellar herniation. Fifty‐two percent of dogs with a SM were clinically normal.

Extramedullary spinal cysts in dogs

OBJECTIVE

To (1) synthesize the terminology used to classify extramedullary spinal cysts in dogs to clarify some of the commonly reported misconceptions, and (2) propose a classification scheme to limit confusion with terminology.

STUDY DESIGN

Literature review.

METHODS

An online bibliographic search was performed in January 2013 for articles relating to extramedullary spinal cysts in dogs using PubMed (http://www.pubmed.gov/) and Google Scholar (http://scholar.google.com/) databases. Only peer-reviewed clinical literature describing cystic lesions pertaining to the spinal cord and associated structures was included.

RESULTS

From 1962 to 2013, 42 articles were identified; 25 (95 dogs) reported meningeal cysts, 10 (24 dogs) described 60 extradural cysts, 3 reports (18 dogs) described discal cysts or acute compressive hydrated nucleus pulposus extrusions (HNPE). Spinal cysts were categorized by location based on cross-sectional imaging as meningeal or extradural non-meningeal. Sub-classification was then performed based on surgical findings and pathology. Meningeal cysts included arachnoid diverticulae and Tarlov (perineural) cysts. Extradural non-meningeal cysts included intraspinal cysts of the vertebral joints, ligaments and discs. Discal cysts also fit this category and have been reported extensively in humans but appear rare in dogs.

CONCLUSIONS

Extramedullary spinal cysts should be first classified according to location with a sub-classification according to pathologic and surgical findings. Previous canine cases of discal cysts appear to represent a different disease entity and the term acute compressive HNPE is therefore preferred.

Development and characterization of a Yucatan miniature biomedical pig permanent middle cerebral artery occlusion stroke model

BACKGROUND

Efforts to develop stroke treatments have met with limited success despite an intense need to produce novel treatments. The failed translation of many of these therapies in clinical trials has lead to a close examination of the therapeutic development process. One of the major factors believed to be limiting effective screening of these treatments is the absence of an animal model more predictive of human responses to treatments. The pig may potentially fill this gap with a gyrencephalic brain that is larger in size with a more similar gray-white matter composition to humans than traditional stroke animal models. In this study we develop and characterize a novel pig middle cerebral artery occlusion (MCAO) ischemic stroke model.

METHODS

Eleven male pigs underwent MCAO surgery with the first 4 landrace pigs utilized to optimize stroke procedure and 7 additional Yucatan stroked pigs studied over a 90 day period. MRI analysis was done at 24 hrs and 90 days and included T2w, T2w FLAIR, T1w FLAIR and DWI sequences and associated ADC maps. Pigs were sacrificed at 90 days and underwent gross and microscopic histological evaluation. Significance in quantitative changes was determined by two-way analysis of variance and post-hoc Tukey's Pair-Wise comparisons.

RESULTS

MRI analysis of animals that underwent MCAO surgery at 24 hrs had hyperintense regions in T2w and DWI images with corresponding ADC maps having hypointense regions indicating cytotoxic edema consistent with an ischemic stroke. At 90 days, region of interest analysis of T1 FLAIR and ADC maps had an average lesion size of 59.17 cc, a loss of 8% brain matter. Histological examination of pig brains showed atrophy and loss of tissue, consistent with MRI, as well as glial scar formation and macrophage infiltration.

CONCLUSIONS

The MCAO procedure led to significant and consistent strokes with high survivability. These results suggest that the pig model is potentially a robust system for the study of stroke pathophysiology and potential diagnostics and therapeutics.

Quantitative analysis of Chiari-like malformation and syringomyelia in the Griffon Bruxellois dog

This study aimed to develop a system of quantitative analysis of canine Chiari-like malformation and syringomyelia on variable quality MRI. We made a series of measurements from magnetic resonance DICOM images from Griffon Bruxellois dogs with and without Chiari-like malformation and syringomyelia and identified several significant variables. We found that in the Griffon Bruxellois dog, Chiari-like malformation is characterized by an apparent shortening of the entire cranial base and possibly by increased proximity of the atlas to the occiput. As a compensatory change, there appears to be an increased height of the rostral cranial cavity with lengthening of the dorsal cranial vault and considerable reorganization of the brain parenchyma including ventral deviation of the olfactory bulbs and rostral invagination of the cerebellum under the occipital lobes.

Evaluation of standard magnetic resonance characteristics used to differentiate neoplastic, inflammatory, and vascular brain lesions in dogs

Magnetic resonance (MR) imaging characteristics are commonly used to help predict intracranial disease categories in dogs, however, few large studies have objectively evaluated these characteristics. The purpose of this retrospective study was to evaluate MR characteristics that have been used to differentiate neoplastic, inflammatory, and vascular intracranial diseases in a large, multi-institutional population of dogs. Medical records from three veterinary teaching hospitals were searched over a 6-year period for dogs that had diagnostic quality brain MR scans and histologically confirmed intracranial disease. Three examiners who were unaware of histologic diagnosis independently evaluated 19 MR lesion characteristics totaling 57 possible responses. A total of 75 dogs with histologically confirmed intracranial disease were included in analyses: 51 with neoplasia, 18 with inflammatory disease, and six with cerebrovascular disease. Only strong contrast enhancement was more common in neoplasia than other disease categories. A multivariable statistical model suggested that extra-axial origin, T2-FLAIR mixed intensity, and defined lesion margins were also predictive of neoplasia. Meningeal enhancement, irregular lesion shape, and multifocal location distinguished inflammatory diseases from the other disease categories. No MR characteristics distinguished vascular lesions and these appeared most similar to neoplasia. These results differed from a previous report describing seven MR characteristics that were predictive of neoplasia in dogs and cats. Findings from the current study indicated that the high performance of MR for diagnosing canine intracranial diseases might be due to evaluator recognition of combinations of MR characteristics vs. relying on any one MR characteristic alone.

Gait analysis in a pre- and post-ischemic stroke biomedical pig model

Severity of neural injury including stroke in human patients, as well as recovery from injury, can be assessed through changes in gait patterns of affected individuals. Similar quantification of motor function deficits has been measured in rodent animal models of such injuries. However, due to differences in fundamental structure of human and rodent brains, there is a need to develop a large animal model to facilitate treatment development for neurological conditions. Porcine brain structure is similar to that of humans, and therefore the pig may make a more clinically relevant animal model. The current study was undertaken to determine key gait characteristics in normal biomedical miniature pigs and dynamic changes that occur post-neural injury in a porcine middle cerebral artery (MCA) occlusion ischemic stroke model. Yucatan miniature pigs were trained to walk through a semi-circular track and were recorded with high speed cameras to detect changes in key gait parameters. Analysis of normal pigs showed overall symmetry in hindlimb swing and stance times, forelimb stance time, along with step length, step velocity, and maximum hoof height on both fore and hindlimbs. A subset of pigs were again recorded at 7, 5 and 3 days prior to MCA occlusion and then at 1, 3, 5, 7, 14 and 30 days following surgery. MRI analysis showed that MCA occlusion resulted in significant infarction. Gait analysis indicated that stroke resulted in notable asymmetries in both temporal and spatial variables. Pigs exhibited lower maximum front hoof height on the paretic side, as well as shorter swing time and longer stance time on the paretic hindlimb. These results support that gait analysis of stroke injury is a highly sensitive detection method for changes in gait parameters in pig.

Clinicopathologic and MRI Characteristics of Presumptive Hypertensive Encephalopathy in Two Cats and Two Dogs

Two dogs and two cats were evaluated for the acute-onset of abnormal mentation, recumbency, and blindness. All cases had systemic hypertension, ranging from 180 mm Hg to 260 mm Hg. MRI of the brain disclosed noncontrast-enhancing, ill-defined, T2-weighted (T2W) hyperintensities in the white matter of the cerebrum in the areas of the frontal, parietal, temporal, and occipital lobes. Lesions were also observed in the caudate nuclei and thalamus (n = 1 in each). Intracranial hemorrhage was observed in one animal. Diffusion-weighted imaging (DWI) was consistent with vasogenic edema in two animals. Retinal lesions were observed in three animals. Hypertension was secondary to renal disease in three animals. A primary underlying disorder was not identified in one animal. Normalization of blood pressure was achieved with amlodipine either alone or in combination with enalapril. In one cat, hypertension spontaneously resolved. In three cases, neurologic improvement occurred within 24–48 hr of normalization of blood pressure. The presumptive diagnosis of hypertensive encephalopathy was supported by the MRI findings and neurologic dysfunction coincident with systemic hypertension in which the neurologic dysfunction improved with treatment of hypertension. The prognosis appears good for the resolution of neurologic deficits with normalization of blood pressure in animals with hypertensive encephalopathy.

Effect of treatment with simvastatin and cyclosporine on neurotransmitter concentrations in cerebrospinal fluid after subarachnoid hemorrhage in dogs

OBJECTIVE

To measure concentrations of glutamate, aspartate, γ-aminobutyric acid (GABA), and glycine in CSF of dogs with experimentally induced subarachnoid hemorrhage (SAH) and to assess effects of cyclosporine and simvastatin on these concentrations.

SAMPLE

CSF samples from 13 dogs.

PROCEDURES

In a previous study, SAH was induced in dogs via 2 injections of autologous blood into the cerebellomedullary cistern 24 hours apart. Dogs were untreated (control; n = 5) or received simvastatin alone (4) or simvastatin in combination with cyclosporine (4). Samples of CSF were collected before the first blood injection (baseline; time 0), before the second blood injection, and on days 3, 7, and 10. For the study reported here, neurotransmitter concentrations in CSF were analyzed via high-performance liquid chromatography. Data were analyzed with a repeated-measures model with adjustments for multiple comparisons by use of the Tukey method.

RESULTS

In control dogs, the glutamate concentration peaked on day 3 and there was a significant increase in GABA and glutamate concentrations. Glutamate concentrations were significantly lower and glycine concentrations significantly higher on day 3 after administration of simvastatin alone or simvastatin in combination with cyclosporine, compared with concentrations for the control group. No significant differences in GABA and aspartate concentrations were detected among treatment groups at any time point.

CONCLUSIONS AND CLINICAL RELEVANCE

Glutamate concentrations were increased in the CSF of dogs with SAH. Simvastatin administration attenuated high glutamate concentrations. A combination of immunosuppression and upregulation of nitric oxide synthase may be useful in lowering high glutamate concentrations in ischemic CNS conditions.

Comparison of concentrations of γ-aminobutyric acid and glutamate in cerebrospinal fluid of dogs with idiopathic epilepsy with and without seizure-related magnetic resonance imaging hyperintense areas in the limbic system

OBJECTIVE

To investigate differences in CSF concentrations of excitatory and inhibitory neurotransmitters in dogs with and without T2-weighted (T2W) MRI hyperintense areas in the limbic system.

SAMPLE

Archived CSF samples and stored brain MRI images of 5 healthy research dogs (group 1), 8 dogs with idiopathic epilepsy (IE) with no abnormal MRI findings (group 2), and 4 dogs with IE with hyperintense areas in the limbic system detected by means of T2W MRI (group 3).

PROCEDURES

Archived CSF samples and stored MRI images obtained from all dogs were evaluated. Dogs in groups 2 and 3 were matched on the basis of age and breed. High-performance liquid chromatography was used to evaluate glutamate and γ-aminobutyric acid (GABA) concentrations in CSF samples.

RESULTS

Glutamate concentrations were higher in CSF of both groups of dogs with IE than in healthy dogs. However, glutamate concentrations in CSF were not significantly higher in dogs with IE and with hyperintense areas than in dogs with IE but no abnormal MRI findings. Concentrations of GABA in CSF were higher in group 3 than in group 2 and in group 2 than in group 1.

CONCLUSIONS AND CLINICAL RELEVANCE

No significant difference was evident between glutamate concentrations in CSF of dogs with IE and with and without hyperintense areas detected by means of T2W MRI. However, glutamate concentrations typically were higher in CSF of dogs with IE and MRI hyperintense areas. Future studies with larger sample sizes should be conducted to confirm this finding and to determine the clinical importance of high glutamate concentrations in CSF of dogs with IE.

Prevalence of effusion in the tympanic cavity in dogs with dysfunction of the trigeminal nerve: 18 cases (2004-2013)

BACKGROUND

Animals with disorders involving the trigeminal nerve or its nuclei in the brainstem can have effusion in the tympanic cavity ipsilateral to the side of the neurological deficits. The tensor veli palatini muscle (TVP), innervated by the mandibular branch of the trigeminal nerve, opens the pharyngeal orifice of the auditory tube. With denervation of the TVP, dysfunction of the auditory tube may occur, which could lead to effusion.

HYPOTHESIS/OBJECTIVES

To determine the prevalence of effusion in the tympanic cavity in dogs with disorders involving the trigeminal nerve.

ANIMALS

Eighteen client-owned dogs were evaluated retrospectively.

METHODS

Retrospective study.

RESULTS

Diagnostic imaging databases were searched for dogs having undergone magnetic resonance imaging (MRI) evaluation for signs referable to dysfunction of the trigeminal nerve. Signalment and neurological examination findings were recorded. The MRI study was evaluated for the presence or absence of effusion. MRI characteristics of the affected trigeminal nerve and the muscles of mastication were recorded. Based on the location of the trigeminal nerve lesion, dogs were divided into three categories: brainstem, trigeminal canal, or extracranial. Eighteen dogs met the inclusion criteria. Six of 18 dogs (33%) had effusion in the tympanic cavity ipsilateral to the affected trigeminal nerve.

CONCLUSION AND CLINICAL IMPORTANCE

A substantial proportion of dogs with a lesion affecting the trigeminal nerve had effusion in the tympanic cavity. This finding likely represents denervation of the TVP muscle, which may have led to dysfunction of the auditory tube.