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Beasley MJ, Shores A. Perspectives on pharmacologic strategies in the management of meningoencephalomyelitis of unknown origin in dogs. Front Vet Sci 2023; 10:1167002. [PMID: 37234070 PMCID: PMC10205981 DOI: 10.3389/fvets.2023.1167002] [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: 02/15/2023] [Accepted: 04/18/2023] [Indexed: 05/27/2023] Open
Abstract
There are many non-infectious inflammatory diseases, assumed to be immune-mediated in origin, recognized to affect the nervous system in canine patients. Concentrating on meningoencephalomyelitis of unknown origin, we will discuss the medications used to treat the underlying disease process, focusing on their adverse effects, therapeutic monitoring when necessary and effectiveness. The literature overwhelmingly supports the use of a steroid/ Cytosar® or steroid/ cyclosporine treatment protocol with the steroid tapered after the acute phase of the disease, leaving the secondary medication to control the disease long term. The decision on when and how quickly to taper the steroid is clinician dependent as a best practices has not been established in the literature. Also discussed will be the supportive care treatments often needed in the acute phase of these patients' diagnosis and treatment such as anti-edema and anti-epileptic agents.
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Affiliation(s)
- Michaela J. Beasley
- College of Veterinary Medicine, Mississippi State University, Starkville, MS, United States
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2
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Dowdy H, Evans JE, Jaffey JA, Wycislo KL, Struthers JD, Hostnik ET. Case Report: Successful Management of a Compressive Intraspinal Coccidioides Species Granuloma in a Cat. Front Vet Sci 2022; 8:801885. [PMID: 35036415 PMCID: PMC8757464 DOI: 10.3389/fvets.2021.801885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 11/23/2021] [Indexed: 11/13/2022] Open
Abstract
A 9-year-old, neutered male, domestic shorthair cat from Arizona, was presented for evaluation of a 7-day history of hind limb paraparesis that progressed to paraplegia. There was no history of respiratory abnormalities. Neurologic examination supported localization of a T3-L3 myelopathy. Computed tomography (CT) revealed an expansile widening of the spinal canal dorsal to L4 associated with a strongly contrast-enhancing mass. Moreover, CT series of the thorax revealed a diffuse miliary pulmonary pattern, as well as tracheobronchial, sternal, and cranial mediastinal lymphadenomegaly. Transthoracic lung lobe and sternal lymph node fine needle aspiration revealed pyogranulomatous inflammation with Coccidioides spp. spherules and endospores. A suspected diagnosis of spinal coccidioidomycosis was made; fluconazole (10.9 mg/kg PO q12h) treatment was initiated, and decompressive neurosurgery was performed. The granuloma was removed en bloc and histopathology revealed marked, chronic-active, pyogranulomatous myelitis with intralesional Coccidioides spp. spherules with endosporulation. Serum anti-Coccidioides spp. antibody titer results revealed a negative IgM and a positive IgG (1:4). The cat was treated with fluconazole for 445 days and examined at various time points, with the last examination 2 years after initial presentation. The cat returned to full ambulation with only mild functional deficits of the right hind limb. In conclusion, this report documents the diagnosis, treatment, and long-term follow up of a cat with a compressive Coccidioides spp. spinal cord granuloma. This case highlights the importance of including coccidioidomycosis as a differential diagnosis for cats with peracute hindlimb paraplegia that have lived in or traveled to regions where Coccidioides spp. is endemic, and demonstrates the potential for a good long-term outcome with decompressive neurosurgery and antifungal therapy.
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Affiliation(s)
- Hannah Dowdy
- Department of Specialty Medicine, College of Veterinary Medicine, Midwestern University, Glendale, AZ, United States
| | - Jason E Evans
- Department of Specialty Medicine, College of Veterinary Medicine, Midwestern University, Glendale, AZ, United States
| | - Jared A Jaffey
- Department of Specialty Medicine, College of Veterinary Medicine, Midwestern University, Glendale, AZ, United States
| | - Kathryn L Wycislo
- Department of Pathology, College of Veterinary Medicine, Midwestern University, Glendale, AZ, United States
| | - Jason D Struthers
- Department of Pathology, College of Veterinary Medicine, Midwestern University, Glendale, AZ, United States
| | - Eric T Hostnik
- Department of Veterinary Clinical Sciences, Veterinary Medical Center, Ohio State University, Columbus, OH, United States
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3
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Hecht S, Anderson KM, Castel A, Griffin JF, Hespel AM, Nelson N, Sun X. Agreement of Magnetic Resonance Imaging With Computed Tomography in the Assessment for Acute Skull Fractures in a Canine and Feline Cadaver Model. Front Vet Sci 2021; 8:603775. [PMID: 33969028 PMCID: PMC8100023 DOI: 10.3389/fvets.2021.603775] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 03/26/2021] [Indexed: 12/05/2022] Open
Abstract
Computed tomography (CT) is the imaging modality of choice to evaluate patients with acute head trauma. However, magnetic resonance imaging (MRI) may be chosen in select cases. The objectives of this study were to evaluate the agreement of MRI with CT in the assessment for presence or absence of acute skull fractures in a canine and feline cadaver model, compare seven different MRI sequences (T1-W, T2-W, T2-FLAIR, PD-W, T2*-W, “SPACE” and “VIBE”), and determine agreement of four different MRI readers with CT data. Pre- and post-trauma CT and MRI studies were performed on 10 canine and 10 feline cadaver heads. Agreement of MRI with CT as to presence or absence of a fracture was determined for 26 individual osseous structures and four anatomic regions (cranium, face, skull base, temporomandibular joint). Overall, there was 93.5% agreement in assessing a fracture as present or absent between MRI and CT, with a significant difference between the pre and post trauma studies (99.4 vs. 87.6%; p < 0.0001; OR 0.042; 95% CI 0.034–0.052). There was no significant difference between dogs and cats. The agreement for the different MRI sequences with CT ranged from 92.6% (T2*-W) to 94.4% (PD-W). There was higher agreement of MRI with CT in the evaluation for fractures of the face than other anatomic regions. Agreement with CT for individual MRI readers ranged from 92.6 to 94.7%. A PD-W sequence should be added to the MR protocol when evaluating the small animal head trauma patient.
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Affiliation(s)
- Silke Hecht
- Department of Small Animal Clinical Sciences, University of Tennessee, Knoxville, TN, United States
| | - Kimberly M Anderson
- Department of Small Animal Clinical Sciences, University of Tennessee, Knoxville, TN, United States
| | - Aude Castel
- Department of Small Animal Clinical Sciences, University of Tennessee, Knoxville, TN, United States
| | - John F Griffin
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, United States
| | - Adrien-Maxence Hespel
- Department of Small Animal Clinical Sciences, University of Tennessee, Knoxville, TN, United States
| | - Nathan Nelson
- Department of Molecular and Biomedical Sciences, North Carolina State University, Raleigh, NC, United States
| | - Xiaocun Sun
- Office of Information Technology, University of Tennessee, Knoxville, TN, United States
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4
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Wyatt S, Llabres-Diaz F, Lee CY, Beltran E. Early CT in dogs following traumatic brain injury has limited value in predicting short-term prognosis. Vet Radiol Ultrasound 2021; 62:181-189. [PMID: 33241888 DOI: 10.1111/vru.12933] [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] [Received: 04/15/2020] [Revised: 09/24/2020] [Accepted: 09/27/2020] [Indexed: 01/06/2023] Open
Abstract
Traumatic brain injury is associated with a high risk of mortality in veterinary patients, however publications describing valid prognostic indicators are currently lacking. The objective of this retrospective observational study was to determine whether early CT findings are associated with short-term prognosis following traumatic brain injury (TBI) in dogs. An electronic database was searched for dogs with TBI that underwent CT within 72 h of injury; 40 dogs met the inclusion criteria. CT findings were graded based on a Modified Advanced Imaging System (MAIS) from grade I (normal brain parenchyma) to VI (bilateral lesions affecting the brainstem with or without any foregoing lesions of lesser grades). Other imaging features recorded included presence of midline shift, intracranial hemorrhage, brain herniation, skull fractures, and percentage of total brain parenchyma affected. Outcome measures included survival to discharge and occurrence of immediate onset posttraumatic seizures. Thirty dogs (75%) survived to discharge. Seven dogs (17.5%) suffered posttraumatic seizures. There was no association between survival to discharge and posttraumatic seizures. No imaging features evaluated were associated with the study outcome measures. Therefore, the current study failed to identify any early CT imaging features with prognostic significance in canine TBI patients. Limitations associated with CT may preclude its use for prognostication; however, modifications to the current MAIS and evaluation in a larger study population may yield more useful results. Despite this, CT is a valuable tool in the detection of structural abnormalities following TBI in dogs that warrants further investigation.
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Affiliation(s)
- Sophie Wyatt
- Department of Veterinary Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, UK
| | - Francisco Llabres-Diaz
- Department of Veterinary Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, UK
| | - Chae Youn Lee
- Department of Veterinary Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, UK
| | - Elsa Beltran
- Department of Veterinary Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, UK
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5
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Vali Y, Gielen I, Soroori S, Ludewig E. The diagnostic value of intravenous contrast computed tomography in addition to plain computed tomography in dogs with head trauma. BMC Vet Res 2021; 17:46. [PMID: 33482817 PMCID: PMC7821486 DOI: 10.1186/s12917-021-02764-6] [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: 04/22/2020] [Accepted: 01/13/2021] [Indexed: 11/23/2022] Open
Abstract
Background The aim of this study is to evaluate additional findings which can be detected by post-contrast computed tomography (CCT) in relation to plain CT (PCT) findings in patients presented with head trauma. Medical records of canine patients with the history of head trauma from three institutions were reviewed. PCT- and CCT-anonymized images were evaluated by a veterinary radiologist separately. From the categorized findings the following conclusions were drawn as: abnormalities were identified on (A) PCT but missed on CCT, (B) CCT but missed on PCT, (C) both PCT and CCT. Results Thirty-two patients were included. The results showed that findings identified on CCT or PCT (category A and B) but missed on the other series were limited to mild soft tissue and sinus changes. Overall, 61 different fracture areas, 6 injuries of the temporomandibular joint (TMJ), 4 orbital injuries, 14 nasal cavities with soft tissue density filling, 13 areas of emphysema, 4 symphysis separations, 12 intracranial hemorrhages, 6 cerebral edema, 5 cerebral midline shifts, 3 intracranial aeroceles, 3 brain herniations and 6 intraparenchymal foreign bodies (defined as an abnormal structure located within the brain: e.g. bony fragments, bullet, teeth,..) were identified on both PCT and CCT separately (category C). Severity grading was different in 50% (3/6) of the reported cerebral edema using PCT and CCT images. Conclusion The results showed that PCT is valuable to identify the presence of intracranial traumatic injuries and CCT is not always essential to evaluate vital traumatic changes.
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Affiliation(s)
- Yasamin Vali
- Diagnostic Imaging, Department for Companion Animals and Horses, University of Veterinary Medicine Vienna (Vetmeduni), Veterinärplatz 1, 1210, Vienna, Austria.
| | - Ingrid Gielen
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Ghent University, Ghent, Belgium
| | - Sarang Soroori
- Department of Radiology and Surgery, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Eberhard Ludewig
- Diagnostic Imaging, Department for Companion Animals and Horses, University of Veterinary Medicine Vienna (Vetmeduni), Veterinärplatz 1, 1210, Vienna, Austria
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Hoehne SN, Yozova ID, Vidondo B, Adamik KN. Comparison of the effects of 7.2% hypertonic saline and 20% mannitol on electrolyte and acid-base variables in dogs with suspected intracranial hypertension. J Vet Intern Med 2020; 35:341-351. [PMID: 33236379 PMCID: PMC7848367 DOI: 10.1111/jvim.15973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 11/04/2020] [Accepted: 11/10/2020] [Indexed: 11/30/2022] Open
Abstract
Background Hyperosmolar agents frequently are used to decrease intracranial pressure but their effects on electrolyte and acid‐base variables have not been prospectively investigated. Objectives Compare duration and magnitude of changes in electrolyte and acid‐base variables after hyperosmolar treatment. Animals Twenty‐eight client‐owned dogs with intracranial hypertension caused by various pathologies. Methods Prospective, randomized, nonblinded, experimental cohort study. Fifteen dogs received a single dose (4 mL/kg) of 7.2% hypertonic saline (HTS), 13 dogs received 20% mannitol (MAN) 1 g/kg IV. Electrolyte and acid‐base variables were measured before (T0), and 5 (T5), 60 (T60), and 120 (T120) minutes after administration. Variables were compared between treatments and among time points within treatment groups. Results Mean plasma sodium and chloride concentrations were higher after HTS than MAN at T5 (158 vs 141 mEq/L; 126 vs 109 mEq/L) and significant differences were maintained at all time points. After HTS, plasma sodium and chloride concentrations remained increased from T0 at all time points. After MAN, plasma sodium and chloride concentrations decreased at T5, but these changes were not maintained at T60 and T120. Plasma potassium concentration was lower at T5 after HTS compared with T0 (3.6 vs 3.9 mEq/L) and compared to MAN (3.6 vs 4.1 mEq/L). At T60 and T120, plasma ionized calcium concentration was lower after HTS than MAN (1.2 vs 1.3 mmol/L). No significant differences were found in acid‐base variables between treatments. Conclusions and Clinical Importance At the administered dose, dogs receiving HTS showed sustained increases in plasma sodium and chloride concentrations, whereas dogs receiving MAN showed transient decreases. Future studies should assess the effects of multiple doses of hyperosmolar agents on electrolyte and acid‐base variables.
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Affiliation(s)
- Sabrina N Hoehne
- Division of Small Animal Emergency and Critical Care, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Ivayla D Yozova
- Massey University Pet Emergency Centre, School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - Beatriz Vidondo
- Department of Clinical Research and Public Health, Veterinary Public Health Institute, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Katja N Adamik
- Division of Small Animal Emergency and Critical Care, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
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Chai O, Mazaki-Tovi M, Klainbart S, Kelmer E, Shipov A, Shamir MH. Serum Concentrations of Neuron-Specific Enolase in Dogs Following Traumatic Brain Injury. J Comp Pathol 2020; 179:45-51. [PMID: 32958147 DOI: 10.1016/j.jcpa.2020.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 05/15/2020] [Accepted: 06/18/2020] [Indexed: 01/15/2023]
Abstract
The ability to make an accurate prognosis, which is a prerequisite for treatment decisions, is very limited in dogs with traumatic brain injury (TBI). To determine whether serum concentrations of neuron-specific enolase (NSE) have prognostic value in dogs following TBI, we conducted a prospective, observational, controlled clinical study in an intensive care unit of a university teaching hospital. The study population comprised 24 dogs admitted to the hospital within 72 h of a known event of TBI between January 2010 and January 2015, as well as 25 control healthy shelter dogs admitted for elective neutering. Seventeen injured dogs (70%) survived to discharge, four were euthanized and three died within 48 h. Serum samples were obtained from all dogs (in injured dogs, within 72 h of TBI) and NSE concentrations were measured using enzyme-linked immonosorbent assay. Associations between NSE levels and outcome, Modified Glasgow Coma Scale, time to sampling, age or haemolysis scale were determined. Mean serum NSE concentrations were decreased in dogs with TBI compared with healthy controls (19.4 ± 4.14 ng/ml vs. 24.9 ± 4.6 ng/ml, P <0.001). No association was found between serum NSE concentrations and either survival or severity of neurological impairment. A negative correlation was found between serum NSE concentrations and time from trauma to blood collection (r = -0.50, P = 0.022). These results indicate that serum NSE concentration in dogs following TBI is not an effective marker for severity or outcome. Further studies are warranted to standardize serum NSE measurements in dogs and to determine the peak and half-life levels of this potential biomarker.
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Affiliation(s)
- O Chai
- Koret School of Veterinary Medicine, Veterinary Teaching Hospital, Hebrew University of Jerusalem, Rehovot, Israel.
| | - M Mazaki-Tovi
- Koret School of Veterinary Medicine, Veterinary Teaching Hospital, Hebrew University of Jerusalem, Rehovot, Israel
| | - S Klainbart
- Koret School of Veterinary Medicine, Veterinary Teaching Hospital, Hebrew University of Jerusalem, Rehovot, Israel
| | - E Kelmer
- Koret School of Veterinary Medicine, Veterinary Teaching Hospital, Hebrew University of Jerusalem, Rehovot, Israel
| | - A Shipov
- Koret School of Veterinary Medicine, Veterinary Teaching Hospital, Hebrew University of Jerusalem, Rehovot, Israel
| | - M H Shamir
- Koret School of Veterinary Medicine, Veterinary Teaching Hospital, Hebrew University of Jerusalem, Rehovot, Israel
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Riese F, Meyerhoff N, Nessler J, Tipold A. Misery of insufficient treatment guidelines in post‐traumatic epilepsy. VETERINARY RECORD CASE REPORTS 2019. [DOI: 10.1136/vetreccr-2018-000716] [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)
- Franziska Riese
- Department of Small Animal Medicine and SurgeryKlinik fuer Kleine HaustiereStiftung Tierarztliche Hochschule HannoverHannoverGermany
| | - Nina Meyerhoff
- Department of Small Animal Medicine and SurgeryKlinik fuer Kleine HaustiereStiftung Tierarztliche Hochschule HannoverHannoverGermany
| | - Jasmin Nessler
- Department of Small Animal Medicine and SurgeryKlinik fuer Kleine HaustiereStiftung Tierarztliche Hochschule HannoverHannoverGermany
| | - Andrea Tipold
- Department of Small Animal Medicine and SurgeryKlinik fuer Kleine HaustiereStiftung Tierarztliche Hochschule HannoverHannoverGermany
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9
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Kostic D, Carlson R, Henke D, Rohn K, Tipold A. Evaluation of IL-1β levels in epilepsy and traumatic brain injury in dogs. BMC Neurosci 2019; 20:29. [PMID: 31208341 PMCID: PMC6580646 DOI: 10.1186/s12868-019-0509-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 06/03/2019] [Indexed: 11/20/2022] Open
Abstract
Background Epilepsy is a common neurological disease in dogs affecting approximately 0.6–0.75% of the canine population. There is much evidence of neuroinflammation presence in epilepsy, creating new possibilities for the treatment of the disease. An increased expression of interleukin-1 beta (IL-1β) was reported in epileptogenic foci. We hypothesized that there is an elevation of IL-1β in serum and CSF of dogs with epilepsy, as well as in serum of dogs with TBI, reflecting involvement of this cytokine in pathophysiology of naturally occurring canine epilepsy in a clinical setting. Results IL-1β levels were evaluated in CSF and serum of six healthy and 51 dogs with epilepsy (structural and idiopathic). In 16 dogs with TBI, only serum was tested. IL-1β concentrations in CSF were not detectable. Serum values were not elevated in dogs with TBI in comparison to healthy controls (p > 0.05). However, dogs with epilepsy had increased levels of IL-1β in serum (p = 0.003) regardless of the underlying cause of the disease (p = 0.0045). There was no significant relationship between the variables and IL-1β levels. Statistically noticeable (p = 0.0630) was that approximately 10% of dog with epilepsy (R2 = 0.105) had increased seizure frequency and IL-1β elevation. Conclusion Increased IL-1β levels were detected in the peripheral blood in dogs with idiopathic and structural epilepsy leading to the assumption that there is an involvement of inflammation in pathophysiology of epilepsy which should be considered in the search for new therapeutic strategies for this disease. However, to better understand the pathogenic role of this cytokine in epilepsy, further evaluation of IL-1β in brain tissue is desired.
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Affiliation(s)
- Draginja Kostic
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Foundation, Buenteweg 9, 30559, Hannover, Germany. .,Centre for Systems Neuroscience, Hannover, Germany.
| | - Regina Carlson
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Foundation, Buenteweg 9, 30559, Hannover, Germany
| | - Diana Henke
- Animal Clinic am Hasenberg, Stuttgart, Germany
| | - Karl Rohn
- Institute of Biometry, Epidemiology, and Information Processing, University of Veterinary Medicine, Hannover, Germany
| | - Andrea Tipold
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Foundation, Buenteweg 9, 30559, Hannover, Germany.,Centre for Systems Neuroscience, Hannover, Germany
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10
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Abstract
Head trauma is a common cause of significant morbidity and mortality in dogs and cats. Traumatic brain injury may occur after head trauma. Understanding the pathophysiology of primary and secondary injury after head trauma is essential for management. This article reviews the pathophysiology of head trauma, patient assessment and diagnostics, and treatment recommendations.
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Affiliation(s)
- Kendon W Kuo
- Emergency and Critical Care, Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, 1220 Wire Road, Auburn, AL 36849- 5540, USA.
| | - Lenore M Bacek
- Emergency and Critical Care, Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, 1220 Wire Road, Auburn, AL 36849- 5540, USA
| | - Amanda R Taylor
- Neurology/Neurosurgery, Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, 1220 Wire Road, Auburn, AL 36849- 5540, USA
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11
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Lewis MJ, Howard JF, Olby NJ. The Relationship between Trans-Lesional Conduction, Motor Neuron Pool Excitability, and Motor Function in Dogs with Incomplete Recovery from Severe Spinal Cord Injury. J Neurotrauma 2017; 34:2994-3002. [PMID: 28462632 DOI: 10.1089/neu.2017.5012] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Spontaneous, acute, complete thoracolumbar spinal cord injury (TL-SCI) in dogs frequently results in permanent deficits modeling chronic paralysis in people. Recovery of walking without recovery of sensation has been interpreted in dogs as reflexive spinal walking. To evaluate this assumption, this study characterized the electrophysiological status of motor and sensory long tracts and local reflex circuitry in dogs with absent recovery of sensation after acute TL-SCI and correlated findings to gait scores. Twenty dogs with permanent deficits after acute, clinically complete TL-SCI and 6 normal dogs were prospectively enrolled. Transcranial magnetic motor evoked potentials (MEPs), somatosensory evoked potentials (SSEPs), H-reflex, and F-waves were evaluated. Gait was quantified using an ordinal, open field scale (OFS) and treadmill-based stepping and coordination scores (SS, RI). MEP latency and H-reflex variables were compared between cases and controls. Associations between presence of MEPs, SSEPs, F-waves or H-reflex variables, and gait scores were determined. Pelvic limb MEPs were detected in 4 cases; no case had trans-lesional sensory conduction. Latency was longer and conduction velocity slower in cases than controls (pa = 0.0064, 0.0023, respectively). Three of 4 cases with pelvic limb MEPs were ambulatory, and gait scores (OFS, SS, RI) were each associated with presence of trans-lesional conduction (pa = 0.006, 0.006, 0.003, respectively). H threshold in cases (mean, 3.2mA ±2.5) was lower than controls (mean, 7.9mA ±3.1; pa = 0.011) and was inversely associated with treadmill-based scores, SS, and RI (pa = 0.042, 0.043, respectively). The association between pelvic limb MEPs and gait scores supports the importance of descending influence on regaining walking after severe TL-SCI in dogs rather than just activation of spinal walking. The inverse association between H-reflex threshold and gait scores implies that increases in motor neuron pool excitability might also contribute to motor recovery.
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Affiliation(s)
- Melissa J Lewis
- 1 Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University , Raleigh, North Carolina.,2 Comparative Medicine Institute, North Carolina State University , Raleigh, North Carolina
| | - James F Howard
- 3 Department of Neurology, School of Medicine, University of North Carolina , Chapel Hill, North Carolina
| | - Natasha J Olby
- 1 Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University , Raleigh, North Carolina.,2 Comparative Medicine Institute, North Carolina State University , Raleigh, North Carolina
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12
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Cardy TJ, Lam R, Peters LM, McLaren PJ, Matas Riera M, De Decker S. Successful medical management of a domestic longhair cat with subdural intracranial empyema and multifocal pneumonia. J Vet Emerg Crit Care (San Antonio) 2017; 27:238-242. [PMID: 28079960 DOI: 10.1111/vec.12566] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 05/21/2015] [Accepted: 06/12/2015] [Indexed: 01/15/2023]
Affiliation(s)
- Thomas J.A. Cardy
- Departments of Clinical Science and Services
- The Royal Veterinary College, University of London; Hawkshead Lane, North Mymms Hertfordshire United Kingdom
| | - Richard Lam
- Departments of Clinical Science and Services
- The Royal Veterinary College, University of London; Hawkshead Lane, North Mymms Hertfordshire United Kingdom
| | - Laureen M. Peters
- Pathology and Pathogen Biology
- The Royal Veterinary College, University of London; Hawkshead Lane, North Mymms Hertfordshire United Kingdom
| | - Philippa J. McLaren
- Pathology and Pathogen Biology
- The Royal Veterinary College, University of London; Hawkshead Lane, North Mymms Hertfordshire United Kingdom
| | - Màrian Matas Riera
- Departments of Clinical Science and Services
- The Royal Veterinary College, University of London; Hawkshead Lane, North Mymms Hertfordshire United Kingdom
| | - Steven De Decker
- Departments of Clinical Science and Services
- The Royal Veterinary College, University of London; Hawkshead Lane, North Mymms Hertfordshire United Kingdom
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13
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14
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Adamik KN, Butty E, Howard J. In vitro effects of 3% hypertonic saline and 20% mannitol on canine whole blood coagulation and platelet function. BMC Vet Res 2015; 11:242. [PMID: 26403081 PMCID: PMC4582639 DOI: 10.1186/s12917-015-0555-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2015] [Accepted: 09/17/2015] [Indexed: 12/11/2022] Open
Abstract
Background Hyperosmolar therapy, using either mannitol or hypertonic saline (HTS), is considered the treatment of choice for intracranial hypertension. However, hyperosmolar agents may impair coagulation and platelet function, limiting their use in patients at risk for hemorrhage. Despite this, studies evaluating the effects of mannitol compared to other hyperosmolar agents in dogs are largely lacking. The aim of this study was to compare the in vitro effects on global hemostasis and platelet function of 20 % mannitol and 3 % HTS on canine blood. Methods Citrated whole blood from 15 healthy dogs was diluted with 0.9 % saline, 20 % mannitol and 3 % HTS in ratios of 1:16 and 1:8. Rotational thromboelastometry (ROTEM) was used to assess clotting time (CT), clot formation time (CFT) and maximal clot firmness (MCF) following extrinsic activation (Ex-tem) and after platelet inhibition (Fib-tem). A platelet function analyzer (PFA-100) was used to assess closure time (CtPFA). Results No significant differences were observed between untreated whole blood and samples diluted with saline. Samples diluted with both mannitol and HTS were hypocoagulable compared to untreated whole blood samples. At a dilution of 1:16, no significant differences were found between any measured parameter in samples diluted with saline compared to mannitol or HTS. At a 1:8 dilution, CtPFA was prolonged in samples diluted with mannitol and HTS compared to saline, and CtPFA was prolonged more with mannitol than HTS. Ex-tem CT was increased at a 1:8 dilution with mannitol compared to HTS. Ex-tem CFT was prolonged at a 1:8 dilution with both agents compared to saline, and was prolonged more with mannitol than HTS. Ex-tem MCF was reduced at a 1:8 dilution with both agents compared to saline. Discussion and Conclusions Data in this study indicate that both mannitol and HTS affect canine platelet function and whole blood coagulation in vitro in a dose-dependent fashion. The most pronounced effects were observed after high dilutions with mannitol, which impaired platelet aggregation, clot formation time, clot strength, and fibrin formation significantly more than HTS. Further in vivo studies are necessary before recommendations can be made.
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Affiliation(s)
- Katja-Nicole Adamik
- Division of Emergency and Critical Care, Small Animal Clinic, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Laenggassstrasse 128, 3012, Bern, Switzerland.
| | - Emmanuelle Butty
- Division of Emergency and Critical Care, Small Animal Clinic, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Laenggassstrasse 128, 3012, Bern, Switzerland.
| | - Judith Howard
- Clinical Diagnostic Laboratory, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Laenggassstrasse 124, 3012, Bern, Switzerland.
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Yanai H, Tapia-Nieto R, Cherubini GB, Caine A. Results of magnetic resonance imaging performed within 48 hours after head trauma in dogs and association with outcome: 18 cases (2007–2012). J Am Vet Med Assoc 2015; 246:1222-9. [DOI: 10.2460/javma.246.11.1222] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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