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Espino L, Miño N. Common Neurologic Diseases in Geriatric Dogs. Animals (Basel) 2024; 14:1753. [PMID: 38929372 PMCID: PMC11200570 DOI: 10.3390/ani14121753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 05/28/2024] [Accepted: 06/05/2024] [Indexed: 06/28/2024] Open
Abstract
The increase in the canine geriatric population means that veterinarians are more often confronted with diseases that are more prevalent in patients in this age group. As in other organ systems, degenerative, neoplastic, and vascular diseases are the most prevalent neurologic disorders in older dogs. A neurological disease in an older dog poses a challenge for the clinician due to the presence of concomitant diseases and age-related changes that make it difficult to interpret the neurological examination. In addition, given the age of the patients, some owners do not allow advanced imaging tests, and it is necessary to establish the most likely presumptive diagnosis to initiate treatment. Although many of these diseases can cause clinical signs that can be very upsetting, some of them can be managed with symptomatic therapy and have a good prognosis, such as idiopathic vestibular syndrome. Moreover, advances in and the greater availability of therapeutic options such as surgery and radiation therapy may increase survival and quality of life in diseases with a more serious prognosis, such as tumours. The aim of this review is to summarize the clinical presentation, diagnosis, and treatment of the more frequent diseases affecting the central nervous systems of geriatric dogs.
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Affiliation(s)
- Luciano Espino
- Departamento de Anatomía, Producción Animal y Ciencias Clínicas Veterinarias, Facultad de Veterinaria de Lugo, Universidad de Santiago de Compostela, 27002 Lugo, Spain;
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Al Kafaji T, Tocco F, Okonji S, Gallucci A. Clinical features and outcome of 10 dogs with suspected idiopathic vestibular epilepsy. J Vet Intern Med 2024; 38:1591-1597. [PMID: 38514172 PMCID: PMC11099704 DOI: 10.1111/jvim.17046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 02/29/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND In humans, vestibular epilepsy (VE) is described as focal seizures with transient signs of vestibular disease. In dogs, 2 cases of vestibular episodes, called vestibular paroxysmia, are reported. HYPOTHESIS/OBJECTIVES The objective of this study was to define the clinical features, phenotypical manifestation, and outcome of suspected VE in dogs. ANIMALS Ten dogs with recurrent vestibular episodes. METHODS Retrospective study. Medical records between 2009 and 2023 were reviewed, and dogs with a normal neurological examination, a history of transient signs of vestibular disease, absence of abnormalities detected on blood exams and brain magnetic resonance imaging (MRI) or computed tomography (CT), besides a minimum 10-month follow-up were included. Clinical improvement was defined as a ≥50% reduction in frequency or the cessation of clinical signs after the onset of antiseizure medications (ASMs). RESULTS Pugs were the most prevalent breed (5/10; 50%). In 2 cases, additional generalized tonic-clonic (GTC) seizures were reported. MRI exam was performed in most cases (9/10; 90%), whereas 1 dog underwent a CT scan (1/10; 10%). Electroencephalography (EEG) was carried out in 3 dogs that showed interictal spikes in the fronto-temporal and fronto-parietal areas. All cases received ASMs, with clinical improvement in 10/10 dogs (100%). CONCLUSION AND CLINICAL IMPORTANCE The presence of GTC seizures, EEG interictal spikes, and responsiveness to ASMs supported the hypothesis of an epileptic origin of vestibular episodes and thus the existence of VE in these dogs, with a presumed idiopathic cause and apparent favorable outcome.
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Affiliation(s)
| | - Fabio Tocco
- Veterinary Neurological Center “La Fenice”SelargiusItaly
| | - Samuel Okonji
- Department of Veterinary Medical SciencesUniversity of BolognaBolognaEmilia‐RomagnaItaly
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Orciani C, Ballesteros C, Troncy E, Berthome C, Bujold K, Bennamoune N, Sparapani S, Pugsley MK, Paquette D, Boulay E, Authier S. The Spontaneous Incidence of Neurological Clinical Signs in Preclinical Species Using Cage-side Observations or High-definition Video Monitoring: A Retrospective Analysis. Int J Toxicol 2024; 43:123-133. [PMID: 38063479 DOI: 10.1177/10915818231218984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
When conducting toxicology studies, the interpretation of drug-related neurological clinical signs such as convulsions, myoclonus/myoclonic jerks, tremors, ataxia, and salivation requires an understanding of the spontaneous incidence of those observations in commonly used laboratory animal species. The spontaneous incidence of central nervous system clinical signs in control animals from a single facility using cage-side observations or high definition video monitoring was retrospectively analyzed. Spontaneous convulsions were observed at low incidence in Beagle dogs and Sprague-Dawley rats but were not identified in cynomolgus monkeys and Göttingen minipigs. Spontaneous myoclonic jerks and muscle twitches were observed at low incidence in Beagle dogs, cynomolgus monkeys, and Sprague-Dawley rats but were not seen in Göttingen minipigs. Spontaneous ataxia/incoordination was identified in all species and generally with a higher incidence when using video monitoring. Salivation and tremors were the two most frequent spontaneous clinical signs and both were observed in all species. Data from the current study unveil potential limitations when using control data obtained from a single study for toxicology interpretation related to low incidence neurological clinical signs while providing historical control data from Beagle dogs, cynomolgus monkeys, Sprague-Dawley rats, and Göttingen minipigs.
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Affiliation(s)
| | | | - Eric Troncy
- GREPAQ, Faculté de Médecine Vétérinaire, Universite de Montreal, Saint Hyacinthe, QC, Canada
| | | | | | | | | | | | - Dominique Paquette
- GREPAQ, Faculté de Médecine Vétérinaire, Universite de Montreal, Saint Hyacinthe, QC, Canada
| | - Emmanuel Boulay
- Charles River, Laval, QC, Canada
- GREPAQ, Faculté de Médecine Vétérinaire, Universite de Montreal, Saint Hyacinthe, QC, Canada
| | - Simon Authier
- Charles River, Laval, QC, Canada
- GREPAQ, Faculté de Médecine Vétérinaire, Universite de Montreal, Saint Hyacinthe, QC, Canada
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Mertens AM, Schenk HC, Volk HA. Current definition, diagnosis, and treatment of canine and feline idiopathic vestibular syndrome. Front Vet Sci 2023; 10:1263976. [PMID: 37808104 PMCID: PMC10556701 DOI: 10.3389/fvets.2023.1263976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 09/07/2023] [Indexed: 10/10/2023] Open
Abstract
Idiopathic vestibular syndrome (IVS) is one of the most common neurological disorders in veterinary medicine. However, its diagnosis and treatment varies between publications. The aim of the current study was to gather experts' opinion about IVS definition, diagnosis, and treatment. An online-survey was used to assess neurology specialists' opinion about the definition, diagnosis and treatment of IVS. The study demonstrated that the definition, diagnosis, and treatment of IVS are largely consistent worldwide, with the EU prioritising less frequently advanced imaging and more often otoscopy to rule out other diseases. IVS was defined by most specialists as an acute to peracute, improving, non-painful peripheral vestibular disorder that often affects cats of any age and geriatric dogs. Regarding diagnosis, a detailed neurological examination and comprehensive blood tests, including thyroid values, blood pressure, and otoscopic examination, was seen as crucial. A thorough workup may also involve MRI and CSF analysis to rule out other causes of vestibular dysfunction. Treatment of IVS typically involved intravenous fluid therapy and the use of an antiemetic, with maropitant once daily being the preferred choice among specialists. Antinausea treatment was considered, however, only by a handful specialists. This survey-based study provides valuable insights from neurology experts and highlights areas that require further research to bridge the gap between theory and practice.
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Affiliation(s)
- Anna Morgana Mertens
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hanover, Germany
- Department of Neurology/Neurosurgery, Tierklinik Lüneburg, Lüneburg, Germany
| | | | - Holger Andreas Volk
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hanover, Germany
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Dutil GF, Guevar J, Schweizer D, Roosje P, Kajin F, Volk HA, Grapes NJ, De Decker S, Gutierrez-Quintana R, Abouzeid J, Freeman P, Faller KME, Stein VM, Maiolini A. Otitis media and interna with or without polyps in cats: association between meningeal enhancement on postcontrast MRI, cerebrospinal fluid abnormalities, and clinician treatment choice and outcome. J Feline Med Surg 2022; 24:e481-e489. [PMID: 36409551 PMCID: PMC10812352 DOI: 10.1177/1098612x221125573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the association between meningeal enhancement (MgE) and cerebrospinal fluid (CSF) analysis results, their individual association with bacteriology results from affected ear samples and whether these test results influenced clinicians' therapeutic choice in cats with otitis media and interna (OMI). METHODS This was a multicentre retrospective study carried out over an 8-year period. Cats diagnosed with OMI, with or without a nasopharyngeal polyp, leading to peripheral vestibular signs were included. Only cats for which MRI with postcontrast T1-weighted sequences and CSF analyses available were included. Cats with intra-axial MRI lesions or empyema were excluded. RESULTS Fifty-eight cats met the inclusion criteria. MgE was reported in 26/58 cases, of which nine had an abnormal CSF result (increased total nucleated cell count [TNCC] or total protein); 32/58 cases had no MgE, of which 10 showed abnormal CSF results. There was no association between bacteriology results (external ear canal or bulla) and MgE or abnormal CSF results. CSF abnormalities were statistically significantly more common in acute cases (n = 16/37) than in chronic cases (n = 3/21; Fischer's test P = 0.04). Prednisolone was prescribed in 10/16 cases with increased TNCC. Among the 42 cases with normal TNCC, 15 received prednisolone and 13 received non-steroidal anti-inflammatory drugs. Various antimicrobial drugs were prescribed in 53/58 cats. Duration of antimicrobial treatment was similar, regardless of positive bacterial culture (5.58 vs 4.22 weeks), abnormal CSF (5.83 vs 4.76 weeks) or MgE (5.33 vs 4.90 weeks). CONCLUSIONS AND RELEVANCE No association was found between the CSF and MgE results. Furthermore, no association was found between MgE, CSF or bacteriology findings. In addition, abnormal CSF results might lead the clinician to treat with corticosteroids, but they did not have any impact on duration of antimicrobial treatment. CSF abnormalities were seen significantly less frequently in chronic cases. The outcome tended to be poorer when MgE was detected on MRI.
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Affiliation(s)
- Guillaume F Dutil
- Division of Clinical Neurology, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Julien Guevar
- Division of Small Animal Surgery, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Daniela Schweizer
- Division of Radiology, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Petra Roosje
- Division of Dermatology, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Filip Kajin
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Germany
| | - Holger A Volk
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Germany
| | - Nick J Grapes
- Department of Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, UK
| | - Steven De Decker
- Department of Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, UK
| | | | - Jad Abouzeid
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Paul Freeman
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Kiterie ME Faller
- Hospital for Small Animals, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Roslin, UK
| | - Veronika M Stein
- Division of Clinical Neurology, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Arianna Maiolini
- Division of Clinical Neurology, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
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Henze L, Foth S, Meller S, Twele F, Charalambous M, Kenward H, Elliott J, Pelligand L, Volk HA. Ondansetron in dogs with nausea associated with vestibular disease: A double-blinded, randomized placebo-controlled crossover study. Vet Med (Auckl) 2022; 36:1726-1732. [PMID: 35906792 PMCID: PMC9511069 DOI: 10.1111/jvim.16504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 07/15/2022] [Indexed: 11/26/2022]
Abstract
Background Nausea and emesis can be, among other signs, common manifestations of acute vestibular system dysfunction in dogs. Currently, antiemetic drugs, such as maropitant and metoclopramide, are used commonly, but do not appear to control nausea. A non‐placebo‐controlled preliminary study suggested good efficacy of 5‐HT3‐receptor antagonists, such as ondansetron, against nausea in dogs with vestibular syndrome. Objectives To assess and confirm the effect of ondansetron on behavior suggestive of nausea in dogs with vestibular syndrome. Animals Fourteen dogs with vestibular syndrome and clinical signs of nausea presented to a neurology service. Methods Placebo‐controlled, double‐blinded, crossover study. Behavioral assessment was performed hourly for 4 hours using an established numerical rating scale. The criteria salivation, lip licking, vocalization, restlessness, lethargy, and general nausea were scored. The occurrence of emesis was recorded. After scoring at T0 (pre‐dose) and T2 (2 hours post‐dose) either ondansetron (0.5 mg/kg) or placebo was injected IV. Two hours post‐dose, treatments were switched. Blood samples were collected to measure serum arginine vasopressin (AVP) concentration, which previously has been shown to correlate with clinical signs of nausea. Results Clinical resolution of nausea was observed 1 hour after administration of ondansetron, whereas serum AVP concentration decreased 4 hours after ondansetron administration. Conclusion and Clinical Importance Administration of ondansetron IV is beneficial for dogs with nausea secondary to acute vestibular syndrome. Ondansetron substantially and rapidly decreased clinical signs of nausea behavior and stopped emesis.
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Affiliation(s)
- Lea Henze
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Sarah Foth
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Sebastian Meller
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Friederike Twele
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Marios Charalambous
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Hannah Kenward
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - Jonathan Elliott
- Department of Comparative Biomedical Sciences, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - Ludovic Pelligand
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - Holger A Volk
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
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Unilateral decrease in inner ear signal in fluid-attenuated inversion recovery sequences in previously suspected canine idiopathic vestibular syndrome. Vet J 2021; 277:105748. [PMID: 34537343 DOI: 10.1016/j.tvjl.2021.105748] [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: 04/22/2021] [Revised: 09/12/2021] [Accepted: 09/13/2021] [Indexed: 12/27/2022]
Abstract
The aetiology of canine idiopathic vestibular syndrome (IVS) remains unclear. In human medicine, characteristic magnetic resonance imaging (MRI) techniques are used to demonstrate differences in endolymph composition between affected and unaffected inner ears. The purpose of this study was to determine whether similar MRI techniques could help to detect changes in the inner ears of canine IVS patients. Medical records from two veterinary referral clinics were reviewed retrospectively. Dogs were included if they had a diagnosis of IVS, obvious lateralisation of clinical signs, and an MRI of the vestibular system. A region of interest (ROI) was manually outlined by defining the anatomical area of the inner ear in T2-weighted and fluid-attenuated inversion recovery (FLAIR) images. In order to calculate the ratio of FLAIR suppression of each ear, the mean grey value of the ROI was determined in both sequences. If a unilateral decrease in suppression was identified, it was compared with the direction of clinical signs. In total, 80 dogs were included in the study. There was a significantly lower degree of suppression on the affected compared to the unaffected side (0.8886 vs. 0.9348, respectively; P = 0.0021). In 92.5% of cases, there was agreement between the most suppressed side on MRI and the direction of clinical signs. This study provides preliminary evidence about the appearance of endolymph on MRI of dogs with IVS. Further studies are needed to investigate associations between the severity of MRI changes and prognosis.
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Grapes NJ, Taylor-Brown FE, Volk HA, De Decker S. Clinical reasoning in feline vestibular syndrome: which presenting features are the most important? J Feline Med Surg 2021; 23:669-678. [PMID: 33176542 PMCID: PMC10812200 DOI: 10.1177/1098612x20970869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate whether clinical variables from the history, clinical presentation, and physical and neurological examinations of cats with vestibular syndrome were statistically predictive of the underlying diagnosis. METHODS In total, 174 cats presenting with vestibular syndrome between January 2010 and May 2019 were investigated. Univariate statistical analysis of clinical variables was performed and those statistically associated with a diagnosis were retained for multivariable binary logistic regression modelling. RESULTS The seven most prevalent diagnoses represented 95% of vestibular presentations, which included: otitis media/interna (n = 48), idiopathic vestibular syndrome (n = 39), intracranial neoplasia (n = 24), middle ear polyp (n = 17), feline infectious peritonitis (n = 13), thiamine deficiency (n = 13) and intracranial empyema (n = 11). Idiopathic vestibular syndrome was commonly associated with non-purebred cats and had 17.8 times the odds of an improving clinical progression (95% confidence interval [CI] 1.3-250.0; P = 0.03). Intracranial neoplasia was associated with older age and chronic onset of clinical signs, and was significantly more likely to have a central vestibular neuroanatomical localisation (95% CI 8.5-344,349,142.0; P = 0.015) with postural deficits on neurological examination. Thiamine deficiency was more common in female cats, with 52.6 times the odds of a waxing and waning clinical progression (95% CI 1.2-1000; P = 0.038) and 6.8 times the odds of presenting with bilateral vestibular signs (95% CI 1.0-45.7; P = 0.047) and wide excursions of the head (95% CI 1.0-45.7; P = 0.047). Middle ear polyps were associated with 8.8 times the odds of presenting with Horner syndrome (95% CI 1.5-50.0; P = 0.015). CONCLUSIONS AND RELEVANCE Although it may be difficult to identify the underlying diagnosis in cats with vestibular syndrome from the presenting features alone, there are instances in which discrete clinical features may help to guide clinical reasoning when evaluating cats with vestibular presentations.
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Affiliation(s)
- Nicholas J Grapes
- Department of Clinical Science and Services, Royal Veterinary College, North Mymms, Hatfield, UK
| | | | - Holger A Volk
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine, Hannover, Germany
| | - Steven De Decker
- Department of Clinical Science and Services, Royal Veterinary College, North Mymms, Hatfield, UK
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Foth S, Meller S, Kenward H, Elliott J, Pelligand L, Volk HA. The use of ondansetron for the treatment of nausea in dogs with vestibular syndrome. BMC Vet Res 2021; 17:222. [PMID: 34154584 PMCID: PMC8218477 DOI: 10.1186/s12917-021-02931-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 06/07/2021] [Indexed: 12/12/2022] Open
Abstract
Background Vestibular syndrome is often accompanied by nausea. Drugs currently approved for its treatment have been developed to stop vomiting but not nausea. The efficacy of 5-HT3 receptor antagonists to reduce nausea has been described for chemotherapy, but not for nausea secondary to vestibular disorders. Methods Sixteen dogs with vestibular syndrome-associated nausea were included in the open-label, multicentre study. The intensity of nausea-like behaviour was analysed before ondansetron administration (0.5 mg/kg i.v.) and 2 h afterwards, using a validated 5-point-scale. The occurrence and frequency of salivation, lip licking, restlessness, vocalisation, lethargy, and vomiting were assessed. Results All dogs initially showed signs of nausea, whereas only 31% showed vomitus. The intensity of nausea was significantly reduced in all dogs (p ≤ 0.0001) 2 h after ondansetron administration, including the clinical signs of nausea analysed in 11 dogs (salivation [p = 0.0078], lip licking [p = 0.0078], restlessness [p = 0.0039], and lethargy [p = 0.0078]) except for vocalisation (p > 0.9999). Conclusions The results provide preliminary evidence of the potential benefit of ondansetron in the treatment of nausea, which was present in all examined dogs. Vomiting was only observed in 5 dogs indicating that nausea can occur separately and should not be perceived only as a preceding stimulation of the vomiting centre. Supplementary Information The online version contains supplementary material available at 10.1186/s12917-021-02931-9.
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Affiliation(s)
- S Foth
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - S Meller
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - H Kenward
- Department of Clinical Science and Services, Royal Veterinary College, Hertfordshire, Hatfield, UK
| | - J Elliott
- Department of Comparative Biomedical Sciences, Royal Veterinary College, Hertfordshire, Hatfield, UK
| | - L Pelligand
- Department of Clinical Science and Services, Royal Veterinary College, Hertfordshire, Hatfield, UK
| | - H A Volk
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany.
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Harrison E, Grapes NJ, Volk HA, De Decker S. Clinical reasoning in canine vestibular syndrome: Which presenting factors are important? Vet Rec 2021; 188:e61. [PMID: 33739504 DOI: 10.1002/vetr.61] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 11/04/2020] [Accepted: 11/09/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND Although the use of clinical reasoning has been evaluated for several neurological presentations, this approach has not yet been investigated for dogs with vestibular syndrome. METHODS Two hundred and thirty-nine dogs presenting with vestibular syndrome were included in this retrospective study. Univariate analysis of variables (clinical history, signalment, clinical presentation and neurological examination findings) was performed. Variables with p < 0.3 were selected for logistic regression. RESULTS Ninety-five percent of dogs were represented by eight conditions: idiopathic vestibular disease (n = 78 dogs), otitis media interna (n = 54), meningoencephalitis of unknown origin (n = 35), brain neoplasia (n = 26), ischaemic infarct (n = 25), intracranial empyema (n = 4), metronidazole toxicity (n = 3) and neoplasia affecting the middle ear (n = 3). Idiopathic vestibular disease was associated with higher age, higher bodyweight, improving clinical signs, pathological nystagmus, facial nerve paresis, absence of Horner's syndrome and a peripheral localisation. Otitis media interna was associated with younger age, male gender, Horner's syndrome, a peripheral localisation and a history of otitis externa. Ischaemic infarct was associated with older age, peracute onset of signs, absence of strabismus and a central localisation. CONCLUSIONS Discrete clinical features can be used to identify the most likely diagnosis in dogs with vestibular syndrome.
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Affiliation(s)
- Eleanor Harrison
- Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, UK
| | - Nick J Grapes
- Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, UK
| | - Holger A Volk
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine, Hannover, Germany
| | - Steven De Decker
- Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, UK
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Radulescu SM, Humm K, Eramanis LM, Volk HA, Church DB, Brodbelt D, O'Neill DG. Vestibular disease in dogs under UK primary veterinary care: Epidemiology and clinical management. J Vet Intern Med 2020; 34:1993-2004. [PMID: 32776616 PMCID: PMC7517853 DOI: 10.1111/jvim.15869] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 07/22/2020] [Accepted: 07/23/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Vestibular disease (VD), central or peripheral, can be a dramatic primary-care presentation. Current literature describes mostly dogs examined in referral centers. HYPOTHESIS/OBJECTIVES Describe the prevalence, presentation, clinical management, and outcomes of VD in dogs under primary veterinary care at UK practices participating in VetCompass. ANIMALS Seven hundred and fifty-nine vestibular cases identified out of 905 544 study dogs. METHODS Retrospective cohort study. Potential VD cases clinically examined during 2016 were verified by reviewing clinical records for signalment, presenting clinical signs, treatments, and outcomes. Multivariable logistic regression was used to evaluate factors associated with VD. RESULTS The overall prevalence of VD was 8 per 10 000 dogs (95% CI = 7-9). Median age at first diagnosis was 12.68 years (interquartile range [IQR], 11.28-14.64). Compared with crossbreeds, breeds with the highest odds of VD diagnosis included French Bulldogs (odds ratio [OR] = 9.25, 95% CI = 4.81-17.76, P < .001), Bulldogs (OR = 6.53, 95% CI = 2.66-16.15, P < .001), King Charles Spaniels (OR = 4.96, 95% CI = 2.52-9.78, P < .001), Cavalier King Charles Spaniels (OR = 3.56, 95% CI = 2.50-5.06, P < .001), and Springer Spaniels (OR = 3.37, 95% CI = 2.52-4.52, P < .001). The most common presenting signs were head tilt (69.8%), nystagmus (68.1%), and ataxia (64.5%). The most frequently used treatments were antiemetics (43.2%), systemic glucocorticoids (33.1%), antimicrobials (25%), and propentofylline (23.25%). There were 3.6% of cases referred. Improvement was recorded in 41.8% cases after a median of 4 days (IQR, 2-10.25). CONCLUSIONS Our study identifies strong breed predispositions for VD. The low referral rates suggest that primary-care data sources offer more generalizable information for benchmarking to help clinicians review their own clinical activities.
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Affiliation(s)
| | - Karen Humm
- Department of Clinical Science and ServicesThe Royal Veterinary CollegeNorth MymmsHertsUK
| | - Louis Mark Eramanis
- Department of Clinical Science and ServicesThe Royal Veterinary CollegeNorth MymmsHertsUK
- Department of Veterinary Clinical Sciences, Faculty of Veterinary and Agricultural SciencesUniversity of MelbourneWerribeeVictoriaAustralia
| | - Holger A. Volk
- Department of Clinical Science and ServicesThe Royal Veterinary CollegeNorth MymmsHertsUK
- Department of Small Animal Medicine and SurgeryUniversity of Veterinary Medicine HannoverHannoverGermany
| | - David B. Church
- Department of Clinical Science and ServicesThe Royal Veterinary CollegeNorth MymmsHertsUK
| | - David Brodbelt
- Department of Pathobiology and Population SciencesThe Royal Veterinary CollegeNorth MymmsHertsUnited Kingdom
| | - Dan Gerard O'Neill
- Department of Pathobiology and Population SciencesThe Royal Veterinary CollegeNorth MymmsHertsUnited Kingdom
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Liatis T, Cherubini GB. Monocular Nystagmus Representing Heimann - Bielschowsky Phenomenon in a Dog With Ipsilateral Vision Loss. Top Companion Anim Med 2020; 40:100439. [PMID: 32690284 DOI: 10.1016/j.tcam.2020.100439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 04/28/2020] [Accepted: 04/28/2020] [Indexed: 10/24/2022]
Abstract
A 6-year-old female-neutered vaccinated Cocker Spaniel presented for preadoption neurological evaluation due to abnormal left-eye movements that had been noticed since young age. Clinical examination revealed left-eye cataract with a nonvisible left and a normal right retina on ophthalmoscopy. Neurological examination revealed absent left-sided menace response and cataract-related ipsilateral visual impairment, and intermittent left-sided abnormal eye movements consisted of intermittent, slow, coarse, variable amplitude, vertical movements of the eye that they were giving the impression of random movements of the eye within the globe as it was floating ("wandering" eye) interchangeable with periods of rest. Blood and infectious diseases tests were unremarkable. Magnetic resonance imaging of the brain was unremarkable, whilst cerebrospinal fluid analysis revealed mildly inflammatory in the light of blood contamination. A presumptive diagnosis of meningoencephalitis of unknown origin was established and trial with dexamethasone was performed, however nystagmus remained unchanged 2 weeks post-treatment. Therefore, based on the fact that monocular nystagmus existed since youth and remained static, and the dog was otherwise neurological-sign-free regardless the discontinuation of steroids, the diagnosis of meningoencephalitis was considered as unlikely and a presumptive diagnosis of Heimann - Bielschowsky phenomenon of the left eye due to cataract-related ipsilateral visual impairment was established. This vergence eye movement abnormality also known as searching, wandering or amaurotic nystagmus is a constant or intermittent benign eye movement abnormality mostly related with vision impairment due to ophthalmological or neurological disease. Heimann - Bielschowsky phenomenon is an underreported eye abnormality in veterinary medicine. Although the most common type of eye movement abnormalities seen in veterinary practice is the bilateral conjugate jerk nystagmus, monocular nystagmus representing Heimann - Bielschowsky phenomenon exists in animals, it has been related with partial or complete vision impairment and it should be recognised by the clinicians.
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Affiliation(s)
- Theophanes Liatis
- Neurology & Neurosurgery Service, Small Animal Hospital, School of Veterinary Medicine, University of Glasgow, Glasgow, United Kingdom; Neurology & Neurosurgery Service, Dick White Referrals, Cambridgeshire, United Kingdom.
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Won S, Yoon J. MRI utricle diameter asymmetry is significantly greater in dogs with idiopathic vestibular syndrome compared with unaffected dogs. Vet Radiol Ultrasound 2020; 61:540-544. [PMID: 32663342 DOI: 10.1111/vru.12893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 05/02/2020] [Accepted: 05/07/2020] [Indexed: 11/26/2022] Open
Abstract
Idiopathic vestibular syndrome (IVS) is the most common cause of acute unilateral peripheral vestibular dysfunction in older dogs. The purpose of this retrospective, cross-sectional study was to characterize morphological changes in the utricle of dogs affected by IVS, using MRI. To evaluate differences between affected and unaffected utricles, the ratio of the largest to the smallest utricle diameter was obtained, as measured on transverse T2-weighted images, and defined as the utricle asymmetricity ratio (UAR). Out of 137 patients diagnosed with IVS after excluding other vestibular diseases by MRI, 101 were eligible for inclusion. Additionally, 31 older dogs with no signs of vestibular disorders or other intracranial diseases were included as a control group. The disease group was divided into two subgroups in which the direction of head tilt and nystagmus symptoms versus the decreased utricle diameters were consistent or inconsistent. The medians of UARs of the IVS and control groups were 0.83 (range 0.37-1.00) and 0.98 (0.70-1.00), respectively. The medians of the UARs of the consistent and inconsistent IVS subgroups were 0.82 (0.37-0.99) and 0.90 (0.74-1.00), respectively. The UAR of the IVS group was significantly decreased than that of the control group and UAR of the consistent sub-group was significantly decreased than that of the inconsistent sub-group (P < .01). In conclusion, significant asymmetry of utricle diameter was identified in dogs with IVS versus unaffected dogs. We propose that canine IVS may possibly be correlated with structural atrophy of the vestibular system.
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Affiliation(s)
| | - Junghee Yoon
- College of Veterinary Medicine and the Research Institute for Veterinary Science, Seoul National University, Seoul, Korea
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Castillo G, Parmentier T, Monteith G, Gaitero L. Inner ear fluid-attenuated inversion recovery MRI signal intensity in dogs with vestibular disease. Vet Radiol Ultrasound 2020; 61:531-539. [PMID: 32564460 DOI: 10.1111/vru.12876] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 03/23/2020] [Accepted: 03/29/2020] [Indexed: 11/29/2022] Open
Abstract
The inner ear contains endolymph and perilymph. The second is comparable and in continuity with the cerebrospinal fluid (CSF) so it is expected to suppress in fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI) if normal. Even though inner ear FLAIR abnormalities have been extensively described in humans with inner ear disease, its diagnostic value in dogs is yet to be proven. The goal of this retrospective cohort study was to investigate the diagnostic utility of FLAIR MRI in dogs with vestibular disease. A review of medical records identified 101 dogs that had brain MRI performed because of vestibular signs. Based on the final diagnosis, patients were allocated to three groups: otitis media/interna, idiopathic vestibular disease, and central vestibular disease. Additionally, a control group (n = 73) included dogs with normal MRI and without vestibular signs. Inner ears were delineated using a region of interest, and signal intensity was measured in FLAIR and T2-weighted images. The percentages of suppression in FLAIR were calculated and compared between affected and unaffected sides of each individual and between groups using a general linear mixed model. Correlation between suppression and CSF cell count and protein concentration was assessed. Affected inner ears in dogs with otitis media/interna had decreased suppression in FLAIR compared to the unaffected side (P < .001), and all other groups (P < .01). No significant correlation was detected between CSF results and suppression. These results show the diagnostic value of FLAIR in otitis media/interna due to lack of suppression in the affected inner ear.
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Affiliation(s)
- Gibrann Castillo
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Thomas Parmentier
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Gabrielle Monteith
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Luis Gaitero
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
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Orlandi R, Gutierrez-Quintana R, Carletti B, Cooper C, Brocal J, Silva S, Gonçalves R. Clinical signs, MRI findings and outcome in dogs with peripheral vestibular disease: a retrospective study. BMC Vet Res 2020; 16:159. [PMID: 32450859 PMCID: PMC7249679 DOI: 10.1186/s12917-020-02366-8] [Citation(s) in RCA: 4] [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: 03/20/2020] [Accepted: 05/10/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Vestibular dysfunction is relatively common in dogs, with a prevalence of 0.08% reported in primary veterinary care in the UK. There are several studies investigating how to differentiate between peripheral and central vestibular disease but only limited information regarding the possible underlying causes for peripheral vestibular dysfunction in dogs. This study therefore aimed to describe the clinical signs, magnetic resonance imaging findings (MRI), underlying causes and outcome in a large population of dogs diagnosed with peripheral vestibular disease. RESULTS One hundred eighty-eight patients were included in the study with a median age of 6.9 years (range 3 months to 14.6 years). Neurological abnormalities included head tilt (n = 185), ataxia (n = 123), facial paralysis (n = 103), nystagmus (n = 97), positional strabismus (n = 93) and Horner syndrome (n = 7). The most prevalent diagnosis was idiopathic vestibular disease (n = 128), followed by otitis media and/or interna (n = 49), hypothyroidism (n = 7), suspected congenital vestibular disease (n = 2), neoplasia (n = 1) and cholesteatoma (n = 1). Long-term follow-up revealed persistence of head tilt (n = 50), facial paresis (n = 41) and ataxia (n = 6) in some cases. Recurrence of clinical signs was observed in 26 dogs. Increasing age was associated with a mild increased chance of diagnosis of idiopathic vestibular syndrome rather than otitis media and/or interna (P = 0.022, OR = 0.866; CI 0.765-0.980). History of previous vestibular episodes (P = 0.017, OR = 3.533; CI 1.251-9.981) was associated with an increased likelihood of resolution of the clinical signs whilst contrast enhancement of cranial nerves VII and/or VIII on MRI (P = 0.018, OR = 0.432; CI 0.251-0.868) was associated with a decreased chance of resolution of the clinical signs. CONCLUSIONS Idiopathic vestibular disease is the most common cause of peripheral vestibular dysfunction in dogs and it is associated with advanced age. Incomplete recovery from peripheral vestibular disease is common, especially in dogs presenting with cranial nerve enhancement on MRI but less so if there is previous history of vestibular episodes.
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Affiliation(s)
- Rocio Orlandi
- Department of Small Animal Clinical Science, Institute of Veterinary Science, University of Liverpool, Neston, CH64 7TE, UK.
| | - Rodrigo Gutierrez-Quintana
- School of Veterinary Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Garscube Estate, 464 Bearsden Road, Glasgow, G61 1QH, UK
| | - Beatrice Carletti
- Department of Small Animal Clinical Science, Institute of Veterinary Science, University of Liverpool, Neston, CH64 7TE, UK
| | - Camilla Cooper
- Department of Small Animal Clinical Science, Institute of Veterinary Science, University of Liverpool, Neston, CH64 7TE, UK
| | - Josep Brocal
- Wear Referrals Veterinary Hospital, Bradbury, Stockton-on-Tees, TS21 2ES, UK
| | - Sara Silva
- School of Veterinary Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Garscube Estate, 464 Bearsden Road, Glasgow, G61 1QH, UK
| | - Rita Gonçalves
- Department of Small Animal Clinical Science, Institute of Veterinary Science, University of Liverpool, Neston, CH64 7TE, UK
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Jang M, Mann FA, Bukoski A, Dodam JR, Lee I. Effect of Midazolam on Vestibular Signs in Two Geriatric Dogs with Vestibular Disease. J Am Anim Hosp Assoc 2020; 56:e56402. [PMID: 32412341 DOI: 10.5326/jaaha-ms-7014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
An abrupt balance impairment, including leaning, falling, and rolling, occurred after IV administration of 0.2 mg/kg midazolam as a preanesthetic medication in two geriatric dogs with a history of nystagmus and head tilt. In the second case, leaning, falling, and rolling recurred after recovery from general anesthesia but gradually ceased after IV administration of 0.01 mg/kg flumazenil. These two cases suggest that the IV administration of midazolam was responsible for the balance impairment in dogs who were suspected to have idiopathic peripheral vestibular disease.
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Affiliation(s)
- Min Jang
- From Seoul National University College of Veterinary Medicine, Seoul, Republic of Korea (M.J., I.L.); and the Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri (F.A.M., A.B., J.R.D.)
| | - F A Mann
- From Seoul National University College of Veterinary Medicine, Seoul, Republic of Korea (M.J., I.L.); and the Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri (F.A.M., A.B., J.R.D.)
| | - Alex Bukoski
- From Seoul National University College of Veterinary Medicine, Seoul, Republic of Korea (M.J., I.L.); and the Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri (F.A.M., A.B., J.R.D.)
| | - John R Dodam
- From Seoul National University College of Veterinary Medicine, Seoul, Republic of Korea (M.J., I.L.); and the Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri (F.A.M., A.B., J.R.D.)
| | - Inhyung Lee
- From Seoul National University College of Veterinary Medicine, Seoul, Republic of Korea (M.J., I.L.); and the Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri (F.A.M., A.B., J.R.D.)
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Soler Arias EA, Trigo RH, Gomez Alvarez CM, Castillo VA. Vestibular dysfunction due to thalamic metastasis of a corticotropic carcinoma in a dog. VETERINARY RECORD CASE REPORTS 2020. [DOI: 10.1136/vetreccr-2019-001058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Elber Alberto Soler Arias
- U. EndocrinologíaHosp Esc Med VetCat.Clin Med Peq AnimalesFac Ciencias VeterinariasUniversidad de Buenos AiresCiudad Autónoma de Buenos AiresBuenos AiresArgentina
| | - Roberto Hector Trigo
- Catedra de PatologíaFac Ciencias VeterinariasUniversidad de Buenos AiresCiudad Autónoma de Buenos AiresBuenos AiresArgentina
| | | | - Víctor Alejandro Castillo
- U. EndocrinologíaHosp Esc Med VetCat.Clin Med Peq AnimalesFac Ciencias VeterinariasUniversidad de Buenos AiresCiudad Autónoma de Buenos AiresBuenos AiresArgentina
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Castel A, Doré V, Vigeral M, Hecht S. Magnetic Resonance Imaging Findings in 13 Neurologic Pot-Bellied Pigs. Front Vet Sci 2020; 7:21. [PMID: 32076601 PMCID: PMC7006440 DOI: 10.3389/fvets.2020.00021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 01/10/2020] [Indexed: 12/03/2022] Open
Abstract
This study reports the magnetic resonance imaging (MRI) findings in 13 pot-bellied pigs presented to our institution with neurological deficits. Nine pigs had abnormal MRI findings (7 with spinal cord localization and 2 with brain localization), with three of them having histopathological confirmation of the diagnoses. MRI diagnoses included a myopathy suspected to be secondary to Erysipelothrix rhusiopathiae, a round cell neoplasia involving the vertebral canal, myelomalacia, a cervical cyst like extradural lesion, pelvic fracture with secondary cauda equina involvement, two cases of fibrocartilaginous embolism or acute non-compressive nucleus pulposus extrusion, multifocal brain infarcts, and a cystic fourth ventricle dilation resulting in obstructive hydrocephalus and syringomyelia. Four pigs had normal MRI studies, with one of them ultimately diagnosed with idiopathic vestibular disease. This retrospective study illustrates the wide variety of diagnoses achieved with MRI of the head or vertebral column in pigs, several of them having never been described in this species. Some of the conditions identified had a good outcome. This justifies using MRI as an ante-mortem diagnostic tool as it can provide relevant information about the prognosis which can significantly influence treatment recommendations. Our findings suggest that MRI should be considered as a valuable imaging modality, when feasible, in pigs with neurological deficits.
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Affiliation(s)
- Aude Castel
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, QC, Canada
| | - Vincent Doré
- Faculty of Veterinary Medicine, CHUV, Farm Animal Hospital, University of Montreal, Saint-Hyacinthe, QC, Canada
| | - Mariana Vigeral
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Knoxville, TN, United States
| | - Silke Hecht
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Knoxville, TN, United States
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Desprez I, Donnelly TM, Mayousse V, Thibaud JL, Parker DL, Pignon C. A case of otitis interna in a ferret (Mustela putorius furo). J Exot Pet Med 2019. [DOI: 10.1053/j.jepm.2019.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Bongartz U, Nessler J, Maiolini A, Stein VM, Tipold A, Bathen-Nöthen A. Vestibular disease in dogs: association between neurological examination, MRI lesion localisation and outcome. J Small Anim Pract 2019; 61:57-63. [PMID: 31515806 DOI: 10.1111/jsap.13070] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 07/26/2019] [Accepted: 08/19/2019] [Indexed: 01/05/2023]
Abstract
OBJECTIVES To determine whether the neurological examination correctly distinguishes between central and peripheral vestibular lesions in dogs. MATERIALS AND METHODS Retrospective study on dogs with vestibular disease presenting to two referral clinics in Germany. RESULTS Ninety-three dogs were included; neurological examination suggested central vestibular disease in 62 and a peripheral lesion in 31. MRI diagnosis was central vestibular disease in 68 dogs and peripheral in 25. Of the 62 dogs with a lesion localisation diagnosed as central vestibular by neurological exam, 61 were correctly identified (98.4%). Twenty-four of the 31 dogs diagnosed with a peripheral lesion by neurological exam had a consistent lesion on MRI (77.4%). CLINICAL SIGNIFICANCE The neurological examination is efficient at identifying lesions in the central vestibular system but less so for peripheral lesions. Therefore it is prudent to recommend imaging in dogs that show signs of peripheral vestibular syndrome but do not rapidly respond to treatment.
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Affiliation(s)
- U Bongartz
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany.,Veterinary Practice A. Bathen-Nöthen, Hatzfeldstraße 6, 51069, Köln, Germany
| | - J Nessler
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany
| | - A Maiolini
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany
| | - V M Stein
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany
| | - A Tipold
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany
| | - A Bathen-Nöthen
- Veterinary Practice A. Bathen-Nöthen, Hatzfeldstraße 6, 51069, Köln, Germany
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Ural K, ERDOĞAN H, ADAK Hİ, ATEŞ DS, Kahraman D. Ataksik kedilerde fekal mikrobiyata transplantasyonu; beyin bağırsak eksenini ispatlar nitelikte olgu serisi. MEHMET AKIF ERSOY ÜNIVERSITESI VETERINER FAKÜLTESI DERGISI 2019. [DOI: 10.24880/maeuvfd.460765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Swales N, Foster A, Barnard N. Retrospective study of the presentation, diagnosis and management of 16 cats with otitis media not due to nasopharyngeal polyp. J Feline Med Surg 2018; 20:1082-1086. [PMID: 29235932 PMCID: PMC11104215 DOI: 10.1177/1098612x17746282] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The aim of this study was to analyse retrospectively cats diagnosed with otitis media (OM) not due to nasopharyngeal polyp, and to review the clinical outcome with surgical and medical management. METHODS Patient records were searched for cats diagnosed with OM. The diagnosis of OM was based on the presence of clinical signs, including neurological signs, respiratory signs and signs of otitis externa, and on the basis of evidence of thickened or irregular bullae walls, or the presence of fluid within the tympanic cavity in those that had diagnostic imaging. In those that did not have imaging, the diagnosis was made on the basis of the presence of fluid in the bulla or organisms cultured using myringotomy. These records were analysed retrospectively. RESULTS Of 16 cats, one had a total ear canal ablation, five had ventral bulla osteotomy surgery and 11 were medically managed. Of the cats that were medically managed, using either topical products, systemic antimicrobials or a combination of both, eight had complete resolution of clinical signs. CONCLUSIONS AND RELEVANCE This small cohort shows that some cats with OM can be successfully managed medically. Surgery is invasive and may not necessarily be required if appropriate medical management is undertaken. This is the first study of OM treatment in cats and provides the basis for further studies, which should aim to establish specific infectious causes of OM and how they can potentially be managed with medical therapies.
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Affiliation(s)
- Nicola Swales
- Small Animal Hospital, Langford Vets, University of Bristol, Langford, UK
| | - Aiden Foster
- Bristol Veterinary School, University of Bristol, Langford, UK
| | - Natalie Barnard
- Small Animal Hospital, Langford Vets, University of Bristol, Langford, UK
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Boudreau CE, Dominguez CE, Levine JM, Mankin J, Anderson KM, Voges AK, Fosgate GT. Reliability of interpretation of neurologic examination findings for the localization of vestibular dysfunction in dogs. J Am Vet Med Assoc 2018; 252:830-838. [DOI: 10.2460/javma.252.7.830] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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25
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Treating peripheral vestibular disease-associated nausea. Vet Rec 2017; 180:407-408. [DOI: 10.1136/vr.j1921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Brady S, Harrison T, Williams C, Evola M, Wack RF. Diagnostic evaluation and treatment of a Chinese crocodile lizard (
Shinisaurus crocodilurus
) with seizures. VETERINARY RECORD CASE REPORTS 2016. [DOI: 10.1136/vetreccr-2016-000368] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Sean Brady
- Veterinary HousecallsSan ClementeCaliforniaUSA
- University of California Davis School of Veterinary MedicineZoological MedicineDavisCaliforniaUSA
| | - Tara Harrison
- North Carolina State University College of Veterinary MedicineAvian and ExoticsRaleighNorth CarolinaUSA
| | - Colette Williams
- University of California Davis School of Veterinary MedicineNeurologyDavisCaliforniaUSA
| | - Maria Evola
- North Carolina State University College of Veterinary MedicineImagingRaleighNorth CarolinaUSA
| | - Raymund F Wack
- Department of Medicine and EpidemiologyUniversity of California Davis School of Veterinary MedicineDavisCaliforniaUSA
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Fraser AR, Long SN, le Chevoir MA. Concurrent idiopathic vestibular syndrome and facial nerve paralysis in a cat. Aust Vet J 2015; 93:252-4. [DOI: 10.1111/avj.12338] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 12/15/2014] [Accepted: 12/16/2014] [Indexed: 11/30/2022]
Affiliation(s)
- AR Fraser
- The University of Melbourne Veterinary Hospital; The University of Melbourne; 250 Princes Hwy Werribee Victoria 3030 Australia
| | - SN Long
- The University of Melbourne Veterinary Hospital; The University of Melbourne; 250 Princes Hwy Werribee Victoria 3030 Australia
| | - MA le Chevoir
- The University of Melbourne Veterinary Hospital; The University of Melbourne; 250 Princes Hwy Werribee Victoria 3030 Australia
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de Matos R, Ruby J, Van Hatten RA, Thompson M. Computed tomographic features of clinical and subclinical middle ear disease in domestic rabbits (Oryctolagus cuniculus): 88 cases (2007–2014). J Am Vet Med Assoc 2015; 246:336-43. [DOI: 10.2460/javma.246.3.336] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Kenward H, Pelligand L, Savary-Bataille K, Elliott J. Nausea: current knowledge of mechanisms, measurement and clinical impact. Vet J 2014; 203:36-43. [PMID: 25453240 DOI: 10.1016/j.tvjl.2014.10.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Revised: 10/08/2014] [Accepted: 10/09/2014] [Indexed: 10/24/2022]
Abstract
Nausea is a subjective sensation, which often acts as a signal that emesis is imminent. It is a widespread problem that occurs as a clinical sign of disease or as an adverse effect of a drug therapy or surgical procedure. The mechanisms of nausea are complex and the neural pathways are currently poorly understood. This review summarises the current knowledge of nausea mechanisms, the available animal models for nausea research and the anti-nausea properties of commercially available anti-emetic drugs. The review also presents subjective assessment and scoring of nausea. A better understanding of the underlying mechanisms of nausea might reveal potential clinically useful biomarkers for objective measurement of nausea in species of veterinary interest.
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Affiliation(s)
- Hannah Kenward
- Department of Comparative Biomedical Sciences, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Herts AL9 7TA, UK.
| | - Ludovic Pelligand
- Department of Comparative Biomedical Sciences, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Herts AL9 7TA, UK; Department of Clinical Sciences and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Herts AL9 7TA, UK
| | | | - Jonathan Elliott
- Department of Comparative Biomedical Sciences, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Herts AL9 7TA, UK
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Palumbo M, Jark P, Machado L, Machado V, Resende L, Borges A. Potencial evocado auditivo para diagnóstico de surdez em gato com síndrome vestibular periférica. ARQ BRAS MED VET ZOO 2013. [DOI: 10.1590/s0102-09352013000600014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Potencial evocado auditivo é um método eletrodiagnóstico que permite avaliação funcional das vias auditivas desde a orelha média até o tronco encefálico. O uso desse teste em medicina veterinária é pouco difundido no Brasil. O presente artigo relata o uso do potencial evocado auditivo para detecção de deficiência auditiva unilateral em um gato com síndrome vestibular periférica secundária a otite média.
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Affiliation(s)
| | - P.C. Jark
- Universidade Estadual Paulista Júlio de Mesquita Filho
| | | | | | | | - A.S. Borges
- Universidade Estadual Paulista Júlio de Mesquita Filho
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Garosi LS, Lowrie ML, Swinbourne NF. Neurological Manifestations of Ear Disease in Dogs and Cats. Vet Clin North Am Small Anim Pract 2012; 42:1143-60. [DOI: 10.1016/j.cvsm.2012.08.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Ruys LJ, Gunning M, Teske E, Robben JH, Sigrist NE. Evaluation of a veterinary triage list modified from a human five-point triage system in 485 dogs and cats. J Vet Emerg Crit Care (San Antonio) 2012; 22:303-12. [DOI: 10.1111/j.1476-4431.2012.00736.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Laura J. Ruys
- Medisch Centrum voor Dieren [Animal Medical Center]; Isolatorweg 45 1014 AS Amsterdam The Netherlands
- Department of Veterinary Clinical Medicine; Vetsuisse Faculty of Bern; Bern Switzerland
| | - Myrna Gunning
- Medisch Centrum voor Dieren [Animal Medical Center]; Isolatorweg 45 1014 AS Amsterdam The Netherlands
| | - Erik Teske
- Department of Clinical Sciences of Companion Animals; Faculty of Veterinary Medicine; Utrecht University; The Netherlands
| | - Joris H. Robben
- Department of Clinical Sciences of Companion Animals; Faculty of Veterinary Medicine; Utrecht University; The Netherlands
| | - Nadja E. Sigrist
- Department of Veterinary Clinical Medicine; Vetsuisse Faculty of Bern; Bern Switzerland
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Bentley RT, March PA. Recurrent vestibular paroxysms associated with systemic hypertension in a dog. J Am Vet Med Assoc 2011; 239:652-5. [DOI: 10.2460/javma.239.5.652] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Huang YY, Tschopp M, Straumann D, Neuhauss SCF. Vestibular deficits do not underlie looping behavior in achiasmatic fish. Commun Integr Biol 2011; 3:379-81. [PMID: 20798832 DOI: 10.4161/cib.3.4.11975] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2010] [Accepted: 04/02/2010] [Indexed: 01/20/2023] Open
Abstract
Zebrafish belladonna (bel) mutants carry a mutation in the lhx2 gene that encodes a Lim domain homeobox transcription factor, leading to a defect in the retinotectal axon pathfinding. As a result, a large fraction of homozygous bel mutants is achiasmatic. Achiasmatic bel mutants display ocular motor instabilities, both reserved optokinetic response (OKR) and spontaneous eye oscillations, and an unstable swimming behavior, described as looping. All these unstable behaviors have been linked to the underlying optic nerve projection defect. Looping has been investigated under different visual stimuli and shown to be vision dependent and contrast sensitive. In addition, looping correlates perfectly with reversed OKR and the spontaneous oscillations of the eyes. Hence, it has been hypothesized that looping is a compensatory response to the perception of self-motion induced by the spontaneous eye oscillations. However, both ocular and postural instabilities could also be caused by a yet unidentified vestibular deficit. Here, we performed a preliminary test of the vestibular function in achiasmatic bel larval mutants in order to clarify the potential role of a vestibular deficit in looping. We found that the vestibular ocular reflex (VOR) is normally directed in both bel mutants and wild types and therefore exclude the possibility that nystagmus and looping in reverse to the rotating optokinetic drum can be attributed to an underlying vestibular deficit.
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Giri DK, Sims WP, Sura R, Cooper JJ, Gavrilov BK, Mansell J. Cerebral and Renal Phaeohyphomycosis in a Dog Infected With Bipolaris Species. Vet Pathol 2010; 48:754-7. [DOI: 10.1177/0300985810375239] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Mycotic meningoencephalitis in dogs may manifest as a primary disease of the central nervous system or as a part of disseminated infection. Fungi belonging to the genus Bipolaris are saprophytic plant pathogens and can cause disease in humans. The authors report a case of Bipolaris infection in a dog with granulomatous meningoencephalitis, nephritis, and vasculitis. The clinical and histological features resembled those of the more common aspergillosis, thus warranting confirmation by molecular methods. Polymerase chain reaction and sequence analysis identified Bipolaris from the brain lesion, indicating its involvement in the disease. To the authors' knowledge, this is the first reported case of meningoencephalitis caused by this fungus in a domestic animal.
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Affiliation(s)
- D. K. Giri
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
- These authors contributed equally to the article
| | - W. P. Sims
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
- These authors contributed equally to the article
| | - R. Sura
- Department of Pathobiology and Veterinary Science, University of Connecticut, Storrs, CT
| | - J. J. Cooper
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
| | - B. K. Gavrilov
- Department of Pathobiology and Veterinary Science, University of Connecticut, Storrs, CT
| | - J. Mansell
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
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