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Paulin MV, Cross N, Gu J, Perkel M, Snead E. Hypodipsic hypernatremia after long-standing polydipsia in a cat with suspect neonatal head trauma. THE CANADIAN VETERINARY JOURNAL = LA REVUE VETERINAIRE CANADIENNE 2023; 64:1021-1027. [PMID: 37915774 PMCID: PMC10581365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
A 16-month-old neutered male domestic shorthair cat weighing 2.7 kg was referred for further evaluation of acute generalized muscle weakness and paraparesis after a long-standing history of polyuria-polydipsia. The diagnosis of hypodipsic/adipsic hypernatremia relied on the key findings of absent spontaneous drinking despite hypernatremia and a hyperosmolar state (444.8 mOsm/kg, reference interval 280 to 310 mOsm/kg). Brain MRI revealed severe multifocal anatomic anomalies of the rostral calvarium and the forebrain, suggestive of encephaloclastic porencephaly. Involvement of the thalamic and hypothalamic regions could have been responsible for the cat's adipsic hypernatremia. The unique aspects of this case were the rare description of central nervous system disease leading to hypodipsia, and the history of chronic polydipsia before the acute onset of hypodipsia. Key clinical message: Multifocal abnormalities of the forebrain can present with polyuria-polydipsia syndrome, hypodipsia/adipsia, or both, depending on the stage of the disease. This likely happens when the hypothalamic and thalamic regions are affected, since they regulate antidiuretic hormone release and thirst, respectively.
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Affiliation(s)
- Mathieu Victor Paulin
- Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, Saskatchewan S7N 5B2 (Paulin, Gu, Perkel, Snead); VCA Canada Calgary, Animal Referral & Emergency Centre (CARE), 7140 12th Street SE, Calgary, Alberta T2H 2Y4 (Cross)
| | - Nathan Cross
- Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, Saskatchewan S7N 5B2 (Paulin, Gu, Perkel, Snead); VCA Canada Calgary, Animal Referral & Emergency Centre (CARE), 7140 12th Street SE, Calgary, Alberta T2H 2Y4 (Cross)
| | - Jasmine Gu
- Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, Saskatchewan S7N 5B2 (Paulin, Gu, Perkel, Snead); VCA Canada Calgary, Animal Referral & Emergency Centre (CARE), 7140 12th Street SE, Calgary, Alberta T2H 2Y4 (Cross)
| | - Michael Perkel
- Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, Saskatchewan S7N 5B2 (Paulin, Gu, Perkel, Snead); VCA Canada Calgary, Animal Referral & Emergency Centre (CARE), 7140 12th Street SE, Calgary, Alberta T2H 2Y4 (Cross)
| | - Elisabeth Snead
- Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, Saskatchewan S7N 5B2 (Paulin, Gu, Perkel, Snead); VCA Canada Calgary, Animal Referral & Emergency Centre (CARE), 7140 12th Street SE, Calgary, Alberta T2H 2Y4 (Cross)
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Nessler J, Wunderlich C, Eikelberg D, Beineke A, Raue J, Runge M, Tipold A, Ganter M, Rehage J. Holoprosencephalia, hypoplasia of corpus callosum and cerebral heterotopia in a male belted Galloway heifer with adipsia. BMC Vet Res 2022; 18:51. [PMID: 35057802 PMCID: PMC8772152 DOI: 10.1186/s12917-022-03152-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 01/10/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Specialized neurons in the diencephalon detect blood hypernatremia in dehydrated animals. These neurons are connected with the pituitary gland, subsequently producing antidiuretic hormone to reabsorb water from urine in the kidneys, and to the forebrain to generate thirst and trigger drinking behavior. CASE PRESENTATION This is the first case report describing clinical findings, magnetic resonance imaging (MRI) and necropsy results of a Belted Galloway heifer with severe clinical signs of dehydration and hypernatremia, but concurrent adipsia and isosthenuria. Due to insufficient recovery with symptomatic treatment, owners elected euthanasia. Postmortem MRI and necropsy revealed a complex forebrain malformation: mild abnormal gyrification of the forebrain cortex, lobar holoprosencephaly, and corpus callosum hypoplasia. The affected brain structures are well known to be involved in osmoregulation and generation of thirst in dogs, humans and rodents. CONCLUSIONS Complex forebrain malformation can be involved in the pathogenesis of hypernatremia and adipsia in bovines.
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Affiliation(s)
- Jasmin Nessler
- Department for Small Animal Internal Medicine and Surgery, University of Veterinary Medicine Hannover, Foundation, Buenteweg 9, 30559, Hannover, Germany.
| | - Christian Wunderlich
- Clinic for Cattle, University of Veterinary Medicine Hannover, Foundation, Bischofsholer Damm 15, 30173, Hannover, Germany
| | - Deborah Eikelberg
- Institute for Pathology, University of Veterinary Medicine Hannover, Foundation, Buenteweg 17, 30559, Hannover, Germany
| | - Andreas Beineke
- Institute for Pathology, University of Veterinary Medicine Hannover, Foundation, Buenteweg 17, 30559, Hannover, Germany
| | - Jonathan Raue
- Department for Small Animal Internal Medicine and Surgery, University of Veterinary Medicine Hannover, Foundation, Buenteweg 9, 30559, Hannover, Germany
| | - Martin Runge
- Lower Saxony State Office for Consumer Protection and Food Safety Food and Veterinary Institute Braunschweig/Hannover, Eintrachtweg 17, 30173, Hannover, Germany
| | - Andrea Tipold
- Department for Small Animal Internal Medicine and Surgery, University of Veterinary Medicine Hannover, Foundation, Buenteweg 9, 30559, Hannover, Germany
| | - Martin Ganter
- Clinic for Swine, Small Ruminants and Forensic Medicine, University of Veterinary Medicine Hannover, Foundation, Bischofsholer Damm 15, 30173, Hannover, Germany
| | - Jürgen Rehage
- Clinic for Cattle, University of Veterinary Medicine Vienna (Vetmeduni Vienna), Veterinaerplatz 1, A-1210, Vienna, Austria
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Akashi Y, Park YT, Oetelaar GS, Murakami M. Successful treatment of hypodipsic/adipsic hypernatremia in a cat with lobar holoprosencephaly using oral desmopressin. JFMS Open Rep 2022; 8:20551169221082542. [PMID: 35342639 PMCID: PMC8949744 DOI: 10.1177/20551169221082542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Case summary A 2-year-old female spayed domestic shorthair cat was presented with a history of collapse, possible hypodipsia/adipsia, severe dehydration and hypernatremia. MRI of the brain revealed a failure of separation of the cerebral hemispheres as characterized by an absence of the rostral part of the corpus callosum, fornix and septum pellucidum and the presence of a single fused lateral ventricle. A diagnosis of hypodipsic/adipsic hypernatremia with lobar holoprosencephaly was made. Dietary management of the cat's condition was attempted by increasing oral water intake, but the cat's hypernatremia and azotemia persisted. Plasma arginine vasopressin (AVP) analysis revealed a low concentration of circulating AVP (2.3 pg/ml), prompting therapy with oral desmopressin in addition to the dietary management. This combined therapy decreased water consumption of the cat from 200 ml/day (85 ml/kg/day) to 100 ml/day (30 ml/kg/day), normalized plasma sodium concentration and resolved the azotemia. Relevance and novel information To our knowledge, this is the second case report of an MRI diagnosis of lobar holoprosencephaly with hypodipsic/adipsic hypernatremia in a cat and the first case report of the successful management of this condition using oral desmopressin. This case report emphasizes that holoprosencephaly should be suspected in cats presented with hypodipsic/adipsic hypernatremia and highlights the utility of MRI in establishing the diagnosis. Measurements of plasma osmolality and AVP concentration corroborate the pathophysiology and support the use of oral desmopressin in addition to dietary management to resolve the hypernatremia.
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Affiliation(s)
- Yoriko Akashi
- Ve C Jiyugaoka Animal Medical Center, Meguro City, Tokyo, Japan
| | - Young Tae Park
- Ve C Jiyugaoka Animal Medical Center, Meguro City, Tokyo, Japan
| | - Garrett S Oetelaar
- VCA Canada CARE Centre, Calgary, AB, Canada.,Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, IN, USA
| | - Masahiro Murakami
- Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, IN, USA
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Evenhuis J, Epstein SE, Della-Maggiore A, Reagan KL. Congenital pituitary cyst resulting in adipsic central diabetes insipidus and secondary hypernatremia in a cat. JFMS Open Rep 2021; 7:2055116921990294. [PMID: 33738109 PMCID: PMC7934035 DOI: 10.1177/2055116921990294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Case summary A 9-month-old intact female domestic mediumhair cat presented with a 5-month history of obtundation, lethargy, hypernatremia (181 mmol/l; reference interval [RI] 151–158 mmol/l), hyperchloremia (142 mmol/l; RI 117–126 mmol/l), azotemia (blood urea nitrogen 51 mg/dl; RI 18–33 mg/dl), creatinine 3.0 mg/dl (RI 1.1–2.2 mg/dl), hyperphosphatemia (8.3 mg/dl; RI 3.2–6.3 mg/dl) and total hypercalcemia (11.4 mg/dl; RI 9–10.9 mg/dl), with concurrent polyuria with adipsia. Neurologic evaluation revealed proprioceptive deficits, and this finding paired with a history of focal seizure-like activity despite improving sodium concentrations suggested a cerebrothalamic lesion. For this reason, and historical and biochemical findings consistent with adipsic diabetes insipidus (DI), MRI of the brain was performed, which revealed a lesion of the hypophyseal fossa consistent with a pituitary cyst. Given the patient’s age and the timeline of clinical signs, a congenital pituitary cyst was strongly suspected. The patient was managed initially with intravenous fluids to correct the hypernatremia, then managed for more than 4 years with topical ocular desmopressin acetate administration and free water administered through a feeding tube. This cat’s clinical diagnosis included a congenital pituitary cyst with subsequent central DI and primary adipsia. Relevance and novel information The clinical presentations of primary adipsia or central DI are both rare in cats. This is the first report to describe these conditions occurring in a cat owing to a congenital pituitary cyst and describes successful long-term management of this condition.
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Affiliation(s)
- Janny Evenhuis
- William R Pritchard Veterinary Medical Teaching Hospital, University of California Davis, Davis, CA, USA
| | - Steven E Epstein
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - Ann Della-Maggiore
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
- MarQueen Pet Emergency and Specialty Group, Roseville, CA, USA
| | - Krystle L Reagan
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
- Krystle L Reagan DVM, PhD, DACVIM (SAIM), Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, CA 95616, USA
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Barnard L, Durand A, Blume L, Lee L, Cameron S. Aventriculi associated with holoprosencephaly in a dog. J Vet Intern Med 2020; 34:2682-2686. [PMID: 33009835 PMCID: PMC7694808 DOI: 10.1111/jvim.15907] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 08/31/2020] [Accepted: 09/15/2020] [Indexed: 11/30/2022] Open
Abstract
CASE DESCRIPTION A 10-month-old neutered male mixed breed dog was presented for assessment of poorly controlled seizures. CLINICAL FINDINGS Magnetic resonance imaging of the brain disclosed complete absence of the lateral and third ventricles and mesencephalic aqueduct. Postmortem computed tomographic (CT) imaging and positive contrast cisterno-ventriculography confirmed the lack of a contiguous ventricular system. However, histopathology identified the presence of vestigial lateral and third ventricles with hypoplastic choroid plexus, atresia of the third ventricle, and fused thalami, consistent with a diagnosis of lobar holoprosencephaly (HPE). CLINICAL RELEVANCE To our knowledge, this report is the first case of radiographically confirmed aventriculi associated with HPE, a rare congenital malformation previously reported in people, to be described in veterinary medicine.
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Affiliation(s)
- Laura Barnard
- Canada West Veterinary Specialists, Vancouver, British Columbia, Canada
| | - Alexane Durand
- Department of Clinical Veterinary Sciences, University of Bern, Bern, Switzerland
| | - Lauren Blume
- Veterinary Imaging Solutions LLC, Milton, Vermont, USA
| | - Laura Lee
- Department of Pathological Sciences, University of Madison - Wisconsin, Madison, Wisconsin, USA
| | - Starr Cameron
- Department of Medical Sciences, University of Wisconsin - Madison, Madison, Wisconsin, USA
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Yu Y, Creighton EK, Buckley RM, Lyons LA. A Deletion in GDF7 is Associated with a Heritable Forebrain Commissural Malformation Concurrent with Ventriculomegaly and Interhemispheric Cysts in Cats. Genes (Basel) 2020; 11:E672. [PMID: 32575532 PMCID: PMC7349246 DOI: 10.3390/genes11060672] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/10/2020] [Accepted: 06/16/2020] [Indexed: 12/17/2022] Open
Abstract
An inherited neurologic syndrome in a family of mixed-breed Oriental cats has been characterized as forebrain commissural malformation, concurrent with ventriculomegaly and interhemispheric cysts. However, the genetic basis for this autosomal recessive syndrome in cats is unknown. Forty-three cats were genotyped on the Illumina Infinium Feline 63K iSelect DNA Array and used for analyses. Genome-wide association studies, including a sib-transmission disequilibrium test and a case-control association analysis, and homozygosity mapping, identified a critical region on cat chromosome A3. Short-read whole genome sequencing was completed for a cat trio segregating with the syndrome. A homozygous 7 bp deletion in growth differentiation factor 7 (GDF7) (c.221_227delGCCGCGC [p.Arg74Profs]) was identified in affected cats, by comparison to the 99 Lives Cat variant dataset, validated using Sanger sequencing and genotyped by fragment analyses. This variant was not identified in 192 unaffected cats in the 99 Lives dataset. The variant segregated concordantly in an extended pedigree. In mice, GDF7 mRNA is expressed within the roof plate when commissural axons initiate ventrally-directed growth. This finding emphasized the importance of GDF7 in the neurodevelopmental process in the mammalian brain. A genetic test can be developed for use by cat breeders to eradicate this variant.
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Affiliation(s)
- Yoshihiko Yu
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO 65211, USA; (Y.Y.); (E.K.C.); (R.M.B.)
- Laboratory of Veterinary Radiology, Nippon Veterinary and Life Science University, Musashino, Tokyo 180-8602, Japan
| | - Erica K. Creighton
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO 65211, USA; (Y.Y.); (E.K.C.); (R.M.B.)
| | - Reuben M. Buckley
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO 65211, USA; (Y.Y.); (E.K.C.); (R.M.B.)
| | - Leslie A. Lyons
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO 65211, USA; (Y.Y.); (E.K.C.); (R.M.B.)
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