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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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Kang DJ, Park WK, Kim SY, Shin DH, Park HM, Kang MH. Case report: Villaret's syndrome caused by middle ear adenocarcinoma in a cat. Front Vet Sci 2023; 10:1225567. [PMID: 37576831 PMCID: PMC10413872 DOI: 10.3389/fvets.2023.1225567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 07/05/2023] [Indexed: 08/15/2023] Open
Abstract
A 7-year-old castrated male American Shorthair cat presented with left-side Horner's syndrome and voice change. The overall clinical presentation included dysphagia, intermittent coughing, unilateral miosis, and third eyelid protrusion of the left eye. A topical 1% phenylephrine was applied, and miosis and protrusion of the third eyelid disappeared within 20 min which suggested a post-ganglionic lesion. Laryngoscopy showed left-sided laryngeal paralysis. Computed tomography (CT) identified a mass lesion invading outside of the left tympanic bulla with osteolysis. Endoscopically assisted ventral bulla osteotomy was performed for tumor resection and definitive diagnosis. Middle ear adenocarcinoma was diagnosed based on histopathology. It appears that these neurological signs occurred due to adenocarcinoma in the tympanic bulla, penetrating the jugular foramen and the hypoglossal canal and damaging the cranial nerve IX (glossopharyngeal nerve), X (vagus nerve), XI (accessory nerve), and XII (hypoglossal nerve) and the sympathetic nerve. To the best of our knowledge, this is the first case report of Villaret's syndrome associated with middle ear adenocarcinoma affecting the nerves passing through the jugular foramen and hypoglossal canal in cats.
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Affiliation(s)
- Dong-Jae Kang
- Department of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University, Seoul, Republic of Korea
| | | | - So-Yeon Kim
- Yonggang Animal Hospital, Seoul, Republic of Korea
| | | | - Hee-Myung Park
- Department of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University, Seoul, Republic of Korea
| | - Min-Hee Kang
- Department of Bio-animal Care, Jangan University, Hwaseong, Gyeonggi-do, Republic of Korea
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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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Bercovitz GR, Gaerig AM, Conway ED, Huey JA, Telle MR, Stavinohova R, Cherubini GB, Capasso A, Myrna KE. Long-lasting otic medications may be a rare cause of neurogenic keratoconjunctivitis sicca in dogs. J Am Vet Med Assoc 2022; 261:97-103. [PMID: 36350754 DOI: 10.2460/javma.22.07.0301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To characterize the clinical course and long-term prognosis of a suspected novel cause of neurogenic keratoconjunctivitis sicca (nKCS) secondary to florfenicol, terbinafine hydrochloride, mometasone furoate (Claro and Neptra) or florfenicol, terbinafine, betamethasone acetate (Osurnia). ANIMALS 29 client-owned dogs. PROCEDURES Online survey and word-of-mouth recruitment were conducted to identify dogs that developed clinical signs of nKCS after application of otitis externa medication containing terbinafine and florfenicol. A retrospective analysis of medical records of dogs meeting inclusion criteria was then conducted. Included dogs had onset of clinical signs of nKCS within 1 day after application of otitis externa medications containing terbinafine and florfenicol and had documentation of low Schirmer tear test value (< 15 mm/min) of affected eyes. RESULTS 29 dogs with medical records available for review met the inclusion criteria. Documented return of clinically normal tear production was identified in 24 of 29 dogs, with a median time from application of ear medication to documented return of clinically normal tear production of 86 days (range, 19 to 482 days). A corneal ulcer was diagnosed in 68% (20/29). Multivariable Cox regression analysis showed being referred to an ophthalmologist (P = .03) and having a deep ulcer (P = .02) were associated with a longer time to documentation of Schirmer tear test ≥ 15 mm/min. CLINICAL RELEVANCE Dogs that developed nKCS within 1 day after application of otitis externa medications containing terbinafine and florfenicol had a good prognosis for return of normal tear production within 1 year.
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Affiliation(s)
- Genia R Bercovitz
- 1Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA
| | | | - Emily D Conway
- 3VCA Great Lakes Veterinary Specialists, Warrensville Heights, OH
| | | | - Mary R Telle
- 5Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS
| | | | | | | | - Kathern E Myrna
- 1Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA
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Kent M, Arnold SA, Perlini M, Glass EN, Barber RM. Unilateral Laryngeal Paralysis Secondary to Otitis Media/Interna in Two Cats. J Am Anim Hosp Assoc 2022. [DOI: 10.5326/jaaha-ms-7099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
ABSTRACT
Two adult cats were presented for coughing, gagging, dysphonia, exaggerated swallowing attempts, unilateral vestibular dysfunction, and/or Horner syndrome. In both cats, unilateral laryngeal paralysis was identified on the side ipsilateral to other neurological deficits. Cross-sectional imaging was consistent with otitis media/interna. In both cats, there also was extensive cellulitis surrounding the tympanic bulla and dissecting through tissue planes to involve the opening of the tympano-occipital fissure on the side ipsilateral to the laryngeal paralysis. Laryngeal paralysis was presumed secondary to involvement of the vagus nerve as it emerged from the tympano-occipital fissure. Antibiotic therapy resulted in resolution of clinical signs in both cats and restored laryngeal function as evidenced by visual examination of the larynx in one cat.
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Galley AP, Beltran E, Tetas Pont R. Neurogenic keratoconjunctivitis sicca in 34 dogs: A case series. Vet Ophthalmol 2021; 25:140-152. [PMID: 34870366 DOI: 10.1111/vop.12949] [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: 11/18/2020] [Revised: 10/03/2021] [Accepted: 10/17/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To describe the clinical findings, imaging features, underlying conditions, treatment, and progression of dogs presented between 2010 and 2019 with neurogenic keratoconjunctivitis sicca (NKCS). METHODS Dogs diagnosed with NKCS were searched in the clinical database. Inclusion criteria were STT-1 readings <15 mm/min, clinical signs of KCS with concurrent ipsilateral xeromycteria. RESULTS Thirty-four cases were identified. Mean age at presentation was 8.2 years, median 8.9 years (0.3-14.7). Twenty dogs were male, and 14 dogs were female. Concurrent neurological deficits included facial neuropathy (n = 13, 38%), peripheral vestibular syndrome (n = 10, 29%), and Horner's syndrome (n = 5, 15%). Advanced imaging was acquired in 53% of cases (n = 18). Etiologies included idiopathic (n = 18, 53%), endocrinopathy (n = 6, 18%), otitis interna (n = 4, 12%), head trauma (n = 3, 9%), iatrogenic (post-TECA-LBO, n = 1, 3%), brainstem mass (n = 1, 3%), and an area of inflammation in the pterygopalatine fossa (n = 1, 3%). Treatment for NKCS was initiated in most cases (n = 30, 88%) including: oral pilocarpine 2% and lacrimostimulant (n = 19), oral pilocarpine 2% only (n = 3), or lacrimostimulant only (n = 8). A mean time follow-up of 3.7 months, median 3 months (1-14) was available in 23 cases (68%). Eleven cases with follow-up were responsive (48%) with resolution of the clinical signs in a median time 4 months (1-10), and all of them were treated with oral pilocarpine (±lacrimostimulant). CONCLUSIONS Most cases presented as idiopathic NKCS; in others, an underlying cause of facial neuropathy was identified. All responsive cases were treated with oral pilocarpine 2%.
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Affiliation(s)
- Amy P Galley
- Royal Veterinary College (RVC), Queen Mother Hospital for Animals (QMHA), London, UK
| | - Elsa Beltran
- Royal Veterinary College (RVC), Queen Mother Hospital for Animals (QMHA), London, UK
| | - Roser Tetas Pont
- Royal Veterinary College (RVC), Queen Mother Hospital for Animals (QMHA), London, UK
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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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McGregor O, Plested MJ, Beltran E. Magnetic resonance imaging of the caudal portion of the digastric muscle in canine idiopathic facial neuropathy. Vet Radiol Ultrasound 2021; 62:455-462. [PMID: 33942951 DOI: 10.1111/vru.12974] [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: 09/18/2020] [Revised: 01/31/2021] [Accepted: 02/09/2021] [Indexed: 11/29/2022] Open
Abstract
Idiopathic is the most common etiology for acute onset of facial neuropathy in dogs with limited number of studies describing MRI characteristics. A retrospective, observational study was performed using archived records, aiming to describe the MRI features of the caudal portion of the digastric muscle in dogs diagnosed with idiopathic facial neuropathy and to determine correlation with prognosis. Client-owned dogs presented to a referral hospital between 2009 and 2019, diagnosed with unilateral idiopathic facial neuropathy and having undergone MRI, with images including the caudal portion of the digastric muscle, were included (n = 19). MRI appearance of the affected muscle, including degree of muscle atrophy, signal intensity, enhancement post-contrast, and enhancement characteristics of the affected facial nerve, was described and compared to the contralateral, clinically unaffected caudal portion of the digastric muscle. Correlation between MRI appearance and outcome at 1-month and 3-months following onset of clinical signs was investigated. The majority of patients demonstrated some degree of muscle atrophy (n = 17, 89%), hyperintensity in T2W (n = 17, 89%), and pre-contrast T1W (n = 15, 79%) images, as well as contrast enhancement of the affected muscle (n = 14, 74%) and affected facial nerve (n = 9, 47%). There was no statistically significant correlation between atrophy or enhancement of the affected caudal portion of the digastric muscle nor between enhancement of the affected facial nerve and outcome. Hyperintensity both in T2W images and pre-contrast T1W images was significantly correlated with a worse prognosis. Ensuring inclusion and evaluation of this muscle in MRI may therefore be indicated in canine idiopathic facial neuropathy.
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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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Chan MK, Toribio JA, Podadera JM, Child G. Incidence, cause, outcome and possible risk factors associated with facial nerve paralysis in dogs in a Sydney population (2001-2016): a retrospective study. Aust Vet J 2019; 98:140-147. [PMID: 31867719 DOI: 10.1111/avj.12906] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 11/10/2019] [Accepted: 11/15/2019] [Indexed: 12/01/2022]
Abstract
OBJECTIVE This study aims to assess the incidence and causes of facial nerve paralysis (FNP) in dogs in the Sydney region. Its outcome and possible risk factors are investigated to prognosticate and aid design of diagnostic and treatment plans. DESIGN Retrospective case study. METHODS Client-owned dogs presented to the University Veterinary Teaching Hospital, Sydney (UVTHS), between 2001 and 2016 with FNP were included (n = 122). The incidence of each cause of FNP was investigated. A reference population of noncases seen at the UVTHS during the same time period was used to study the association between idiopathic facial nerve paralysis (IFNP) and gender, age and breed. RESULTS IFNP (29.5%) was the most common diagnosis. Male dogs (odds ratio [OR], 2.3) had increased odds of IFNP compared with female dogs. Age was a significant risk factor for both the occurrence of FNP and IFNP. There was higher occurrence of IFNP among middle-aged dogs (5-13 years) and reduced risk in juvenile dogs (less than 2 years). Cavalier King Charles Spaniels were over-represented for FNP (OR, 6.9) and IFNP (OR, 17.5). For IFNP, 6 of 16 dogs with known follow-up showed definitive resolution within 3 years of diagnosis. Concurrent vestibular signs were common in dogs with middle/inner ear abnormality and intracranial disease; and were also seen in 50% of dogs with IFNP. CONCLUSION The results of this study demonstrate statistical predilections in age, gender and breed for IFNP. Guarded prognosis for recovery should be given to dogs diagnosed with IFNP and supportive management instigated.
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Affiliation(s)
- M K Chan
- Sydney School of Veterinary Science, The University of Sydney, New South Wales, Australia
| | - J-Alml Toribio
- Sydney School of Veterinary Science, The University of Sydney, New South Wales, Australia
| | - J M Podadera
- Sydney School of Veterinary Science, The University of Sydney, New South Wales, Australia
| | - G Child
- Sydney School of Veterinary Science, The University of Sydney, New South Wales, Australia
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Bertram CA, Klopfleisch R, Erickson NA, Lübke-Becker A, Müller K. Leiomyosarcoma of the external ear canal as a cause of otitis externa, media, interna in a chinchilla (Chinchilla lanigera). J Exot Pet Med 2019. [DOI: 10.1053/j.jepm.2019.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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13
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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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Østevik L, Rudlang K, Holt Jahr T, Valheim M, Njaa BL. Bilateral tympanokeratomas (cholesteatomas) with bilateral otitis media, unilateral otitis interna and acoustic neuritis in a dog. Acta Vet Scand 2018; 60:31. [PMID: 29788991 PMCID: PMC5964671 DOI: 10.1186/s13028-018-0386-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 05/16/2018] [Indexed: 11/15/2022] Open
Abstract
Background An aural cholesteatoma, more appropriately named tympanokeratoma, is an epidermoid cyst of the middle ear described in several species, including dogs, humans and Mongolian gerbils. The cyst lining consists of stratified, keratinizing squamous epithelium with central accumulation of a keratin debris. This case report describes vestibular ganglioneuritis and perineuritis in a dog with chronic otitis, bilateral tympanokeratomas and presumed extension of otic infection to the central nervous system. Case presentation An 11-year-old intact male Dalmatian dog with chronic bilateral otitis externa and sudden development of symptoms of vestibular disease was examined. Due to the dog’s old age the owner opted for euthanasia without any further examination or treatment and the dog was submitted for necropsy. Transection of the ears revealed grey soft material in the external ear canals and pearly white, dry material consistent with keratin in the tympanic bullae bilaterally. The brain and meninges were grossly unremarkable. Microscopical findings included bilateral otitis externa and media, unilateral otitis interna, ganglioneuritis and perineuritis of the spiral ganglion of the vestibulocochlear nerve and multifocal to coalescing, purulent meningitis. A keratinizing squamous epithelial layer continuous with the external acoustic meatus lined the middle ear compartments, consistent with bilateral tympanokeratomas. Focal bony erosion of the petrous portion of the temporal bone and squamous epithelium and Gram-positive bacterial cocci were evident in the left cochlea. The findings suggest that meningitis developed secondary to erosion of the temporal bone and ganglioneuritis and/or perineuritis of the vestibulocochlear nerve. Conclusions Middle ear tympanokeratoma is an important and potentially life-threatening otic condition in the dog. Once a tympanokeratoma has developed expansion of the cyst can lead to erosion of bone and extension of otic infection to the inner ear, vestibulocochlear ganglion and nerve potentially leading to bacterial infection of the central nervous system. Electronic supplementary material The online version of this article (10.1186/s13028-018-0386-4) contains supplementary material, which is available to authorized users.
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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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Belmudes A, Pressanti C, Barthez PY, Castilla-Castaño E, Fabries L, Cadiergues MC. Computed tomographic findings in 205 dogs with clinical signs compatible with middle ear disease: a retrospective study. Vet Dermatol 2017; 29:45-e20. [DOI: 10.1111/vde.12503] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2017] [Indexed: 02/02/2023]
Affiliation(s)
- Audrey Belmudes
- Small Animal Hospital; Dermatology Service; Université de Toulouse; ENVT; 23 chemin des Capelles 31076 Toulouse France
| | - Charline Pressanti
- Small Animal Hospital; Dermatology Service; Université de Toulouse; ENVT; 23 chemin des Capelles 31076 Toulouse France
| | | | - Eloy Castilla-Castaño
- Small Animal Hospital; Dermatology Service; Université de Toulouse; ENVT; 23 chemin des Capelles 31076 Toulouse France
| | - Lionel Fabries
- Centre Scanner Vétérinaire; 45 avenue de Toulouse 31650 Saint Orens France
| | - Marie C. Cadiergues
- UDEAR; Université de Toulouse; INSERM; ENVT; 23 chemin des Capelles 31076 Toulouse France
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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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Dawson C, Volk HA, Lam R, Sanchez RF. Exophthalmia due to intracranial abscess from grass seed foreign material in a dog. VETERINARY RECORD CASE REPORTS 2014. [DOI: 10.1136/vetreccr-2014-000085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Charlotte Dawson
- Veterinary Clinical SciencesThe Royal Veterinary CollegeNorth MymmsHertsUK
| | | | - Richard Lam
- Veterinary Clinical SciencesThe Royal Veterinary CollegeNorth MymmsHertsUK
| | - Rick F Sanchez
- Veterinary Clinical SciencesThe Royal Veterinary CollegeNorth MymmsHertsUK
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Calvo I, Espadas I, Hammond G, Pratschke K. Epineurial repair of an iatrogenic facial nerve neurotmesis after total ear canal ablation and lateral bulla osteotomy in a dog with concurrent cranio-mandibular osteopathy. J S Afr Vet Assoc 2014; 85:1050. [PMID: 25686402 DOI: 10.4102/jsava.v85i1.1050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Revised: 01/06/2014] [Accepted: 02/07/2014] [Indexed: 11/01/2022] Open
Abstract
A 7-year-old male entire West Highland white terrier was referred to the Small Animal Hospital at the University of Glasgow for bilateral, chronic, medically unresponsive otitis media and externa. A history of cranio-mandibular osteopathy was also reported. Bilateral total ear canal ablation and lateral bulla osteotomy was performed with the aid of a pneumatic burr. Extensive bone proliferation was present bilaterally originating from the caudal mandibular ramus and tympanic bulla which incorporated the horizontal canal on each side. The right facial nerve was identified leaving the stylomastoid foramen and running in a cranial direction through a 1.5 cm diameter cuff of bone surrounding the horizontal canal and external acoustic meatus. Despite careful dissection, a facial nerve neurotmesis ensued which required microsurgical epineurial repair. Neurologic examination performed 12 h post-operatively revealed abnormalities consistent with right facial nerve paralysis. At 3 months, the facial nerve function was found to have improved significantly and was assessed to be normal four months after surgery. To the authors' knowledge, this clinical communication described the first reported clinical case where unilateral facial nerve paralysis resulting from iatrogenic facial nerve neurotmesis was successfully treated by microsurgical epineurial repair.
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Affiliation(s)
- Ignacio Calvo
- Small Animal Hospital - Division of Small Animal Sciences, School of Veterinary Medicine, University of Glasgow.
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