1
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Riker J, Njaa BL, Rissi DR. Intracranial inflammatory polyp with cerebellopontine compression and leptomeningitis secondary to chronic otitis in a red kangaroo. J Vet Diagn Invest 2023; 35:806-809. [PMID: 37615172 PMCID: PMC10621546 DOI: 10.1177/10406387231195848] [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: 08/25/2023] Open
Abstract
CNS lesions associated with chronic otitis have not been reported in red kangaroos (Macropus rufus), to our knowledge. Here we describe an intracranial inflammatory polyp secondary to chronic otitis in a 6-y-old female red kangaroo with right auricular discharge, loss of balance, and head tilt. Autopsy highlighted a pale-yellow, firm, intracranial polypoid growth that extended from the right tympanic cavity through the internal acoustic meatus and intracranially, with compression of the right cerebellopontine angle. Anaerobic bacterial culture yielded Bacteroides pyogenes from fresh brain and a right external ear swab. Histologically, the tympanic cavity was effaced by neutrophils and macrophages surrounded by lymphocytes and plasma cells, as well as edematous fibrovascular tissue. The epithelial lining of the mucoperiosteum was hyperplastic, with epithelial pseudoglands surrounded by fibrovascular tissue. Areas of temporal bone lysis and remodeling were associated with the inflammatory changes, which occasionally surrounded adjacent nerves. Fibrovascular tissue and inflammatory cells extended from the tympanic cavity through the internal acoustic meatus and into the intracranial cavity, forming the polypoid growth observed grossly; the polyp consisted of a dense core of fibrovascular tissue with scattered clusters of neutrophils and foamy macrophages. Lymphocytes and plasma cells surrounded the leptomeningeal perivascular spaces in the brainstem, cerebellum, and occipital lobe.
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Affiliation(s)
- Jesse Riker
- Department of Pathology, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | | | - Daniel R. Rissi
- Athens Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
- Department of Pathology, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
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2
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Rawson F, Foreman M, Mignan T, Galer J, Fraser A, Crawford A. Clinical presentation, treatment, and outcome of 24 dogs with bacterial meningitis or meningoencephalitis without empyema (2010-2020). J Vet Intern Med 2023; 37:223-229. [PMID: 36639963 PMCID: PMC9889693 DOI: 10.1111/jvim.16605] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 11/23/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Bacterial meningitis (BM) and meningoencephalitis (BMEM) are associated with high case fatality rates and neurologic sequelae in people, but limited data exists on outcome in dogs. HYPOTHESIS/OBJECTIVES To report the clinicopathologic features, treatment and outcome of BM/BMEM in dogs, with a focus on clinical presentation, relapse and long-term neurological deficits. ANIMALS Twenty-four client-owned dogs diagnosed with BM/BMEM without empyema. METHODS Retrospective case series of dogs diagnosed with BM/BMEM from 5 veterinary referral hospitals between January 2010 and August 2020. RESULTS Twenty-four dogs were included. Median duration of clinical signs was 2 days (range ≤24 hours to 30 days) and signs recorded included pyrexia (3) and cervical hyperesthesia (10). Neurological deficits were present in 18 dogs including altered mentation (12), ataxia (8), nonambulatory status (8), head tilt (8), and cranial nerve deficits (13). Intracellular bacteria were visualized on cerebrospinal fluid (CSF) analysis in 15/24 dogs, with positive CSF bacteriological culture in 8/21. Otitis media/interna (OMI) was diagnosed in 15/24 dogs, of which 6/15 dogs underwent total ear canal ablation and lateral bulla osteotomy. Twenty dogs survived to hospital discharge. Median duration of antibiotic administrations was 8 weeks (range, 2-16 weeks). Glucocorticoids were administered to 15 dogs. Median follow-up time was 92 days (range, 10-2233 days). Residual neurological deficits were reported in 9 dogs, with a single case of suspected relapse. CONCLUSIONS AND CLINICAL IMPORTANCE Clinical signs were variable in dogs with BM/BMEM, the nidus of bacterial infection was often OMI and the majority of dogs made a full recovery with treatment.
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Affiliation(s)
- Faye Rawson
- Royal Veterinary CollegeNorth MymmsUK,Langford Veterinary ServicesUniversity of BristolBristolUK
| | | | | | | | - Anne Fraser
- Davies Veterinary SpecialistsHitchinUK,Anderson Moores Veterinary SpecialistsWinchesterUK
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3
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Blanco C, Moral M, Minguez JJ, Lorenzo V. Clinical Presentation, MRI Characteristics, and Outcome of Conservative or Surgical Management of Spinal Epidural Empyema in 30 Dogs. Animals (Basel) 2022; 12:ani12243573. [PMID: 36552493 PMCID: PMC9774607 DOI: 10.3390/ani12243573] [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: 11/02/2022] [Revised: 12/06/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
Spinal epidural empyema (SEE) represents a neurological emergency in veterinary medicine, but information on this condition is limited to date. This retrospective case series study describes the clinical and magnetic resonance imaging (MRI) features, and the outcome of conservative or surgical management of SEE in 30 dogs diagnosed with SEE from September 2015 to March 2020 at one referral neurology centre. The most frequent clinical sign was pain 28/30 (93%), and 22/30 (73%) showed neurological signs with ambulatory paraparesis/tetraparesis 15/30 (50%), monoparesis 1/30 (3.3%), non-ambulatory paraparesis 3/30 (10%), or paraplegia 3/30 (10%). MRI was valuable for the diagnosis and in the follow-up. In this group of dogs, 24/30 (80%) were conservatively treated and 6/30 (20%) were surgically treated. The outcome was considered favourable in all dogs: 20/30 (66.6%) achieved full recovery (3 surgically treated and 17 medically treated) and 10/30 (33.3%) dogs had an improvement in the neurological signs with residual ambulatory paresis (3 surgically treated and 7 medically treated). Surgical treatment showed better short-term (7 days) outcomes than medical treatment in non-ambulatory paraparetic or paraplegic dogs (33%). Nevertheless, this study suggests that a good recovery may be achieved with conservative treatment even for non-ambulatory or paraplegic dogs. Further prospective studies, with a standardised protocol of diagnostic tests and a homogeneous distribution of conservatively and surgically treated dogs, are needed to establish treatment guidelines.
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Affiliation(s)
- Carlos Blanco
- Neurología Veterinaria, Calle Diseño n 26, 28906 Getafe, Spain
- Correspondence:
| | - Meritxell Moral
- Neurología Veterinaria, Calle Diseño n 26, 28906 Getafe, Spain
| | - Juan José Minguez
- Scarsdale Vets-Pride Veterinary Centre, Riverside Road, Derby DE24 8HX, UK
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4
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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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Bancroft S, Heinrich N, Wolf C. Otogenic intracranial abscessation secondary to an inflammatory polyp with chronic otitis media/interna in a cat. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Sara Bancroft
- McKeever Dermatology Clinics Eden Prairie Minnesota USA
| | | | - Christina Wolf
- Blue Pearl Veterinary Partners Eden Prairie Minnesota USA
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6
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Gonçalves R, De Decker S, Walmsley G, Butterfield S, Maddox TW. Inflammatory Disease Affecting the Central Nervous System in Dogs: A Retrospective Study in England (2010–2019). Front Vet Sci 2022; 8:819945. [PMID: 35155652 PMCID: PMC8829331 DOI: 10.3389/fvets.2021.819945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 12/15/2021] [Indexed: 11/29/2022] Open
Abstract
The epidemiology of inflammatory diseases affecting the central nervous system (CNS) in dogs is largely unknown. We aimed to report the relative proportion of different causes of inflammatory disease affecting the CNS in dogs and identify predictors for infectious vs. immune-mediated conditions and predictors for the most common diseases affecting the brain and the spinal cord. This was a retrospective cohort study over a 10-year period in 2 referral institutions using multivariable and multinomial logistic regression for identification of risk factors. In total, 1,140 client-owned dogs diagnosed with inflammatory disease affecting the CNS were included. Fifteen different diagnoses were identified, with immune-mediated (83.6%) disease being more common than infectious conditions (16.4%). The most common immune-mediated conditions diagnosed were meningoencephalitis of unknown origin (47.5%) and steroid-responsive meningitis–arteritis (30.7%), and the most common infectious conditions were discospondylitis (9.3%) and otogenic intracranial infection (2.2%). Older age (p < 0.001, OR = 1.019, 95% CI: 1.014–1.024), higher body weight (p < 0.001, OR = 1.049, 95% CI: 1.025–1.074), male sex (p = 0.009, OR = 1.685, 95% CI: 1.141–2.488), longer duration of the clinical signs before presentation (p < 0.001, OR = 1.011, 95% CI: 1.006–1.017), progressive nature of the clinical signs (p < 0.001, OR = 2.295, 95% CI: 1.463–3.599), identification of a possibly associated preceding event (p = 0.0012, OR = 1.93, 95% CI: 1.159–3.213), and hyperesthesia on presentation (p < 0.001, OR = 2.303, 95% CI: 1.528–3.473) were associated with a diagnosis of infectious diseases. Our data shows that immune-mediated diseases are more common than infectious conditions as a cause for inflammatory CNS disease in dogs. The risk factors for the most common diagnoses were identified from signalment, history, and findings of the physical and neurological examinations to give valuable information that can guide clinicians with their investigations.
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Affiliation(s)
- Rita Gonçalves
- Department of Small Animal Clinical Science, Small Animal Teaching Hospital, University of Liverpool, Liverpool, United Kingdom
- Department of Musculoskeletal and Ageing Science, Institute of Lifecourse and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
- *Correspondence: Rita Gonçalves
| | - Steven De Decker
- Department of Clinical Science and Services, Royal Veterinary College, University of London, London, United Kingdom
| | - Gemma Walmsley
- Department of Small Animal Clinical Science, Small Animal Teaching Hospital, University of Liverpool, Liverpool, United Kingdom
- Department of Musculoskeletal and Ageing Science, Institute of Lifecourse and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Sarah Butterfield
- Department of Clinical Science and Services, Royal Veterinary College, University of London, London, United Kingdom
| | - Thomas W. Maddox
- Department of Small Animal Clinical Science, Small Animal Teaching Hospital, University of Liverpool, Liverpool, United Kingdom
- Department of Musculoskeletal and Ageing Science, Institute of Lifecourse and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
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7
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Scherf G, Sutherland-Smith J, Uriarte A. Dogs and cats with presumed or confirmed intracranial abscessation have low apparent diffusion coefficient values. Vet Radiol Ultrasound 2022; 63:197-200. [PMID: 35050530 DOI: 10.1111/vru.13064] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 10/09/2021] [Accepted: 10/12/2021] [Indexed: 12/01/2022] Open
Abstract
Intracranial abscessation is a life-threatening condition in dogs and cats, and rapid diagnosis is important for prognosis and treatment planning. The aims of this retrospective, single-center, case series study were to describe clinical and MRI diffusion-weighted imaging characteristics in three dogs and three cats with presumed or confirmed intracranial abscessation. All lesions appeared hyperintense on b1000 trace diffusion-weighted images, hypointense on apparent diffusion coefficient (ADC) map, with mean ADC values ranging from 0.37 to 1.24 × 10-3 mm2 /s. The majority (5/6) of the obtained mean ADC values were low (<1.10 × 10-3 mm2 /s), as previously reported in the human literature.
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Affiliation(s)
- Grégoire Scherf
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts, USA
| | - James Sutherland-Smith
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts, USA
| | - Ane Uriarte
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts, USA
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8
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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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Danciu CG, Szladovits B, Crawford AH, Ognean L, De Decker S. Cerebrospinal fluid analysis lacks diagnostic specificity in dogs with vestibular disease. Vet Rec 2021; 189:e557. [PMID: 34101197 DOI: 10.1002/vetr.557] [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: 07/10/2020] [Revised: 04/20/2021] [Accepted: 05/23/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND Although, vestibular syndrome is a common neurological presentation, little is known about the diagnostic value of cerebrospinal fluid (CSF) analysis in vestibular syndrome in dogs. METHODS Medical records were retrospectively reviewed, and dogs with vestibular disease that had undergone magnetic resonance imaging of the head, CSF analysis and were diagnosed with central or peripheral vestibular syndrome were included. Disorders affecting the central vestibular system included meningoencephalitis of unknown origin (MUO), brain neoplasia, ischaemic infarct, intracranial empyema or metronidazole toxicity. Disorders affecting the peripheral vestibular system included idiopathic vestibular disease, otitis media/interna or neoplasia affecting the inner ear structures. Total nucleated cell concentration (TNCC), total protein concentration (TP) and cytologic assessment were recorded. RESULTS A total of 102 dogs met the inclusion criteria. The sensitivity and specificity of increased CSF TNCC to differentiate central from peripheral vestibular syndrome was 49% and 90%, while the sensitivity and specificity of increased TP was 58% and 39%, respectively. The TNCC and TP in dogs with MUO were significantly higher than in dogs with idiopathic vestibular disease (p = 0.000 and p = 0.004). MUO was associated with lymphocytic pleocytosis, while idiopathic vestibular disease and ischaemic infarct were associated with the presence of activated macrophages or normal cytology (p = 0.000). CONCLUSION Although consistent CSF abnormalities were observed in dogs with MUO, CSF analysis did not allow reliable differentiation between central and peripheral vestibular syndrome. CSF analysis is not reliable as the sole diagnostic technique in dogs with vestibular disease.
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Affiliation(s)
- Cecilia Gabriella Danciu
- Department of Veterinary Preclinical and Clinical Science and Service, Faculty of Veterinary Medicine, University of Agricultural Science and Veterinary Medicine, Cluj-Napoca, Romania
| | - Balazs Szladovits
- Department of Pathobiology and Populations Sciences, Royal Veterinary College, University of London, Hatfield, UK
| | - Abbe Harper Crawford
- Department of Veterinary Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, UK
| | - Laurentiu Ognean
- Department of Veterinary Preclinical and Clinical Science and Service, Faculty of Veterinary Medicine, University of Agricultural Science and Veterinary Medicine, Cluj-Napoca, Romania
| | - Steven De Decker
- Department of Veterinary Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, UK
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10
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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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11
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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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12
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Bersan E, Maddox T, Walmsley G, Piviani M, Burrow R. CT-guided drainage of a brainstem abscess in a cat as an emergency treatment procedure. JFMS Open Rep 2020; 6:2055116919896111. [PMID: 32095257 PMCID: PMC7011327 DOI: 10.1177/2055116919896111] [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] [Indexed: 11/21/2022] Open
Abstract
Case summary A 3-year-old male neutered domestic shorthair cat was presented with a 1-week
progressive and rapidly deteriorating history of lethargy and abnormal
behaviour. Neurolocalisation indicated multifocal intracranial lesions
(right oculomotor nerve, brainstem [obtundation, non-ambulatory
tetraparesis, vestibular dysfunction and intermittent decerebrate rigidity]
and possibly the thalamus [left-sided pleurothotonus]), or more likely a
single brainstem lesion with mass effect. MRI of the brain demonstrated a
brainstem abscess causing severe dorsal displacement particularly affecting
the pons and the medulla oblongata causing cerebellar vermis herniation
through the foramen magnum. CT-guided free-hand technique drainage of the
brain abscess was performed and broad spectrum antibiotics were started
based on sensitivity results. The cat recovered uneventfully from
anaesthesia displaying marked improvement immediately after the procedure.
Antibiotics were continued for 8 months; repeat imaging prior to withdrawal
found complete resolution of the brainstem abscess. Relevance and novel information Free-hand CT-guided drainage of a brainstem abscess is not without risk;
however, in this case it led to significant clinical improvement and
stabilisation likely owing to reduced intracranial pressure. It also
provided a diagnostic sample that allowed successful medical treatment
planning and outcome. To our knowledge, this is the first report describing
the successful management of a brainstem abscess by CT-guided drainage in
the veterinary literature. It suggests that stereotactic drainage followed
by medical therapy can be considered a successful therapeutic alternative to
brain surgery or medical treatment alone, providing an emergency treatment
in cases of acute brainstem dysfunction.
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Affiliation(s)
- Erika Bersan
- Small Animal Teaching Hospital, Institute of Veterinary Sciences, University of Liverpool, Neston, UK.,Department of Musculoskeletal Biology, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK
| | - Thomas Maddox
- Small Animal Teaching Hospital, Institute of Veterinary Sciences, University of Liverpool, Neston, UK.,Department of Musculoskeletal Biology, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK
| | - Gemma Walmsley
- Small Animal Teaching Hospital, Institute of Veterinary Sciences, University of Liverpool, Neston, UK.,Department of Musculoskeletal Biology, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK
| | - Martina Piviani
- Small Animal Teaching Hospital, Institute of Veterinary Sciences, University of Liverpool, Neston, UK
| | - Rachel Burrow
- Small Animal Teaching Hospital, Institute of Veterinary Sciences, University of Liverpool, Neston, UK
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Santiago R, Ros C, García de Carellán Mateo A, Laborda‐Vidal P. Evaluation of cerebral blood flow with transcranial Doppler ultrasound in a dog with surgically treated intracranial subdural empyema. VETERINARY RECORD CASE REPORTS 2019. [DOI: 10.1136/vetreccr-2019-000935] [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)
| | - Carlos Ros
- NeurologyUniversidad Católica de Valencia San Vicente Martir Facultad de VeterinariaValenciaSpain
| | | | - Patricia Laborda‐Vidal
- Departamento de Medicina y Cirugía AnimalFacultad de VeterinariaUniversidad CEU Cardenal HerreraAlfara del PatriarcaValenciaSpain
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Diangelo L, Cohen-Gadol A, Heng HG, Miller MA, Hague DW, Rossmeisl JH, Bentley RT. Glioma Mimics: Magnetic Resonance Imaging Characteristics of Granulomas in Dogs. Front Vet Sci 2019; 6:286. [PMID: 31555671 PMCID: PMC6722480 DOI: 10.3389/fvets.2019.00286] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 08/13/2019] [Indexed: 01/03/2023] Open
Abstract
Granulomas can "mimic" gliomas on magnetic resonance imaging (MRI) in human patients. The goal of this retrospective study was to report canine brain granulomas that were consistent with glioma based upon MRI, report their histologic diagnosis, and identify MRI criteria that might be useful to distinguish granuloma from glioma. Ten granulomas, initially suspected to be glioma based on MRI, were ultimately diagnosed as granulomatous meningoencephalomyelitis (n = 5), infectious granulomas (n = 3) or other meningoencephalitis (n = 2). Age was 1.6-15.0 years and two dogs were brachycephalic breeds. MRI characteristics overlapping with glioma included intra-axial, heterogeneous, T2-weighted hyperintense, T1-weighted hypointense to isointense mass lesions with contrast-enhancement. Signals on fluid attenuation inversion recovery, gradient echo and diffusion weighted imaging also matched glioma. Peri-lesional edema and mass effect were toward the high end of findings reported for glioma. MRI characteristics that would be considered unusual for glioma included dural contact (n = 4), T2-hypointensity (n = 2), concomitant meningeal-enhancement (n = 9), and minor changes in the contralateral brain (n = 2). Cerebrospinal fluid analysis revealed albuminocytological dissociation or mild pleocytosis. These cases show that granulomas can "mimic" glioma on canine brain MRI. In individual cases, certain MRI findings may help increase the index of suspicion for granuloma. Lack of pronounced cerebrospinal fluid pleocytosis does not exclude granuloma. Signalment is very useful in the suspicion of glioma, and many of these dogs with granuloma were of ages and breeds in which glioma is less commonly seen.
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Affiliation(s)
- Lauren Diangelo
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, United States
| | - Aaron Cohen-Gadol
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, United States.,Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Hock Gan Heng
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, United States
| | - Margaret A Miller
- Department of Comparative Pathobiology, Purdue University, West Lafayette, IN, United States
| | - Devon W Hague
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL, United States
| | - John H Rossmeisl
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA, United States
| | - R Timothy Bentley
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, United States
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Forward AK, Plessas IN, Guilherme S, De Decker S. Retrospective evaluation of the clinical presentation, magnetic resonance imaging findings, and outcome of dogs diagnosed with intracranial empyema (2008-2015): 9 cases. J Vet Emerg Crit Care (San Antonio) 2019; 29:431-438. [PMID: 31218823 DOI: 10.1111/vec.12859] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 06/28/2017] [Accepted: 07/01/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To describe the clinical presentation, advanced imaging findings, and short- and long-term outcomes in dogs with intracranial empyema. DESIGN Retrospective case series. ANIMALS Client-owned dogs diagnosed with intracranial empyema. METHODS Medical records from 2 referral hospitals were searched for dogs diagnosed with intracranial empyema. To be included in this study, dogs had to fulfill 1 or more of the following 3 inclusion criteria: a magnetic resonance imaging (MRI) scan with space occupying accumulation of extra-axial material suggestive of empyema, a cerebrospinal fluid analysis suggestive of empyema, or direct visualization of purulent material during intracranial surgery. RESULTS Nine dogs with intracranial empyema were included, with a median age of 3.5 years (range: 4 mo-12.5 y). All presented as emergencies with 7 of the 9 dogs showing neurological abnormalities and 2 of the 9 with retrobulbar swelling and exophthalmos. Six had surgical intervention, 1 was medically managed, and the remaining 2 dogs were euthanized. Typical MRI findings included extra-axial, T1-weighted hypo- to isointense, T2-weighted hyperintense material compared to gray matter with varying degrees of contrast enhancement, with 6 of 8 showing evidence of contiguous infection from adjacent structures on MRI. For 7 dogs, ≥1 samples were sent for culture and sensitivity, with Enterococcus (surgical swab), Streptococcus pneumonia (from cerebral spinal fluid), and coagulase positive Staphylococcus (ear swab) being cultured. The median antimicrobial course length was 6 weeks (range: 2-28 wk). All dogs for which treatment was attempted survived to discharge, with a median hospitalization time of 7 days (range: 4-10 d). Four of the 7 are still alive at the time of writing (1 lost to follow-up; 2 euthanized for other reasons) with all 4 considered neurologically normal with a successful long-term outcome. CONCLUSION Although intracranial empyema in dogs is a rare condition, excellent outcomes are possible in those cases treated appropriately.
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Affiliation(s)
- Alexander K Forward
- Department of Clinical Science and Services, The Royal Veterinary College, University of London, North Mymms, Hertfordshire, UK
| | - Ioannis N Plessas
- Davies Veterinary Specialists, Manor Farm Business Park, Hertfordshire, UK
| | - Sérgio Guilherme
- Davies Veterinary Specialists, Manor Farm Business Park, Hertfordshire, UK
| | - Steven De Decker
- Department of Clinical Science and Services, The Royal Veterinary College, University of London, North Mymms, Hertfordshire, UK
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16
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Martin S, Drees R, Szladovits B, Beltran E. Comparison of medical and/or surgical management of 23 cats with intracranial empyema or abscessation. J Feline Med Surg 2019; 21:566-574. [PMID: 30106317 PMCID: PMC10814531 DOI: 10.1177/1098612x18792657] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
OBJECTIVES Feline intracranial abscessation or empyema is infrequently reported in the veterinary literature. To date, the largest study is based on a population of 19 cats with otogenic infection. The aim of this study was to review a larger population of cats with intracranial empyema from multiple aetiologies and document their signalment, imaging findings, treatment protocols (including medical and/or surgical management) and to compare outcomes. METHODS Cases presenting to a single referral centre over a 10 year period with compatible history, neurological signs and imaging findings consistent with intracranial abscessation and empyema were reviewed retrospectively. RESULTS Twenty-three cats met the inclusion criteria. Advanced imaging (CT and/or MRI) was performed in 22/23 cats; one case was diagnosed via ultrasound. Ten cases underwent medical and surgical management combined, 10 underwent solely medical management and three were euthanased at the time of diagnosis. Short-term outcome showed that 90% of surgically managed and 80% of medically managed cats were alive at 48 h post-diagnosis. Long-term survival showed that surgically managed cases and medically managed cases had a median survival time of 730 days (range 1-3802 days) and 183 days (range 1-1216 days), respectively. No statistical significance in short- or long-term survival ( P >0.05) was found between medically and surgically managed groups. CONCLUSIONS AND RELEVANCE Feline intracranial abscessation and empyema are uncommon conditions that have historically been treated with combined surgical and medical management. This study documents that, in some cases, intracranial abscessation and empyema can also be successfully treated with medical management alone.
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Affiliation(s)
- Sophie Martin
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK
| | - Randi Drees
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK
| | - Balazs Szladovits
- Department of Pathobiology and Population Sciences, Royal Veterinary College, Hatfield, UK
| | - Elsa Beltran
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK
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Moore SA, Bentley RT, Carrera-Justiz S, Foss KD, da Costa RC, Cook LB. Clinical features and short-term outcome of presumptive intracranial complications associated with otitis media/interna: a multi-center retrospective study of 19 cats (2009-2017). J Feline Med Surg 2019; 21:148-155. [PMID: 29667535 PMCID: PMC10814610 DOI: 10.1177/1098612x18764582] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
OBJECTIVES The aim of this study was to compile an overview of the clinical features of intracranial complication of otitis media/interna (OMI) in cats managed across five veterinary referral hospitals. Of additional interest were culture results that could inform empirical antibiotic selection, as well as outcome with both medical and surgical management. METHODS A retrospective medical record review was conducted at five veterinary referral practices to identify cats with a diagnosis of intracranial complication secondary to OMI between 2009 and 2017. Clinical features, diagnostic findings, treatment and outcome were recorded. RESULTS At total of 19 cats were identified. Sixty-three percent had no previous history of ear infection. Otoscopic examination was normal in 47% of cases. The most common bacterial isolate was Pasteurella multocida, which was identified in 24% of cases. Outcome was successful for 83% of cats managed with ventral bulla osteotomy (VBO) and in 66% of cats managed without surgical intervention. CONCLUSIONS AND RELEVANCE Clinical suspicion of intracranial complications of OMI should remain high in cats with central vestibular disease even if otoscopic examination is normal. Antibiotic selection should be based on a culture and sensitivity; however, initial antibiotic therapy should include broad-spectrum coverage with special consideration for P multocida. Cats with intracranial complications of OMI can have a good outcome with either surgical or medical management and prospective studies are needed to assess the role of VBO in enhancing recovery.
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Affiliation(s)
- Sarah A Moore
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, OH, USA
| | - R Timothy Bentley
- Department of Veterinary Clinical Sciences, Purdue University College of Veterinary Medicine, West Lafayette, IN, USA
| | - Sheila Carrera-Justiz
- Department of Small Animal Clinical Services, University of Florida College of Veterinary Medicine, Gainesville, FL, USA
| | - Kari D Foss
- Department of Veterinary Clinical Medicine, University of Illinois College of Veterinary Medicine, Urbana, IL, USA
| | - Ronaldo C da Costa
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, OH, USA
| | - Laurie B Cook
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, OH, USA
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18
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Peress FR. What Is Your Neurologic Diagnosis? J Am Vet Med Assoc 2019; 254:347-349. [PMID: 30668240 DOI: 10.2460/javma.254.3.347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Imai A, Kondo H, Suganuma T, Nagata M. Clinical analysis and nonsurgical management of 11 dogs with aural cholesteatoma. Vet Dermatol 2019; 30:42-e12. [PMID: 30637895 DOI: 10.1111/vde.12707] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Aural cholesteatomas, also called tympanokeratomas, are destructive and expansile growths of keratinizing epithelium that develop in the middle ear. They have been reported sporadically in dogs, and surgery is usually the recommended treatment. OBJECTIVES To describe the common clinical, radiological and histological findings of cholesteatoma; to report on the outcome of conservative management. ANIMALS Eleven dogs (13 ears) with cholesteatomas. METHODS AND MATERIALS Medical records were reviewed for dogs diagnosed with cholesteatoma between 2012 and 2018. All dogs had computed tomography (CT) and/or magnetic resonance imaging (MRI) followed by trans-canal endoscopic procedure (TEP) for removal and biopsy of middle ear lesions. Dogs were then treated with in-clinic flushing initially weekly tapered to monthly, as well as at-home ear cleaning and application of topical otic steroid medication, initially daily then tapered to once or twice weekly. RESULTS Nine dogs had a history of chronic otitis externa; head tilt or facial paralysis was present in seven and four cases, respectively. Otic examination identified a protruding nodule in seven ears. CT demonstrated soft tissue-like material in 12 bullae and expansion in seven bullae. MRI revealed minimally contrast-enhancing bulla contents in 12 ears. Post-TEP and with maintenance medical treatment, nine ears had no further signs of middle ear disease during a mean follow-up of 27.9 months. CONCLUSIONS AND CLINICAL IMPORTANCE The results suggest that otitis externa may not necessarily precede cholesteatoma in all dogs. MRI appears to be more sensitive than CT for identifying cholesteatomas. Conservative treatment of cholesteatomas could be useful before or as an alternative to surgery.
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Affiliation(s)
- Akihiro Imai
- Dermatology Service, Synergy Animal General Hospital, 815 Ishigami, Kawaguchi, Saitama, 333-0823, Japan
| | - Hirotaka Kondo
- Laboratory of Veterinary Pathology, Department of Veterinary Medicine, College of Bioresource Science, Nihon University, 1866 Kameino, Fujisawa, Kanagawa, 252-0880, Japan
| | - Tsunenori Suganuma
- Diagnostic Image Service, Synergy Animal General Hospital, 815 Ishigami, Kawaguchi, Saitama, 333-0823, Japan
| | - Masahiko Nagata
- Dermatology Service, Synergy Animal General Hospital, 815 Ishigami, Kawaguchi, Saitama, 333-0823, Japan
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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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Classification of Pathogenic Bacteria in Cerebrospinal Fluid of Patients with Intracranial Infection After Neurosurgery and Selective Use of Antibacterial Agents. Jundishapur J Microbiol 2018. [DOI: 10.5812/jjm.60788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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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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Classen J, Bruehschwein A, Meyer-Lindenberg A, Mueller R. Comparison of ultrasound imaging and video otoscopy with cross-sectional imaging for the diagnosis of canine otitis media. Vet J 2016; 217:68-71. [DOI: 10.1016/j.tvjl.2016.09.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 08/24/2016] [Accepted: 09/28/2016] [Indexed: 11/25/2022]
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Greci V, Mortellaro CM. Management of Otic and Nasopharyngeal, and Nasal Polyps in Cats and Dogs. Vet Clin North Am Small Anim Pract 2016; 46:643-61. [DOI: 10.1016/j.cvsm.2016.01.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Wu CC, Chang YP. Cerebral Ventriculitis Associated with Otogenic Meningoencephalitis in a Dog. J Am Anim Hosp Assoc 2015; 51:272-8. [PMID: 26083434 DOI: 10.5326/jaaha-ms-6174] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A dog was evaluated for rapidly progressive mentation change, ataxia, and tetraparesis. The dog's neurological status deteriorated drastically. It became comatose with bilateral mydriasis, and the pupillary light reflex was absent. An anti-inflammatory dose of methylprednisolone was administered, and temporary stabilization of neurological status was achieved. MRI findings were suggestive of ventriculitis and meningoencephalitis originating from the left tympanic cavity. A gadolinium leakage phenomenon was noted, likely resulting from severe damage to the blood-cerebrospinal fluid barrier during the inflammatory process. Analysis of the cerebrospinal fluid and materials in the left tympanic cavity further confirmed the diagnosis. Following surgical and antibiotic treatment, the dog recovered well with only a mild residual head tilt. Seven months after surgery, the dog had a recurrent infection of the left tympanic cavity without intracranial involvement. A second surgery led to an uneventful recovery, and the dog was clinically normal except for a mild head tilt 3 yr after the initial presentation. This is the first report describing ventriculitis associated with otogenic meningoencephalitis in dogs and a gadolinium leakage phenomenon displayed on MRI. The long-term outcome of ventriculitis-complicated otogenic meningoencephalitis in dogs could be satisfied with prompt diagnosis and treatment.
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Affiliation(s)
- Chih-Ching Wu
- From the Graduate Institute of Veterinary Clinical Science, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan, Province of China
| | - Ya-Pei Chang
- From the Graduate Institute of Veterinary Clinical Science, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan, Province of China
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Mickelson M, Olby N, Schwartz M. Bacterial meningitis and subdural empyema caused by
Actinomyces canis
in a dog. VETERINARY RECORD CASE REPORTS 2015. [DOI: 10.1136/vetreccr-2015-000175] [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)
- Megan Mickelson
- Department of Clinical SciencesNCSU College of Veterinary MedicineRaleighNCUSA
- School of Veterinary MedicineUniversity of WisconsinMadison, 2015 Linden DriveMadisonWIUSA
| | - Natasha Olby
- Department of Clinical SciencesNCSU College of Veterinary MedicineRaleighNCUSA
| | - Malte Schwartz
- Department of Clinical SciencesNCSU College of Veterinary MedicineRaleighNCUSA
- Sage Centers for Veterinary Specialty and Emergency Care7121 Amador Plaza RdDublinCA94568
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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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Siak MK, Paul A, Drees R, Arthur I, Burrows AK, Tebb AJ, Malik R. Otogenic meningoencephalomyelitis due to Cryptococcus gattii(VGII) infection in a cat from Western Australia. JFMS Open Rep 2015; 1:2055116915585022. [PMID: 28491355 PMCID: PMC5362871 DOI: 10.1177/2055116915585022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2014] [Indexed: 11/18/2022] Open
Abstract
Case summary A 7-year-old spayed domestic longhair cat from Perth, Western Australia, presented with left-sided head tilt, dysphonia, head shaking, inappetence and weight loss. A polypoid lesion had previously been removed from the external ear canal. Otitis media with extension into the external ear canal was suspected and investigated using video-otoscopy and computed tomography examination. Invasive disease with extension from the middle ear to the base of the skull, and intracranial extension into the caudal fossa and cranial cervical vertebral canal was detected. Cytology of external ear canal exudate showed capsulated budding yeasts and Cryptococcus gattii VGII was cultured. Treatment with amphotericin B infusions and oral fluconazole was prescribed, with nutritional support via oesophagostomy tube. The cat clinically recovered 12 months after treatment commenced. Relevance and novel information This case report describes the successful medical treatment of otogenic meningoencephalomyelitis due to C gattii (VGII) infection in a cat.
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Affiliation(s)
- Meng K Siak
- Animal Dermatology Clinic Perth, Murdoch Veterinary Hospital, School of Veterinary and Biomedical Science, Western Australia, Australia
| | - Amanada Paul
- Murdoch University Veterinary Hospital, School of Veterinary and Biomedical Science, Western Australia, Australia
| | - Randi Drees
- Vet CT Specialists, St John’s Innovation Centre, Cambridge, UK
| | - Ian Arthur
- Mycology Laboratory, PathWest Laboratory Medicine Western Australia (QEII Medical Centre), Nedlands, Western Australia, Australia
| | - Amanda K Burrows
- Animal Dermatology Clinic Perth, Murdoch Veterinary Hospital, School of Veterinary and Biomedical Science, Western Australia, Australia
| | - Anna J Tebb
- Western Australian Veterinary Emergency and Specialty, Success, Western Australia, Australia
| | - Richard Malik
- Centre for Veterinary Education, The University of Sydney, New South Wales, Australia
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Newman AW, Estey CM, McDonough S, Cerda-Gonzalez S, Larsen M, Stokol T. Cholesteatoma and meningoencephalitis in a dog with chronic otitis externa. Vet Clin Pathol 2014; 44:157-63. [PMID: 25385218 DOI: 10.1111/vcp.12212] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A 10-year-old female spayed German Shepherd dog, with a year-long history of recurrent left ear infections, was presented for progressive ataxia, head tilt, and pain on opening of the mouth. On physical examination, a large amount of ceruminous debris was present in the left ear and multiple neurologic defects localizing to the cerebellum and vestibular system were identified. Magnetic resonance imaging (MRI) demonstrated a minimally contrast-enhancing mass within the left bulla, an intracranial space-occupying, heterogeneously contrast-enhancing lesion at the level of the left cerebello-medullary junction, and contrast enhancement of the ipsilateral meninges. Cerebrospinal fluid analysis revealed a marked mixed cell pleocytosis (nucleated cell count 655 cells/μL). The mass was visualized within the horizontal ear canal by otoscopic examination and a biopsy was taken. Impression smears of the biopsy contained many anucleate keratinized squamous epithelial cells, mild mixed inflammation, and few presumptive fibroblasts. With the provided clinical history and MRI findings, a cytologic diagnosis of cholesteatoma was made. A ventral bulla osteotomy was performed, and histopathologic examination of resected tissue confirmed the cytologic diagnosis of cholesteatoma. The dog's clinical symptoms improved postoperatively, but the dog died of unrelated causes, 3.5 months later. To our knowledge, this is the first description of the cytologic features of a cholesteatoma, which is a nonneoplastic, but locally invasive epidermoid cyst, in the middle ear of dogs.
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Affiliation(s)
- Ashleigh W Newman
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
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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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Pilton JL, Ley CJ, Voss K, Krockenberger MB, Barrs VR, Beatty JA. Atypical, abscessated nasopharyngeal polyp associated with expansion and lysis of the tympanic bulla. J Feline Med Surg 2014; 16:699-702. [PMID: 24319059 PMCID: PMC11164163 DOI: 10.1177/1098612x13514421] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
A 5-year-old, male neutered domestic shorthair cat was referred for investigation of lethargy, weight loss, pyrexia and upper respiratory tract signs. On computed tomography, an expansile, osteodestructive lesion in the right tympanic bulla was identified. A soft tissue mass extended from the bulla into the nasopharynx, cranium and subcutaneous tissues. The nasopharyngeal mass ruptured during handling, liberating purulent material from which Pasteurella multocida was isolated in pure culture. The lesion was most likely an atypical, abscessated nasopharyngeal polyp. The cat was treated with bulla osteotomy and antibiotics, and made a complete recovery.
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Affiliation(s)
- Joanna L Pilton
- Faculty of Veterinary Science, University of Sydney, Sydney, Australia
| | - Charles J Ley
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Katja Voss
- Faculty of Veterinary Science, University of Sydney, Sydney, Australia
| | | | - Vanessa R Barrs
- Faculty of Veterinary Science, University of Sydney, Sydney, Australia
| | - Julia A Beatty
- Faculty of Veterinary Science, University of Sydney, Sydney, Australia
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33
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Correction: Evaluation of recipes of home-prepared maintenance diets for dogs. J Am Vet Med Assoc 2014. [DOI: 10.2460/javma.245.2.177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Williams JM, Riedesel EA, Jeffery ND, Alcott CJ. What is your diagnosis? Subdural empyema. J Am Vet Med Assoc 2014; 245:175-7. [PMID: 24984124 DOI: 10.2460/javma.245.2.175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Jackie M Williams
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50010
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Delk KW, Mejia-Fava J, Jiménez DA, Kent M, Myrna K, Mayer J, Divers S. Diagnostic Imaging of Peripheral Vestibular Disease in a Chinese Goose (Anser cygnoides). J Avian Med Surg 2014; 28:31-7. [DOI: 10.1647/1082-6742-28.1.31] [Citation(s) in RCA: 6] [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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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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Harran NX, Bradley KJ, Hetzel N, Bowlt KL, Day MJ, Barr F. MRI findings of a middle ear cholesteatoma in a dog. J Am Anim Hosp Assoc 2012; 48:339-43. [PMID: 22843826 DOI: 10.5326/jaaha-ms-5777] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This article describes the MRI features of a middle ear cholesteatoma in an 8 yr old flat-coated retriever. Physical examination revealed pain on opening the jaw, and otoscopic examination showed tympanic membrane rupture associated with hyperplastic tissue at the entrance of the middle ear. Standard MRI sequences allowed for the identification of a severely expanded bulla containing material that was isointense to brain tissue on T1-weighted images and of mixed intensity on T2-weighted and fluid-attenuated inversion recovery sequences. No postcontrast enhancement of the content was present, but the lining of the bulla was partially enhanced. The images allowed evaluation of the surgical margins and the secondary changes due to the expansion of the mass. Surgery was performed and histopathology confirmed the presumptive diagnosis of cholesteatoma. In the present case, MRI appeared to serve as a good alternative to computed tomography for the diagnosis of cholesteatoma.
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Affiliation(s)
- Nathaniel X Harran
- Diagnostic Imaging Department, School of Veterinary Sciences, University of Bristol, Bristol, United Kingdom.
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Abstract
SUMMARY The primary purpose of diagnostic imaging is to enable clinicians to make correct decisions about a patient's diagnosis and severity of its condition and, thereby, to contribute to effective and efficient treatment. Advanced imaging modalities are inherently better detectors of morphological lesions than radiography; hence, they offer the possibility of more accurate diagnosis and staging, with correspondingly better patient outcomes. However, there is a lack of evidence that better outcomes are being realised for veterinary patients. Furthermore, increased use of advanced imaging carries the possibility of increased misuse, primarily through unnecessary studies that contribute little to patient management other than increased costs. SCOPE This article is intended to be relevant to all veterinary species. Advanced imaging of cats is not sufficiently developed as a specific discipline that a balanced review could be based purely on feline examples or references.
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Affiliation(s)
- Christopher R Lamb
- Department of Veterinary Clinical Sciences, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hertfordshire AL9 7TA, UK.
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Schuenemann RM, Oechtering G. Cholesteatoma after lateral bulla osteotomy in two brachycephalic dogs. J Am Anim Hosp Assoc 2012; 48:261-8. [PMID: 22611216 DOI: 10.5326/jaaha-ms-5760] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This report describes a French bulldog and a pug that presented to the authors' hospital following total ear canal ablation (TECA) and lateral bulla osteotomy (LBO), with signs of recurring otitis media and difficulty opening their mouths. The bulldog also had unilateral facial paralysis and sensory deficits of the trigeminal nerve on the ipsilateral side. Computed tomography and MRI scans suggested cholesteatoma in the bulldog, but showed only slight enlargement of the bulla in the pug. Histopathologic examination of samples yielded cholesteatoma in both cases. The authors suspect that development of the cholesteatomas was linked to the TECA/LBO surgery in both cases. Cholesteatomas may occur more frequently than currently thought. Even if only slight changes of the bulla wall are detected on CT, early-stage cholesteatoma should be considered. The narrow anatomic conditions in brachycephalic dogs possibly predispose such breeds to develop cholesteatoma after middle ear surgery because complete removal of all inflammatory and epithelial tissue can be more difficult than in other breeds. To the authors' knowledge, this is the first report of an aural cholesteatoma causing sensory deficits of the trigeminal nerve.
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Wolff CA, Holmes SP, Young BD, Chen AV, Kent M, Platt SR, Savage MY, Schatzberg SJ, Fosgate GT, Levine JM. Magnetic resonance imaging for the differentiation of neoplastic, inflammatory, and cerebrovascular brain disease in dogs. J Vet Intern Med 2012; 26:589-97. [PMID: 22404482 DOI: 10.1111/j.1939-1676.2012.00899.x] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2011] [Revised: 01/22/2012] [Accepted: 01/24/2012] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The reliability and validity of magnetic resonance imaging (MRI) for detecting neoplastic, inflammatory, and cerebrovascular brain lesions in dogs are unknown. OBJECTIVES To estimate sensitivity, specificity, and inter-rater agreement of MRI for classifying histologically confirmed neoplastic, inflammatory, and cerebrovascular brain disease in dogs. ANIMALS One hundred and twenty-one client-owned dogs diagnosed with brain disease (n = 77) or idiopathic epilepsy (n = 44). METHODS Retrospective, multi-institutional case series; 3 investigators analyzed MR images for the presence of a brain lesion with and without knowledge of case clinical data. Investigators recorded most likely etiologic category (neoplastic, inflammatory, cerebrovascular) and most likely specific disease for all brain lesions. Sensitivity, specificity, and inter-rater agreement were calculated to estimate diagnostic performance. RESULTS MRI was 94.4% sensitive (95% confidence interval [CI] = 88.7, 97.4) and 95.5% specific (95% CI = 89.9, 98.1) for detecting a brain lesion with similarly high performance for classifying neoplastic and inflammatory disease, but was only 38.9% sensitive for classifying cerebrovascular disease (95% CI = 16.1, 67.0). In general, high specificity but not sensitivity was retained for MR diagnosis of specific brain diseases. Inter-rater agreement was very good for overall detection of structural brain lesions (κ = 0.895, 95% CI = 0.792, 0.998, P < .001) and neoplastic lesions, but was only fair for cerebrovascular lesions (κ = 0.299, 95% CI = 0, 0.761, P = .21). CONCLUSIONS AND CLINICAL IMPORTANCE MRI is sensitive and specific for identifying brain lesions and classifying disease as inflammatory or neoplastic in dogs. Cerebrovascular disease in general and specific inflammatory, neoplastic, and cerebrovascular brain diseases were frequently misclassified.
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Affiliation(s)
- C A Wolff
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843, USA
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Brain abscess in seven cats due to a bite wound: MRI findings, surgical management and outcome. J Feline Med Surg 2011; 13:672-80. [PMID: 21872794 PMCID: PMC7130018 DOI: 10.1016/j.jfms.2011.07.020] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2011] [Indexed: 11/23/2022]
Abstract
UNLABELLED PRESENTATION AND LESION LOCALISATION: Seven adult domestic shorthair cats were presented with a 1- to 6-day history of progressive neurological signs. A focal skin puncture and subcutaneous swelling over the dorsal part of the head were detected on physical examination. Neurological examination indicated lesion(s) in the right forebrain in four cats, multifocal forebrain in one cat, left forebrain in one cat, and multifocal forebrain and brainstem in the remaining cat. In all cats, magnetic resonance imaging revealed a space-occupying forebrain lesion causing a severe mass effect on adjacent brain parenchyma. CLINICAL APPROACH AND OUTCOME: All cats were managed with a combination of medical and surgical treatment. At surgery a small penetrating calvarial fracture was detected in all cats, and a tooth fragment was found within the content of the abscess in two cats. The combination of surgical intervention, intensive care and intravenous antimicrobials led to a return to normal neurological function in five cats. PRACTICAL RELEVANCE As this series of cases indicates, successful resolution of a brain abscess due to a bite injury depends on early recognition and combined used of antimicrobials and surgical intervention. A particular aim of surgery is to remove any skull and foreign body (tooth) fragments that may represent a continuing focus of infection.
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Martin-Vaquero P, da Costa RC, Daniels JB. Presumptive meningoencephalitis secondary to extension of otitis media/interna caused by Streptococcus equi subspecies zooepidemicus in a cat. J Feline Med Surg 2011; 13:606-9. [PMID: 21640625 PMCID: PMC7129658 DOI: 10.1016/j.jfms.2011.04.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2011] [Indexed: 10/28/2022]
Abstract
A 5-year-old castrated male domestic longhair cat was presented with neurological signs consistent with a central vestibular lesion and left Horner's syndrome. Computed tomography images revealed hyperattenuating, moderately contrast-enhancing material within the left tympanic bulla, most consistent with left otitis media/interna. Marked neutrophilic pleocytosis was identified on cerebrospinal fluid analysis. Streptococcus equi subspecies zooepidemicus (SEZ) was isolated from the cerebrospinal fluid. Intracranial extension of otitis media/interna is relatively infrequent in small animals. There are no reports of otitis media/interna caused by SEZ in dogs or cats. This is the first report of otitis media/interna and presumptive secondary meningoencephalitis caused by SEZ in a cat.
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Affiliation(s)
- Paula Martin-Vaquero
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA.
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Wolf D, Lüpke M, Wefstaedt P, Klopmann T, Nolte I, Seifert H. Optimising magnetic resonance image quality of the ear in healthy dogs. Acta Vet Hung 2011; 59:53-68. [PMID: 21354941 DOI: 10.1556/avet.59.2011.1.5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The aim of this study was to develop an examination protocol for magnetic resonance imaging, in order to display diagnostically important information of the canine middle and inner ear. To ensure that this protocol could also be used as a basis for determining pathological changes, the anatomical structures of the ear were presented in detail. To minimise stress through anaesthesia in live animals, preliminary examinations were carried out on four dog cadavers. During these initial examinations, three-dimensional (3D) sequences proved to be superior to two-dimensional ones. Therefore, only 3D sequences were applied for the main examinations performed on six clinically healthy Beagles. The anonymised MR images were rated by three experienced reviewers using a five-point scale. The most valuable sequence was a T2-weighted CISS sequence (TR = 16.7 ms, TE = 8.08 ms). This sequence proved to be most suitable for illustrating the inner ear structures and enabled good tissue contrasts. The sequence ranked second best was also a T2-weighted DESS sequence (TR = 19 ms, TE = 6 ms), allowing the imaging of the tympanic cavity and enabling 3D reconstruction due to its isotropic voxels. Due to low contrast and strong noise, the other sequences (TSE, FISP, MP RAGE) were not suitable for anatomical illustration of the middle and inner ear.
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Affiliation(s)
| | - Matthias Lüpke
- 1 University of Veterinary Medicine Hanover, Foundation Institute for General Radiology and Medical Physics Bischofsholer Damm 15 D-30173 Hanover Germany
| | - Patrick Wefstaedt
- 2 University of Veterinary Medicine Hanover, Foundation Small Animal Clinic Bischofsholer Damm 15 D-30173 Hanover Germany
| | - Thilo Klopmann
- 2 University of Veterinary Medicine Hanover, Foundation Small Animal Clinic Bischofsholer Damm 15 D-30173 Hanover Germany
| | - Ingo Nolte
- 2 University of Veterinary Medicine Hanover, Foundation Small Animal Clinic Bischofsholer Damm 15 D-30173 Hanover Germany
| | - Hermann Seifert
- 1 University of Veterinary Medicine Hanover, Foundation Institute for General Radiology and Medical Physics Bischofsholer Damm 15 D-30173 Hanover Germany
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Abstract
Mycoplasmas are frequently isolated from many animal species. In domestic cats, mycoplasmas may be isolated from respiratory and ocular mucosae, but other sites are also occasionally colonized by these organisms. No cases of Mycoplasma species-associated neurologic disease have been reported in cats. We describe a case of Mycoplasma felis-associated meningoencephalitis in a 10-month-old domestic shorthair cat.
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45
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The neurology of balance: Function and dysfunction of the vestibular system in dogs and cats. Vet J 2010; 185:247-58. [DOI: 10.1016/j.tvjl.2009.10.029] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2009] [Revised: 10/28/2009] [Accepted: 10/29/2009] [Indexed: 11/23/2022]
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Abstract
The vestibular system is the major sensory (special proprioceptive) system that, along with the general proprioceptive and visual systems, maintains balance. Clinical signs of vestibular disease include asymmetric ataxia, head tilt, and pathologic nystagmus. Neuroanatomic localization of observed vestibular signs to either the peripheral or central components of the vestibular system is paramount to the management of the patient with vestibular dysfunction, as the etiology, diagnostic approaches, and prognoses are dependent on the neuroanatomic diagnosis. This article reviews functional vestibular neuroanatomy as well as the diagnosis and treatment of common causes of small animal vestibular disease.
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Affiliation(s)
- John H Rossmeisl
- Neurology and Neurosurgery, Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Virginia Tech, Blacksburg, VA 24061, USA.
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47
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Hecht S, Adams WH. MRI of Brain Disease in Veterinary Patients Part 2: Acquired Brain Disorders. Vet Clin North Am Small Anim Pract 2010; 40:39-63. [DOI: 10.1016/j.cvsm.2009.09.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Bilderback AL, Faissler D. Surgical management of a canine intracranial abscess due to a bite wound. J Vet Emerg Crit Care (San Antonio) 2009; 19:507-12. [PMID: 19821895 DOI: 10.1111/j.1476-4431.2009.00467.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To describe the successful surgical management of a brain abscess in a dog secondary to bite wound. CASE SUMMARY A 10-year-old neutered female Welsh Corgi/Chihuahua, weighing 5.3 kg, was presented for evaluation of seizures, ataxia, and falling to the left 8 days after a presumptive fight with another dog. On examination at presentation, the dog was alert, responsive, and ambulatory with tetra-ataxia, falling to the left, left-sided postural deficits, and absent left menace response. Within 24 hours, the dog progressed to nonambulatory tetraparesis with minimal motor, absent postural reactions of all limbs, left nasal hypalgesia, reduced gag reflex, and depressed mentation. Computed tomographic images of the brain were suggestive of a bite wound fracture of the right parietal bone with secondary meningoencephalitis, right parietal lobe abscessation, and white matter edema adjacent to the bone fracture. A modified right rostrotentorial craniectomy was performed, the abscess was identified, contents of the abscess were removed, and the surgical site was flushed extensively before closing. Corynebacterium spp. was cultured from within the abscess. Within hours of surgery, the dog was quiet but alert, responsive, and sitting up in her cage. In addition to surgical intervention, intensive care, broad-spectrum IV antimicrobials, and supportive therapy led to significant neurologic improvement with only occasional seizures and mild postural reaction deficits of the left hindlimb remaining. NEW OR UNIQUE INFORMATION PROVIDED Abscess formation within the CNS is uncommon in dogs and cats and is associated with a high mortality rate. In veterinary medicine the management of brain abscesses is controversial with limited information available regarding treatment. This is the first case report that demonstrates surgical intervention in combination with antimicrobial therapy can be used successfully in the treatment of a canine brain abscess.
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Negrin A, Cherubini GB, Lamb C, Benigni L, Adams V, Platt S. Clinical signs, magnetic resonance imaging findings and outcome in 77 cats with vestibular disease: a retrospective study. J Feline Med Surg 2009; 12:291-9. [PMID: 19932040 DOI: 10.1016/j.jfms.2009.10.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2009] [Accepted: 10/06/2009] [Indexed: 10/20/2022]
Abstract
Medical records of 77 cats that had clinical signs of vestibular disease and magnetic resonance imaging (MRI) of the head were reviewed retrospectively. The aetiological, clinical and MRI characteristics were described and evaluated for a relationship with patient outcome. Forty cats (52%) had signs of central vestibular dysfunction (CVD), which was part of a multifocal disease in 17 cats (43%). The most frequent causes of CVD were inflammatory conditions (18 cats; 45%), including bacterial inflammation as an intracranial extension of otitis interna (five cats; 13%), feline infectious peritonitis (three cats; 8%) and toxoplasmosis (two cats; 5%). Neoplasia (12 cats; 30%) and vascular disease (four cats; 10%) were respectively the second and the third most frequent causes of CVD. Thiamine deficiency was diagnosed in one cat based on MRI findings and improvement following vitamin B(1) supplementation. Of 37 cats (48%) with peripheral vestibular dysfunction (PVD), idiopathic vestibular syndrome (IVS) was suspected in 16 (43%) and otitis media/interna was suspected in 16 (43%). Within the group of cats with evident MRI lesions, the location of the imaged lesions agreed with the clinical classification of vestibular dysfunction in 52/55 (95%) cats. Most of the cats (nine cases; 56%) with presumed IVS had rapid and complete recovery of their clinical signs. As most of these cats presented with progressive clinical signs over 3 weeks they were classified as having 'atypical' IVS to differentiate them from cats with the typical non-progressive IVS. No underlying systemic diseases were documented in any of these cases. Statistically significant predictors of survival included neurolocalisation (central or peripheral vestibular system), age and gender. No difference in survival was observed between cats with presumed idiopathic peripheral syndrome and cats with otitis media/interna.
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Affiliation(s)
- Arianna Negrin
- Department of Animal Medicine and Surgery, Faculty of Veterinary Medicine, Autonomous University of Barcelona, 08193 Bellaterra, Barcelona, Spain.
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Oliver JAC, Llabrés-Diaz FJ, Gould DJ, Powell RM. Central nervous system infection withStaphylococcus intermediussecondary to retrobulbar abscessation in a dog. Vet Ophthalmol 2009; 12:333-7. [DOI: 10.1111/j.1463-5224.2009.00713.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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