Protozoal meningoencephalitis and myelitis in 4 dogs associated with Trypanosoma cruzi infection.

American trypanosomiasis is caused by the zoonotic protozoa Trypanosoma cruzi and primarily results in heart disease. Organisms also infect the central nervous system (CNS). The Texas A&M University veterinary teaching hospital archive was searched for dogs with CNS disease with intralesional protozoal amastigotes. This study summarizes 4 cases of dogs with disseminated trypanosomiasis and CNS involvement confirmed by quantitative polymerase chain reaction (qPCR) with T. cruzi primers. Clinical signs included lethargy, respiratory distress, tetraparesis, and seizures. Central nervous system lesions included meningeal congestion (1/4), necrosis with hemorrhage in the spinal cord gray and white matter (2/4), and histiocytic meningoencephalitis (4/4), and meningomyelitis (2/4) with intralesional and intracellular protozoal. Genotyping identified 1 case of T. cruzi discrete typing unit (DTU) TcI and 2 cases as TcIV, both are common variants in the United States. Trypanosomiasis should be considered a differential diagnosis for dogs with CNS signs in T. cruzi-endemic areas.

Disseminated Neospora caninum infection in a dog with severe colitis.

A 12-y-old spayed female Schipperke dog with a previous diagnosis of inflammatory bowel disease was presented with a 2-mo history of severe colitis. The patient's condition progressed to hepatopathy, pneumonia, and dermatitis following management with prednisolone and dexamethasone sodium phosphate. Colonic biopsies identified severe necrosuppurative colitis with free and intracellular parasitic zoites. Postmortem examination confirmed extensive chronic-active ulcerative colitis, severe acute necrotizing hepatitis and splenitis, interstitial pneumonia, ulcerative dermatitis, myelitis (bone marrow), and mild meningoencephalitis with variable numbers of intracellular and extracellular protozoal zoites. PCR on samples of fresh colon was positive for Neospora caninum. Immunohistochemistry identified N. caninum tachyzoites in sections of colon, and a single tissue cyst in sections of brain. Administration of immunosuppressive drugs may have allowed systemic dissemination of Neospora from the intestinal tract.

Evaluation of magnetic resonance imaging for the differentiation of inflammatory, neoplastic, and vascular intradural spinal cord diseases in the dog.

Magnetic resonance imaging (MRI) is a common test for dogs with suspected intradural spinal cord lesions, however studies on diagnostic performance for this test are lacking. Objectives of this multi-institutional, retrospective, case-control study were to estimate sensitivity and specificity of MRI for (1) distinguishing between histopathologically confirmed intradural spinal cord disease versus degenerative myelopathy in dogs, (2) categorizing intradural spinal cord diseases as neoplastic, inflammatory, or vascular; and (3) determining tumor type within the etiologic category of neoplasia. Additional aims were to (1) determine whether knowledge of clinical data affects sensitivity and specificity of MRI diagnoses; and (2) report interrater agreement for MRI classification of intradural spinal lesions. Cases were recruited from participating hospital databases over a 7-year period. Three reviewers independently evaluated each MRI study prior to and after provision of clinical information. A total of 87 cases were sampled (17 degenerative myelopathy, 53 neoplasia, nine inflammatory, and eight vascular). Magnetic resonance imaging had excellent (>97.6%) sensitivity for diagnosis of intradural spinal cord lesions but specificity varied before and after provision of clinical data (68.6% vs. 82.4%, P = 0.023). Magnetic resonance imaging had good sensitivity (86.8%) and moderate specificity (64.7-72.5%) for diagnosing neoplasia. Sensitivity was lower for classifying inflammatory lesions but improved with provision of clinical data (48.1% vs. 81.5%, P = 0.015). Magnetic resonance imaging was insensitive for diagnosing vascular lesions (25.0%). Interrater agreement was very good for correctly diagnosing dogs with intradural lesions (ĸ = 0.882-0.833), and good (ĸ = 0.726-0.671) for diagnosing dogs with neoplasia.

Parelaphostrongylus tenuis Cerebrospinal Nematodiasis in a Horse with Cervical Scoliosis and Meningomyelitis.

There are reports of horses with acute onset acquired cervical scoliosis and cutaneous analgesia. The underlying dorsal gray column myelitis that produces these neurologic signs has been only presumptively attributed to migration of Parelaphostrongylus tenuis within the spinal cord. Despite previous confirmation brain by polymerase chain reaction testing, of P. tenuis within the brain of horses by polymerase chain reaction testing, genetic testing has failed to definitively identify the presence of this parasite in cases of equine myelitis. This case report provides molecular confirmation via polymerase chain reaction of P. tenuis within the cervical spinal cord of a horse with scoliosis and cutaneous analgesia.

A new method of walking rehabilitation using cognitive tasks in an adult chimpanzee (Pan troglodytes) with a disability: a case study.

There are few studies of long-term care and rehabilitation of animals which acquired physical disabilities in captivity, despite their importance for welfare. An adult male chimpanzee named Reo at the Primate Research Institute of Kyoto University, developed acute myelitis, inflammation of the spinal cord, which resulted in impaired leg function. This report describes a walking rehabilitation system set up in a rehabilitation room where he lives. The rehabilitation apparatus consisted of a touch monitor presenting cognitive tasks and a feeder presenting food rewards at a distance of two meters from the monitor, to encourage him to walk between the monitor and the feeder repeatedly. Initially, Reo did not touch the monitor, therefore we needed adjustment of the apparatus and procedure. After the habituation to the monitor and cognitive tasks, he started to show behaviors of saving food rewards without walking, or stopping participation to the rehabilitation. Finally it took seven phases of the adjustment to determine the final setting; when the monitor automatically displayed trials in 4-h, AM (1000-1200 hours) and PM (1400-1600 hours) sessions through a day, Reo spontaneously walked from the monitor to the feeder to receive rewards, and returned to the monitor to perform the next trial. Comparison of Reo's locomotion in a no-task period and under the final setting revealed that the total travel distance increased from 136.7 to 506.3 m, movement patterns became multiple, and the percentage of walking increased from 1.2 to 27.2 % in PM session. The findings of this case study suggest that cognitive tasks may be a useful way to rehabilitate physically disabled chimpanzees, and thus improve their welfare in captivity.

SUSCEPTIBILITY ARTIFACTS ON T2*-WEIGHTED MAGNETIC RESONANCE IMAGING OF THE CANINE AND FELINE SPINE.

The T2*-weighted gradient recalled echo sequence is a sensitive means to detect blood degradation products. While not a routine sequence in magnetic resonance imaging of the spine in small animals, it can provide additional valuable information in select cases. The goal of this retrospective, cross-sectional study was to describe findings when acquiring this sequence during magnetic resonance imaging examination of the spine in small animals. The University of Tennessee's veterinary radiology database was searched for dogs and cats that underwent magnetic resonance imaging for suspect spinal disease in which a T2*-weighted gradient recalled echo sequence was acquired and susceptibility artifact was identified. The following information was recorded: signalment, clinical signs, location and appearance of susceptibility artifact, and final diagnosis. Thirty-nine cases were included in the study. Extradural susceptibility artifacts were observed in cases of intervertebral disc herniation with or without associated hemorrhage (n = 28), extradural hemorrhage associated with spinal trauma (n = 2), hemophilia (n = 1), and in a cystic extradural mass (n = 1). Remaining lesions displaying susceptibility artifact were intramedullary and included presumptive acute noncompressive nucleus pulposus extrusion (n = 2), hematoma (n = 1), hemangiosarcoma metastasis (n = 1), intramedullary disc extrusion (n = 1), presumptive meningomyelitis (n = 1), and a mass of undetermined etiology (n = 1). Inclusion of a T2*-weighted gradient recalled echo sequence may be helpful in spinal magnetic resonance imaging when standard imaging sequences are ambiguous or intramedullary lesions are observed.

Neurotropic T-cell-rich B-cell lymphoma in a 14-year-old Morgan gelding.

A 14-year-old Morgan gelding was presented for progressive weakness and muscle atrophy. The horse was initially diagnosed with equine protozoal myelitis based on history, physical examination, and laboratory diagnostics. Despite therapy, the horse declined clinically and was euthanized. Necropsy revealed a rare form of neurotropic lymphoma, described in this report.

Lymphome de cellules-B riches en cellules-T neurotropes chez un hongre Morgan âgé de 14 ans. Un hongre Morgan âgé de 14 ans a été présenté pour une faiblesse progressive et une atrophie musculaire. On a d'abord diagnostiqué la myélite protozoaire équine chez le cheval en se basant sur l'anamnèse, l'examen physique et le diagnostic en laboratoire. Malgré la thérapie, l'état clinique du cheval s'est détérioré et il a été euthanasié. La nécropsie a révélé une forme rare de lymphome neutropique, qui est décrite dans ce rapport.(Traduit par Isabelle Vallières).

STIR muscle hyperintensity in the cervical muscles associated with inflammatory spinal cord disease of unknown origin.

OBJECTIVES: To assess the relation of a distinctive pattern of short tau inversion recovery muscle hyperintensity with inflammatory cerebrospinal fluid result in dogs. METHODS: All dogs that had a short tau inversion recovery sequence performed in addition to other magnetic resonance sequences of the cervical spine and concurrent cerebrospinal fluid evaluation during the study period were included. All magnetic resonance studies were anonymised and reviewed by a board certified radiologist and board certified neurologist. A board certified pathologist examined the cerebrospinal fluid and the results were reviewed. RESULTS: Forty-nine cases fulfilled the inclusion criteria. Repeatable patterns of short tau inversion recovery hyperintensity were identified in 20 dogs. The clinical diagnosis in all these 20 cases was of meningoencephalomyelitis of unknown origin. This diagnosis was confirmed by inflammatory cerebrospinal fluid changes in 18 and suspected from clinical presentation and response to therapy in the remaining 2. CLINICAL SIGNIFICANCE: In this study, the short tau inversion recovery changes identified were restricted to cases with inflammatory spinal cord disease. The short tau inversion recovery change had a sensitivity of 78%, and a specificity of 92% in predicting inflammatory cerebrospinal fluid, suggesting that short tau inversion recovery sequences are a useful addition to the investigation of suspected inflammatory spinal cord disease.

An unusual case of spinal cord restricted mycobacteriosis in a European mink.

Granulomatous myelitis due to infection with Mycobacterium avium was diagnosed in a 4-year-old male neutered European mink (Mustela lutreola). The causative agent was detected by an acid-fast stain and further characterized by polymerase chain reaction and DNA sequencing of the PCR product. A thorough histological evaluation of the remaining organs revealed no granulomatous lesions or detectable acid-fast organisms. Although minks are generally highly susceptible for mycobacteria, localised infections, especially of the central nervous system, are unusual and may represent an atypical chronic form of the disease.

CT and MRI imaging diagnosis of epidural idiopathic sterile pyogranulomatous inflammation in a dog spinal canal.

A 12-year-old neutered male shih tzu developed progressive pelvic limb paraparesis. Computed tomography showed a radiolucent mass lesion in the spinal canal at the left side of the 11th thoracic vertebra. The mass was not enhanced by intravenous contrast medium injection. It was hyperintense on both T1- and T2-weighted magnetic resonance images. The signal intensity of the mass was decreased with a fat suppression technique, indicating a fatty origin. After removal of the mass via T11-T12 hemilaminectomy, chronic panniculitis was confirmed by histopathological examination. This case demonstrates the utility of computed tomography and magnetic resonance imaging for the diagnosis of spinal canal pyogranulomatous inflammation.

Parasite meningomyelitis in cats in Uruguay.

Two outbreaks of progressive hind limb paresis in cats (Felis catus) caused by parasitic meningomyelitis in Uruguay are reported. The case studies occurred in 2008 and 2009 respectively, in the rural areas of Fray Bentos (33° 07' 40.39'' S) and were characterized by hindquarter paralysis. This paralysis was progressive and had a chronic progression of approximately 12 months until the death or euthanasia of the animals. Clinical symptoms started with ataxia of the hindquarters with lateral side-to-side swaying and culminated in total paralysis. Two animals were sent for necropsy in 2009. The main histopathological findings were severe myelitis in the lumbar spinal cord with perivascular cuffing and white matter necrosis, severe nonsuppurative meningitis with thrombi in subarachnoid blood vessels, and intravascular presence of multiple adult parasites. From the morphological characteristics of the parasites and location in the leptomeninges, the parasite was identified as the nematode Gurltia paralysans.

Parasite meningomyelitis in cats in Uruguay / Meningomielites parasitária em gatos no Uruguai

Two outbreaks of progressive hind limb paresis in cats (Felis catus) caused by parasitic meningomyelitis in Uruguay are reported. The case studies occurred in 2008 and 2009 respectively, in the rural areas of Fray Bentos (33º 07' 40.39" S) and were characterized by hindquarter paralysis. This paralysis was progressive and had a chronic progression of approximately 12 months until the death or euthanasia of the animals. Clinical symptoms started with ataxia of the hindquarters with lateral side-to-side swaying and culminated in total paralysis. Two animals were sent for necropsy in 2009. The main histopathological findings were severe myelitis in the lumbar spinal cord with perivascular cuffing and white matter necrosis, severe nonsuppurative meningitis with thrombi in subarachnoid blood vessels, and intravascular presence of multiple adult parasites. From the morphological characteristics of the parasites and location in the leptomeninges, the parasite was identified as the nematode Gurltia paralysans.

São relatados dois surtos de paralisia progressiva dos membros posteriores em gatos (Felis catus), causada por meningomielite parasitária no Uruguai. Os estudos de casos ocorreram entre os anos 2008 e 2009, respectivamente, nas zonas rurais de Fray Bentos (33º 07' 40,39" S) e foram caracterizados por paralisia dos membros posteriores. Esta paralisia era progressiva e tinha evolução crônica de aproximadamente 12 meses, até que os animais vinham a óbito ou eram eutanasiados. Os sintomas clínicos começaram com ataxia dos membros posteriores, com movimentos laterais, terminado em paralisia total. Em 2009, dois animais foram encaminhados para necropsia. Os achados histopatológicos foram caracterizados por severa mielite na medula espinhal lombar com manguitos perivasculares linfocitarios e necrose da substância branca, severa meningite não supurativa com trombos nos vasos sanguíneos subaracnóideos, e presença intravascular de múltiplos parasitos adultos. De acordo com as características morfológicas dos parasitos e localização nas leptomeninges, este foi identificado como um nematóide da espécie Gurltia paralysans.

First detection of the equine herpesvirus 1 neuropathogenic variant in Brazil.

This report describes the first detection of an equine herpesvirus 1 (EHV-1) neuropathogenic variant (G2254/D752) in Brazil from a case of fatal equine herpesvirus myeloencephalopathy (EHM) in a mare. The results of nucleotide sequencing of the EHV-1 ORF30 gene showed that two other Brazilian EHV-1 isolates from EHM cases are representatives of the non-neuropathogenic variant (A2254/N752), suggesting that other unidentified factors are probably also involved in the neuropathogenicity of EHV-1 in horses. These findings will contribute to the epidemiological knowledge of EHV-1 infection in Brazil.

Diagnosis of Parelaphostrongylus spp. infection as a cause of meningomyelitis in calves.

Migration of Parelaphostrongylus spp. has been documented to cause central nervous system damage in a number of aberrant host species but appears to be uncommon in cattle. The current report describes the clinical and laboratory findings, antemortem and definitive diagnosis, and response to treatment of Parelaphostrongylus spp. infection in five 3-7- month-old Limousin calves from 2 farms. All calves had signs of acute (n = 2) and chronic (n = 3) progressive spinal cord dysfunction. Cerebrospinal fluid analysis revealed a marked eosinophilic (acute cases) or lymphocytic (chronic cases) pleocytosis and elevated protein in all calves. A necropsy and histopathologic evaluation was performed on 2 euthanized calves, and histopathology revealed lymphoplasmacytic and eosinophilic meningomyelitis with multiple intradural and intramedullary expansile hyperplastic lymphoid nodules containing germinal centers and nematode fragments. DNA sequencing was performed on nested polymerase chain reaction products amplified with parasite-specific primers obtained from formalin-fixed and frozen spinal cord; PCR products from these 2 calves were 100% identical to Parelaphostrongylus species on DNA sequencing, confirming the diagnosis. Surviving calves rapidly improved following treatment with anthelmintics and corticosteroids. This case series identified Parelaphostrongylus spp. (likely P. tenuis) as a cause of spinal cord disease in calves and highlights the need for vigilance against aberrant parasite migration in calves grazing wet, snail-infested pastures. Cerebrospinal fluid eosinophilia is useful for supporting an antemortem diagnosis of Parelaphostrongylus in calves with acute neurologic disease; however, a lymphocytosis is observed in chronic or treated cases.

The pathogenesis and treatment of acute spinal cord injuries in dogs.

Mechanical damage to the spinal cord initiates a secondary injury cascade that results in ischemia, disturbances in ion concentrations, excitotoxicity, production of reactive oxygen species, inflammation, and apoptosis. Over weeks to months a glial scar forms, and scarring can result in the development of syringomyelia. In the early phase of the disease, treatment should focus on maintaining systemic blood pressure and oxygenation, decompression of the spinal cord, and stabilization, if indicated. There are currently no proven neuroprotective drug therapies for limiting secondary damage, but blinded clinical trials are underway. Transplantation with olfactory ensheathing cells and mesenchymal stem cells show promise, as do potassium channel antagonists. Canine clinical trials of these therapies are ongoing.

Inflammatory diseases of the spine in small animals.

Discospondylitis and steroid-responsive meningitis-arteritis are the most frequently seen inflammatory diseases of the spine. Advanced imaging techniques and the examination of the cerebrospinal fluid are helpful to receive a definitive or presumptive diagnosis. Most inflammatory lesions are of unknown cause, but bacterial, fungal, or parasitic infections may be detected. Specific treatment depends on the cause.

Feline spinal cord diseases.

The objective of this article is to review the recent literature that reports on the most common diseases affecting the spinal cord of cats, and to draw some general conclusions that will be useful to formulate diagnosis and prognosis for feline spinal patients. The most common types of feline spinal cord diseases documented were inflammatory/infectious diseases, and feline infectious peritonitis was the most common disease, representing approximately 50% of all feline myelitis. Neoplasms were documented in approximately 25% of cases; lymphosarcoma was the most common tumor affecting the spinal cord of cats, with reported prevalence between 28% and 40%. Cats diagnosed with spinal lymphosarcoma were significantly younger (median age 4 years) than cats with other spinal cord tumors (median age 10 years). Cats with clinical signs of intervertebral disc disease had a median age of 8 years, and 67% had Hansen type I disc protrusions. The most commonly affected intervertebral disc was at the L4 to L5 intervertebral disc space. Fibrocartilaginous embolism-affected older cats (median age 10 years), seemed to predominate in the cervicothoracic intumescence, and clinical signs were markedly lateralized, especially when the cervical region was affected.

Myelitis due to reactivated spinal toxoplasmosis in a cat.

The diagnosis, management, and subsequent post-mortem confirmation of a case of suspected reactivated spinal toxoplasmosis in a 10-year-old female neutered Cornish Rex are described. While an ante-mortem diagnosis of toxoplasmosis was considered possible based on the neuroanatomical diagnosis of central nervous system (CNS) disease primarily involving spinal cord segment C6-T2 and the progressive elimination of other potential causes, Toxoplasma gondii antibody titres were consistent with previous exposure rather than active infection. A poor response to appropriate therapy did not support a diagnosis of toxoplasmosis. A post-mortem morphological diagnosis of marked segmental non-suppurative myelitis and necrosis, and an aetiological diagnosis of toxoplasmosis were made. The clinical and pathological findings are supportive of CNS inflammation due to reactivation of latent tissue T gondii cysts.