Meningoencephalitis of unknown origin in dogs

Background: Meningoencephalitis of unknown origin (MUO) is a critical cause of neurological disorders in dogs, mainly affecting small young individuals. Its symptomatology is varied and depends on the affected neuroanatomic region. The ante mortem diagnosis of this condition is uncertain, being achieved by discarding other conditions and often occurring definitively only by performing a necropsy. Thus, this study aims to report 2 cases of meningoencephalitis, one necrotizing and the other granulomatous in dogs. Cases: Case 1. A 3-year-old, Shih Tzu bitch with a body weight of 4 kg, showing proprioceptive ataxia, behavior of walking in circles, and evolving rapidly to non-ambulatory paresis, was treated. The neurological examination showed a posture of decerebrate stiffness and absence of withdrawal reflex and proprioception, suggesting brainstem injury. Laboratory tests showed mild neutrophilia and lymphopenia, while the rapid test for distemper was non-reactive. The cerebrospinal fluid (CSF) analysis showed lymphocytic pleocytosis, and the PCR tests of the CSF, blood, and urine for the detection of infectious diseases were negative, as well as the culture. With no improvement in clinical condition and exams showing a progressive degenerative condition unresponsive to available treatments, the tutor opted for euthanasia of the patient. The subsequently requested necropsy confirmed the diagnosis of granulomatous meningoencephalitis. Case 2. This case refers to a 1-year-and-5-month-old male Maltese breed weighing 4.8 kg. This animal presented walking in circles behavior and loss of vision for a week, with signs worsening rapidly. In the neurological evaluation, the patient presented sensitivity in the middle ear, difficulty opening the mouth, hearing deficit in the right ear, blindness in the right eye, a proprioceptive deficit in the right anterior limb, and head pressing. Laboratory tests showed nonregenerative anemia and mild lymphopenia. After 1 day of hospitalization, the patient showed worsening clinical condition, with obstruction, absence of facial and auricular sensitivity, and nasal stimulus. In addition, onset of generalized seizures was observed; therefore, CSF was analyzed, which did not present significant alterations except for detecting reactive lymphocytes. The bacteriological culture of CSF resulted in no bacterial growth. In addition, the same neurological PCR panel performed for the previous patient was negative. After 5 days of intensive care, the patient presented a cardiorespiratory arrest and died. The subsequently requested necropsy confirmed the diagnosis of necrotizing meningoencephalitis. Discussion: The 2 reported cases confirm that MUO should be considered during the differential diagnoses of patients with neurological alterations. It is known that small-breed dogs are predisposed to these diseases. Laboratory tests and medical imaging are crucial for clinical guidance, helping to discard other neurological pathologies, especially those due to bacterial, fungal, and/or viral agents. However, definitive diagnosis of MUO can only be performed through necropsy and histopathological analysis. For the reported cases, CSF analysis, neurological PCR panel for detecting possible infectious agents, and bacterial culture were essential to rule out other possible causes of meningoencephalitis. Unfortunately, MUO includes progressive neurological disorders causing the patient's death.

Complications after cerebrospinal fluid collection in dogs with brain neoplasm / Complicações após colheita do líquido cerebroespinhal em cães com neoplasma encefálico

Cerebrospinal fluid (CSF) collection in dogs with brain neoplasms (BN) may be associated with complications owing to increased intracranial pressure caused by expansive lesions. Although this procedure has been performed in dogs with BN, no data regarding complications after CSF tap in these animals is available. Thus, this retrospective study aimed to identify the rate and types of complications observed after CSF taps in dogs with BN. Thirty dogs with BN were included in the study. In 83% (25/30) of the cases, clinical recovery after CSF tap was considered normal, and in 17% (5/30) the recovery was abnormal. The main clinical and neurological signs observed in dogs with abnormal clinical recovery were apnea (5/5), absence of pupillary photomotor reflex (3/5), coma (2/5), and stupor (1/5). In 40% (2/5) of the dogs, herniation of the cerebellum through the foramen magnum was observed on necropsy. In conclusion, the rate of complications after CSF taps was 17%, and was characterized by apnea, absent pupillary photomotor reflex, altered level of consciousness, and encephalic herniation.

A colheita do líquido cerebroespinhal (LCE) em cães com neoplasmas encefálicos (NE) pode estar associada a complicações devido ao aumento da pressão intracraniana (PIC), causada pela lesão expansiva. Embora o procedimento seja realizado em cães com NE, não foram encontrados dados referentes às complicações após colheita de LCE nesses pacientes. Sendo assim, o objetivo do presente estudo retrospectivo foi identificar a taxa, bem como os tipos de complicações observadas após a colheita de LCE em cães com neoplasma encefálico. Dos 30 cães com NE incluídos no estudo, em 83% (25/30) dos casos a evolução clínica após a colheita do LCE foi considerada normal e, em 17% (5/30) anormal. Os principais sinais clínicos e neurológicos observados nos cães com evolução clínica anormal foram apneia (5/5), reflexo fotomotor pupilar ausente (3/5), coma (2/5) e estupor (1/5). Em 40% (2/5) foi observado herniação do cerebelo na necropsia. Com base nos resultados encontrados, conclui-se que a taxa de complicações após a colheita de LCE foi baixa (17%) e as alterações encontradas foram apneia, seguido de reflexo fotomotor pupilar ausente, alteração no nível de consciência e herniação encefálica.

An anatomical training model for cerebrospinal liquid collection and myelography in embalmed dog cadavers / Modelo anatômico para treinamento de colheita de líquido cerebroespinhal e mielografia em cadáveres de cães quimicamente preparados

In research and academic activities, guidelines are essential and imperative especially on the use of animals. Alternative methods that do not bring academic or scientific harm should also be sought. This study aimed to develop a training model for the collection of cerebrospinal fluid (CSF) and myelography in the cervical and lumbar regions in cadavers of embalmed dogs, using an alcoholic solution and curing salts for fixation and conservation. The dogs were divided into 4 grups of 8 animal each and stored between 2ºC and 6ºC, for 30, 60, 90, or 120 days. Durotomy was performed to implant two urethral catheters (one in the cranial direction and another in the caudal direction to the spinal cord access site), in the subduraracnoid space. This space was fixed via manual infusion of saline solution with a 20-mL syringe to simulate the presence of the CSF and the positive pressure, while the puncture was made. Four cadavers of each group were randomly selected for the CSF puncture from the atlantooccipital joint and in the lumbar region between L5 and L6, respectively, and four were used for CSF puncture training, in which radiographic contrast (myelography) was injected in the same locations. This model was cost-effective, did not utilize toxic products, and can preserve cadavers for up to 120 days. In this novel anatomical model, a maximum of 15 students can be trained on CSF puncture, allowing cervical and lumbar myelography and at least 30 perforations per cadaver.

É essencial e imperioso ter critério quanto ao uso de animais em pesquisa e atividades de ensino e, consequentemente, buscar métodos alternativos que não causem prejuízo acadêmico ou científico. Para que não ocorra deterioração dos tecidos, a fixação e conservação de peças anatômicas e cadáveres devem ser realizadas. Objetivou-se, com este estudo, desenvolver um modelo anatômico para treinamento de colheita de líquido cerebroespinhal (LCE) e mielografia, nas regiões cervical e lombar. Os cães foram divididos em quatro grupos contendo oito animais cada e armazenados entre 2ºC e 6ºC, por 30, 60, 90 ou 120 dias. Foi realizada durotomia para implantação de duas sondas uretrais, no espaço subaracnóide. A infusão manual de solução fisiológica com seringa de 20 mL foi utilizada para simular a presença do LCE e a pressão positiva, enquanto era feita a punção. Quatro cadáveres de cada grupo foram selecionados para a punção de LCE na articulação atlantooccipital e na região lombar entre L5 e L6, e quatro foram utilizados para o treinamento da punção de LCE e injeção de contraste radiográfico (mielografia). A técnica anatômica empregada possibilitou o desenvolvimento de um modelo visando ao ensino e pesquisa da radiologia em cadáveres de cães quimicamente preparados, a custo baixo e sem utilização de produtos tóxicos, mantidos sob refrigeração por 120 dias. Com isso, um máximo de 15 alunos podem ser treinados em punção do LCR, permitindo mielografia cervical e lombar com 30 perfurações por cadáver.

Clinical findings of equine leukoencephalomalacia / Achados clínicos de leucoencefalomalácia equina

Equine leukoencephalomalacia (LEM) is a disease caused by the ingestion of food, especially corn, contaminated by fumonisin, a Fusarium verticillioides (synonymous with F. moniliforme) metabolite. The clinical signs of brain injuries have an acute onset and rapid evolution. This study aimed to describe the clinical findings in 11 animals diagnosed with LEM, including cerebrospinal fluid (CSF) analysis. Of these animals, 91% (10/11) were horses, and only 9% (1/11) were asinine. The clinical localization of the lesions was 64% (7/10) cerebral, manifested mainly by altered mental state and behavioral disturbance, and 36% (4/11) were brainstem lesions, manifested by incoordination, head tilt, nystagmus, facial hypoalgesia, difficulty in apprehension, chewing, and swallowing food. Postmortem findings revealed that 82% (9/11) of the lesions were in the cerebrum and 18% (2/11) in the brainstem. CSF findings, such as xanthochromia (43%, 3/7), hyperproteinorrachia (50%, 3/6), and pleocytosis (43%, 3/7) were observed. The affected animals showed neurological signs that were compatible with cerebral and/or brainstem injuries. The CSF from animals with LEM may present with xanthochromia, hyperproteinorrachia, and pleocytosis, reinforcing the fact that this disease should be included in the differential diagnosis of encephalomyelopathies.(AU)

A leucoencefalomalácia (LEM) é uma enfermidade que acomete equídeos causada pela ingestão de milho e seus derivados e feno contaminados pela micotoxina fumonisina, um metabólito do fungo Fusarium verticillioides (sinônimo para F. moniliforme). Os sinais clínicos apresentam início agudo e evolução rápida e são decorrentes de lesões encefálicas. O objetivo deste estudo é descrever os achados clínicos de 11 equídeos diagnosticados com LEM, incluindo a análise do líquido cefalorraquidiano (LCR). 91% dos animais afetados eram equinos e somente 9% (1/11) era asinino. A localização clínica das lesões era 64% (7/10) cerebrais, manifestadas por alterações no estado mental e comportamento e 36% (4/10) no tronco encefálico, manifestadas por incoordenação, desvio lateral de cabeça, nistagmo, hipoalgesia da face e dificuldade de apreensão, mastigação e deglutição de alimentos. Comparativamente, os achados post mortem revelaram que 82% (9/11) das lesões eram no cérebro e 18% (2/11) no tronco encefálico. Alterações no LCR, tais como xantocromia (43%, 3/7), hiperproteinorraquia (50%, 3/6) e pleocitose (43%, 3/7), foram observadas. Os animais afetados apresentaram sinais clínicos compatíveis com lesões encefálicas e/ou de tronco cerebral. O LCR de animais com LEM pode apresentar xantocromia, hiperproteinorraquia, e pleocitose, reforçando que esta doença deve ser incluída como diagnóstico diferencial de encefalomielites.(AU)

Meningomielite eosinofílica provavelmente associada à toxoplasmose em um gato / Eosinophilic meningomyelitis probably associated with toxoplasmosis in a cat

Background: The cerebrospinal fluid (CSF) of healthy cats presents up to 5 cells/µL, with predominance of mononuclear cells and the presence of more than 1% eosinophils is rare and should always be considered an abnormal finding. There is no consensus on the term eosinophilic pleocytosis, as it is used to indicate the presence of more than 10 eosinophils/µL or more than 10% of the total leukocytes. The increase in eosinophils in the CSF may result from infectious, inflammatory, neoplastic and idiopathic diseases. The objective of this paper is to report a case of marked pleocytosis in CSF, with 84% eosinophils, probably due to toxoplasmosis, in a cat with paraparesis and diffuse spinal pain. Case: A mixed breed female cat, neutered, adult and domiciled in a rural area was presented due to gait abnormalities in the pelvic limbs that started one day before presentation. The general physical examination was unremarkable. On neurological examination it was observed asymmetric deficit of postural reactions in pelvic limbs, patellar reflex normal to increased and pain elicited on palpation of the thoracic and lumbar spine. Based on these findings, the neurological syndrome was classified as thoracolumbar, but with diffuse pain, and the main differential diagnoses were inflammatory/ infectious and neoplastic diseases. The leukogram showed eosinophilia and the serum biochemistry showed no significant changes. Serological assays for feline immunodeficiency virus and feline leukemia virus were negative. Analysis of cerebrospinal fluid (CSF) identified marked pleocytosis with 84% eosinophils and increase in protein concentration. Myelography showed no compressive or expansive changes. Fungal culture for CSF cryptococcosis was negative. Serum immunofluorescence antibody titer for Toxoplasma gondii (IgG) was 1:256. There was a marked improvement after treatment with sulfametoxazole/trimethoprim and pyrimethamine and after 3 weeks of treatment, there was almost complete recovery of neurological signs and after 9 months the cat was neurologically normal. Discussion: The most common causes of acute-onset thoracolumbar spinal cord syndrome in cats, with diffuse pain on spinal palpation, are meningomyelitis of inflammatory/infectious origin, such as feline infectious peritonitis (FIP) and neoplasms such as lymphoma. Other meningomyelitis of inflammatory origin, such as infectious and immune-mediated meningomyelitis of unknown origin are considered uncommon in cats. Although the clinical, systemic and neurological signs of FIP and toxoplasmosis may have similarities, in the present case FIP was not considered responsible for the observed signs, as the evolution of the case and the analysis of the CSF tend to be different. The peripheral eosinophilia, the cytological analysis of the CSF, characterized by marked eosinophilic pleocytosis, associated with a positive titer for toxoplasmosis, good response to treatment and improvement in the neurological condition, with survival for more than 9 months after treatment, rules out the possibility of FIP. Neurological signs observed in the absence of systemic signs are more common in cases of protozoan reactivation, which probably occurred in the present case. The possibility of toxoplasmosis in the patient in this report was reinforced by the fact that the animal came from a rural area. Eosinophilia of CSF is most commonly associated with parasitic infections, although it can be caused by a variety of infectious agents, but in the cat of the present report, the marked eosinophilic pleocytosis was likely due to toxoplasmosis, which is a rare occurrence in this specie. In conclusion, toxoplasmosis should be considered in the differential diagnosis of focal spinal cord lesions in cats. The identification of laboratory findings as well as the appropriate therapy favored the good evolution of the condition.

Clinical findings of equine leukoencephalomalacia / Achados clínicos de leucoencefalomalácia equina

Equine leukoencephalomalacia (LEM) is a disease caused by the ingestion of food, especially corn, contaminated by fumonisin, a Fusarium verticillioides (synonymous with F. moniliforme) metabolite. The clinical signs of brain injuries have an acute onset and rapid evolution. This study aimed to describe the clinical findings in 11 animals diagnosed with LEM, including cerebrospinal fluid (CSF) analysis. Of these animals, 91% (10/11) were horses, and only 9% (1/11) were asinine. The clinical localization of the lesions was 64% (7/10) cerebral, manifested mainly by altered mental state and behavioral disturbance, and 36% (4/11) were brainstem lesions, manifested by incoordination, head tilt, nystagmus, facial hypoalgesia, difficulty in apprehension, chewing, and swallowing food. Postmortem findings revealed that 82% (9/11) of the lesions were in the cerebrum and 18% (2/11) in the brainstem. CSF findings, such as xanthochromia (43%, 3/7), hyperproteinorrachia (50%, 3/6), and pleocytosis (43%, 3/7) were observed. The affected animals showed neurological signs that were compatible with cerebral and/or brainstem injuries. The CSF from animals with LEM may present with xanthochromia, hyperproteinorrachia, and pleocytosis, reinforcing the fact that this disease should be included in the differential diagnosis of encephalomyelopathies.(AU)

A leucoencefalomalácia (LEM) é uma enfermidade que acomete equídeos causada pela ingestão de milho e seus derivados e feno contaminados pela micotoxina fumonisina, um metabólito do fungo Fusarium verticillioides (sinônimo para F. moniliforme). Os sinais clínicos apresentam início agudo e evolução rápida e são decorrentes de lesões encefálicas. O objetivo deste estudo é descrever os achados clínicos de 11 equídeos diagnosticados com LEM, incluindo a análise do líquido cefalorraquidiano (LCR). 91% dos animais afetados eram equinos e somente 9% (1/11) era asinino. A localização clínica das lesões era 64% (7/10) cerebrais, manifestadas por alterações no estado mental e comportamento e 36% (4/10) no tronco encefálico, manifestadas por incoordenação, desvio lateral de cabeça, nistagmo, hipoalgesia da face e dificuldade de apreensão, mastigação e deglutição de alimentos. Comparativamente, os achados post mortem revelaram que 82% (9/11) das lesões eram no cérebro e 18% (2/11) no tronco encefálico. Alterações no LCR, tais como xantocromia (43%, 3/7), hiperproteinorraquia (50%, 3/6) e pleocitose (43%, 3/7), foram observadas. Os animais afetados apresentaram sinais clínicos compatíveis com lesões encefálicas e/ou de tronco cerebral. O LCR de animais com LEM pode apresentar xantocromia, hiperproteinorraquia, e pleocitose, reforçando que esta doença deve ser incluída como diagnóstico diferencial de encefalomielites.(AU)

Central nervous system infiltration in acute lymphoblastic leukemia in a dog

Background: Acute lymphoblastic leukemia (ALL) is a malignant neoplasia in which there is proliferation of lymphoid progenitor cells in the bone marrow, blood, and extramedullary sites. This disorder has a fast and progressive development; in dogs, cases of infiltration of ALL cells in the central nervous system (CNS) are uncommon and rare. Diagnosis can be achieved with the help of the clinical history and physical, radiographic, hematological, myelographic, and cerebrospinal fluid (CSF) tests in patients with or without neurological clinical signs. The present report aims to describe a case of ALL and the presence of lymphoblasts in the CSF of a dog with neurological clinical signs. Case: An 8-year-old Lhasa Apso dog was examined at the Veterinary Hospital of Universidade Federal do Paraná, Curitiba campus. At the physical examination, the animal exhibited apathy and paralysis of pelvic limbs, which progressed to tetraplegia. Abdominal palpation revealed presence of hepatosplenomegaly and absence of lymphadenomegaly. No alterations were observed in radiographs of the cervical, thoracic or lumbar spine. A complete blood count revealed presence of non-regenerative anemia (hematocrit = 22%), extreme lymphocytosis (185,229 cells/µL), lymphoblasts at a level of 72% (133,364 cells/µL), and thrombocytopenia (66,000 platelets/µL). The biochemical tests revealed increased alkaline phosphatase (859 IU/L). The levels of alanine aminotransferase, creatinine, urea, total protein, albumin, and globulin were normal. The diagnosis of ALL was achieved with the help of a myelogram. The myelogram findings included 39% of mature lymphocytes and 59% of lymphoblasts exhibiting large size, spherical shape, poorly delimited borders, with a high nucleus/cytoplasm ratio, marked cytoplasmic basophilia, and 2 to 3 evident nucleoli; metarubricytes (1%) and promyelocytes (0.6%) were also observed. The CSF contained an increased number of nucleated cells (27 cells/µL) comprising lymphocytes (43%), macrophages (33%), and segmented neutrophils (24%). Of the 11.6 lymphocytes per µL of CSF, 8.1 were lymphoblasts, which indicates infiltration of ALL cells in the CNS. The animal died one day after collection of bone barrow and CSF. Discussion: Relevant alterations observed in this case included the neurological signs caused by the infiltration of neoplastic cells in the CNS, severe leukocytosis and lymphocytosis, with large amounts of lymphoblasts in the blood and predominance of lymphoblasts in the bone marrow, which are alterations typically found in ALL. The animal also exhibited non-regenerative anemia and thrombocytopenia, which were secondary to infiltration of leukemic cells in the bone marrow. The CSF exhibited pleocytosis (27 cells/ µL), and 30% of the cells observed were lymphoblasts. Lymphoblast infiltration in the CNS of leukemic dogs is rare, and other studies have reported absence of neurological signs or neurological signs different from those observed in the present study. CSF analysis in indicated in cases of leukemia to assess leukemic cell infiltration in the CNS. In the case reported here, the plasma level of alkaline phosphatase was increased (859 IU/L) as a consequence of hepatomegaly and hepatic cholestasis. ALL is a very aggressive, proliferative neoplasia, and the resulting lymphoblasts infiltrated the CNS of the animal. In cases of ALL, performing complete blood count, myelogram, and CSF analysis is indicated whether the patients exhibit neurological signs or not.(AU)

Cerebrospinal fluid analysis in 58 ruminants showing neurological disorders / Análise do líquido cefalorraquidiano em 58 ruminantes com distúrbios neurológicos

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

Os ruminantes podem ser afetados por uma grande variedade de doenças do sistema nervoso central (SNC). A análise do líquido cefalorraquidiano (LCR) constitui a base da avaliação diagnóstica ante mortem de ruminantes com sinais clínicos envolvendo o SNC. Apesar de sua importância como ferramenta para auxiliar no diagnóstico, os dados referentes aos exames do LCR em casos espontâneos de doenças do SNC em ruminantes no Brasil são limitados, e, a maioria dos relatos envolve estudos experimentais. Portanto, este trabalho teve como objetivo relatar os resultados da análise do LCR em 58 ruminantes com distúrbios neurológicos. Amostras do LCR foram obtidas de 32 bovinos, 20 ovinos e 6 caprinos por punção da cisterna cerebelo-medular (n=54) ou espaço lombossacro (n=4) para posterior análise. Esses ruminantes apresentaram sinais neurológicos relacionados a infecções virais (n=13), micóticas (n=3) ou bacterianas (n=15), e desordens tóxicas (n=21), traumáticas (n=4) ou congênitas (n=2) A análise do LCR de ruminantes com infecções virais apresentou pleocitose linfocítica, embora, em vários casos de raiva, o LCR não tenha apresentado alterações. Pleocitose neutrofílica, turbidez, presença de coágulos de fibrina e coloração anormal foram evidentes no LCR da maioria dos casos de infecções bacterianas do SNC, como meningoencefalites, meningites, abscessos, mielite e um caso de conidiobolomicose. Por outro lado, o LCR não foi alterado na maioria dos casos dos distúrbios tóxicos, como botulismo e encefalopatia hepática. A densidade elevada no LCR foi observada em 60% dos ruminantes diagnosticados com polioencefalomalácia. Nossos resultados mostram que a avaliação do LCR é uma valiosa ferramenta de diagnóstico, quando usada em associação com os achados epidemiológicos, clínicos e patológicos para o diagnóstico de doenças do SNC em ruminantes.(AU)

Cerebrospinal fluid analysis in 58 ruminants showing neurological disorders / Análise do líquido cefalorraquidiano em 58 ruminantes com distúrbios neurológicos

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

Os ruminantes podem ser afetados por uma grande variedade de doenças do sistema nervoso central (SNC). A análise do líquido cefalorraquidiano (LCR) constitui a base da avaliação diagnóstica ante mortem de ruminantes com sinais clínicos envolvendo o SNC. Apesar de sua importância como ferramenta para auxiliar no diagnóstico, os dados referentes aos exames do LCR em casos espontâneos de doenças do SNC em ruminantes no Brasil são limitados, e, a maioria dos relatos envolve estudos experimentais. Portanto, este trabalho teve como objetivo relatar os resultados da análise do LCR em 58 ruminantes com distúrbios neurológicos. Amostras do LCR foram obtidas de 32 bovinos, 20 ovinos e 6 caprinos por punção da cisterna cerebelo-medular (n=54) ou espaço lombossacro (n=4) para posterior análise. Esses ruminantes apresentaram sinais neurológicos relacionados a infecções virais (n=13), micóticas (n=3) ou bacterianas (n=15), e desordens tóxicas (n=21), traumáticas (n=4) ou congênitas (n=2) A análise do LCR de ruminantes com infecções virais apresentou pleocitose linfocítica, embora, em vários casos de raiva, o LCR não tenha apresentado alterações. Pleocitose neutrofílica, turbidez, presença de coágulos de fibrina e coloração anormal foram evidentes no LCR da maioria dos casos de infecções bacterianas do SNC, como meningoencefalites, meningites, abscessos, mielite e um caso de conidiobolomicose. Por outro lado, o LCR não foi alterado na maioria dos casos dos distúrbios tóxicos, como botulismo e encefalopatia hepática. A densidade elevada no LCR foi observada em 60% dos ruminantes diagnosticados com polioencefalomalácia. Nossos resultados mostram que a avaliação do LCR é uma valiosa ferramenta de diagnóstico, quando usada em associação com os achados epidemiológicos, clínicos e patológicos para o diagnóstico de doenças do SNC em ruminantes.(AU)

Análise do líquido cérebro-espinhal em cães e gatos com afecções neurológicas / Cerebrospinal fluid analysis in dogs and cats with neurological diseases

Background: Cerebrospinal fluid (CSF) analysis is of great importance for evaluation of patients with central nervoussystem problems, because it helps to confirm or exclude many diseases when evaluated together with other relevant clinical and ancillary laboratory tests. As there are few studies in Brazil describing results of CSF analysis in dogs and cats,the objective of the present study was to evaluate results of CSF analysis in a period of ten years, grouping the changesobserved, mainly total and differential cell count and total protein concentration, according to the following etiologicalcategories of diseases: inflammatory, degenerative, traumatic, neoplastic and vascular disorders.Materials, Methods & Results: Medical records of dogs and cats with neurological diseases that had CSF collected andanalyzed at a Veterinary Teaching Hospital between 2008 and 2017 were retrospectively reviewed. Patient data includedbreed, sex, body weight, age at presentation, findings of clinical and neurological examination, results of CSF analysis,diagnostic imaging and other laboratory tests results including PCR and serologies for infectious diseases. A total of 245CSF exams were studied (240 dogs and five cats). The established normal range for protein concentration was less than25 mg/dL for cisternal collection and less than 45 mg/dL for lumbar puncture. Total nucleated cell count was considerednormal when less than 5 cells/µL, with a predominance of mononuclear cells. Both pleocytosis and increased concentrationof the protein level were classified as discrete, moderate and marked, and the pleocytosis was further classified as mononuclear, neutrophilic and mixed cell pleocytosis. The information obtained was analyzed in relation to the neurologicalsyndromes and etiological categories of neurological...

Análise do líquido cérebro-espinhal em cães e gatos com afecções neurológicas / Cerebrospinal fluid analysis in dogs and cats with neurological diseases

Background: Cerebrospinal fluid (CSF) analysis is of great importance for evaluation of patients with central nervoussystem problems, because it helps to confirm or exclude many diseases when evaluated together with other relevant clinical and ancillary laboratory tests. As there are few studies in Brazil describing results of CSF analysis in dogs and cats,the objective of the present study was to evaluate results of CSF analysis in a period of ten years, grouping the changesobserved, mainly total and differential cell count and total protein concentration, according to the following etiologicalcategories of diseases: inflammatory, degenerative, traumatic, neoplastic and vascular disorders.Materials, Methods & Results: Medical records of dogs and cats with neurological diseases that had CSF collected andanalyzed at a Veterinary Teaching Hospital between 2008 and 2017 were retrospectively reviewed. Patient data includedbreed, sex, body weight, age at presentation, findings of clinical and neurological examination, results of CSF analysis,diagnostic imaging and other laboratory tests results including PCR and serologies for infectious diseases. A total of 245CSF exams were studied (240 dogs and five cats). The established normal range for protein concentration was less than25 mg/dL for cisternal collection and less than 45 mg/dL for lumbar puncture. Total nucleated cell count was considerednormal when less than 5 cells/µL, with a predominance of mononuclear cells. Both pleocytosis and increased concentrationof the protein level were classified as discrete, moderate and marked, and the pleocytosis was further classified as mononuclear, neutrophilic and mixed cell pleocytosis. The information obtained was analyzed in relation to the neurologicalsyndromes and etiological categories of neurological...(AU)

Encefalite parasitária em cadela / Parasitic encephalitis in a bitch

Background: Encephalitis is common in most inflammatory and infectious diseases of the central nervous system, andbacterial and viral pathogens, protozoa, fungi, and erythematous parasites are recognized as etiological agents. Clinicalsigns vary according to the anatomical location and severity of the inflammation. Some parasites may undergo aberrantmigration into the brain of dogs and cats, which is are considered a rare clinical phenomenon. This case report describesthe occurrence of parasitic encephalitis in a mixed breed bitch about 4 year-old.Case: A mixed breed bitch, about 4 year-old, rescued from the street with weakness of the pelvic limbs, was treated at theVeterinary Hospital of the Federal University of Piauí - UFPI. After A clinical and neurological examination, the patientwas hospitalized for diagnosis, treatment, confirmation and follow-up of her clinical evolution. Complementary tests wereperformed to evaluate her general condition, given her unknown history because she was a rescue dog. Complete blood count(CBC), hemoparasite screening, biochemical function (urea, creatinine, ALT, alkaline phosphatase, total protein, albuminand globulin), abdominal and pelvic ultrasound, serological and parasitological tests for leishmaniasis, distemper antigenand ehrlichiosis antibody detection tests were performed, and cerebrospinal fluid (CSF) was collected for analysis. TheCBC revealed normocytic hypochromic anemia and thrombocytopenia. Biochemical functions were within normal limits,except for alanine aminotransferase (ALT), which was slightly low. The ultrasound examination showed splenomegaly.The canine distemper, ehrlichiosis and leishmaniasis tests were negative. The results of the CSF analysis revealed the presence of spherical structures compatible with parasitic cysts, suggestive of Echinococcus granulosus. After the laboratorydiagnosis of parasitic encephalitis, the animal was treated with prednisolone...

Encefalite parasitária em cadela / Parasitic encephalitis in a bitch

Background: Encephalitis is common in most inflammatory and infectious diseases of the central nervous system, andbacterial and viral pathogens, protozoa, fungi, and erythematous parasites are recognized as etiological agents. Clinicalsigns vary according to the anatomical location and severity of the inflammation. Some parasites may undergo aberrantmigration into the brain of dogs and cats, which is are considered a rare clinical phenomenon. This case report describesthe occurrence of parasitic encephalitis in a mixed breed bitch about 4 year-old.Case: A mixed breed bitch, about 4 year-old, rescued from the street with weakness of the pelvic limbs, was treated at theVeterinary Hospital of the Federal University of Piauí - UFPI. After A clinical and neurological examination, the patientwas hospitalized for diagnosis, treatment, confirmation and follow-up of her clinical evolution. Complementary tests wereperformed to evaluate her general condition, given her unknown history because she was a rescue dog. Complete blood count(CBC), hemoparasite screening, biochemical function (urea, creatinine, ALT, alkaline phosphatase, total protein, albuminand globulin), abdominal and pelvic ultrasound, serological and parasitological tests for leishmaniasis, distemper antigenand ehrlichiosis antibody detection tests were performed, and cerebrospinal fluid (CSF) was collected for analysis. TheCBC revealed normocytic hypochromic anemia and thrombocytopenia. Biochemical functions were within normal limits,except for alanine aminotransferase (ALT), which was slightly low. The ultrasound examination showed splenomegaly.The canine distemper, ehrlichiosis and leishmaniasis tests were negative. The results of the CSF analysis revealed the presence of spherical structures compatible with parasitic cysts, suggestive of Echinococcus granulosus. After the laboratorydiagnosis of parasitic encephalitis, the animal was treated with prednisolone...(AU)

Mieloencefalite equina por protozoario (MEP): revisão de literatura / Equine protozoal myeloencephalitis (EPM): literature review

A mieloencefalite protozoária equina (MEP) é uma doença infecciosa causada principalmente pelo protozoário Sarcocystis neurona que produz disfunção neurológica no cérebro e na medula, porém pode ser causada também pelo Neospora caninum e Neospora huguesi. O equino é o hospedeiro acidental e o vetor do protozoário é o gambá (hospedeiros definitivos). Um exame é o teste imunológico do líquor, que proporciona um diagnóstico preciso. No tratamento é utilizado coccidioestatico, antiinflamatório, vitaminas e analgésicos, e evitar que o hospedeiro definitivo tenha acesso aos alimentos dos equinos. O objetivo do presente trabalho foi desenvolver uma revisão de literatura sobre mieloencefalite protozoária equina.(AU)

Equine protozoal myeloencephalitis (EPM) is an infectious disease caused mainly by the protozoan Sarcocystis neuron that produces neurological dysfunction in the brain and marrow, but can also be caused by Neospora caninum and Neospora huguesi. The equine is the accidental host and the vector of the protozoan is the opossum (definitive hosts). An examination is the CSF test, which provides an accurate diagnosis. In the treatment coccidiostatic, anti-inflammatory, vitamins and analgesics are used, and to avoid that the definitive host has access to the food of the horses. The objective of the present work was to develop a literature review on equine protozoal myeloencephalitis.(AU)

Mieloencefalite equina por protozoario (MEP): revisão de literatura / Equine protozoal myeloencephalitis (EPM): literature review

A mieloencefalite protozoária equina (MEP) é uma doença infecciosa causada principalmente pelo protozoário Sarcocystis neurona que produz disfunção neurológica no cérebro e na medula, porém pode ser causada também pelo Neospora caninum e Neospora huguesi. O equino é o hospedeiro acidental e o vetor do protozoário é o gambá (hospedeiros definitivos). Um exame é o teste imunológico do líquor, que proporciona um diagnóstico preciso. No tratamento é utilizado coccidioestatico, antiinflamatório, vitaminas e analgésicos, e evitar que o hospedeiro definitivo tenha acesso aos alimentos dos equinos. O objetivo do presente trabalho foi desenvolver uma revisão de literatura sobre mieloencefalite protozoária equina.

Equine protozoal myeloencephalitis (EPM) is an infectious disease caused mainly by the protozoan Sarcocystis neuron that produces neurological dysfunction in the brain and marrow, but can also be caused by Neospora caninum and Neospora huguesi. The equine is the accidental host and the vector of the protozoan is the opossum (definitive hosts). An examination is the CSF test, which provides an accurate diagnosis. In the treatment coccidiostatic, anti-inflammatory, vitamins and analgesics are used, and to avoid that the definitive host has access to the food of the horses. The objective of the present work was to develop a literature review on equine protozoal myeloencephalitis.

Cranial cavity filled with cerebrospinal fluid in an otter (Lontra longicaudis) - case report / Cavitação craniana preenchida por fluido cerebroespinhal em lontra (Lontra longicaudis) - relato de caso

Computed tomography of the head of an otter with a history of incoordination, visual deficits, and seizures was performed. Intracranial images revealed a large non-enhancing fluid attenuating cystic lesion in the left frontoparietal region communicating with the left lateral ventricle and subarachnoid space. These findings are consistent with a congenital brain cavity filled by cerebrospinal fluid, with porencephaly being the most probable diagnosis based on the clinical and tomographic findings. The authors highlight the rarity of such a cystic lesion in wild animals, with this being the first report in otters.(AU)

Realizou-se o exame tomográfico do crânio de uma lontra com histórico de incoordenação, déficit visual e convulsões. Imagens intracranianas revelaram grande lesão cística não captante de contraste em região frontoparietal esquerda, apresentando comunicação com o ventrículo lateral esquerdo e espaço subaracnoidea. Esses achados foram consistentes com cavitação cerebral congênita preenchida por fluido cerebroespinhal, sendo porencefalia o diagnóstico de maior probabilidade com base nos achados clínicos e tomográficos. Destaca-se a raridade dessa condição em animais silvestres, sendo este o primeiro relato em lontras.(AU)

Cranial cavity filled with cerebrospinal fluid in an otter (Lontra longicaudis) - case report / Cavitação craniana preenchida por fluido cerebroespinhal em lontra (Lontra longicaudis) - relato de caso

Computed tomography of the head of an otter with a history of incoordination, visual deficits, and seizures was performed. Intracranial images revealed a large non-enhancing fluid attenuating cystic lesion in the left frontoparietal region communicating with the left lateral ventricle and subarachnoid space. These findings are consistent with a congenital brain cavity filled by cerebrospinal fluid, with porencephaly being the most probable diagnosis based on the clinical and tomographic findings. The authors highlight the rarity of such a cystic lesion in wild animals, with this being the first report in otters.(AU)

Realizou-se o exame tomográfico do crânio de uma lontra com histórico de incoordenação, déficit visual e convulsões. Imagens intracranianas revelaram grande lesão cística não captante de contraste em região frontoparietal esquerda, apresentando comunicação com o ventrículo lateral esquerdo e espaço subaracnoidea. Esses achados foram consistentes com cavitação cerebral congênita preenchida por fluido cerebroespinhal, sendo porencefalia o diagnóstico de maior probabilidade com base nos achados clínicos e tomográficos. Destaca-se a raridade dessa condição em animais silvestres, sendo este o primeiro relato em lontras.(AU)

Hidrocefalia canina ­ relato de caso / Canine hydrocephalus ­ case report / Hidrocefalia canina ­ relato de caso

Hidrocefalia é o acúmulo de líquido cefalorraquidiano de origens diversas. Tal acúmulo gera aumento da pressão intracraniana e pode causar compressão e danos a tecidos neurológicos. Estes danos são a causa dos sinais clínicos associados a esta afecção. O presente artigo relata um caso de hidrocefalia em uma fêmea canina da raça Shih Tzu de 45 dias de idade. O animal apresentava alterações comportamentais, vocalização excessiva, incoordenação motora, aumento de volume craniano, oligodpsia entre outros. A cadela foi diagnosticada com hidrocefalia por meio de exames de imagem. Foi instituída terapia medicamentosa com acetazolamida e furosemida para controle paliativo da afecção. Ocorreu melhora do quadro clínico após o início da terapêutica e o animal, apresentou sobrevida de aproximadamente um ano.(AU)

Hydrocephalus is the accumulation of cerebrospinal fluid in the brain coming from diverse origins. Such accumulation generates an increase in intracranial pressure and may cause compression and damage to neurological tissues. These damages are the cause of the onset of clinical signs associated with the condition. This study reports a case of hydrocephalus in a 45-day-old Shi Tzu female dog. The animal presented behavioral alterations, excessive vocalization, motor incoordination, cranial volume increase, polydipsia, among other clinical signals. Imaging tests were used for diagnosing it with hydrocephalus. Drug therapy with acetazolamide and furosemide was introduced for palliative control of the condition. The clinical scenario improved after the initiation of therapy and the animal presented a survival of approximately one year.(AU)

Hidrocefalia es el acúmulo de líquido cefalorraquídeo de diversos orígenes. Dicha acumulación genera un aumento en la presión intracraneal y puede causar compresión y daños a los tejidos neurológicos. Estos daños son la causa de los signos clínicos asociados a esta afección. El presente artículo informa sobre un caso de hidrocefalia en una hembra canina de la raza Shih Tzu de 45 días de edad. El animal presentaba alteraciones de comportamiento, vocalización excesiva, falta de coordinación motora, aumento del volumen craneal, oligodipsia entre otros. La perra fue diagnosticada con hidrocefalia por pruebas de imágenes. Se instituyó medicamentos con acetazolamida y furosemida para control paliativo de la enfermedad. El cuadro clínico mejoró después del inicio de la terapia y el animal presentó sobrevida de aproximadamente un año.(AU)

Hidrocefalia canina ­ relato de caso / Canine hydrocephalus ­ case report / Hidrocefalia canina ­ relato de caso

Hidrocefalia é o acúmulo de líquido cefalorraquidiano de origens diversas. Tal acúmulo gera aumento da pressão intracraniana e pode causar compressão e danos a tecidos neurológicos. Estes danos são a causa dos sinais clínicos associados a esta afecção. O presente artigo relata um caso de hidrocefalia em uma fêmea canina da raça Shih Tzu de 45 dias de idade. O animal apresentava alterações comportamentais, vocalização excessiva, incoordenação motora, aumento de volume craniano, oligodpsia entre outros. A cadela foi diagnosticada com hidrocefalia por meio de exames de imagem. Foi instituída terapia medicamentosa com acetazolamida e furosemida para controle paliativo da afecção. Ocorreu melhora do quadro clínico após o início da terapêutica e o animal, apresentou sobrevida de aproximadamente um ano.(AU)

Hydrocephalus is the accumulation of cerebrospinal fluid in the brain coming from diverse origins. Such accumulation generates an increase in intracranial pressure and may cause compression and damage to neurological tissues. These damages are the cause of the onset of clinical signs associated with the condition. This study reports a case of hydrocephalus in a 45-day-old Shi Tzu female dog. The animal presented behavioral alterations, excessive vocalization, motor incoordination, cranial volume increase, polydipsia, among other clinical signals. Imaging tests were used for diagnosing it with hydrocephalus. Drug therapy with acetazolamide and furosemide was introduced for palliative control of the condition. The clinical scenario improved after the initiation of therapy and the animal presented a survival of approximately one year.(AU)

Hidrocefalia es el acúmulo de líquido cefalorraquídeo de diversos orígenes. Dicha acumulación genera un aumento en la presión intracraneal y puede causar compresión y daños a los tejidos neurológicos. Estos daños son la causa de los signos clínicos asociados a esta afección. El presente artículo informa sobre un caso de hidrocefalia en una hembra canina de la raza Shih Tzu de 45 días de edad. El animal presentaba alteraciones de comportamiento, vocalización excesiva, falta de coordinación motora, aumento del volumen craneal, oligodipsia entre otros. La perra fue diagnosticada con hidrocefalia por pruebas de imágenes. Se instituyó medicamentos con acetazolamida y furosemida para control paliativo de la enfermedad. El cuadro clínico mejoró después del inicio de la terapia y el animal presentó sobrevida de aproximadamente un año.(AU)

Polioencephalomalacia in ruminants from the semi-arid region of Rio Grande do Norte, Brazil / Polioencefalomalácia em ruminantes na região semiárida do estado do Rio Grande do Norte, Brazil

The present study aimed to describe epidemiological, clinical, laboratorial, and pathological findings of polioencephalomalacia (PEM) in ruminants from the semi-arid region of Rio Grande do Norte, Brazil. A total of seven ruminants (five sheep, one cattle, and one goat) with pathological diagnosis of PEM were included. Four cases were associated with thiamine deficiency, on account of chronic ruminal acidosis caused by diets rich in carbohydrate, with mainly concentrates, ground soybean hulls, and melon. Three ruminants from an outbreak of petroleum poisoning presented macro and microscopic lesions consistent with changes of malacia and edema in deep structures of the brain, as described in ruminants with PEM associated with sulfur intoxication. Major macroscopic changes included congestion of cerebral vessels, edema, and herniation of the cerebellum. The most observed microscopic lesions, among all assessed cases, were laminar and segmental neuronal necrosis at different regions of the brain, spongiosis, nuclear pyknosis, and red nucleus neurons. Cerebrospinal fluid analysis revealed nonspecific alterations, requiring its association with epidemiological, clinical, and pathological findings, as the results described here are similar to those reported in toxic diseases with neurological manifestations, such as botulism.

O presente trabalho objetiva descrever os achados epidemiológicos, clínicos, laboratoriais e patológicos de casos de polioencefalomalácia (PEM) em ruminantes na região semiárida do Rio Grande do Norte. Sete ruminantes (cinco ovinos, um bovino e um caprino) com diagnóstico patológico de PEM foram incluídos. Quatro casos foram associados à deficiência de tiamina devido acidose láctica ruminal crônica por oferta de alimentação rica em carboidratos, destacando-se os concentrados, casca de soja triturada e melão. Três ruminantes de um surto de intoxicação por petróleo apresentaram lesões macro e microscópicas condizentes com alterações de malácia e edema em estruturas profundas do encéfalo, descritas em ruminantes com PEM associada à intoxicação por enxofre. As principais alterações macroscópicas incluíram congestão dos vasos cerebrais, edema e conificação do cerebelo. Em todos os casos avaliados, as lesões microscópicas mais observadas foram a necrose neuronal laminar e segmentar em diferentes regiões do encéfalo, espongiose, picnose nuclear e a presença de neurônios vermelhos. A análise do líquido cefalorraquidiano revelou alterações inespecíficas, sendo necessário sua associação aos achados epidemiológicos, clínicos e patológicos, pois os resultados aqui descritos são semelhantes aos relatados em doenças tóxicas com manifestações neurológicas, como o botulismo.