Corticosteroid monotherapy versus combined cytarabine continuous rate infusion and corticosteroid therapy in dogs with meningoencephalitis of unknown origin: A blinded, randomized, controlled trial.

BACKGROUND: Treatment options available for meningoencephalitis of unknown origin (MUO) in dogs are suboptimal, and currently, no single treatment protocol appears to be superior. OBJECTIVES: Compare neurological deterioration rates at 7 days between dogs with MUO treated with corticosteroids alone or combined with cytosine arabinoside (CA) continuous rate infusion (CRI) and compare clinical deterioration and survival at 30 and 100 days. ANIMALS: Sixty-nine dogs with magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) features or both compatible with MUO. METHODS: Parallel, blinded, randomized controlled trial. Simple randomization into 2 treatment groups: 4 mg/kg/day prednisolone (or dexamethasone equivalent) for 2 days or 200 mg/m2 CA CRI over 8 hours plus 2 mg/kg/day prednisolone. Blinding of the treatment protocol was carried out using reversible redaction of clinical records, and treatment failure was defined as deterioration of neurological assessment or death. Using intention-to-treat analysis, proportions failing treatment at 7, 30, and 100 days were compared using Fisher's exact test. All-cause mortality at 100 days was compared using Kaplan-Meier survival curves. RESULTS: Thirty-five dogs were allocated to corticosteroid only, and 34 dogs were allocated to combined CA CRI and corticosteroid. Proportions failing treatment at 7, 30, and 100 days were 7/35 (20%), 9/35 (26%), and 15/35 (43%) in the corticosteroid-only group and 8/34 (24%), 11/34 (32%), and 23/34 (68%) in the corticosteroid and CA CRI group. All-cause mortality at 100 days was not significantly different between groups (P = .62). Clinically relevant treatment-related adverse effects were not observed. CONCLUSIONS AND CLINICAL IMPORTANCE: We found no difference in outcome between corticosteroid monotherapy and combined cytarabine CRI and corticosteroid therapy at 7, 30, and 100 days after diagnosis in dogs with MUO.

C-reactive protein in dogs with suspected bacterial diskospondylitis: 16 cases (2010-2019).

OBJECTIVES: C-reactive protein (CRP) is an acute phase protein used in multiple canine inflammatory conditions including steroid responsive meningitis-arteritis, immune-mediated polyarthritis and bronchopneumonia. The aim of this study was to assess whether serum CRP is elevated in cases of diskospondylitis. METHODS: Medical records from 2010 to 2019 were searched to identify dogs diagnosed with diskospondylitis based on findings consistent on CT or MRI and with CRP tested. RESULTS: A total of 16 dogs met the inclusion criteria. All cases had back pain. Fourteen cases had elevated CRP, with a median value of 100.7 mg/l (reference range for CRP values: 0-10 mg/l), 12 were pyrexic and six had leucocytosis. The two dogs with normal CRP were normothermic and did not have leucocytosis. CRP was measured four to six weeks into antimicrobial treatment in eight of 14 dogs and was normal in all cases. One dog developed a suspected bacterial empyema diagnosed on MRI; this occurred two weeks after antibiotic treatment was discontinued based on a normal CRP level at follow-up. CONCLUSIONS: Serum CRP is elevated in cases of diskospondylitis and may be clinically more useful to screen dogs with back pain than pyrexia or leucocytosis alone. Further long-term clinical evaluation in a prospective study is needed to assess its use as a treatment monitoring tool and in decision making.

Multiple Cervical Vertebral Malformations in a 21-Week-Old Kitten.

A 21 wk old, 2 kg neutered male domestic shorthair presented with a 24 hr history of acute-onset severe nonambulatory tetraparesis with no known inciting cause. Neurologic examination revealed a C1-C5 myelopathy. Computed tomography of the vertebral column and thorax revealed incomplete ossification of the C2 and C3 vertebrae and lung bullae. After 4 wk of conservative management, the client reported a return to normal ambulation with reluctance to jump up. To the authors' knowledge, this is the first report of a feline case of incomplete ossification of cervical vertebrae. The cervical malformations outlined in this report are differentials to consider in cases of acute-onset tetraparesis in cats.

Low frequency of pre-treatment and post-treatment haematological abnormalities in dogs with non-infectious meningoencephalitis treated with cytosine arabinoside and prednisolone.

BACKGROUND: Cytosine arabinoside (CA) and prednisolone are drugs commonly used together in the management of canine non-infectious meningoencephalitis (NIME). The aim of this study was to report the haematological findings before and after CA and prednisolone treatment and identify any adverse haematological events in this clinical setting, following the veterinary cooperative oncology group established common terminology criteria for recording adverse events following administration of chemotherapy or biological antineoplastic therapy. RESULTS: While 48 patients with a presumptive diagnosis of NIME had pretreatment haematology results, only 12 patients met the inclusion criteria of also having post-treatment haematology results available for review after being treated with prednisolone and CA at a standard dose (200 mg/m2) in a single referral hospital in the UK. Forty-nine post-treatment haematology results were available for these 12 patients. CONCLUSIONS: Four adverse haematological events were identified in four patients. None of these events were convincingly attributable to CA administration.

Imaging diagnosis-magnetic resonance imaging features of a cerebral hemangioblastoma in a dog.

The magnetic resonance (MR) imaging features of a cerebral hemangioblastoma in a 9-year-old dog are described. Imaging revealed a well-defined contrast-enhancing lesion of the rostral forebrain that appeared extraparenchymal. Histopathology of the excised mass showed clusters of small blood vessels interspersed with interstitial cells staining positive for neuronal specific enolase, features consistent with a cerebral hemangioblastoma; the mass also appeared intraparenchymal after further immunohistochemistry study. This neoplasm should be considered a rare differential diagnosis for intracranial masses in dogs.

Canine spinal nephroblastoma: long-term outcomes associated with treatment of 10 cases (1996-2009).

OBJECTIVE: To report clinical outcome associated with treatment of canine spinal cord nephroblastoma (CSN). STUDY DESIGN: Case series. ANIMALS: Dogs (n=10) with histopathologically confirmed CSN. METHODS: Records of dogs with CSN were reviewed and clinicopathologic, diagnostic imaging, treatment, outcome, and survival data were collected. RESULTS: CSN resulted in clinical signs of chronic, progressive T3-L3 myelopathy in young, large breed dogs, with an overrepresentation of German Shepherd Dogs (n=4). All CSN were located between T9 and L2. Dogs treated with cytoreductive surgery (n=6) or radiotherapy (1) survived longer (median, 374 days; range, 226-560 days) than dogs treated palliatively (3; median, 55 days; range, 38-176 days). Tumors confined to an intradural-extramedullary (ID-EM) location were associated with superior survival (n=6; median, 380 days; range, 176-560 days) than tumors with intramedullary (IM) involvement (n=4; median, 140 days; range, 38-269 days). Treatment resulted in temporary improvement in neurologic function in 9 dogs, including all dogs treated surgically, but local disease progression resulted in death of 8 dogs. CONCLUSIONS: Results of this observational study suggest that surgical cytoreduction and radiotherapy are effective at improving survival in dogs with CSN, and that ID-EM tumors may be associated with a more favorable prognosis than IM neoplasms.