Outcomes of surgically and conservatively managed thoracolumbar and lumbosacral intervertebral disc herniations in cats.

BACKGROUND: Limited information is available regarding intervertebral disc herniation (IVDH) and its treatment in cats. OBJECTIVES: Describe outcomes after surgical or conservative treatment of cats with thoracolumbar and lumbosacral IVDH. ANIMALS: Ninety-two cats from 2 referral populations (2012-2022) with compressive IVDH between the T3 and S1 vertebrae. METHODS: Retrospective cohort study evaluating outcomes of surgical (49 cats) and conservative (36 cats) management of IVDH; 7 cats were euthanized at diagnosis. Outcome was assessed using hospital and referring veterinarian records and client questionnaires. Successful outcome was defined as regained or improved ambulation, urinary and fecal continence, and no requirement for analgesic medication. RESULTS: Incidence of IVDH during the study period was 0.44% (92/20849). Surgical treatment resulted in 62% (6 weeks) and 74% success (6 months). Conservative treatment resulted in 54% (6 weeks) and 65% success (6 months). Neurological grade at presentation was higher in cats treated surgically (median, 2; range, 1-5) than in those treated conservatively (median, 2; range, 0-4; P = .001). Regardless of treatment type, cats suffering trauma were more likely to have a successful outcome 6 weeks after treatment compared with those without history of trauma (odds ratio, 5.3; 95% confidence interval, 1.05-26.78; P = .04). Neurological deficits remained in the majority of cats for both treatment types (92%, conservative; 86%, surgical at 6 weeks). Acute-on-chronic IVDH with characteristics of both extrusion and protrusion were identified in 10% of cats. CONCLUSIONS AND CLINICAL IMPORTANCE: Conservative treatment could be as effective as surgical decompression in cats with thoracolumbar or lumbosacral IVDH.

Retrospective study and outcome of 307 cats with feline infectious peritonitis treated with legally sourced veterinary compounded preparations of remdesivir and GS-441524 (2020-2022).

OBJECTIVES: Feline infectious peritonitis (FIP) is a serious disease that arises due to feline coronavirus infection. The nucleoside analogues remdesivir and GS-441524 can be effective in its treatment, but most studies have used unregulated products of unknown composition. The aim of the present study was to describe the treatment of FIP using legally sourced veterinary-prescribed regulated veterinary compounded products containing known amounts of remdesivir (injectable) or GS-441524 (oral tablets). METHODS: Cats were recruited via email advice services, product sales contacts and study publicity. Cats were excluded if they were deemed unlikely to have FIP, were not treated exclusively with the veterinary compounded products, or if there was a lack of cat and/or treatment (including response) data. Extensive cat and treatment data were collected. RESULTS: Among the 307 cats recruited, the predominant type of FIP was most commonly abdominal effusive (49.5%) and then neurological (14.3%). Three treatment protocols were used; remdesivir alone (33.9%), remdesivir followed by GS-441524 (55.7%) and GS-441524 alone (10.4%). The median (range) initial treatment period duration and longest follow-up time point after starting treatment were 84 (1-330) days and 248 (1-814) days, respectively. The most common side effect was injection pain (in 47.8% of those given subcutaneous remdesivir). Of the 307 cats, 33 (10.8%) relapsed, 15 (45.5%) during and 18 (54.5%) after the initial treatment period. At the longest follow-up time point after completion of the initial treatment period, 84.4% of cats were alive. The cats achieving a complete response within 30 days of starting treatment were significantly more likely to be alive at the end of the initial treatment period than those cats that did not. CONCLUSIONS AND RELEVANCE: Legally sourced remdesivir and GS-441524 products, either alone or used sequentially, were very effective in the treatment of FIP in this group of cats. Variable protocols precluded statistical comparison of treatment regimens.

Clinical presentation, treatment, and outcome of 24 dogs with bacterial meningitis or meningoencephalitis without empyema (2010-2020).

BACKGROUND: Bacterial meningitis (BM) and meningoencephalitis (BMEM) are associated with high case fatality rates and neurologic sequelae in people, but limited data exists on outcome in dogs. HYPOTHESIS/OBJECTIVES: To report the clinicopathologic features, treatment and outcome of BM/BMEM in dogs, with a focus on clinical presentation, relapse and long-term neurological deficits. ANIMALS: Twenty-four client-owned dogs diagnosed with BM/BMEM without empyema. METHODS: Retrospective case series of dogs diagnosed with BM/BMEM from 5 veterinary referral hospitals between January 2010 and August 2020. RESULTS: Twenty-four dogs were included. Median duration of clinical signs was 2 days (range ≤24 hours to 30 days) and signs recorded included pyrexia (3) and cervical hyperesthesia (10). Neurological deficits were present in 18 dogs including altered mentation (12), ataxia (8), nonambulatory status (8), head tilt (8), and cranial nerve deficits (13). Intracellular bacteria were visualized on cerebrospinal fluid (CSF) analysis in 15/24 dogs, with positive CSF bacteriological culture in 8/21. Otitis media/interna (OMI) was diagnosed in 15/24 dogs, of which 6/15 dogs underwent total ear canal ablation and lateral bulla osteotomy. Twenty dogs survived to hospital discharge. Median duration of antibiotic administrations was 8 weeks (range, 2-16 weeks). Glucocorticoids were administered to 15 dogs. Median follow-up time was 92 days (range, 10-2233 days). Residual neurological deficits were reported in 9 dogs, with a single case of suspected relapse. CONCLUSIONS AND CLINICAL IMPORTANCE: Clinical signs were variable in dogs with BM/BMEM, the nidus of bacterial infection was often OMI and the majority of dogs made a full recovery with treatment.

Case Report: Diffuse Lumbar Hyperostosis Causing Vertebral Canal Stenosis in a Dog With Concurrent Multicentric T-Cell Lymphoma.

A 4-year-old female spayed Bullmastiff-cross presented with a 24-h history of progressive paraparesis. Neurological examination was consistent with L4-S3 myelopathy. On magnetic resonance imaging (MRI), all vertebrae showed homogenously increased short tau inversion recovery (STIR) signal with strong contrast enhancement. The vertebral canal was concentrically narrowed along the length of the L5 vertebra secondary to bony proliferation of the vertebral pedicles, dorsal lamina, and vertebral body. Cytological analysis of the peripheral lymph nodes and subsequent flow cytometry was consistent with T-cell lymphoma. The dog was euthanised due to poor prognosis. Necropsy confirmed the presence of stage V multicentric T-cell lymphoma, as well as diffuse hyperostosis of the vertebral bodies. This is the first report of presumed paraneoplastic lumbar skeletal hyperostosis.

Serum C-reactive protein in dogs with paraplegia secondary to acute intervertebral disc extrusion.

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.

Dexamethasone Can Be Safely and Effectively Used for Treatment of Masticatory Muscle Myositis in Dogs.

Dexamethasone is the glucocorticoid of choice in many human inflammatory and immune-mediated conditions, given its reported effectiveness and limited side effect profile. In veterinary medicine, the glucocorticoid of choice is prednisone, however the safety of longer-term use of dexamethasone has not previously been studied. The aim of this study was to evaluate the safety, effectiveness and side effects of dexamethasone use as the glucocorticoid treatment for masticatory muscle myositis in dogs - an immune-mediated inflammatory condition. 93% of dogs showed a clinical improvement within two weeks of treatment, and 100% by ten weeks. 35% of dogs showed adverse reactions, however these were all mild and resolved with tapering of the dexamethasone dose. In conclusion, dexamethasone can be safely and effectively used for the treatment of masticatory muscle myositis in dogs, and should be considered for use in these cases, either alone or alongside additional immunosuppressive medications. Side effects are mild and resolve with tapering of the dexamethasone dose.