1
|
Green S, Olby N. Levetiracetam-responsive paroxysmal exertional dyskinesia in a Welsh Terrier. J Vet Intern Med 2021; 35:1093-1097. [PMID: 33638219 PMCID: PMC7995356 DOI: 10.1111/jvim.16068] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 01/28/2021] [Accepted: 02/04/2021] [Indexed: 01/12/2023] Open
Abstract
A 5-and-a-half-year old, 9-kg, spayed, female Welsh Terrier presented with a 12 month history of paroxysmal exertion-induced dyskinesia (PED) characterized by recurrent episodes of involuntary hyperkinetic movements, abnormal muscle tone, and contractions triggered by exercise. A single episode occurred within 2 hours after exercise, lasted from 7 to 10 minutes, and resolved without treatment. The owner sought treatment for the dog when the episodes began to last longer (20-30 minutes), and occurred as long as 2.5 to 8 hours after exercise. Diazepam administered intranasally at the start of an episode promptly alleviated the symptoms. Maintenance therapy with levetiracetam proved effective, such that the dog was gradually returned to exercise. However, attempts to wean the dog off the drug resulted in reoccurrence. Although the pathophysiology of PED is not fully understood, the clinical presentation and the positive response to antiepileptic therapy highlight the overlap between disease pathways in epilepsy and PED in dogs.
Collapse
Affiliation(s)
- Sherril Green
- Stanford University ‐ Comparative MedicineStanfordCaliforniaUSA
| | - Natasha Olby
- North Carolina State University ‐ College of Veterinary MedicineRaleighNorth CarolinaUSA
| |
Collapse
|
2
|
Packer RA, Wachowiak I, Thomovsky SA, Berg J, Vasquez L, O'Brien DP. Phenotypic characterization of PIGN-associated paroxysmal dyskinesia in Soft-coated wheaten terriers and preliminary response to acetazolamide therapy. Vet J 2021; 269:105606. [PMID: 33593494 DOI: 10.1016/j.tvjl.2021.105606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 12/30/2020] [Accepted: 12/31/2020] [Indexed: 10/22/2022]
Abstract
A hereditary movement disorder in Soft coated wheaten terriers (SCWT) has been associated with a mutation in PIGN which encodes an enzyme involved in synthesis of glycosylphosphatidylinositol (GPI). The objective of this study was to describe and classify the clinical phenotype and assess therapeutic response. Twenty-five SCWT and related dogs homozygous for PIGN:c.398C>T with paroxysmal dyskinesia were available for inclusion. Medical records and video recordings of 17 dogs were evaluated in a retrospective case series. Affected dogs had episodes of involuntary, hyperkinetic movements and dystonia. Median age of onset was 2.5 years. A typical episode consisted of rapid, irregular hyperflexion and extension of the pelvic limbs with some degree of truncal dystonia. A mild episode consisted of spontaneous flexion of one pelvic limb while walking which could resemble a lameness. Episodes lasted several minutes to several hours and occurred up to 10 times/day or more. They were not associated with exercise or fasting but were sometimes triggered by excitement or stress. Acetazolamide therapy improved nine of 11 dogs, in seven cases abolishing episodes. Five of 17 dogs treated with other agents had mild improvement with clonazepam (n = 2), levetiracetam (n = 1), or phenobarbital (n = 2). Paroxysmal dyskinesias must be differentiated from seizure disorders since they often respond to different therapies. The SCWT phenotype consisted predominantly of hyperkinesia, and can respond dramatically to acetazolamide. GPI anchors proteins to the cell surface including carbonic anhydrase IV which modulates synaptic pH in the brain. Altered activity of this enzyme may be the target of acetazolamide therapy.
Collapse
Affiliation(s)
- R A Packer
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.
| | - I Wachowiak
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - S A Thomovsky
- Department of Veterinary Clinical Sciences, Purdue University College of Veterinary Medicine, West Lafayette, Indiana, USA
| | - J Berg
- Animal Specialty Center, Yonkers, New York, USA
| | - L Vasquez
- Gulf Coast Veterinary Neurology and Neurosurgery, Houston, Texas, USA
| | - D P O'Brien
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA
| |
Collapse
|
3
|
Gagliardo T, Ruggeri R, Di Paola A, Baroni M, Cherubini GB, Gallucci A, Falzone C, Trimboli S, Albul A, Gandini G. Clinical features of muscle cramp in 14 dogs. J Vet Intern Med 2021; 35:372-377. [PMID: 33247617 PMCID: PMC7848340 DOI: 10.1111/jvim.15965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 10/30/2020] [Accepted: 11/05/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Muscle cramps (MCs) are prolonged, involuntary, painful muscle contractions characterized by an acute onset and short duration, caused by peripheral nerve hyperactivity. OBJECTIVES To provide a detailed description of the clinical features and diagnostic findings in dogs affected by MCs. ANIMALS Fourteen dogs. METHODS Multicenter retrospective case series. Cases were recruited by a call to veterinary neurologists working in referral practices. Medical records and videotapes were searched for dogs showing MCs. The follow-up was obtained by telephone communication with the owner and the referring veterinarian. RESULTS Three patterns of presentation were identified depending on the number of affected limbs and presence/absence of migration of MCs to other limbs. In 9/14 (64%) of dogs, MCs were triggered by prompting the dogs to move. 8/14 (58%) dogs were overtly painful with 6/14 (42%) showing mild discomfort. The cause of MCs was hypocalcemia in 11/14 (79%) dogs: 9 dogs were affected by primary hypoparathyrodism, 1 dog by intestinal lymphoma and 1 dog by protein losing enteropathy. In 3/14 cases (21%) the cause was not identified, and all 3 dogs were German Shepherds. CONCLUSIONS AND CLINICAL IMPORTANCE Muscle cramps can manifest in 1 of 3 clinical patterns. Muscle cramps are elicited when dogs are encouraged to move and do not always appear as painful events, showing in some cases only discomfort. The main cause of MCs in this study was hypocalcemia consequent to primary hypoparathyroidism. In dogs having MCs of unknown etiology, idiopathic disease or paroxysmal dyskinesia could not be ruled out.
Collapse
Affiliation(s)
- Teresa Gagliardo
- Department of Veterinary Medical SciencesUniversity of BolognaBolognaItaly
| | - Roberta Ruggeri
- Department of Veterinary Medical SciencesUniversity of BolognaBolognaItaly
| | - Andrea Di Paola
- Department of Veterinary Medical SciencesUniversity of BolognaBolognaItaly
| | - Massimo Baroni
- Clinica Veterinaria Valdinievole Monsummano TermePistoiaItaly
| | - Giunio B. Cherubini
- Department of Neurology and NeurosurgeryDick White ReferralsSix Mile BottomUnited Kingdom
| | | | | | | | - Andrey Albul
- Veterinary Hospital of Neurology, Traumatology and Intensive CareSaint‐PetersburgRussia
| | - Gualtiero Gandini
- Department of Veterinary Medical SciencesUniversity of BolognaBolognaItaly
| |
Collapse
|
4
|
Johnston L, Leister E, Singer L. Severe metabolic acidosis due to acetazolamide intoxication in a dog. Aust Vet J 2020; 99:11-14. [PMID: 33025586 DOI: 10.1111/avj.13027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 09/22/2020] [Accepted: 09/22/2020] [Indexed: 12/01/2022]
Abstract
CASE REPORT This case report describes the clinical signs and case management of a 1-year-old neutered male Siberian Husky that accidentally ingested 635 mg/kg of oral acetazolamide (a carbonic anhydrase inhibitor). The dog presented with severe tachypnoea due to the development of hyperchloraemic metabolic acidosis and associated hypokalaemia that persisted for 7 days. Clinical and biochemical changes resolved with intravenous and subsequent oral supplementation of sodium bicarbonate and potassium. Complete recovery occurred within 9 days of presentation. CONCLUSION To the authors' knowledge, this is the first case that reports overdosage of an oral carbonic anhydrase inhibitor in a dog and subsequent recovery with adequate supplementation and supportive care.
Collapse
Affiliation(s)
- L Johnston
- Internal Medicine, Veterinary Specialist Services, Eastlake Street, Carrara, Queensland, 4211, Australia
| | - E Leister
- Emergency and Critical care, Pet ICU, Lexington Road, Underwood, Queensland, 4119, Australia
| | - L Singer
- Internal Medicine, Veterinary Specialist Services, Eastlake Street, Carrara, Queensland, 4211, Australia
| |
Collapse
|
5
|
Nessler J, Hug P, Mandigers PJJ, Leegwater PAJ, Jagannathan V, Das AM, Rosati M, Matiasek K, Sewell AC, Kornberg M, Hoffmann M, Wolf P, Fischer A, Tipold A, Leeb T. Mitochondrial PCK2 Missense Variant in Shetland Sheepdogs with Paroxysmal Exercise-Induced Dyskinesia (PED). Genes (Basel) 2020; 11:genes11070774. [PMID: 32660061 PMCID: PMC7397061 DOI: 10.3390/genes11070774] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/07/2020] [Accepted: 07/08/2020] [Indexed: 01/08/2023] Open
Abstract
Four female Shetland Sheepdogs with hypertonic paroxysmal dyskinesia, mainly triggered by exercise and stress, were investigated in a retrospective multi-center investigation aiming to characterize the clinical phenotype and its underlying molecular etiology. Three dogs were closely related and their pedigree suggested autosomal dominant inheritance. Laboratory diagnostic findings included mild lactic acidosis and lactaturia, mild intermittent serum creatine kinase (CK) elevation and hypoglycemia. Electrophysiological tests and magnetic resonance imaging of the brain were unremarkable. A muscle/nerve biopsy revealed a mild type II fiber predominant muscle atrophy. While treatment with phenobarbital, diazepam or levetiracetam did not alter the clinical course, treatment with a gluten-free, home-made fresh meat diet in three dogs or a tryptophan-rich, gluten-free, seafood-based diet, stress-reduction, and acetazolamide or zonisamide in the fourth dog correlated with a partial reduction in, or even a complete absence of, dystonic episodes. The genomes of two cases were sequenced and compared to 654 control genomes. The analysis revealed a case-specific missense variant, c.1658G>A or p.Arg553Gln, in the PCK2 gene encoding the mitochondrial phosphoenolpyruvate carboxykinase 2. Sanger sequencing confirmed that all four cases carried the mutant allele in a heterozygous state. The mutant allele was not found in 117 Shetland Sheepdog controls and more than 500 additionally genotyped dogs from various other breeds. The p.Arg553Gln substitution affects a highly conserved residue in close proximity to the GTP-binding site of PCK2. Taken together, we describe a new form of paroxysmal exercise-induced dyskinesia (PED) in dogs. The genetic findings suggest that PCK2:p.Arg553Gln should be further investigated as putative candidate causal variant.
Collapse
Affiliation(s)
- Jasmin Nessler
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover Foundation, 30559 Hannover, Germany; (J.N.); (A.T.)
| | - Petra Hug
- Institute of Genetics, Vetsuisse Faculty, University of Bern, 3001 Bern, Switzerland; (P.H.); (V.J.)
| | - Paul J. J. Mandigers
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, 3584 CM Utrecht, The Netherlands; (P.J.J.M.); (P.A.J.L.)
| | - Peter A. J. Leegwater
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, 3584 CM Utrecht, The Netherlands; (P.J.J.M.); (P.A.J.L.)
| | - Vidhya Jagannathan
- Institute of Genetics, Vetsuisse Faculty, University of Bern, 3001 Bern, Switzerland; (P.H.); (V.J.)
| | - Anibh M. Das
- Department of Pediatrics, Hannover Medical School, 30625 Hannover, Germany;
| | - Marco Rosati
- Section of Clinical and Comparative Neuropathology, Institute of Veterinary Pathology at the Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-Universität, 80539 Munich, Germany; (M.R.); (K.M.)
| | - Kaspar Matiasek
- Section of Clinical and Comparative Neuropathology, Institute of Veterinary Pathology at the Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-Universität, 80539 Munich, Germany; (M.R.); (K.M.)
| | - Adrian C. Sewell
- Biocontrol, Labor für Veterinärmedizinische Diagnostik, 55218 Ingelheim, Germany;
| | | | | | - Petra Wolf
- Nutritional Physiology and Animal Nutrition, University of Rostock, 18059 Rostock, Germany;
| | - Andrea Fischer
- Section of Neurology, Clinic of Small Animal Medicine, Ludwig-Maximilians-Universität, 80539 Munich, Germany;
| | - Andrea Tipold
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover Foundation, 30559 Hannover, Germany; (J.N.); (A.T.)
| | - Tosso Leeb
- Institute of Genetics, Vetsuisse Faculty, University of Bern, 3001 Bern, Switzerland; (P.H.); (V.J.)
- Correspondence: ; Tel.: +41-316-312-326
| |
Collapse
|
6
|
Polidoro D, Van Ham L, Santens P, Cornelis I, Charalambous M, Broeckx BJG, Bhatti SFM. Phenotypic characterization of paroxysmal dyskinesia in Maltese dogs. J Vet Intern Med 2020; 34:1541-1546. [PMID: 32415795 PMCID: PMC7379016 DOI: 10.1111/jvim.15804] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 04/22/2020] [Accepted: 05/01/2020] [Indexed: 01/03/2023] Open
Abstract
Background Paroxysmal dyskinesias (PDs) are a group of central nervous system diseases characterized by episodes of abnormal involuntary hyperkinetic movement without altered consciousness that increasingly have been recognized in dogs. Objectives To present the phenotypical characterization, treatment, and outcome of a PD observed in Maltese dogs. Animals Client‐owned Maltese dogs (n = 19) with presumed diagnosis of PD. Methods Data were collected retrospectively from medical records (2014‐2019), and supporting information was added prospectively by using a questionnaire directed to the owners of the affected dogs. Results The episodes were characterized mainly by sudden dystonia of ≥1 limbs and generalized body tremors with preserved consciousness. The mean age of clinical onset was 5.4 years. Episode frequency varied widely both among and within individuals. Median episode duration was 4.5 minutes. Most episodes were stress‐ or exercise‐induced. Acetazolamide was administered to 6 dogs, and 4 dogs experienced a decrease in episode frequency. In 7 dogs that received a gluten‐free diet, 6 dogs became episode‐free. In 4 dogs, the episodes stopped spontaneously and in 2 dogs no medication or specific diet was given and the episodes continued at the same frequency. Conclusions and Clinical Importance Given the breed predisposition and regional distribution of the disease, additional research should focus on elucidating the underlying genetic cause doing so might advance both our understanding of the pathophysiology and treatment of this disease, not only in dogs, but also in humans. Regardless of the treatment protocol selected, prognosis appears fair to good.
Collapse
Affiliation(s)
- Dakir Polidoro
- Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Luc Van Ham
- Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Patrick Santens
- Department of Neurology, Faculty of Medicine and Health Sciences, Ghent University Hospital, Ghent, Belgium
| | - Ine Cornelis
- Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Marios Charalambous
- Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Bart J G Broeckx
- Laboratory of Animal Genetics, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Sofie F M Bhatti
- Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| |
Collapse
|
7
|
Stee K, Van Poucke M, Peelman L, Lowrie M. Paradoxical pseudomyotonia in English Springer and Cocker Spaniels. J Vet Intern Med 2019; 34:253-257. [PMID: 31729100 PMCID: PMC6979413 DOI: 10.1111/jvim.15660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 10/28/2019] [Indexed: 12/30/2022] Open
Abstract
Background Paramyotonia congenita and Brody disease are well‐described conditions in humans, characterized by exercise‐induced myotonic‐like muscle stiffness. A syndrome similar to Brody disease has been reported in cattle. Reports of a similar syndrome in dogs are scarce. Objectives To define and describe the clinical, diagnostic, and genetic features and disease course of paradoxical pseudomyotonia in Spaniel dogs. Animals Seven client‐owned dogs (4 English Springer Spaniels and 3 English Cocker Spaniels) with clinically confirmed episodes of exercise‐induced generalized myotonic‐like muscle stiffness. Methods Sequential case study. Results All dogs were <24 months of age at onset. The episodes of myotonic‐like generalized muscle stiffness always occurred with exercise, and spontaneously resolved with rest in <45 seconds in all but 1 dog. Extreme outside temperatures seemed to considerably worsen episode frequency and severity in most dogs. Complete blood count, serum biochemistry including electrolytes, urinalysis, brain magnetic resonance imaging, cerebrospinal fluid analysis, electromyography, motor nerve conduction velocity, ECG, and echocardiography were unremarkable. Muscle biopsy samples showed moderate but nonspecific muscle atrophy. The episodes seemed to remain stable or decrease in severity and frequency in 6/7 dogs, and often could be decreased or prevented by avoiding the episode triggers. The underlying genetic cause is not identified yet, because no disease‐causing variants could be found in the coding sequence or splice sites of the 2 major candidate genes, SCN4A and ATP2A1. Conclusions and Clinical Importance Paradoxical pseudomyotonia is a disease affecting Spaniels. It is of variable severity but benign in most cases.
Collapse
Affiliation(s)
| | - Mario Van Poucke
- Department of Nutrition, Genetics and Ethology, Ghent University, Merelbeke, Belgium
| | - Luc Peelman
- Department of Nutrition, Genetics and Ethology, Ghent University, Merelbeke, Belgium
| | - Mark Lowrie
- Dovecote Veterinary Hospital, Derby, United Kingdom
| |
Collapse
|
8
|
Santifort KM, Lowrie M. Paroxysmal non‐kinesigenic dyskinesia characterised by dystonia in a crossbred dog. VETERINARY RECORD CASE REPORTS 2017. [DOI: 10.1136/vetreccr-2017-000429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
9
|
Kolicheski AL, Johnson GS, Mhlanga-Mutangadura T, Taylor JF, Schnabel RD, Kinoshita T, Murakami Y, O'Brien DP. A homozygous PIGN missense mutation in Soft-Coated Wheaten Terriers with a canine paroxysmal dyskinesia. Neurogenetics 2017; 18:39-47. [PMID: 27891564 PMCID: PMC5243907 DOI: 10.1007/s10048-016-0502-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 11/13/2016] [Indexed: 12/26/2022]
Abstract
Hereditary paroxysmal dyskinesias (PxD) are a heterogeneous group of movement disorders classified by frequency, duration, and triggers of the episodes. A young-adult onset canine PxD has segregated as an autosomal recessive trait in Soft-Coated Wheaten Terriers. The medical records and videos of episodes from 25 affected dogs were reviewed. The episodes of hyperkinesia and dystonia lasted from several minutes to several hours and could occur as often as >10/day. They were not associated with strenuous exercise or fasting but were sometimes triggered by excitement. The canine PxD phenotype most closely resembled paroxysmal non-kinesigenic dyskinesia (PNKD) of humans. Whole genome sequences were generated with DNA from 2 affected dogs and analyzed in comparison to 100 control canid whole genome sequences. The two whole genome sequences from dogs with PxD had a rare homozygous PIGN:c.398C > T transition, which predicted the substitution of an isoleucine for a highly conserved threonine in the encoded enzyme. All 25 PxD-affected dogs were PIGN:c.398T allele homozygotes, whereas there were no c.398T homozygotes among 1185 genotyped dogs without known histories of PxD. PIGN encodes an enzyme involved in the biosynthesis of glycosylphosphatidylinositol (GPI), which anchors a variety of proteins including CD59 to the cell surface. Flow cytometry of PIGN-knockout HEK239 cells expressing recombinant human PIGN with the c.398T variant showed reduced CD59 expression. Mutations in human PIGN have been associated with multiple congenital anomalies-hypotonia-seizures syndrome-1 (MCAHS1). Movement disorders can be a part of MCAHS1, but this is the first PxD associated with altered GPI anchor function.
Collapse
Affiliation(s)
- Ana L Kolicheski
- Department of Veterinary Pathobiology, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
| | - Gary S Johnson
- Department of Veterinary Pathobiology, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
| | - Tendai Mhlanga-Mutangadura
- Department of Veterinary Pathobiology, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
| | - Jeremy F Taylor
- Division of Animal Sciences, College of Agriculture, Food and Natural Resources, University of Missouri, Columbia, MO, USA
| | - Robert D Schnabel
- Division of Animal Sciences, College of Agriculture, Food and Natural Resources, University of Missouri, Columbia, MO, USA
- Informatics Institute, University of Missouri, Columbia, MO, USA
| | - Taroh Kinoshita
- Department of Immunoregulation, Research Institute for Microbial Diseases, and Laboratory of Immunoglycobiology, WPI Immunology Frontier Research Center, Osaka University, Osaka, Japan
| | - Yoshiko Murakami
- Department of Immunoregulation, Research Institute for Microbial Diseases, and Laboratory of Immunoglycobiology, WPI Immunology Frontier Research Center, Osaka University, Osaka, Japan
| | - Dennis P O'Brien
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO, 65211, USA.
| |
Collapse
|
10
|
De Risio L, Forman OP, Mellersh CS, Freeman J. Paroxysmal Dyskinesia in Norwich Terrier Dogs. Mov Disord Clin Pract 2016; 3:573-579. [PMID: 30838250 DOI: 10.1002/mdc3.12334] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 12/29/2015] [Accepted: 01/09/2016] [Indexed: 12/26/2022] Open
Abstract
Background Episodic muscular hypertonicity in Norwich terrier dogs was first reported in a brief communication in 1984. Since then, the condition has remained poorly characterized. Objectives The aims of this study were to characterize the phenomenology, clinical course, and family history of paroxysmal dyskinesia in the Norwich terrier and to estimate its prevalence in the United Kingdom. Methods The owners of Norwich terrier dogs born since January 1, 2000 were invited to complete a specifically designed questionnaire aimed at identifying affected and unaffected dogs and investigating the clinical characteristics of this paroxysmal dyskinesia. Pedigrees were collected and reviewed. Results The questionnaire was returned for 198 Norwich terrier dogs. Of these, 26 (13%) were classified as affected by paroxysmal dyskinesia after revision of the questionnaires and after obtaining videos of the episodes, veterinary medical records, and telephone interviews with the owners. All dogs were neurologically normal between episodes. No significant abnormalities were detected on diagnostic investigations. Mean age at the first episode was 3 years. The episodes were characterized by sustained muscular hypertonicity in the pelvic limbs, lumbar region, and thoracic limbs, impairing posture and locomotion without loss of consciousness. Episode frequency varied both between and within individuals. Stress, anxiety, excitement, and variation in daily routine were recognized as episode triggers in 13 dogs. Episode duration generally was from 2 to 5 minutes (range, from < 2 to 30 minutes). The majority of affected dogs were related. Conclusions Paroxysmal dyskinesia segregates in an extended pedigree of Norwich terrier dogs and thus is potentially an inherited disorder in this breed.
Collapse
Affiliation(s)
- Luisa De Risio
- Neurology/Neurosurgery Unit Center for Small Animal Studies Animal Health Trust Lanwades Park, Kentford, Newmarket Suffolk United Kingdom
| | - Oliver P Forman
- Kennel Club Genetics Center Animal Health Trust Newmarket Suffolk United Kingdom
| | - Cathryn S Mellersh
- Kennel Club Genetics Center Animal Health Trust Newmarket Suffolk United Kingdom
| | - Julia Freeman
- Neurology/Neurosurgery Unit Center for Small Animal Studies Animal Health Trust Lanwades Park, Kentford, Newmarket Suffolk United Kingdom
| |
Collapse
|
11
|
Lowrie M, Garosi L. Classification of involuntary movements in dogs: Tremors and twitches. Vet J 2016; 214:109-16. [PMID: 27387736 DOI: 10.1016/j.tvjl.2016.05.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 04/25/2016] [Accepted: 05/17/2016] [Indexed: 10/21/2022]
Abstract
This review focuses on important new findings in the field of involuntary movements (IM) in dogs and illustrates the importance of developing a clear classification tool for diagnosing tremor and twitches. Developments over the last decade have changed our understanding of IM and highlight several caveats in the current tremor classification. Given the ambiguous association between tremor phenomenology and tremor aetiology, a more cautious definition of tremors based on clinical assessment is required. An algorithm for the characterisation of tremors is presented herein. The classification of tremors is based on the distinction between tremors that occur at rest and tremors that are action-related; tremors associated with action are divided into postural or kinetic. Controversial issues are outlined and thus reflect the open questions that are yet to be answered from an evidence base of peer-reviewed published literature. Peripheral nerve hyper-excitability (PNH; cramps and twitches) may manifest as fasciculations, myokymia, neuromyotonia, cramps, tetany and tetanus. It is anticipated that as we learn more about the aetiology and pathogenesis of IMs, future revisions to the classification will be needed. It is therefore the intent of this work to stimulate discussions and thus contribute to the development of IM research.
Collapse
Affiliation(s)
- Mark Lowrie
- Dovecote Veterinary Hospital, 5 Delven Lane, Castle Donington, Derby DE74 2LJ, UK.
| | - Laurent Garosi
- Davies Veterinary Specialists, Manor Farm Business Park, Higham Gobion, Hitchin SG5 3HR, UK
| |
Collapse
|
12
|
Royaux E, Bhatti S, Harvey R, Garosi L, Shelton GD, Van Ham L. Acetazolamide-responsive paroxysmal dyskinesia in a 12-week-old female golden retriever dog. Vet Q 2015; 36:45-9. [DOI: 10.1080/01652176.2015.1123822] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|
13
|
Richter A, Hamann M, Wissel J, Volk HA. Dystonia and Paroxysmal Dyskinesias: Under-Recognized Movement Disorders in Domestic Animals? A Comparison with Human Dystonia/Paroxysmal Dyskinesias. Front Vet Sci 2015; 2:65. [PMID: 26664992 PMCID: PMC4672229 DOI: 10.3389/fvets.2015.00065] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 11/13/2015] [Indexed: 12/17/2022] Open
Abstract
Dystonia is defined as a neurological syndrome characterized by involuntary sustained or intermittent muscle contractions causing twisting, often repetitive movements, and postures. Paroxysmal dyskinesias are episodic movement disorders encompassing dystonia, chorea, athetosis, and ballism in conscious individuals. Several decades of research have enhanced the understanding of the etiology of human dystonia and dyskinesias that are associated with dystonia, but the pathophysiology remains largely unknown. The spontaneous occurrence of hereditary dystonia and paroxysmal dyskinesia is well documented in rodents used as animal models in basic dystonia research. Several hyperkinetic movement disorders, described in dogs, horses and cattle, show similarities to these human movement disorders. Although dystonia is regarded as the third most common movement disorder in humans, it is often misdiagnosed because of the heterogeneity of etiology and clinical presentation. Since these conditions are poorly known in veterinary practice, their prevalence may be underestimated in veterinary medicine. In order to attract attention to these movement disorders, i.e., dystonia and paroxysmal dyskinesias associated with dystonia, and to enhance interest in translational research, this review gives a brief overview of the current literature regarding dystonia/paroxysmal dyskinesia in humans and summarizes similar hereditary movement disorders reported in domestic animals.
Collapse
Affiliation(s)
- Angelika Richter
- Faculty of Veterinary Medicine, Institute of Pharmacology, Pharmacy and Toxicology, University of Leipzig, Leipzig, Germany
| | - Melanie Hamann
- Department of Veterinary Medicine, Institute of Pharmacology and Toxicology, Free University Berlin, Berlin, Germany
| | - Jörg Wissel
- Department of Neurological Rehabilitation and Physical Therapy, Vivantes Hospital Spandau and Humboldt Hospital, Berlin, Germany
- Department of Neurology, Vivantes Hospital Spandau and Humboldt Hospital, Berlin, Germany
| | - Holger A. Volk
- Clinical Science and Services, The Royal Veterinary College, Hatfield, UK
| |
Collapse
|
14
|
Marioni-Henry K, Rusbridge C, Volk HA. Clinical Features in Border Terrier Dogs with Paroxysmal Involuntary Movements. Mov Disord Clin Pract 2015; 3:73-79. [PMID: 30713898 DOI: 10.1002/mdc3.12232] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 07/01/2015] [Accepted: 07/07/2015] [Indexed: 11/06/2022] Open
Abstract
Background There have been anecdotal reports of episodic involuntary movements in the Border Terrier dog breed for over a decade. Recently, it has been hypothesized that this condition may be a form of paroxysmal dystonic choreoathetosis. The aim of this study was to characterize the phenomenology and clinical course of this condition and compare it to known human movement disorders. Methods Data were collected retrospectively from clinical cases treated by veterinary neurologists and additional information was collected prospectively with an ad-hoc online survey directed to owners of affected dogs. Results The episodes are characterized by generalized dystonia, tremors, titubation, and, in some cases, autonomic signs, such as salivation and vomiting. The median age at onset of the episodes was 3 years and the interval between clusters of episodes could last several months. Most of the episodes occurred from rest, and 67% of the owners reported that the episodes were associated with a trigger, most often excitement. Some owners reported an improvement after changing their dog's diet. We hypothesize that the Border Terrier attacks represent a form of paroxysmal nonkinesigenic dyskinesia. Conclusions The finding of a dystonia phenotype within an inbred population suggests a genetic predisposition, and elucidating the genetic cause could facilitate improved understanding of dystonia. This genetic predisposition and the effect of treatment with anticonvulsant drugs and dietary changes on the severity of the paroxysms warrant further investigation on this condition.
Collapse
Affiliation(s)
- Katia Marioni-Henry
- Royal (Dick) School of Veterinary Studies Hospital for Small Animals, Veterinary Center The University of Edinburgh Roslin United Kingdom
| | - Clare Rusbridge
- Fitzpatrick Referrals Godalming United Kingdom.,School of Veterinary Medicine Faculty of Health & Medical Sciences University of Surrey Guildford United Kingdom
| | - Holger A Volk
- Department of Clinical Science and Services Royal Veterinary College Hatfield United Kingdom
| |
Collapse
|
15
|
Urkasemsin G, Olby NJ. Clinical characteristics of Scottie Cramp in 31 cases. J Small Anim Pract 2015; 56:276-80. [PMID: 25599802 DOI: 10.1111/jsap.12317] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 10/10/2014] [Accepted: 11/26/2014] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To report the clinical features, with response to therapy and long-term outcome of Scottie Cramp as described by owners. METHODS Owners of affected dogs provided a description of clinical signs, age of onset and disease progression. Medical records, pedigrees and videotapes of cramp episodes were evaluated. RESULTS Thirty-one dogs were recruited; 19 showed generalised spasticity and 12 exhibited only hind limb spasticity and skipping. Episodes were noted in the first year of life in 76% of dogs and were triggered by excitement, stress and exercise. Episode frequency and severity decreased over time with behaviour modification and decreased exposure to triggers playing a role in their development. One dog was euthanased because of severe refractory signs. Fluoxetine reduced the frequency and duration of episodes in seven dogs, but not in one severely affected dog. Female dogs were over-represented with only eight affected males in the study cohort, and the presence of dogs with cerebellar degeneration in the same pedigrees may suggest a more complex mode of inheritance than previously reported. CLINICAL SIGNIFICANCE The disorder recognised as Scottie Cramp by dog owners includes dogs with hind limb spasticity in addition to generalised cramping. Signs usually improve over time without specific treatment.
Collapse
Affiliation(s)
- G Urkasemsin
- Department of Clinical Sciences, College of Veterinary, Medicine, North Carolina State University, Raleigh, NC, 27607, USA
| | | |
Collapse
|
16
|
Abstract
Paroxysmal dyskinesias are episodic movement disorders characterized by muscle hypertonicity that can produce involuntary movements. Signs emanate from the central nervous system; consciousness is not impaired, ictal electroencephalography is normal, and there are no autonomic signs, distinguishing them from seizure disorders. In humans they are classified into 3 groups, each responding to different therapies. A mutation in the gene for brevican (BCAN) has been identified as the cause of Episodic Falling in Cavalier King Charles spaniels. Further elucidation of the genetic causes will enhance our ability to identify and treat these canine diseases.
Collapse
Affiliation(s)
- Ganokon Urkasemsin
- Department of Pre-Clinic and Applied Animal Science, Faculty of Veterinary Science, Mahidol University, 999 Phuttamonthon Sai 4 Road, Salaya, Phuttamonthon, Nakhon Pathom 73170, Thailand
| | - Natasha J Olby
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC 27607, USA.
| |
Collapse
|
17
|
Park HJ, Seo DK, Song KH, Seo KW. Paroxysmal dyskinesia suspected as canine epileptoid cramping syndrome in a young Yorkshire terrier dog. J Vet Med Sci 2014; 76:1129-32. [PMID: 24805907 PMCID: PMC4155193 DOI: 10.1292/jvms.14-0015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A 9-month-old intact female Yorkshire terrier dog was presented with episodic partial seizure-like cramping of the limbs. The patient's episodes began six months previously; the interval between episodes became shorter, and the duration of the episodes increased. Various tests including neurologic examination, blood examination, abdominal radiography, ultrasonographic examination, angiographic computed tomography (CT) and brain magnetic resonance imaging (MRI) detected no remarkable changes. After these tests were conducted, the patient's condition was suspected to be canine epileptoid cramping syndrome (CECS), which could be a form of paroxysmal dyskinesia (PD), and as a trial therapy, Science Diet k/d (Hill's Pet Nutrition, Topeka, KS, U.S.A.) was prescribed. The clinical signs were dramatically reduced after diet therapy, and we diagnosed the patient with CECS. This is the first case report of CECS in a Yorkshire terrier dog.
Collapse
Affiliation(s)
- Hyung-Jin Park
- College of Veterinary Medicine, Chungnam National University, Daejeon 305-764, Republic of Korea
| | | | | | | |
Collapse
|
18
|
Myokymia and neuromyotonia in veterinary medicine: a comparison with peripheral nerve hyperexcitability syndrome in humans. Vet J 2013; 197:153-62. [PMID: 23583699 DOI: 10.1016/j.tvjl.2013.03.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Revised: 01/12/2013] [Accepted: 03/04/2013] [Indexed: 01/17/2023]
Abstract
Involuntary muscle hyperactivity can result from muscle or peripheral nerve hyperexcitability or central nervous system dysfunction. In humans, diseases causing hyperexcitability of peripheral nerves are grouped together under the term 'peripheral nerve hyperexcitability' (PNH). Hyperexcitability of the peripheral motor nerve can result into five different phenotypic main variants, i.e. fasciculations, myokymia, neuromyotonia, cramps and tetany, each with their own clinical and electromyographic characteristics. This review focuses on the most commonly described expressions of PNH in veterinary medicine, i.e. myokymia and neuromyotonia, in particular in young Jack Russell terriers. Data from 58 veterinary cases with generalized myokymia and neuromyotonia were analyzed, including unpublished treatment and follow-up data on eight Jack Russell terriers from a previous study and seven additional Jack Russell terriers. A dysfunction of the potassium channel or its associated proteins has been found in many human syndromes characterized by PNH, in particular in generalized myokymia and neuromyotonia, and is suspected to occur in veterinary medicine. Potential pathomechanisms of potassium channel dysfunction leading to signs of PNH are broad and include genetic mutations, antibody-mediated attack or ion channel maldistribution due to axonal degeneration or demyelination. A more accurate classification of the different PNH syndromes will facilitate a more rapid diagnosis and guide further research into natural occurring PNH in animals.
Collapse
|
19
|
Vanhaesebrouck AE, Shelton GD, Garosi L, Harcourt-Brown TR, Couturier J, Behr S, Harvey RJ, Jeffery ND, Matiasek K, Blakemore WF, Granger N. A novel movement disorder in related male Labrador Retrievers characterized by extreme generalized muscular stiffness. J Vet Intern Med 2011; 25:1089-96. [PMID: 21781161 DOI: 10.1111/j.1939-1676.2011.0757.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES To describe the clinical phenotype of a new motor disorder in Labrador Retrievers. ANIMALS AND METHODS Case series study. Seven young male Labrador Retrievers presented for evaluation of stiff gait. RESULTS All affected dogs had generalized muscular stiffness, persistent at rest and resulting in restricted joint movements. They showed a forward flexed posture, festinating gait, and bradykinesia. Signs developed between 2 and 16 months of age and tended to stabilize in adulthood. Needle electromyogram in the conscious state showed continuous motor unit activity in resting epaxial and proximal limb muscles. This activity was abolished by general anesthesia. Muscle and nerve histopathology was normal. In 2 dogs necropsied, astrocytosis was evident throughout the spinal cord gray matter, reticular formation and caudate nuclei. Decreased neuronal counts were selectively found in the spinal cord Rexed's lamina VII, but not in VIII and IX. Pedigree analysis showed that the affected dogs were from 5 related litters. CONCLUSIONS AND CLINICAL IMPORTANCE This new hypertonicity syndrome in Labrador Retrievers is unique because of the selective distribution of the histological lesions, the lack of progression in adulthood, and its exclusive occurrence in male dogs. Pedigree analysis suggests an X-linked hereditary disease, although other modes of inheritance cannot be ruled out with certainty. We hypothesize that altered output from basal nuclei and reticular formation together with motor neuron disinhibition caused by a decreased number of spinal cord interneurons leads to the muscular stiffness.
Collapse
Affiliation(s)
- A E Vanhaesebrouck
- Department of Veterinary Medicine, The Queen's Veterinary School Hospital, University of Cambridge, Cambridge, UK.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Cisneros LE, Palumbo MIP, Mortari AC, Rahal SC, Resende LAL, Vulcano LC, Borges AS. What is your neurologic diagnosis? Hyperadrenocorticism. J Am Vet Med Assoc 2011; 238:1247-9. [PMID: 21568766 DOI: 10.2460/javma.238.10.1247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Luis E Cisneros
- Department of Reproduction and Veterinary Radiology, UNESP - Univ Estadual Paulista, Rubião Júnior s/n, Botucatu, SP 18618-000, Brazil
| | | | | | | | | | | | | |
Collapse
|