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Pedersen TR, Bach MBT, Stougaard CL, Gredal H, Rusbridge C, Finnerup NB, Berendt M. Clinical predictors of syringomyelia in Cavalier King Charles Spaniels with chiari-like malformation based on owners' observations. Acta Vet Scand 2024; 66:5. [PMID: 38331821 PMCID: PMC10851586 DOI: 10.1186/s13028-024-00725-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 01/17/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Syringomyelia (SM) is a prevalent inherited developmental condition in Cavalier King Charles Spaniels (CKCSs) with Chiari-like malformation (CM), accompanied by a variety of clinical manifestations, including signs of neuropathic pain. Magnetic resonance imaging (MRI) is the gold standard in SM diagnosis. However, it is desirable to establish clinical predictors that can identify CKCSs with a large clinical syrinx that needs treatment, as some owners cannot afford or lack access to MRI. The aims of the study were to investigate owner-reported clinical signs of SM and clinical predictors of a large clinical syrinx, using predictive values of significant signs, individually and in combinations. Eighty-nine CKCSs participated in this retrospective study. Based on MRI diagnosis, dogs were distributed into three groups: CM without syrinx or with a maximum transverse width < 2 mm (n = 13), CM with small syrinx 2.00-3.99 mm (n = 26) and CM with large syrinx ≥4 mm (n = 50). A structured investigator-owner interview using a standardized questionnaire was used to collect data regarding clinical signs of CM and SM. The statistical tests Pearson's chi-square, Fisher's Exact and Spearman's rank order were used to assess the difference in owner-reported signs between groups. For signs with significant differences, positive and negative predictive values (PPV and NPV) were calculated. RESULTS Following clinical signs were reported significantly more frequent in dogs with a large syrinx: phantom scratching, bilateral scratching of the neck or shoulder, aversion when that area is touched, or exacerbation of clinical signs when the dog is emotionally aroused. Each individual sign had a high PPV, indicative of a large clinical syrinx. The PPV increased further when the signs phantom scratching, aversion to touch to the head, neck or shoulder, and a preferred head posture during sleep were present in combination. CONCLUSIONS Specific clinical signs can be used individually and in combination as clinical predictors of a large clinical syrinx in CKCSs with CM and SM. General practitioners can utilize this information to identify CKCSs with a large syrinx to initiate necessary treatment. This is particularly useful in cases where access to or affordability of an MRI diagnosis is limited.
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Affiliation(s)
- Tenna Remler Pedersen
- Department of Clinical Veterinary Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlaegevej 16, C DK-1870, Frederiksberg, Denmark.
| | - Maiken Bayer Thode Bach
- Department of Clinical Veterinary Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlaegevej 16, C DK-1870, Frederiksberg, Denmark
| | - Camilla Løkke Stougaard
- Department of Clinical Veterinary Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlaegevej 16, C DK-1870, Frederiksberg, Denmark
| | - Hanne Gredal
- Department of Clinical Veterinary Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlaegevej 16, C DK-1870, Frederiksberg, Denmark
| | - Clare Rusbridge
- Department of Clinical Sciences, School of Veterinary Medicine, University of Surrey, Daphne Jackson Rd, GU2 7AL, Guildford, Great Britain
| | - Nanna Brix Finnerup
- The Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 165, 8200, Aarhus N, Denmark
| | - Mette Berendt
- Department of Clinical Veterinary Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlaegevej 16, C DK-1870, Frederiksberg, Denmark
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Carisch L, Golini L, Schurna L, Bergamino C, Beckmann KM, Hilbe M, Asawapattanakul T, Baumgärtner W, Puff C, Wang‐Leandro A. Hypertensive nonobstructive hydrocephalus as main magnetic resonance imaging feature in a dog with disseminated choroid plexus carcinomatosis. J Vet Intern Med 2023; 37:1493-1500. [PMID: 37224288 PMCID: PMC10365043 DOI: 10.1111/jvim.16737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 05/07/2023] [Indexed: 05/26/2023] Open
Abstract
Obstructive or nonobstructive hypertensive hydrocephalus is reported in choroid plexus tumors. Choroid plexus tumors typically present as T2-weighted hyperintense intraventricular masses with occasional cerebrospinal fluid-drop metastasis. Acquired neoplastic nonobstructive hydrocephalus without visible mass lesion in magnetic resonance imaging is not reported in dogs. A 4.5-year-old Rhodesian Ridgeback presented with reduced mental status, unilaterally absent pupillary light reflex, and neck pain. Magnetic resonance imaging revealed a nonobstructive hydrocephalus and widened lumbar subarachnoid space with no evidence of a primary mass lesion. Postmortem examination confirmed a disseminated choroid plexus tumor affecting the ependyma and choroid plexi of all ventricles and the cerebral and lumbar subarachnoid space. Disseminated choroid plexus carcinomatosis should be considered as a possible cause of hypertensive hydrocephalus even in absence of a primary mass.
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Affiliation(s)
- Lea Carisch
- Clinic for Diagnostic Imaging, Department of Diagnostics and Clinical Services, Vetsuisse FacultyUniversity of ZurichZurichSwitzerland
| | - Lorenzo Golini
- Division of Neurology and Neurosurgery, Department of Small Animals Vetsuisse FacultyUniversity of ZurichZurichSwitzerland
| | - Lea Schurna
- Institute of Veterinary Pathology, Vetsuisse FacultyUniversity of ZurichZurichSwitzerland
| | - Chiara Bergamino
- Clinic for Diagnostic Imaging, Department of Diagnostics and Clinical Services, Vetsuisse FacultyUniversity of ZurichZurichSwitzerland
| | - Katrin M. Beckmann
- Division of Neurology and Neurosurgery, Department of Small Animals Vetsuisse FacultyUniversity of ZurichZurichSwitzerland
| | - Monika Hilbe
- Institute of Veterinary Pathology, Vetsuisse FacultyUniversity of ZurichZurichSwitzerland
| | - Thanaporn Asawapattanakul
- Department of PathologyUniversity of Veterinary Medicine Hannover, FoundationHannoverGermany
- Center for Systems NeuroscienceHannoverGermany
| | - Wolfgang Baumgärtner
- Department of PathologyUniversity of Veterinary Medicine Hannover, FoundationHannoverGermany
- Center for Systems NeuroscienceHannoverGermany
| | - Christina Puff
- Department of PathologyUniversity of Veterinary Medicine Hannover, FoundationHannoverGermany
| | - Adriano Wang‐Leandro
- Clinic for Diagnostic Imaging, Department of Diagnostics and Clinical Services, Vetsuisse FacultyUniversity of ZurichZurichSwitzerland
- Department of Diagnostic Imaging, Clinic for Small AnimalsUniversity of Veterinary Medicine Hannover, FoundationHannoverGermany
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Abstract
BACKGROUND Migraine is a complex neurological disorder that affects a significant percentage of the human species, from all geographic areas and cultures. Cognitive symptoms and dysfunctions are interim and disabling components of this disorder and may be related to the brain processes underlying the pathophysiology. Yet they are often undervalued by clinicians. In this review, we present the different types of cognitive dysfunctions associated with migraine and the mechanisms that are potentially causing them. FINDINGS While reversible attack-related cognitive dysfunction seems extremely consistent and likely related to functional cortical and subcortical brain changes occurring during attacks, interictal cognitive dysfunction is less consistent and might become more relevant as attack frequency and disease complexity increase. Migraine traits do not seem a predisposition to long-term cognitive decline. Cognitive dysfunction is a frequent manifestation of migraine attacks and may be specific to this disorder; it is important to understand if it could be useful in migraine diagnosis. Attack-related cognitive dysfunction is clinically relevant and contributes to disability, so it should be perceived as a therapeutic target. While there is no evidence to support that migraine increases the risk of long-term or persistent cognitive dysfunction, the fact that it occurs during the attacks and may persist in subjects with frequent or complicated attacks should prompt the understanding of the mechanisms related to its pathophysiology for it may also clarify the processes underlying migraine.
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Abstract
Failure of analgesic drugs in clinical development is common. Along with the current "reproducibility crisis" in pain research, this has led some to question the use of animal models. Experimental models tend to comprise genetically homogeneous groups of young, male rodents in restricted and unvarying environments, and pain-producing assays that may not closely mimic the natural condition of interest. In addition, typical experimental outcome measures using thresholds or latencies for withdrawal may not adequately reflect clinical pain phenomena pertinent to human patients. It has been suggested that naturally occurring disease in veterinary patients may provide more valid models for the study of painful disease. Many painful conditions in animals resemble those in people. Like humans, veterinary patients are genetically diverse, often live to old age, and enjoy a complex environment, often the same as their owners. There is increasing interest in the development and validation of outcome measures for detecting pain in veterinary patients; these include objective (eg, locomotor activity monitoring, kinetic evaluation, quantitative sensory testing, and bioimaging) and subjective (eg, pain scales and quality of life scales) measures. Veterinary subject diversity, pathophysiological similarities to humans, and diverse outcome measures could yield better generalizability of findings and improved translation potential, potentially benefiting both humans and animals. The Comparative Oncology Trial Consortium in dogs has pawed the way for translational research, surmounting the challenges inherent in veterinary clinical trials. This review describes numerous conditions similarly applicable to pain research, with potential mutual benefits for human and veterinary clinicians, and their respective patients.
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Mauler DA, De Decker S, De Risio L, Volk HA, Dennis R, Gielen I, Van der Vekens E, Goethals K, Van Ham L. Spinal Arachnoid Diverticula: Outcome in 96 Medically or Surgically Treated Dogs. J Vet Intern Med 2017; 31:849-853. [PMID: 28426173 PMCID: PMC5435043 DOI: 10.1111/jvim.14714] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Revised: 02/27/2017] [Accepted: 03/16/2017] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Little is reported about the role of medical management in the treatment of spinal arachnoid diverticula (SAD) in dogs. OBJECTIVES To describe the outcome of 96 dogs treated medically or surgically for SAD. ANIMALS Ninety-six dogs with SAD. METHODS Retrospective case series. Medical records were searched for spinal arachnoid diverticula and all dogs with information on treatment were included. Outcome was assessed with a standardized questionnaire. RESULTS Fifty dogs were managed medically and 46 dogs were treated surgically. Dogs that underwent surgery were significantly younger than dogs that received medical management. No other variables, related to clinical presentation, were significantly different between both groups of dogs. The median follow-up time was 16 months (1-90 months) in the medically treated and 23 months (1-94 months) in the surgically treated group. Of the 38 dogs treated surgically with available long-term follow-up, 82% (n = 31) improved, 3% (n = 1) remained stable and 16% (n = 6) deteriorated after surgery. Of the 37 dogs treated medically with available long-term follow-up, 30% (n = 11) improved, 30% (n = 11) remained stable, and 40% (n = 15) deteriorated. Surgical treatment was more often associated with clinical improvement compared to medical management (P = .0002). CONCLUSIONS AND CLINICAL IMPORTANCE The results of this study suggest that surgical treatment might be superior to medical treatment in the management of SAD in dogs. Further studies with standardized patient care are warranted.
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Affiliation(s)
- D A Mauler
- Veterinary Medical Teaching Hospital, College of Veterinary Medicine, University of Missouri, Columbia, MO
| | - S De Decker
- Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, Hertfordshire, UK
| | - L De Risio
- Centre for Small Animal Studies, Animal Health Trust, Newmarket, Suffolk, UK
| | - H A Volk
- Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, Hertfordshire, UK
| | - R Dennis
- Centre for Small Animal Studies, Animal Health Trust, Newmarket, Suffolk, UK
| | - I Gielen
- Department of Medical Imaging of Domestic Animals and Orthopedics of Small Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - E Van der Vekens
- Department of Medical Imaging of Domestic Animals and Orthopedics of Small Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - K Goethals
- Department of Comparative Physiology and Biostatistics, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - L Van Ham
- Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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Silva-Néto RP, Almeida Soares A. Does Migraine Occur Only in Humans or Other Animals May Suffer from This Disease Too? Headache 2017; 57:487. [DOI: 10.1111/head.13036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 12/15/2016] [Indexed: 11/30/2022]
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Landsberg G, Maďari A, Žilka N. Behavioural and Medical Differentials of Cognitive Decline and Dementia in Dogs and Cats. CANINE AND FELINE DEMENTIA 2017. [PMCID: PMC7121040 DOI: 10.1007/978-3-319-53219-6_2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Cognitive dysfunction syndrome (CDS) is a diagnosis of exclusion given that there is no specific diagnostic test or tool and that medical disorders can cause the same set of signs. The veterinary surgeon must first identify that signs are present, collect a full history and then perform a full physical examination and relevant diagnostic tests to rule out medical causes for the signs including blood and urine analysis, radiographs and diagnostic imaging such as magnetic resonance imaging (MRI) where indicated.
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Affiliation(s)
- Gary Landsberg
- North Toronto Veterinary Behaviour, Specialty Clinic, Thornhill, Ontario Canada
| | - Aladár Maďari
- Univ of Veterinary Medicine and Pharmacy, Small Animal Clinic, Košice, Slovakia
| | - Norbert Žilka
- Slovak Academy of Sciences, Institute of Neuroimmunology, Bratislava, Slovakia
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Plessas IN, Volk HA, Rusbridge C, Vanhaesebrouck AE, Jeffery ND. Comparison of gabapentin versus topiramate on clinically affected dogs with Chiari-like malformation and syringomyelia. Vet Rec 2015; 177:288. [DOI: 10.1136/vr.103234] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2015] [Indexed: 01/21/2023]
Affiliation(s)
- I. N. Plessas
- Department of Clinical Science and Services; Royal Veterinary College; Hawkshead Lane North Mymms AL9 7TA UK
| | - H. A. Volk
- School of Veterinary Medicine, University of Surrey; Guildford Surrey GU2 7XH UK
| | - C. Rusbridge
- Department of Neurology; Fitzpatrick Referrals; Halfway Lane, Eashing, Godalming Surrey GU7 2QQ UK
| | - A. E. Vanhaesebrouck
- Department of Veterinary Medicine; Veterinary Medicine School, University of Cambridge; Madingley Road Cambridge CB3 0ES UK
| | - N. D. Jeffery
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine, Iowa State University; 2503 Vet Med, 1600 South 16th Street Ames Iowa 50011 USA
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Affiliation(s)
- C. Stalin
- Small Animal Clinical Sciences; School of Veterinary Medicine; College of Medical; Veterinary and Life Sciences; University of Glasgow; Garscube Campus, Bearsden Road Glasgow G61 1QH UK
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