Cerebrospinal Fluid Analysis in Recumbent Adult Dairy Cows With or Without Spinal Cord Lesions

A novel machine learning-based web application for field identification of infectious and inflammatory disorders of the central nervous system in cattle

BACKGROUND

Central nervous system (CNS) infections in cattle are a major cause of economic loss and mortality. Machine learning (ML) techniques are gaining widespread application in solving predictive tasks in both human and veterinary medicine.

OBJECTIVES

Our primary aim was to develop and compare ML models that could predict the likelihood of a CNS disorder of infectious or inflammatory origin in neurologically-impaired cattle. Our secondary aim was to create a user-friendly web application based on the ML model for the diagnosis of infection and inflammation of the CNS.

ANIMALS

Ninety-eight cattle with CNS infection and 86 with CNS disorders of other origin.

METHODS

Retrospective observational study. Six different ML methods (logistic regression [LR]; support vector machine [SVM]; random forest [RF]; multilayer perceptron [MLP]; K-nearest neighbors [KNN]; gradient boosting [GB]) were compared for their ability to predict whether an infectious or inflammatory disease was present based on demographics, neurological examination findings, and cerebrospinal fluid (CSF) analysis.

RESULTS

All 6 methods had high prediction accuracy (≥80%). The accuracy of the LR model was significantly higher (0.843 ± 0.005; receiver operating characteristic [ROC] curve 0.907 ± 0.005 ) than the other models and was selected for implementation in a web application.

CONCLUSION AND CLINICAL IMPORTANCE

Our findings support the use of ML algorithms as promising tools for veterinarians to improve diagnosis. The open-access web application may aid clinicians in achieving correct diagnosis of infectious and inflammatory neurological disorders in livestock, with the added benefit of promoting appropriate use of antimicrobials.

Assessment of cerebrospinal fluid analysis and short-term survival outcomes in South American camelids: A retrospective study of 54 cases (2005-2021)

BACKGROUND

Cerebrospinal fluid (CSF) is commonly analyzed in South American camelids with suspected neurologic disease because of ease of collection and characteristic findings associated with certain diseases.

OBJECTIVES

To assess CSF findings associated with short-term survival or non-survival in South American camelids in which neurologic disease was a differential diagnosis based on history and physical examination.

ANIMALS

Twenty-one llamas and 33 alpacas that underwent CSF analysis at the University of Missouri Veterinary Health Center.

METHODS

Retrospective study. Medical records of camelids that underwent CSF analysis between January 2005 and September 2021 were studied. Short-term survival was defined as survival to discharge from the Veterinary Health Center. A Fisher's exact test was used to compare species, CSF results, and survival.

RESULTS

Odds of survival were 3.9 times higher in camelids with a total nucleated cell count (TNCC) <3 cells/μL (P = .04). No significant association was found between survival and total protein concentration (TPC; P = .15) or percentage of eosinophils (P = 1.0). No significant correlation was found between species and increased TNCC (P = .63), TPC (P = .55), or percentage of eosinophils (P = .30). Among camelids diagnosed with Paralephostrongylus tenuis infestation, odds of survival were 4.95 times higher in alpacas (P = .05).

CONCLUSIONS

Cerebrospinal fluid TNCC ≥3 cells/μL is associated with decreased odds of short-term survival in South American camelids.

Interpretation of cerebrospinal fluid analysis from recumbent cows using different thresholds of red blood cell count

BACKGROUND

Hemodilution of the cerebrospinal fluid (CSF) could confound interpretation of results. Accurately predicting total nucleated cells count (TNCC) and total protein concentration (TPC) attributable to hemodilution is difficult.

OBJECTIVE

To determine the effects of hemodilution on TPC and TNCC in bovine CSF.

METHODS

Retrospective review of CSF analysis results of downer dairy cows treated at Centre hospitalier universitaire vétérinaire between January 2006 and December 2014. Descriptive statistics were performed using 3 scenarios.

RESULTS

Among the 235 samples included, red blood cell (RBC) count (RBCC) ranged from 0 to 869 220 RBC/μL (median = 6.6), TPC ranged from 0.04 to 6.51 g/L (median = 0.27), and TNCC ranged from 0 to 7500 cell/μL (median = 1.1). Among the 157 samples that had <30 RBC/μL (a threshold used in other species), TPC and TNCC varied between 0.13 and 1.06 g/L (median = 0.27) and between 0 and 31.4 cell/μL (median = 0.6), respectively. Eighty-four samples had TPC <0.25 g/L and TNCC ≤4.5 cell/μL. Among those 84 samples, RBCC varied between 0 and 1290 RBC/μL (median = 4.7). In 20 samples, TNCC was 0 with a variation in RBCC between 0 and 840 RBC/μL (median = 3.9). No strong correlations between RBCC and TNCC and TPC were found.

CONCLUSIONS

A cutoff around 200 RBC/μL is proposed as clinically meaninful in bovine CSF. Results between 200 and 1290 RBC/μL are equivocal.

Cerebrospinal fluid analysis in 58 ruminants showing neurological disorders

ABSTRACT: Ruminants may be affected by a wide variety of central nervous system (CNS) diseases. Cerebrospinal fluid (CSF) analysis forms the basis for ante mortem diagnostic evaluation of ruminants with clinical signs involving the CNS. Despite its importance as a tool to aid diagnosis, data regarding CSF examinations in spontaneous cases of CNS diseases in ruminants from Brazil are limited, and most reports involve experimental studies. Therefore, this study aimed to report the results of CSF analysis in 58 ruminants showing signs of neurological disorders. CSF samples for analysis were obtained from 32 cattle, 20 sheep, and 6 goats by cerebello-medullary cistern (n=54) or lumbosacral space (n=4) puncture. These ruminants showed neurological signs related to viral (n=13), mycotic (n=3), or bacterial (n=15) infections, and toxic (n=21), traumatic (n=4), or congenital disorders (n=2). CSF analysis from ruminants with viral infections presented lymphocytic pleocytosis, even though CSF showed no changes in several cases of rabies. Neutrophilic pleocytosis, cloudiness, presence of fibrin clots, and abnormal coloration were evident in the CSF of most cases of CNS bacterial infection, such as meningoencephalitis, meningitis, abscesses, myelitis, and a case of conidiobolomycosis. On the other hand, CSF was unchanged in most cases of toxic disorders, as botulism and hepatic encephalopathy. Elevated CSF density was observed in 60% of ruminants diagnosed with polioencephalomalacia. Our findings show that evaluation of CSF is a valuable diagnostic tool when used in association with epidemiological, clinical and pathological findings for diagnosis of CNS diseases in ruminants.

Clinical Chemistry Investigations in Recumbent and Healthy German Holstein Cows After the Fifth Day in Milk

Introduction

Recumbency is a frequent symptom occurring throughout lactation. Its cause can be related to the energy or mineral metabolism, or to trauma or infectious diseases. We compared various clinical chemistry parameters between healthy and recumbent cows and between cows with different causes of recumbency and determined if hypocalcaemia manifests in later lactation.

Material and Methods

Recumbent (n = 32) and healthy (n = 32) German Holstein cows were studied. After clinical examination, a serum sample was taken to measure the concentrations of Mg, Ca, Fe, Na, K, Pi, β-hydroxybutyrate, total bilirubin, non-esterified fatty acids (NEFA), urea, and creatinine as well as activities of alkaline phosphatase, aspartate aminotransferase (AST), creatine kinase (CK), and γ-glutamyl transferase in recumbent cows > 5 d in milk and control cows matched for age, lactation number, and pregnancy stage.

Results

In recumbent cows, mean serum concentrations of NEFA, bilirubin, and CK were statistically higher, while those of Fe, K, and Pi were significantly lower. Parameters compared between different recumbency diagnoses showed some descriptive Fe, K, urea, and AST differences, but these were not statistically significant.

Conclusion

The results show that only a limited number of parameters have diagnostic besides therapeutic value. Although of minor importance in our study, hypocalcaemia should be considered a cause of recumbency, even outside the typical risk period of parturient paresis.

Survival associated with cerebrospinal fluid analysis in downer adult dairy cows: A retrospective study (2006-2014)

Background

Threshold values for total nucleated cell count (TNCC) and protein concentration in cerebrospinal fluid (CSF) of downer dairy cows suggestive of a spinal cord lesion were recently published.

Objectives

Determine short‐ and long‐term survival of downer cows that underwent CSF analysis using the reported threshold values. Evaluate the prognostic value of these threshold values to predict short‐ and long‐term survival.

Animals

Two hundred and fourteen downer adult dairy cows that underwent CSF analysis during hospitalization at the Centre Hospitalier Universitaire Vétérinaire (CHUV) of the Université de Montréal.

Methods

Retrospective study. Medical records of downer adult dairy cows presented to the hospital between January 2006 and October 2014 for which CSF analysis results were available were studied. Short‐term (discharge from hospital) and long‐term (completion of lactation) survival were determined and compared in accordance with CSF TNCC and protein concentration, using a Chi‐square test.

Results

Cows with CSF TNCC and/or protein concentration above the threshold values had a significantly lower short‐term survival rate (P = .02). The odds of nonsurvival of cows with one or both CSF values above the threshold values was 2.16 times higher than the odds for cows with values under the threshold values. CSF TNCC >4.5 cells/μL had sensitivity and specificity of 17.3% (95% CI: 10.7%‐25.7%) and 92.3% (95% CI: 85.4%‐96.6%), respectively, for predicting short‐term nonsurvival. CSF protein concentration >0.39 g/L had sensitivity and specificity of 20.9% (95% CI: 13.7%‐29.7%) and 91.4% (95% CI: 84.2%‐96.0%), respectively.

Conclusions

CSF analysis above threshold values used in this study is associated with increased odds of short‐term nonsurvival.