Clinical predictors of syringomyelia in Cavalier King Charles Spaniels with chiari-like malformation based on owners' observations.

BACKGROUND: Syringomyelia (SM) is a prevalent inherited developmental condition in Cavalier King Charles Spaniels (CKCSs) with Chiari-like malformation (CM), accompanied by a variety of clinical manifestations, including signs of neuropathic pain. Magnetic resonance imaging (MRI) is the gold standard in SM diagnosis. However, it is desirable to establish clinical predictors that can identify CKCSs with a large clinical syrinx that needs treatment, as some owners cannot afford or lack access to MRI. The aims of the study were to investigate owner-reported clinical signs of SM and clinical predictors of a large clinical syrinx, using predictive values of significant signs, individually and in combinations. Eighty-nine CKCSs participated in this retrospective study. Based on MRI diagnosis, dogs were distributed into three groups: CM without syrinx or with a maximum transverse width < 2 mm (n = 13), CM with small syrinx 2.00-3.99 mm (n = 26) and CM with large syrinx ≥4 mm (n = 50). A structured investigator-owner interview using a standardized questionnaire was used to collect data regarding clinical signs of CM and SM. The statistical tests Pearson's chi-square, Fisher's Exact and Spearman's rank order were used to assess the difference in owner-reported signs between groups. For signs with significant differences, positive and negative predictive values (PPV and NPV) were calculated. RESULTS: Following clinical signs were reported significantly more frequent in dogs with a large syrinx: phantom scratching, bilateral scratching of the neck or shoulder, aversion when that area is touched, or exacerbation of clinical signs when the dog is emotionally aroused. Each individual sign had a high PPV, indicative of a large clinical syrinx. The PPV increased further when the signs phantom scratching, aversion to touch to the head, neck or shoulder, and a preferred head posture during sleep were present in combination. CONCLUSIONS: Specific clinical signs can be used individually and in combination as clinical predictors of a large clinical syrinx in CKCSs with CM and SM. General practitioners can utilize this information to identify CKCSs with a large syrinx to initiate necessary treatment. This is particularly useful in cases where access to or affordability of an MRI diagnosis is limited.

Kinetic gait analysis in healthy dogs and dogs with osteoarthritis: An evaluation of precision and overlap performance of a pressure-sensitive walkway and the use of symmetry indices.

In veterinary practice, a thorough gait examination is essential in the clinical workup of any orthopedic patient, including the large population of dogs with chronic pain as a result of osteoarthritis. The traditional visual gait examination is, however, a subjective discipline, and systems for kinetic gait analysis may potentially offer an objective alternative for gait assessment by the measurement of ground reaction forces. In order to avoid unnecessary testing of patients, a thorough, stepwise evaluation of the diagnostic performance of each system is recommended before clinical use for diagnostic purposes. The aim of the study was to evaluate the Tekscan pressure-sensitive walkway system by assessing precision (agreement between repetitive measurements in individual dogs) and overlap performance (the ability to distinguish dogs with lameness due to osteoarthritis from clinically healthy dogs). Direction of travel over the walkway was investigated as a possible bias. Symmetry indices are commonly used to assess lameness by comparing ground reaction forces across different combinations of limbs in each dog. However, SIs can be calculated in several different ways and specific recommendations for optimal use of individual indices are currently lacking. Therefore the present study also compared indices in order to recommend a specific index preferable for future studies of canine osteoarthritis. Forty-one clinically healthy dogs and 21 dogs with osteoarthritis were included in the study. High precision was demonstrated. The direction of travel over the walkway was excluded as a possible bias. A significant overlap was observed when comparing ground reaction forces measured in dogs with osteoarthritis compared to clinically healthy dogs. In some affected dogs, symmetry indices comparing contralateral limbs differed from clinically healthy dogs, but in general, the overlap performance was insufficient and, consequently, general use of this method for diagnostic purposes in dogs with osteoarthritis cannot be recommended.