The diagnostic utility of hypophosphatemia for differentiating generalized tonic-clonic seizures from syncope in dogs: A case control study.

Transient hypophosphatemia is often detected in humans following generalized tonic-clonic seizures (GTCS), and serum phosphorus concentration (sPi) serves as a marker to differentiate GTCS from syncope. The objective of this retrospective study was to assess the usefulness of hypophosphatemia as a diagnostic marker for GTCS in dogs. Eighty-seven and 26 client-owned dogs with GTCS or syncope, respectively, were enrolled. Dogs were included if the episode occurred ≤ 3 h from presentation, and if sPi and serum creatinine (sCr) were measured. Dogs were excluded if aged < 1 year or if sCr exceeded 176.8 µmol/L. There were no group differences in sCr. Hypophosphatemia (sPi ≤ 0.97 mmol/L) occurred in 28 dogs (32%) in the seizure group, and in no dogs in the syncope group. Median sPi was significantly (P < 0.001) lower in the seizure group (1 mmol/L, [range, 0.31-2.87 mmol/L]) compared to the syncope group (1.35 mmol/L [range, 0.97-2.71 mmol/L]). Furthermore, in dogs presented while seizing (n = 24/87; 28%) median sPi was significantly lower compared to those that were not (0.9 mmol/L [range, 0.3-1.74 mmol/L] vs. 1 mmol/L [range, 0.33-2.18 mmol/L], P = 0.050). ROC analysis of sPi as a marker of GTCS yielded an AUC of 0.757 (95% confidence interval 0.667-0.847), with an optimum cutoff point of 0.97 mmol/L, corresponding to specificity and sensitivity levels of 100% and 44%, respectively. In conclusion, sPi may, in certain cases, serve as an additional diagnostic tool to differentiate GTCS from syncope in dogs. Hypophosphatemia, especially with sPi < 0.97 mmol/L, may be useful in clinical practice to rule in GTCS.

The prognostic value of the Koret CT score in dogs following traumatic brain injury.

Traumatic brain injury (TBI) is a common condition in veterinary medicine with relatively high mortality rate. Recently, a study that correlated abnormal computed tomography (CT) findings with outcome in dogs with head trauma established a prognostic scoring system termed Koret CT score (KCTS). The purpose of this study was to evaluate the accuracy of the KCTS in making short- and long-term prognosis in dogs presented within 72 h of TBI. Thirty-five dogs that were admitted to a hospital during 2010-2019 with TBI and were CT-scanned within 72 h of injury were included in the study. Retrospectively collected data included signalment, modified Glasgow Coma Scale score (MGCS), CT findings, and outcome, i.e. short-term (defined as 10 days) and long-term (6 months) survival. CT images were reviewed and the KCTS was calculated for all dogs. Association between KCTS and outcome was examined. A significant negative association was found between KCTS and both short- and long-term survival. The area under receiver operating characteristic curve for KCTS for short- and long-term survival was 0.9 and 0.87, respectively. Furthermore, the probability of survival in the short term was predicated by the KCTS in an almost linear fashion and a score of 3 points or less on the KCTS was associated with survival with 85% sensitivity and 100% specificity. These results validate the prognostic value of the KCTS in dogs with TBI and provide a complementary tool for serial clinical and neurological evaluation.

Serum Concentrations of Neuron-Specific Enolase in Dogs Following Traumatic Brain Injury.

The ability to make an accurate prognosis, which is a prerequisite for treatment decisions, is very limited in dogs with traumatic brain injury (TBI). To determine whether serum concentrations of neuron-specific enolase (NSE) have prognostic value in dogs following TBI, we conducted a prospective, observational, controlled clinical study in an intensive care unit of a university teaching hospital. The study population comprised 24 dogs admitted to the hospital within 72 h of a known event of TBI between January 2010 and January 2015, as well as 25 control healthy shelter dogs admitted for elective neutering. Seventeen injured dogs (70%) survived to discharge, four were euthanized and three died within 48 h. Serum samples were obtained from all dogs (in injured dogs, within 72 h of TBI) and NSE concentrations were measured using enzyme-linked immonosorbent assay. Associations between NSE levels and outcome, Modified Glasgow Coma Scale, time to sampling, age or haemolysis scale were determined. Mean serum NSE concentrations were decreased in dogs with TBI compared with healthy controls (19.4 ± 4.14 ng/ml vs. 24.9 ± 4.6 ng/ml, P <0.001). No association was found between serum NSE concentrations and either survival or severity of neurological impairment. A negative correlation was found between serum NSE concentrations and time from trauma to blood collection (r = -0.50, P = 0.022). These results indicate that serum NSE concentration in dogs following TBI is not an effective marker for severity or outcome. Further studies are warranted to standardize serum NSE measurements in dogs and to determine the peak and half-life levels of this potential biomarker.

Detection of Intraspinal Spirocerca lupi in Canine Cerebrospinal Fluid by Polymerase Chain Reaction.

Aberrant migration of Spirocerca lupi into the spinal cord is an important cause of severe progressive neurological dysfunction in dogs. Although early diagnosis is essential to prevent deterioration, ante-mortem diagnosis of this condition remains challenging. The aim of this study was to evaluate the detection of the 18S ribosomal DNA (rDNA) S. lupi gene in the cerebrospinal fluid (CSF) of presumptively-affected dogs using polymerase chain reaction (PCR). Dogs with a non-compressive spinal cord lesion, pleocytosis with presence of eosinophils in the CSF and a characteristic clinical presentation were included. CSF samples from eight dogs were available for the study, of which seven were definitively diagnosed with intraspinal spirocercosis by PCR of either the CSF samples (6/7) or tissue samples obtained at necropsy examination (3/7), or both (2/7). Of these seven positive cases, only one dog had a negative CSF PCR, indicating a sensitivity of 86% for detecting nematode DNA in the CSF of infected dogs using this PCR protocol. The nematode DNA sequences obtained from the CSF of six dogs and the spinal cord tissue of three dogs were 98-100% identical to the publicly available sequences of S. lupi, confirming the diagnosis. These findings indicate that PCR targeting the 18S rDNA of S. lupi in CSF is useful for the ante-mortem diagnosis of canine intraspinal spirocercosis.

The prognostic value of cerebrospinal fluid characteristics in dogs without deep pain perception due to thoracolumbar disc herniation.

Providing a pre-operative prognosis for dogs presented with absent deep pain perception (DPP) is extremely challenging, as the overall recovery rates widely vary. This study assesses the possible correlation between the severity of spinal cord injury and CSF cytology in 31 paraplegic dogs presented with absent DPP due to acute thoracolumbar intervertebral disc herniation (TL-IVDH). All dogs underwent surgical decompression immediately following diagnosis. CSF TNCC, macrophage percentage and macrophage to monocyte (MΦ:M) ratio were significantly higher in dogs that failed to regain DPP within 10 days post-operatively and in dogs that failed to regain ambulation at the end of the study period (P< 0.05). MΦ:M of 0.73 and higher corresponded to a sensitivity of 54% and specificity of 100% for prediction of a negative long-term outcome. CSF TNCC, macrophage percentage and MΦ:M ratio effectively predicted regaining DPP and the long-term outcome in dogs that lost DPP due to acute TL-IVDH.

Tumor necrosis factor-α and interleukin-6 concentrations in cerebrospinal fluid of dogs after seizures.

BACKGROUND: Idiopathic and acquired epilepsy are common in dogs. Up to 30% of these dogs are refractory to pharmacological treatment. Accumulating experimental evidence indicates that brain immune response and presence of inflammatory mediators decrease the threshold for individual seizures and contribute to epileptogenesis. HYPOTHESIS: Dogs with seizures have higher cerebrospinal interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) concentrations compared to dogs with no seizures. METHODS: A prospective double blinded study; cerebrospinal fluid (CSF) and serum IL-6, TNF-α and total protein (TP) concentrations were measured by a blinded investigator for the study group and CSF IL-6 and TNF-α levels and TP concentrations were measured in the control group (CG). ANIMALS: Dogs presented with seizures that had enough CSF collected to allow analysis were included in the study group. Twelve apparently healthy, quarantined, stray dogs served as control (CG). RESULTS: Cerebrospinal fluid TNF-α and IL-6 concentrations were significantly higher (P = .011, P = .039) in dogs with seizures (0 ± 70.66, 0.65 ± 10.93 pg/mL) compared to the CG (0 ± 19, 0.73 ± 0.55 pg/mL). When assessing cytokine concentrations of specifically the idiopathic epilepsy (IE) dogs compared to the CG, only TNF-α concentrations (8.66 ± 62, 0 ± 19 pg/mL) were significantly higher (P = .01). CSF TP concentrations were not significantly higher in the study dogs compared to the CG. CONCLUSIONS AND CLINICAL IMPORTANCE: Higher TNF-α and IL-6 concentration in the CSF of dogs with naturally occurring seizures. The higher supports the hypothesis that inflammatory processes through certain mediators play a role in the pathogenesis of seizures in dogs.

Association of cerebrospinal fluid analysis findings with clinical signs and outcome in acute nonambulatory thoracolumbar disc disease in dogs.

BACKGROUND: Cerebrospinal fluid (CSF) pleocytosis recently was associated with the severity of neurologic signs in dogs with intervertebral disc disease (IVDD). HYPOTHESIS/OBJECTIVES: To look for an association among CSF cell counts, total protein concentration, and severity of neurologic signs at presentation with outcome in dogs with acute thoracolumbar IVDD. Our hypothesis was that CSF total nucleated cell count (TNCC) and percentage cell types would be associated with the severity of spinal cord damage and therefore with both the presenting clinical signs and the prognosis of affected dogs. ANIMALS: Fifty-four dogs with acute nonambulatory thoracolumbar IVDD were evaluated. METHODS: Retrospective study. Signalment, neurologic grade, CSF TNCC, protein concentration, red blood cells count and differential cell percentages, and short- and long-term outcomes were evaluated. RESULTS: CSF pleocytosis (>5 cells/µL) was present in 54% of dogs and was positively associated with neurologic grade at presentation and with postoperative time to regaining ambulation. Neutrophils were observed most frequently. The percentage of CSF macrophages and macrophage to monocyte ratio were higher (P = .001, for both) in dogs presented without deep pain sensation (DPS) that did not regain ambulation. Receiver operator characteristics curve analysis yielded a cut-off point of 13% macrophages with a sensitivity and specificity of 100 and 83%, respectively, for prediction of a negative outcome. CONCLUSIONS AND CLINICAL IMPORTANCE: CSF pleocytosis is positively associated with the severity of spinal cord damage in dogs with thoracolumbar IVDD. The percentage of CSF macrophages can be used as a prognostic indicator for regaining ambulation in dogs that have lost DPS.

Successful medical management of lumbar intervertebral disc prolapse in a ferret.

Thoracolumbar disc herniation was diagnosed in a two-year-old ferret using a myelogram followed by a computed tomography scan. The ferret was paraplegic with no control over urination and defecation. Conservative treatment that included cage rest and passive range of motion exercises for three weeks followed by extensive physiotherapy and hydrotherapy resulted in full recovery two months after the onset of treatment. Although intervertebral disc disease has been reported previously in four ferrets, this is the first report in which a postmyelogram computed tomography was used to demonstrate the herniated disc, and physiotherapy was used as principal treatment modality.

L-thyroxine responsive cricopharyngeal achalasia associated with hypothyroidism in a dog.

An eight-year-old, male boxer dog was presented with a one-month history of hindlimb weakness followed by compulsive ineffective drinking, dysphagia, regurgitation and nasal reflux during drinking. A neurological examination revealed weakness and conscious proprioception deficits in both hindlimbs with normal spinal reflexes. The dog's swallowing function was examined by fluoroscopy. This showed normal prehension of the barium paste, bolus formation and contraction of the pharyngeal muscle, but no opening of the upper oesophageal sphincter was detected. A serum thyroid stimulating hormone level of 0.402 ng/dl and serum total T4 of 0-01 microg/dl were determined. The dog fully recovered one month after L-thyroxine therapy. The association found between cricopharyngeal achalasia and hypothyroidism suggests that hypothyroidism should be included in the list of differential diagnoses for dogs with cricopharyngeal achalasia.

Natural Clostridium botulinum type C toxicosis in a group of cats.

Clinical signs of botulism were observed in a group of eight cats, four of which died, after being fed pelican carrion. Clostridium botulinum type C was isolated from one cat. The microorganism and its toxin were found in the pelican. This is apparently the first report of natural botulism in cats.

Dog bite wounds in dogs and cats: a retrospective study of 196 cases.

The age, type, etc., time of injury, body areas injured, treatment modalities and mortality rates were reviewed in 185 dogs and 11 cats that were bitten by dogs. Male dogs were more frequently bitten than females, and small dogs (< or = 10 kg) were not only the most common victims but also were more likely to suffer multiple injuries. Mortality occurred only in cases with thoracic or abdominal injuries. Exploratory thoracotomy, performed in some of the cases presented with penetrating thoracic injury, did not prove to alter prognosis. Cats are not as frequently bitten as dogs, and are often younger than the mean age of cats in the overall hospital population.

Double-blind randomized study evaluating regeneration of the rat transected sciatic nerve after suturing and postoperative low-power laser treatment.

This double-blind randomized study evaluated the therapeutic effect of low-power laser irradiation (LPLI) on peripheral nerve regeneration, after complete transection and direct anastomosis of the rat sciatic nerve. After this procedure, 13 of 24 rats received postoperative LPLI, with a wavelength of 780 nm laser, applied transcutaneously, 30 min daily for 21 consecutive days, to corresponding segments of the spinal cord and to the injured sciatic nerve. Positive somatosensory evoked responses were found in 69.2 percent of the irradiated rats (p = 0.019), compared to 18.2 percent of the non-irradiated rats. Immunohistochemical staining in the laser-treated group showed an increased total number of axons (p = 0.026), and better quality of the regeneration process, due to an increased number of large-diameter axons (p = 0.021), compared to the non-irradiated control group. The study suggests that postoperative LPLI enhances the regenerative processes of peripheral nerves after complete transection and anastomosis.

Radiographic findings during recovery from discospondylitis.

The diagnosis of discospondylitis is based on radiographic changes in the vertebrae. The limitations of this method are the time gap between the onset of clinical signs and the first appearance of the radiographic findings, as well as the disassociation between the clinical and radiographic signs during recovery. It is known that the radiographic changes appear only two to four weeks after the onset of clinical signs, but the characteristics of radiographic changes during recovery has yet to be documented, thus making follow-up radiographs difficult to interpret. A prospective and retrospective study was designed to document typical radiographic changes during recovery from discospondylitis. We reviewed 12 dogs that had complete and uneventful recovery with antibiotic therapy alone. Periodic follow-up radiographs and clinical examinations were conducted up to five months after the onset of clinical signs to correlate between the clinical status and radiographic changes during recovery. Although the clinical signs improved within the first 10 days of antibiotic therapy, the radiographic deterioration continued before regression and signs of radiographic recovery were noticed. This radiographic deterioration, despite successful antibiotic therapy, appeared shorter in young dogs (less than one year old) and lasted three to nine weeks in older dogs.

Partial surgical removal of an intramedullary epidermoid cyst from the spinal cord of a dog.

An intramedullary space-occupying lesion in the form of an epidermoid cyst was diagnosed in a one-and-a-half-year-old flat-coated retriever. Dorsal laminectomy and durotomy were performed in order to establish the diagnosis followed by excision of one third of the cyst. The remaining cystic tissue that was intimately attached to the spinal cord parenchyma was left in place in order to avoid further damage to the nervous tissue. The dog's neurological status improved dramatically after the surgery, but deteriorated four months later due to recurrence of the cyst.

Free skin grafting for treatment of distal limb skin defects in cats.

The technique and results of free skin grafts have been described in dogs, horses, rabbits, goats and mice. The procedure in cats is, however, described only indirectly in papers relating to dogs. A standard technique has been developed by the authors for use in cats, and is reported for 17 grafts in 16 cats with traumatic injury to the legs resulting in large areas of skin loss. This paper describes the preparation of the wound for grafting, the harvesting of the graft, graft placement, postoperative care and the results of the application of this technique. The success rate in this series of cases was high. This was attributed to proper preparation of the recipient site, collection of the graft and postoperative bandaging. The results suggest that the success rate of free skin grafts in cats is considerably higher than that achieved by the present authors in dogs, and reported for dogs by other surgeons in the literature.

Arnold-Chiari malformation in a captive African lion cub.

Progressive ataxia, delayed growth, dementia and tremors were noted in a female African lion (Panthera leo) cub at the Tel-Aviv Ramat-Gan Zoological Center (Israel). The lioness was 3-mo-old when clinical signs were first noticed. Repeated neurological evaluations and blood tests were conducted in an attempt to establish a diagnosis. A congenital abnormality was suspected and the lioness died 6 molater. Post mortem examination revealed an Arnold-Chiari malformation. The abnormality was classified as a Chiari type 2 malformation, based on the herniation of the cerebellar vermis and paravermis and the slight caudal displacement of the medulla, combined with lack of displacement in other parts of the brainstem.

Immunoreactivity of canine mammary neoplasms with monoclonal antibody CC49.

Monoclonal antibody (MAb) CC49 binds to human tumour-associated glycoprotein termed TAG-72. CC49 is a second-generation MAb with higher affinity to TAG-72 than the original MAb B72.3. CC49 was applied to 42 samples from different canine mammary tumours, belonging to seven different histopathological types. Immunoreactivity was detected by the use of an avidin-biotin complex immunoperoxidase method. Most sections from all types of mammary neoplasm reacted with this MAb. Normal tissue did not stain or stained only weakly. The results of this study suggest CC49 has selective immunoreactivity for a variety of canine mammary tumours, which seems superior to that reported with MAb 72.3. These results support the proposal for further study of diagnostic and therapeutic uses of CC49 in the management of canine mammary tumours.

Subarachnoid cyst in a cat.

A five-year-old domestic longhair was presented with hind-limb ataxia and some degree of incontinence of two weeks' duration. An enlarged spinal canal from the twelfth thoracic (T12) vertebra to the third lumbar (L3) vertebra was identified on survey radiographs. An intradural-extramedullary cavity at the twelfth (T12) and thirteenth (T13) thoracic vertebrae, filled with contrast material, was demonstrated on myelography. A left-sided hemilaminectomy was performed over this region, and a subarachnoid cavitation or cyst was found to be the cause of the severe spinal-cord compression. The cyst was drained. The cat showed improvement in the neurological signs during the first three weeks postoperatively. Six months later, no neurological deficits were identified on follow-up examination.

Semirigid external fixation for repair of fractures in young animals.

An alternative method for external coaptation of fractures in young animals utilizes tongue depressors incorporated in a bandage consisting of a thick layer of cotton padding, gauze bandaging, and adhesive tape. This method was used in 13 cases with fractures of the tibia or the radius and ulna, some of which were open. Five cases (four dogs and a cat) had displaced fractures, and eight cases had either nondisplaced or only mildly displaced fractures. Size of the animal was not considered a limiting factor. Bandages were examined periodically. All fractures healed uneventfully, and the splints were removed 21-to-44 days after application. This method of external coaptation proved to be easy to apply and modify during the healing process and was applicable to a wide variety of fractures with good results.