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Kopanke JH, Chen AV, Brune JE, Brenna AC, Thomovsky SA. Creatine kinase and its isoenzymes in the serum and cerebrospinal fluid of healthy canines. Vet Clin Pathol 2023; 52:654-660. [PMID: 37985467 DOI: 10.1111/vcp.13268] [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] [Received: 01/01/2023] [Revised: 03/12/2023] [Accepted: 04/26/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Creatine kinase (CK) exists as three isoenzymes (CK-MM, CK-MB, and CK-BB) that are predominantly expressed in specific tissues and can be detected in both the serum and cerebrospinal fluid (CSF). CSF CK has been relatively unstudied in veterinary medicine, although studies in human medicine have demonstrated that changes in total CSF CK activity can indicate neurologic abnormalities. OBJECTIVES The purpose of this study was to establish reference intervals for CK and its three major isoenzymes in the serum and CSF of clinically healthy dogs. By establishing a definitive reference interval for this enzyme in healthy canines, the diagnostic use and possible significance of CK in clinical disease can be studied. METHODS Serum and/or CSF were collected from healthy dogs. Total CK activity was measured spectrophotometrically, and isoenzyme distributions were determined using the QuickGel CK Vis Isoenzyme Kit and a densitometric scanner. Total CK and CK isoenzyme activities were determined within 8 h of collection. RESULTS The median serum total CK in healthy canines was 159.0 U/L (range: 53.0-539.0 U/L), while the median CSF total CK was 3.7 U/L (range: 2.0-84.0 U/L). CK-BB and CK-MM were approximately equal in the serum, while CK-MM was the predominant isoenzyme in the CSF. CONCLUSIONS Knowledge of the normal distribution and concentration of CK in canine serum and CSF will set the foundation for future studies of canine CK as a potentially clinically useful biomarker.
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Affiliation(s)
- Jennifer H Kopanke
- Department of Veterinary Clinical Sciences, Washington State University College of Veterinary Medicine, Pullman, Washington, USA
| | - Annie V Chen
- Department of Veterinary Clinical Sciences, Washington State University College of Veterinary Medicine, Pullman, Washington, USA
| | - Jourdan E Brune
- Department of Veterinary Clinical Sciences, Washington State University College of Veterinary Medicine, Pullman, Washington, USA
| | - Amanda C Brenna
- Department of Veterinary Clinical Sciences, Washington State University College of Veterinary Medicine, Pullman, Washington, USA
| | - Stephanie A Thomovsky
- Department of Veterinary Clinical Sciences, Washington State University College of Veterinary Medicine, Pullman, Washington, USA
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2
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Fuchs J, Domaniža M, Kuricová M, Lipták T, Ledecký V. Comparison of Imaging Methods and Population Pattern in Dogs with Spinal Diseases in Three Periods between 2005 and 2022: A Retrospective Study. Vet Sci 2023; 10:vetsci10050359. [PMID: 37235442 DOI: 10.3390/vetsci10050359] [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: 11/29/2022] [Revised: 05/10/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023] Open
Abstract
The aim of this study was the long-term comparison of the imaging methods used in dogs with neurologic diseases related to the spine and spinal cord. We also compared the occurrence of neurological diseases according to the localization, gender, age, and breed. As the availability of magnetic resonance imaging (MRI) has increased over the years, resulting in increased diagnostic and therapeutic success rates, the study was divided into three time periods (2005-2014, 2015-2018, and 2019-2022). Our results suggest changes in the population structure of the dogs studied and changes in the use of diagnostic methods that directly or indirectly influence the choice and success rate of therapy. Our results may be of interest to owners, breeders, practicing veterinarians, and insurance companies.
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Affiliation(s)
- Jakub Fuchs
- Small Animal Clinic, Veterinary University Hospital, University of Veterinary Medicine and Pharmacy, Komenskeho 73, 04181 Kosice, Slovakia
| | - Michal Domaniža
- Small Animal Clinic, Veterinary University Hospital, University of Veterinary Medicine and Pharmacy, Komenskeho 73, 04181 Kosice, Slovakia
| | - Mária Kuricová
- Small Animal Clinic, Veterinary University Hospital, University of Veterinary Medicine and Pharmacy, Komenskeho 73, 04181 Kosice, Slovakia
| | - Tomáš Lipták
- Small Animal Clinic, Veterinary University Hospital, University of Veterinary Medicine and Pharmacy, Komenskeho 73, 04181 Kosice, Slovakia
| | - Valent Ledecký
- Small Animal Clinic, Veterinary University Hospital, University of Veterinary Medicine and Pharmacy, Komenskeho 73, 04181 Kosice, Slovakia
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3
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Sekiguchi N, Ito D, Ishikawa C, Tanaka N, Kitagawa M. Heavily T2-weighted imaging findings of spinal cord swelling in dogs with intervertebral disc extrusion. J S Afr Vet Assoc 2022. [DOI: 10.36303/jsava.2022.93.1.500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Affiliation(s)
- N Sekiguchi
- Laboratory of Veterinary Neurology, School of Veterinary Medicine, Nihon University,
Japan
| | - D Ito
- Laboratory of Veterinary Neurology, School of Veterinary Medicine, Nihon University,
Japan
| | - C Ishikawa
- Laboratory of Veterinary Neurology, School of Veterinary Medicine, Nihon University,
Japan
| | - N Tanaka
- Laboratory of Veterinary Neurology, School of Veterinary Medicine, Nihon University,
Japan
| | - M Kitagawa
- Laboratory of Veterinary Neurology, School of Veterinary Medicine, Nihon University,
Japan
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4
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Murthy VD, Li CF, Hicks J, Kroll J, Giuffrida M, Dickinson P, Toedebusch CM. Serum phosphorylated neurofilament heavy chain as a diagnostic biomarker for progressive myelomalacia in dogs with thoracolumbar intervertebral disc herniation. J Vet Intern Med 2021; 35:2366-2373. [PMID: 34476832 PMCID: PMC8478056 DOI: 10.1111/jvim.16251] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 08/09/2021] [Accepted: 08/10/2021] [Indexed: 02/06/2023] Open
Abstract
Background Serum phosphorylated neurofilament‐heavy chain (pNF‐H) has not been longitudinally evaluated in dogs that develop progressive myelomalacia (PMM) after Type I intervertebral disc herniation (IVDH). Objectives To determine if serum pNF‐H concentrations would predict outcome of neuroligical disease in dogs with acute, severe thoracolumbar myelopathy secondary to Type I IVDH. Animals Thirty‐nine client‐owned dogs with thoracolumbar myelopathy secondary to IVDH. Methods Prospective controlled cohort study. Serum was collected from dogs undergoing hemilaminectomy at multiple timepoints. Final neurological status was established at 12 months and groups were stratified accordingly. Comparisons between outcome and pNF‐H concentration at each timepoint was examined using Kruskal‐Wallis analysis of variance on ranks and receiver operator characteristics curve analysis. Results Median serum pNF‐H concentrations were not significantly different between deep pain negative dogs that did or did not recover at any timepoint (baseline: 0.37 ng/mL [0‐0.9 ng/mL] vs 0 ng/mL [0‐0.9 ng/mL], P > 1; 24 hours: 1.25 ng/mL [0.35‐7.23 ng/mL] vs 1.53 ng/mL [0‐11.94 ng/mL], P > 1; 48 hours: 1.22 ng/mL [0.63‐6.62 ng/mL] vs 2.12 ng/mL [0‐20.72 ng/mL], P > 1; 72 hours: 2.77 ng/mL [1.33‐6.62 ng/mL] vs 16.69 ng/mL [4.02‐40.12 ng/mL], P > 1). Dogs that developed PMM had significantly higher serum pNF‐H concentrations after surgery compared to all other cohorts at 24 hours: 39.88 ng/mL (25.74‐50.68 ng/mL); P < .05 and 72 hours: 223.9 ng/mL (155.4‐263.7 ng/mL); P < .05. A serum pNF‐H concentration ≥31.39 ng/mL was 83.33% sensitive and 100% specific for identifying PMM in this cohort. Conclusions and Clinical Importance Serum pNF‐H is a promising biomarker for antemortem diagnosis of PMM in dogs with acute, severe thoracolumbar myelopathy secondary to Type I IVDH.
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Affiliation(s)
- Vishal D Murthy
- Department of Surgical and Radiological Sciences, College of Veterinary Medicine, University of California, Davis, California, USA
| | - Chai-Fei Li
- Department of Surgical and Radiological Sciences, College of Veterinary Medicine, University of California, Davis, California, USA
| | - Jill Hicks
- Department of Surgical and Radiological Sciences, College of Veterinary Medicine, University of California, Davis, California, USA
| | - Jacqueline Kroll
- Department of Surgical and Radiological Sciences, College of Veterinary Medicine, University of California, Davis, California, USA
| | - Michelle Giuffrida
- Department of Surgical and Radiological Sciences, College of Veterinary Medicine, University of California, Davis, California, USA
| | - Peter Dickinson
- Department of Surgical and Radiological Sciences, College of Veterinary Medicine, University of California, Davis, California, USA
| | - Christine M Toedebusch
- Department of Surgical and Radiological Sciences, College of Veterinary Medicine, University of California, Davis, California, USA
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Foreman M, Vettorato E, Caine A, Monti P, Cherubini GB, Eminaga S. Serum C-reactive protein in dogs with paraplegia secondary to acute intervertebral disc extrusion. J Vet Intern Med 2021; 35:1857-1864. [PMID: 34085305 PMCID: PMC8295702 DOI: 10.1111/jvim.16179] [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] [Received: 12/05/2020] [Revised: 05/05/2021] [Accepted: 05/14/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Apart from the absence of nociception, there is no readily available prognostic test for dogs presenting with paraplegia secondary to acute intervertebral disc extrusion (IVDE). OBJECTIVE To assess if serum C-reactive protein (CRP) can predict the postoperative outcome in paraplegic dogs undergoing surgery for IVDE and to assess the association between serum CRP and presence/absence of nociception on admission, and serum CRP and presence/absence of intramedullary changes seen on magnetic resonance imaging (MRI). ANIMALS One hundred dogs that underwent surgery at our hospital between 2018 and 2020 because of acute paraplegia secondary to IVDE and in which serum CRP was measured. METHODS Retrospective observational cohort study. Dogs were classified as 4 or 5 according to the modified Frankel score (MFS) depending on presence/absence of nociception, respectively. MRI images were reviewed and the T2-weighted hyperintensity: L2 vertebral body length was measured. Postoperative outcome was defined as positive if nociception, ambulation or both returned after decompressive surgery. RESULTS The median (95% CI) serum CRP was 4 (4-5) and 6 (4-7) mg/L in MSF4 and MSF5, respectively (P = .03). A weak linear relationship (R2 = 0.049, P = .03) was found between CRP and the T2-weighted hyperintensity: L2 vertebral length. Outcome data was available for 85 dogs: CRP was 4 (4-5) and 5 (4-10) mg/L in positive and negative outcome dogs, respectively (P = .32). CONCLUSION AND CLINICAL IMPORTANCE Serum CRP did not predict outcome after surgery in dogs with paraplegia secondary to IVDE.
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Affiliation(s)
| | | | - Abby Caine
- Dick White Referrals, Cambs, United Kingdom
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6
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Fitz FR, Reese M. Association between cerebrospinal fluid lactate concentration and central nervous system disease in dogs. Vet Clin Pathol 2020; 49:583-589. [PMID: 33336823 DOI: 10.1111/vcp.12918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 03/11/2020] [Accepted: 03/15/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Cerebrospinal fluid (CSF) analysis is a sensitive tool for evaluating patients with neurologic diseases but is rarely specific. Biomarkers can be measured from any bodily fluid and can be useful indicators for the presence, severity, and prognosis of diseases. OBJECTIVES This study was designed to evaluate if CSF lactate can be used as a biomarker in dogs with central nervous system disease. METHODS Peripheral venous blood and CSF were collected from 49 dogs with various intracranial diseases to evaluate correlations between blood and CSF lactate levels. Total nucleated cell count (TNCC) and CSF protein concentrations were also evaluated. All samples obtained were divided into normal (NG) and abnormal (AG) dogs based on a TNCC of ≤5 and >5 cells/μL and a protein concentration of ≤25 and >25 mg/dL, respectively. The AG dogs were further subdivided into those having <100 TNCCs/µL (AGL) and those having >100 TNCCs/µL (AGH). They were also subdivided into groups based on seizure activity (AGS), and inflammatory (AGI), or neoplastic diseases (AGN), and the respective lactate concentrations were then compared. RESULTS Lactate concentrations were significantly increased in CSF and venous blood samples in the AG compared with the NG dogs, but no differences were found among the individual disease processes. In all dogs, CSF lactate concentrations were higher than venous blood lactate levels; however, no direct correlation between CSF and blood lactate concentrations was identified. CONCLUSIONS Cerebrospinal fluid lactate can be used as a biomarker in clinical settings as it can be measured via a commercially available lactometer immediately after collection without the need for special instrumentation or laboratory personnel.
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Affiliation(s)
| | - Michael Reese
- Southeast Veterinary Neurology, Boynton Beach, FL, USA
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7
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Olby NJ, da Costa RC, Levine JM, Stein VM. Prognostic Factors in Canine Acute Intervertebral Disc Disease. Front Vet Sci 2020; 7:596059. [PMID: 33324703 PMCID: PMC7725764 DOI: 10.3389/fvets.2020.596059] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 10/12/2020] [Indexed: 12/17/2022] Open
Abstract
Knowledge of the prognosis of acute spinal cord injury is critical to provide appropriate information for clients and make the best treatment choices. Acute intervertebral disc extrusions (IVDE) are a common cause of pain and paralysis in dogs with several types of IVDE occurring. Important prognostic considerations are recovery of ambulation, return of urinary and fecal continence, resolution of pain and, on the negative side, development of progressive myelomalacia. Initial injury severity affects prognosis as does type of IVDE, particularly when considering recovery of continence. Overall, loss of deep pain perception signals a worse outcome. When considering Hansen type 1 IVDE, the prognosis is altered by the choice of surgical vs. medical therapy. Concentration of structural proteins in the plasma, as well as inflammatory mediators, creatine kinase, and myelin basic protein in the cerebrospinal fluid (CSF) can provide additional prognostic information. Finally, cross-sectional area and length of T2 hyperintensity and loss of HASTE signal on MRI have been associated with outcome. Future developments in plasma and imaging biomarkers will assist in accurate prognostication and optimization of patient management.
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Affiliation(s)
- Natasha J. Olby
- Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, NC, United States
| | - Ronaldo C. da Costa
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, United States
| | - Jon M. Levine
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, United States
| | - Veronika M. Stein
- Department for Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
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8
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Lampe R, Foss KD, Hague DW, Barger AM. Comparison of creatine kinase in cerebrospinal fluid collected from the cerebellomedullary and lumbar cisterna in 10 dogs with neurologic disease. Vet Clin Pathol 2020; 49:436-439. [PMID: 32737934 DOI: 10.1111/vcp.12885] [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: 08/27/2019] [Revised: 11/12/2019] [Accepted: 12/06/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Analysis of cerebrospinal fluid CK (CSF-CK) might be useful as a prognostic indicator in dogs with neurologic disease. Previous studies have mostly analyzed CSF-CK collected from the cerebellomedullary (CM) cisterna, but CSF collection sites could affect its levels. OBJECTIVES This is a pilot study aimed to evaluate differences in CSF-CK concentrations when collected from the CM or lumbar cisterna in dogs presenting with neurologic disease. METHODS Ten dogs presenting for neurologic disease underwent magnetic resonance imaging and CSF collection from both the CM and lumbar cisterna. Cerebrospinal fluid CK was analyzed within 30 minutes. RESULTS Ten dogs were prospectively recruited. Overall, there was no statistically significant difference between CSF-CK collected from the CM or lumbar cisterna (P = .31). When evaluated by neurolocalization, CSF-CK was different between sites in dogs with thoracolumbar myelopathy (P = .024), but not in dogs with intracranial or cervical neurolocalization (P = .93). All dogs with thoracolumbar myelopathy had equivocal or higher CK levels at the lumbar collection site compared with levels at the CM collection site. CONCLUSIONS Cerebrospinal fluid CK values differed depending on the CSF site collection, especially in dogs with thoracolumbar myelopathy. In dogs with thoracolumbar myelopathy, CSF-CK was likely to be higher when CSF was taken from the lumbar cisterna compared with the CM cisterna. Collecting CSF from the thoracolumbar site could provide better prognostic information than if collected at the CM collection site.
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Affiliation(s)
- Rachel Lampe
- Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Kari D Foss
- Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Devon W Hague
- Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Anne M Barger
- Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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Cerebrospinal Fluid and Central Nervous System Cytology. COWELL AND TYLER'S DIAGNOSTIC CYTOLOGY AND HEMATOLOGY OF THE DOG AND CAT 2020. [PMCID: PMC7151995 DOI: 10.1016/b978-0-323-53314-0.00014-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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10
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Bittermann S, Schild C, Marti E, Mirkovitch J, Schweizer D, Henke D. Analysis of blood degradation products and ferritin in the cerebrospinal fluid of dogs with acute thoracolumbar intervertebral disk extrusion, a prospective pilot study. BMC Vet Res 2019; 15:148. [PMID: 31088486 PMCID: PMC6518634 DOI: 10.1186/s12917-019-1878-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 04/23/2019] [Indexed: 11/23/2022] Open
Abstract
Background Hemorrhage in the spinal canal leads to further damage of the spinal cord influencing outcome in dogs with intervertebral disk (IVD) extrusion. The aim of the study was to evaluate blood degradation products and ferritin in the cerebrospinal fluid (CSF) of dogs with thoracolumbar IVD extrusion, and their association to clinical parameters and MRI findings. Results In the CSF of dogs with IVD extrusion, both net oxyhemoglobin absorption (NOA) and net bilirubin absorption (NBA) were significantly higher compared to the control groups of dogs with steroid responsive meningitis arteritis (SRMA) and idiopathic epilepsy (IE) (P < 0.001), but NOA compared to the idiopathic epilepsy group contaminated artificially with blood (IEc) was not (P = 0.890). Ferritin concentration was significantly higher in dogs with IVD extrusion compared to dogs with IE (P = 0.034), but not to dogs with SRMA (P = 0.526). There was no association between NOA, NBA or ferritin concentration and severity or duration of clinical signs. In dogs with a higher ferritin concentration the outcome was better (P = 0.018). In dogs with evidence of hemorrhage on MRI, NOA and NBA were significantly higher (P = 0.016, P = 0.009), but not ferritin (P = 0.0628). Conclusion and clinical importance Quantification of blood degradation products and ferritin in the CSF of dogs to assess subarachnoidal hemorrhage is feasible; however, larger case numbers are needed to evaluate the relevance of NBA and ferritin as prognostic indicators.
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Affiliation(s)
- Sophie Bittermann
- Division of Neurological Sciences, Division of Clinical Veterinary Neurology, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Laenggassstrasse 128, 3012, Bern, Switzerland.
| | - Christof Schild
- Institute of Clinical Chemistry, Inselspital, Bern University Hospital and University of Bern, INO-F3010, Bern, Switzerland
| | - Eliane Marti
- Department of Clinical Research and Veterinary Public Health, Vetsuisse Faculty, University of Bern, Laenggassstrasse 128, 3012, Bern, Switzerland
| | - Jelena Mirkovitch
- Department of Clinical Research and Veterinary Public Health, Vetsuisse Faculty, University of Bern, Laenggassstrasse 128, 3012, Bern, Switzerland
| | - Daniela Schweizer
- Division of Neurological Sciences, Division of Veterinary Radiology, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Laenggassstrasse 128, 3012, Bern, Switzerland
| | - Diana Henke
- Division of Neurological Sciences, Division of Clinical Veterinary Neurology, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Laenggassstrasse 128, 3012, Bern, Switzerland
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Bilodeau MÈ, Achard D, Francoz D, Grimes C, Desrochers A, Nichols S, Babkine M, Fecteau G. Survival associated with cerebrospinal fluid analysis in downer adult dairy cows: A retrospective study (2006-2014). J Vet Intern Med 2018; 32:1780-1786. [PMID: 30216558 PMCID: PMC6189354 DOI: 10.1111/jvim.15305] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 06/23/2018] [Accepted: 07/24/2018] [Indexed: 12/25/2022] Open
Abstract
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.
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Affiliation(s)
- Marie-Ève Bilodeau
- Faculté de Médecine Vétérinaire, Département des Sciences Cliniques, Université de Montréal, St-Hyacinthe, Quebec, Canada
| | | | - David Francoz
- Faculté de Médecine Vétérinaire, Département des Sciences Cliniques, Université de Montréal, St-Hyacinthe, Quebec, Canada
| | | | - André Desrochers
- Faculté de Médecine Vétérinaire, Département des Sciences Cliniques, Université de Montréal, St-Hyacinthe, Quebec, Canada
| | - Sylvain Nichols
- Faculté de Médecine Vétérinaire, Département des Sciences Cliniques, Université de Montréal, St-Hyacinthe, Quebec, Canada
| | - Marie Babkine
- Faculté de Médecine Vétérinaire, Département des Sciences Cliniques, Université de Montréal, St-Hyacinthe, Quebec, Canada
| | - Gilles Fecteau
- Faculté de Médecine Vétérinaire, Département des Sciences Cliniques, Université de Montréal, St-Hyacinthe, Quebec, Canada
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12
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Rosenstein PG, Tennent-Brown BS, Hughes D. Clinical use of plasma lactate concentration. Part 2: Prognostic and diagnostic utility and the clinical management of hyperlactatemia. J Vet Emerg Crit Care (San Antonio) 2018. [PMID: 29533517 DOI: 10.1111/vec.12706] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To review the current literature pertaining to the use of lactate as a prognostic indicator and therapeutic guide, the utility of measuring lactate concentrations in body fluids other than blood or plasma, and the clinical management of hyperlactatemia in dogs, cats, and horses. DATA SOURCES Articles were retrieved without date restrictions primarily via PubMed, Scopus, and CAB Abstracts as well as by manual selection. HUMAN AND VETERINARY DATA SYNTHESIS Increased plasma lactate concentrations are associated with increased morbidity and mortality. In populations with high mortality, hyperlactatemia is moderately predictive in identifying nonsurvivors. Importantly, eulactatemia predicts survival better than hyperlactatemia predicts death. Consecutive lactate measurements and calculated relative measures appear to outperform single measurements. The use of lactate as a therapeutic guide has shown promising results in people but is relatively uninvestigated in veterinary species. Increased lactate concentrations in body fluids other than blood should raise the index of suspicion for septic or malignant processes. Management of hyperlactatemia should target the underlying cause. CONCLUSION Lactate is a valuable triage and risk stratification tool that can be used to separate patients into higher and lower risk categories. The utility of lactate concentration as a therapeutic target and the measurement of lactate in body fluids shows promise but requires further research.
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Affiliation(s)
- Patricia G Rosenstein
- Department of Veterinary Clinical Sciences, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, Victoria, Australia
| | - Brett S Tennent-Brown
- Department of Veterinary Clinical Sciences, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, Victoria, Australia
| | - Dez Hughes
- Department of Veterinary Clinical Sciences, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, Victoria, Australia
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13
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Nye CJ, Mariani CL. Validation of a portable monitor for assessment of cerebrospinal fluid lactate in dogs. Vet Clin Pathol 2018; 47:108-114. [DOI: 10.1111/vcp.12567] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Carolyn J. Nye
- Comparative Neuroimmunology and Neurooncology Laboratory; College of Veterinary Medicine; North Carolina State University; Raleigh NC USA
| | - Christopher L. Mariani
- Comparative Neuroimmunology and Neurooncology Laboratory; College of Veterinary Medicine; North Carolina State University; Raleigh NC USA
- Department of Clinical Sciences; College of Veterinary Medicine; North Carolina State University; Raleigh NC USA
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14
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Wang-Leandro A, Siedenburg JS, Hobert MK, Dziallas P, Rohn K, Stein VM, Tipold A. Comparison of Preoperative Quantitative Magnetic Resonance Imaging and Clinical Assessment of Deep Pain Perception as Prognostic Tools for Early Recovery of Motor Function in Paraplegic Dogs with Intervertebral Disk Herniations. J Vet Intern Med 2017; 31:842-848. [PMID: 28440586 PMCID: PMC5435037 DOI: 10.1111/jvim.14715] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 01/25/2017] [Accepted: 03/16/2017] [Indexed: 01/12/2023] Open
Abstract
Background Prognostic tools to predict early postoperative motor function recovery (MFR) after thoracolumbar intervertebral disk herniation (IVDH) in paraplegic dogs represent an opportunity to timely implement novel therapies that could shorten recovery times and diminish permanent neurological dysfunctions. Hypothesis Fractional anisotropy (FA) values obtained using diffusion tensor imaging have a higher prognostic value than a lesion extension ratio in T2‐weighted images (T2W‐LER) and clinical assessment of deep pain perception (DPP) for MFR. Animals Thirty‐five paraplegic dogs with diagnosis of acute or subacute thoracolumbar IVDH. Methods Prospective, descriptive observational study. At admission, absence or presence of DPP, T2W‐LER, and FA values was evaluated. MFR was assessed within 4 weeks after decompressive surgery. Values of T2W‐LER and FA of dogs with and without MFR were compared using t‐tests. All 3 methods were evaluated for their sensitivity and specificity as a prognostic factor. Results No differences were found between groups regarding T2W‐LER. FA values differed statistically when measured caudally of lesion epicenter being higher in dogs without MFR compared to dogs with MFR (P = .023). Logistic regression analysis revealed significance in FA values measured caudally of the lesion epicenter (P = .033, area under the curve = 0.72). Using a cutoff value of FA = 0.660, the technique had a sensitivity of 80% and a specificity of 55%. Evaluation of DPP had a sensitivity of 73.3% and specificity of 75% (P = .007). Conclusions and Clinical Importance Evaluation of DPP showed a similar sensitivity and a better specificity predicting early MFR than quantitative magnetic resonance imaging.
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Affiliation(s)
- A Wang-Leandro
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany.,Centre of Systems Neuroscience, Hannover, Germany
| | - J S Siedenburg
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - M K Hobert
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - P Dziallas
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - K Rohn
- Institute of Biometry, Epidemiology, and Information Processing, University of Veterinary Medicine Hannover, Hannover, Germany
| | - V M Stein
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - A Tipold
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany.,Centre of Systems Neuroscience, Hannover, Germany
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15
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Crawford AH, De Decker S. Clinical presentation and outcome of dogs treated medically or surgically for thoracolumbar intervertebral disc protrusion. Vet Rec 2017; 180:569. [PMID: 28283670 DOI: 10.1136/vr.103871] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2017] [Indexed: 11/04/2022]
Abstract
To date, few studies have investigated the clinical characteristics of thoracolumbar intervertebral disc protrusion (IVDP). The aim of this retrospective study was to evaluate the presentation and outcome of dogs receiving medical or surgical treatment for thoracolumbar IVDP. Eighty-four dogs were included, with a median age of 9.4 years. German shepherd dogs and Staffordshire bull terriers were the most common breeds. Significantly more surgically treated dogs (n=53) had neurological deficits and were non-ambulatory, compared with medically treated (n=31). Outcome data were available for 27 of 31 medically managed dogs; 11 initially improved, 7 remained stable and 9 deteriorated. Of 18 dogs that initially improved or stabilised, 10 (55.6 per cent) demonstrated recurrence of clinical signs within 12 months of diagnosis. Outcome data were available for 45 of 50 surgically treated dogs that survived to hospital discharge; 34 improved, 9 remained stable and 2 deteriorated following surgery. Of 43 dogs that improved or stabilised with surgical treatment, 11 (25.6 per cent) demonstrated recurrence of clinical signs within 12 months of surgery. Overall, significantly more surgically treated dogs (71.1 per cent) had a successful outcome, consisting of sustained clinical improvement of more than 12 months duration, compared with medically treated dogs (29.6 per cent).
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Affiliation(s)
- A H Crawford
- Department of Clinical Science and Services, Queen Mother Hospital for Animals, Royal Veterinary College, University of London, Hatfield, UK
| | - S De Decker
- Department of Clinical Science and Services, Queen Mother Hospital for Animals, Royal Veterinary College, University of London, Hatfield, UK
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16
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Jeffery ND, Barker AK, Hu HZ, Alcott CJ, Kraus KH, Scanlin EM, Granger N, Levine JM. Factors associated with recovery from paraplegia in dogs with loss of pain perception in the pelvic limbs following intervertebral disk herniation. J Am Vet Med Assoc 2016; 248:386-94. [DOI: 10.2460/javma.248.4.386] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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17
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18
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Abstract
STUDY DESIGN Prospective study. OBJECTIVE To identify proteins with differential expression in the cerebrospinal fluid (CSF) from 15 clinically normal (control) dogs and 15 dogs with cervical spondylomyelopathy (CSM). SUMMARY OF BACKGROUND DATA Canine CSM is a spontaneous, chronic, compressive cervical myelopathy similar to human cervical spondylotic myelopathy. There is a limited knowledge of the molecular mechanisms underlying these conditions. Differentially expressed CSF proteins may contribute with novel information about the disease pathogenesis in both dogs and humans. METHODS Protein separation was performed with 2-dimensional electrophoresis. A Student t test was used to detect significant differences between groups (P < 0.05). Three comparisons were made: (1) control versus CSM-affected dogs, (2) control versus non-corticosteroid-treated CSM-affected dogs, and (3) non-corticosteroid-treated CSM-affected versus corticosteroid-treated CSM-affected dogs. Protein spots exhibiting at least a statistically significant 1.25-fold change between groups were selected for subsequent identification with capillary-liquid chromatography tandem mass spectrometry. RESULTS A total of 96 spots had a significant average change of at least 1.25-fold in 1 of the 3 comparisons. Compared with the CSF of control dogs, CSM-affected dogs demonstrated increased CSF expression of 8 proteins including vitamin D-binding protein, gelsolin, creatine kinase B-type, angiotensinogen, α-2-HS-glycoprotein, SPARC (secreted protein, acidic, rich in cysteine), calsyntenin-1, and complement C3, and decreased expression of pigment epithelium-derived factor, prostaglandin-H2 D-isomerase, apolipoprotein E, and clusterin. In the CSF of CSM-affected dogs, corticosteroid treatment increased the expression of haptoglobin, transthyretin isoform 2, cystatin C-like, apolipoprotein E, and clusterin, and decreased the expression of angiotensinogen, α-2-HS-glycoprotein, and gelsolin. CONCLUSION Many of the differentially expressed proteins are associated with damaged neural tissue, bone turnover, and/or compromised blood-spinal cord barrier. The knowledge of the protein changes that occur in CSM and upon corticosteroid treatment of CSM-affected patients will aid in further understanding the pathomechanisms underlying this disease. LEVEL OF EVIDENCE N/A.
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19
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Granger N, Carwardine D. Acute spinal cord injury: tetraplegia and paraplegia in small animals. Vet Clin North Am Small Anim Pract 2014; 44:1131-56. [PMID: 25441629 DOI: 10.1016/j.cvsm.2014.07.013] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Spinal cord injury (SCI) is a common problem in animals for which definitive treatment is lacking, and information gained from its study has benefit for both companion animals and humans in developing new therapeutic approaches. This review provides an overview of the main concepts that are useful for clinicians in assessing companion animals with severe acute SCI. Current available advanced ancillary tests and those in development are reviewed. In addition, the current standard of care for companion animals following SCI and recent advances in the development of new therapies are presented, and new predictors of recovery discussed.
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Affiliation(s)
- Nicolas Granger
- The School of Veterinary Sciences, University of Bristol, Langford House, Langford, North Somerset BS40 5HU, UK.
| | - Darren Carwardine
- The School of Veterinary Sciences, University of Bristol, Langford House, Langford, North Somerset BS40 5HU, UK
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20
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Abstract
Cross-sectional imaging techniques have facilitated diagnosis of central nervous system (CNS) diseases. However, there is still frequently a lack of definition of the cause of neurologic lesions, because tissue sampling from the pathologic site is often difficult and there are few clinical diagnostic tools to assist diagnosis. Biomarkers can assist in understanding the cause, diagnosis, severity, and prognosis for neural injury. Integration of conventional testing and new diagnostic techniques will overcome shortcomings in understanding infectious diseases of the CNS. Diagnostic tests may be limited by poor positive and negative predictive values, which must be recognized when interpreting test results.
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21
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Levine GJ, Cook JR, Kerwin SC, Mankin J, Griffin JF, Fosgate GT, Levine JM. Relationships between cerebrospinal fluid characteristics, injury severity, and functional outcome in dogs with and without intervertebral disk herniation. Vet Clin Pathol 2014; 43:437-46. [PMID: 24976308 DOI: 10.1111/vcp.12165] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Cerebrospinal fluid (CSF) is commonly acquired in dogs with intervertebral disk herniation (IVDH) and is a common method to assess inflammatory responses following spinal cord injury (SCI). OBJECTIVES The purpose of the study was to describe relationships between cisternal CSF characteristics, behavioral measures of SCI, T2- weighted (T2W) hyperintensity on magnetic resonance imaging (MRI), and long-term outcome in dogs with IVDH. Diagnostic accuracy of CSF for differentiating IVDH from other myelopathies was also assessed. METHODS The retrospective case series included 727 dogs, 443 with thoracolumbar IVDH, 103 with cervical IVDH, and 181 with other spinal cord diseases. Signalment, initial neurologic function, ambulatory function at long-term follow-up, T2W MRI, and CSF variables were recorded for dogs with IVDH. Signalment, etiology, and CSF data were retrieved for dogs with other myelopathies. Associations between CSF predictors, diagnosis, and outcomes were assessed. RESULTS CSF total nucleated cell count (TNCC) increased with SCI severity (rho -0.256, P < .001) in dogs with IVDH, TNCC was significantly higher in the presence of T2W hyperintensity (P = .001) in dogs with thoracolumbar IVDH, but TNCC, RBC count, microprotein, and percent neutrophils decreased with increasing injury duration (rho -0.253, P < .001; rho -0.269, P < .001; rho -0.141, P = .004, and rho -0.356, P < .001, respectively). CSF characteristics were not accurate for differentiating IVDH from other spinal cord diseases. CONCLUSIONS In dogs with IVDH, CSF TNCC, RBC count, microprotein, and percent neutrophils are correlated with clinical aspects of SCI such as injury severity and duration, but cannot differentiate IVDH from other etiologies.
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Affiliation(s)
- Gwendolyn J Levine
- Department of Veterinary Pathobiology, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX, USA
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22
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Use of autologous mesenchymal stem cells derived from bone marrow for the treatment of naturally injured spinal cord in dogs. Stem Cells Int 2014; 2014:437521. [PMID: 24723956 PMCID: PMC3956412 DOI: 10.1155/2014/437521] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2013] [Accepted: 01/16/2014] [Indexed: 02/04/2023] Open
Abstract
The use of stem cells in injury repair has been extensively investigated. Here, we examined the therapeutic effects of autologous bone marrow mesenchymal stem cells (MSC) transplantation in four dogs with natural traumatic spinal cord injuries. MSC were cultured in vitro, and proliferation rate and cell viability were evaluated. Cell suspensions were prepared and surgically administered into the spinal cord. The animals were clinically evaluated and examined by nuclear magnetic resonance. Ten days after the surgical procedure and MSC transplantation, we observed a progressive recovery of the panniculus reflex and diminished superficial and deep pain response, although there were still low proprioceptive reflexes in addition to a hyperreflex in the ataxic hind limb movement responses. Each dog demonstrated an improvement in these gains over time. Conscious reflex recovery occurred simultaneously with moderate improvement in intestine and urinary bladder functions in two of the four dogs. By the 18th month of clinical monitoring, we observed a remarkable clinical amelioration accompanied by improved movement, in three of the four dogs. However, no clinical gain was associated with alterations in magnetic resonance imaging. Our results indicate that MSC are potential candidates for the stem cell therapy following spinal cord injury.
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Musteata M, Nicolescu A, Solcan G, Deleanu C. The 1H NMR profile of healthy dog cerebrospinal fluid. PLoS One 2013; 8:e81192. [PMID: 24376499 PMCID: PMC3871169 DOI: 10.1371/journal.pone.0081192] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Accepted: 10/17/2013] [Indexed: 12/14/2022] Open
Abstract
The availability of data for reference values in cerebrospinal fluid for healthy humans is limited due to obvious practical and ethical issues. The variability of reported values for metabolites in human cerebrospinal fluid is quite large. Dogs present great similarities with humans, including in cases of central nervous system pathologies. The paper presents the first study on healthy dog cerebrospinal fluid metabolomic profile using 1H NMR spectroscopy. A number of 13 metabolites have been identified and quantified from cerebrospinal fluid collected from a group of 10 mix breed healthy dogs. The biological variability as resulting from the relative standard deviation of the physiological concentrations of the identified metabolites had a mean of 18.20% (range between 9.3% and 44.8%). The reported concentrations for metabolites may be used as normal reference values. The homogeneity of the obtained results and the low biologic variability show that the 1H NMR analysis of the dog’s cerebrospinal fluid is reliable in designing and interpreting clinical and therapeutic trials in dogs with central nervous system pathologies.
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Affiliation(s)
- Mihai Musteata
- Clinics Department, Faculty of Veterinary Medicine, University of Agricultural Science and Veterinary Medicine Iasi, Romania
| | - Alina Nicolescu
- Group of Biospectroscopy, Institute of Macromolecular Chemistry, Roumanian Academy, Iasi, Romania
- Group of Biospectroscopy, Centre of Organic Chemistry, Roumanian Academy, Bucharest, Romania
| | - Gheorghe Solcan
- Clinics Department, Faculty of Veterinary Medicine, University of Agricultural Science and Veterinary Medicine Iasi, Romania
| | - Calin Deleanu
- Group of Biospectroscopy, Institute of Macromolecular Chemistry, Roumanian Academy, Iasi, Romania
- Group of Biospectroscopy, Centre of Organic Chemistry, Roumanian Academy, Bucharest, Romania
- * E-mail:
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Jeffery N, Levine J, Olby N, Stein V. Intervertebral Disk Degeneration in Dogs: Consequences, Diagnosis, Treatment, and Future Directions. J Vet Intern Med 2013; 27:1318-33. [DOI: 10.1111/jvim.12183] [Citation(s) in RCA: 90] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2013] [Revised: 06/25/2013] [Accepted: 08/01/2013] [Indexed: 01/25/2023] Open
Affiliation(s)
- N.D. Jeffery
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; Iowa State University; Ames IA
| | - J.M. Levine
- Department of Small Animal Clinical Sciences; College of Veterinary Medicine and Biomedical Sciences; Texas A&M University; College Station TX
| | - N.J. Olby
- College of Veterinary Medicine; North Carolina State University; Raleigh NC
| | - V.M. Stein
- Department of Small Animal Medicine and Surgery; University of Veterinary Medicine Hannover; Hannover Germany
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Thomovsky S, Chen-Allen AV. Will he walk again? Only Dr. Nociception knows! Vet J 2013; 198:7-8. [PMID: 23962612 DOI: 10.1016/j.tvjl.2013.06.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Accepted: 06/24/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Stephanie Thomovsky
- College of Veterinary Medicine, Washington State University, Pullman, WA 99164-7060, USA.
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Roerig A, Carlson R, Tipold A, Stein V. Cerebrospinal fluid tau protein as a biomarker for severity of spinal cord injury in dogs with intervertebral disc herniation. Vet J 2013; 197:253-8. [DOI: 10.1016/j.tvjl.2013.02.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Revised: 01/28/2013] [Accepted: 02/04/2013] [Indexed: 01/18/2023]
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27
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Galán-Rodríguez A, Carletti BE, Morgaz-Rodríguez J, Gamito-Gómez A, Muñoz-Rascón P, Martín-Suárez EM. Short communication: cerebrospinal fluid lactate and pyruvate concentrations and ratio in healthy adult dogs. Vet Rec 2013; 173:249. [PMID: 23863216 DOI: 10.1136/vr.101671] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- A Galán-Rodríguez
- Department of Animal Medicine and Surgery, University of Córdoba, Córdoba, 14014, Spain
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