Inflammatory disease of the central nervous system

Neuroinflammatory diseases of the central nervous system of dogs: A retrospective study of 207 cases (2008-2019)

In this study we describe 207 cases of neuroinflammatory diseases of the central nervous system (CNS) in dogs autopsied at the Athens Veterinary Diagnostic Laboratory (University of Georgia, United States) from 2008 to 2019. Idiopathic and infectious diseases were diagnosed in 111 cases (53.6%) and 96 cases (46.4%), respectively. Idiopathic diseases consisted of granulomatous meningoencephalomyelitis (n = 42; 37.8% of idiopathic cases), nonspecific lymphoplasmacytic meningoencephalomyelitis (n = 39; 35.1%), necrotizing meningoencephalomyelitis (n = 22; 19.8%), presumed steroid-responsive meningitis-arteritis (n = 6; 5.4%), and necrotizing leukoencephalitis (n = 2; 1.8%). Infectious diseases consisted of bacterial infections (n = 49; 51% of infectious cases), viral infections (n = 39; 40.6%), fungal infections (n = 5; 5.2%), and parasitic infections (n = 3; 3.1%). Our study provides an overview of the most frequent neuroinflammatory diseases of the CNS of dogs in our diagnostic routine; indicates that a comprehensive diagnostic approach, including a thorough evaluation of the pathology findings and ancillary laboratory testing results, is important for an adequate diagnosis of neurologic diseases in dogs; and underscores the problems associated with the variability in tissue sample collection methods among cases. The great number of nonspecific lymphoplasmacytic meningoencephalitis also highlights the need for development of molecular laboratory tests to identify potential infectious agents in these cases.

Non-suppurative meningoencephalitis of unknown origin in cats and dogs: an immunohistochemical study

Non-suppurative meningoencephalitis of unknown cause is a frequent finding in dogs and cats. Fifty-three dogs and 33 cats with non-suppurative meningoencephalitis of unknown aetiology were examined immunohistochemically for 18 different infectious agents, including viruses, bacteria and prion protein^Sc. In 14 (26%) of the dogs and 13 (39%) of the cats a causative agent was identified in the central nervous system (CNS), two dogs and one cat giving positive results for two infectious agents simultaneously. The study revealed infections with known causative agents (porcine herpes virus 1, feline infectious peritonitis virus, Escherichia coli) and a new disease pattern of parvovirus infection in the CNS of dogs and cats. Infection of the CNS with feline leukaemia virus was found in a cat. Five dogs and four cats gave positive results for West Nile virus (WNV) antigen. In one dog, canine parainfluenza virus antigen was detected in the brain. Four dogs and four cats gave positive results for encephalomyocarditis virus (EMCV). The significance of the detection of WNV and EMCV antigen requires further study. The aetiology remained undetermined in 39 dogs (74%) and 20 cats (61%). Although it is possible that non-infectious causes play a more important role than previously thought, infections with hitherto unrecognized agents cannot be ruled out.

Infectious diseases of the central nervous system

Neurologic disease is seen commonly in cats, with infectious causes accounting for 30-45% of cases. However, since a specific infection cannot be identified in 12-40% of these cases, it is essential that we try to understand these cases better in the hope that we can eventually identify the cause(s), and so determine how best to treat and/or prevent them.

Relation of clinical signs to pathological changes in 19 cases of canine distemper encephalomyelitis

In an attempt to associate the clinical neurological syndromes with the neuropathological features of canine distemper (CD), 19 spontaneous cases with neurological involvement were examined, before and after euthanasia. Seventeen dogs were less than one year of age and all except two (89.4%) were unvaccinated against CD. Various extraneural signs associated with CD encephalomyelitis (CDE) were seen in 15 dogs. Generalized or localized myoclonus was the most common sign observed (13/19). Seventeen of the dogs presented with signs suggestive of one neuroanatomical location of lesions. Of these animals, seven had signs of cerebral, two of cerebellar, four of cervical, one of cervicothoracic, two of thoracolumbar and two of lumbosacral syndrome. The diagnosis of CD was confirmed immunohistochemically (detection of CD viral antigen), serologically (neutralizing serum antibody titre > or = 16) and histopathologically (CDV inclusion bodies, type of central nervous system lesions). An association of the neuroanatomical lesion location and the histopathological findings was noted in 14 out of 17 dogs (82.3%). Myoclonus could be attributed to lower motor neuron damage in eight out of 13 dogs (61.5%).

Electroencephalographic findings of encephalitis in beagle dogs experimentally infected with canine distemper virus (CDV)

The present research study had two goals. Firstly, the effect of medetomidine/propofol on the electroencephalographic (EEG) recordings of nine SPF dogs was analysed. It was found that the basic pooled pattern of EEG recordings was characterized by a mean amplitude of 28 uV (range = 15-70 uV) and mean frequency of 1.8 Hz (range = 1-2.5 Hz), with superimposed low voltage (amplitude range = 4-20 uV; mean 14 uV) and fast activity (frequency range = 10-27 Hz; mean 18 Hz). All results were significantly constant (P < 0.05) and accurately reproducible (R = 0.70). The second goal was to investigate the value of EEG findings from dogs experimentally infected with canine distemper virus (CDV) under the same anaesthetic conditions, for the diagnosis of encephalitis. It was found that the EEG traces were characterized by high voltage, slow activity (HVSA) with superimposed low voltage, fast activity (LVFA). By comparing the mean values of amplitude and frequency for each single phase at different time intervals, it was found that only the mean value of the superimposed frequency was linearly distributed and changed significantly (P < 0.001). Thus, at least three readings should be taken from phase III of the EEG recording in order to obtain accurate values. The study has shown that electroencephalography can supply valuable information in cases of CDV encephalitis and can assist greatly in the differential diagnosis.

Clinical and electroencephalographic findings of inflammatory and infectious diseases of the central nervous system in dogs: a retrospective study

In the present study medical records of 97 dogs with inflammatory/infectious diseases of the central nervous system (CNS), including 26 dogs with a history of seizures, were retrospectively examined. The aims of the study were to analyse the incidence rate of seizures, to search for criteria to recognize specific inflammatory diseases and to determine how far electroencephalography may be useful in the early confirmation of encephalitis and encephalitis-associated seizures. The incidence rate of seizures in this dog population was 26.8%, and dogs with protozoal encephalitis had the highest rate. Signalment, history, extraneural and neurological signs including localization contributed only a little to a specific diagnosis. Surprisingly focal clinical signs were observed in two-thirds of the dogs. Either focal or multifocal clinical signs were related mainly to the forebrain in dogs with a history of seizures and to the brainstem in dogs without seizures. Cerebrospinal fluid (CSF) analyses were useful to separate encephalitis from other CNS diseases and to distinguish certain conditions from others in approximately half the cases. Electroencephalography (EEG) revealed two distinct patterns in 25 examined dogs with histopathologically confirmed disease entities, which were characterized by high voltage, slow activity (HVSA) with superimposed low voltage, fast activity (LVFA). These changes were consistent and no significant differences (P > 0.05) between dogs with and without seizures, nor between different disease entities, were noted. However, all the dogs with seizures had in addition a uniform paroxysmal EEG activity with a high voltage (mean = 106.3 microV), fast activity (mean = 8.5 Hz) pattern. Moreover in several dogs from the present study this pattern had a focal distribution despite the fact that clinically seizures appear generalized. Therefore it was concluded that EEG may be a very helpful diagnostic tool to confirm an early diagnosis of encephalitis and to separate potential seizure cases from those without seizures.

Diagnosis of inflammatory and infectious diseases of the central nervous system in dogs: a retrospective study

The medical records of 220 dogs with inflammatory/infectious diseases of the central nervous system (CNS) were retrospectively examined. The aims of the study were to determine if clinical and clinicopathologic data (not including biopsy or necropsy examination) could distinguish inflammatory CNS diseases from diseases of other types, and to search for criteria allowing differentiation of specific inflammatory diseases. The signalment, historical findings, extraneural and neurological signs, and the lesion site contributed marginally to a specific diagnosis. Multifocal signs were only noticed in one third of the dogs with inflammatory/infectious diseases. Particular neurological abnormalities were more frequent in certain diseases than in others (eg, myoclonus was frequent in dogs with distemper, but it was also found in those with other meningoencephalomyelitides). Hematologic findings contributed to the diagnosis in certain conditions (eg, canine distemper encephalitis, protozoal encephalomyelitis, steroid-responsive meningitis-arteritis). Cerebrospinal fluid examinations, including immunoglobulin G index and cytology were useful to separate meningoencephalomyelitides from the other CNS diseases and to distinguish certain conditions from others. In most cases a specific diagnosis depended on a combination of clinical signs and ancillary diagnostic aids. Still, a specific diagnosis remained very difficult, if not impossible, in at least one third of the dogs.

Myelitis and meningitis

Animals with meningomyelitis have clinical neurologic signs that typically range from paraspinal discomfort to tetraplegia; however, most affected animals also show evidence of multifocal CNS involvement with brain stem and cerebral cortical structures being affected most commonly. The cause, duration, and host response to the disease process will determine the clinical signs in individual animals. Confirmation of a specific causative agent is difficult, but CSF analysis and immunotesting of serum and CSF yield the most rewarding diagnostic results. Successful treatment is based on formulation of an appropriate and aggressive therapeutic regimen. In some diseases, no effective treatment is available, and some animals may develop permanent neurologic disabilities.

The pathophysiologic basis of behavior problems

A wide range of physical disorders in small animals manifest as abnormal behavior. Owners may present physically ill animals exhibiting aggression or other personality changes, self-mutilation or excessive pruritus, hyperactivity, abnormal elimination patterns, or other problems. Pathophysiology should be investigated in cases of sudden or persistent changes in the behavior of an animal.

Ocular manifestations of systemic disease in the dog and cat. Recent developments

The number of canine and feline clinical diseases that may be manifested as ocular dysfunction continues to increase. Veterinarians are often presented with sick patients who also have eye disease. Conversely, animals are examined for eye disease that on closer inspection also have a systemic illness. A decision must be made; is there a relationship between the observed ocular and systemic problem, or are they separate morbid processes? If they are related, can the ocular signs be used to better define the systemic illness, chart its course, or establish a prognosis? It is hoped this article will aid the clinician in gaining a better perspective on the complex relationship between the eyes and systemic disease.