Treatment of age-related hearing loss in dogs with the vibrant soundbridge middle ear implant: short-term results in 3 dogs.

BACKGROUND: Age-related hearing loss (ARHL), or presbycusis, is the most common form of acquired hearing loss in dogs. Middle ear implants have been used successfully in people with ARHL who cannot benefit from conventional hearing aids. HYPOTHESIS: Audibility improves in dogs with ARHL after implantation of the Vibrant Soundbridge (VSB) middle ear implant. ANIMALS: Three Beagle dogs with ARHL, mean age 11.1 years. METHODS: The dogs were assessed pre- and postoperatively by brainstem-evoked response audiometry (BERA), otoscopy, and computed tomography scans of the ears. A VSB middle ear implant was implanted unilaterally. Three months later the functionality of the implants was assessed by auditory steady-state responses (ASSRs), after which the dogs were euthanized for histopathological examination. RESULTS: The VSB was implanted successfully in all dogs. Recovery from surgery was uneventful, except for transient facial nerve paralysis in 2 dogs. ASSRs showed that hearing improved after activation of the implants with a mean of 20.7, 13, and 16.3 dB at 1, 2, and 4 kHz, respectively. The implantation procedure did not affect residual hearing (with inactive implants) as measured by BERA. CONCLUSIONS AND CLINICAL IMPORTANCE: Implantation of the VSB resulted in lower ASSR thresholds, but only at the higher gain settings of the audioprocessor. As in humans, a more powerful audioprocessor is required to treat sensorineural hearing loss exceeding 20 dB in dogs. A substantial improvement in patient-owner communication will have to be demonstrated in future studies before the procedure can be recommended in clinical practice.

Effects of aging on inner ear morphology in dogs in relation to brainstem responses to toneburst auditory stimuli.

BACKGROUND: Age-related hearing loss (ARHL) is the most common form of hearing loss in humans and is increasingly recognized in dogs. HYPOTHESIS: Cochlear lesions in dogs with ARHL are similar to those in humans and the severity of the histological changes is reflected in tone audiograms. ANIMALS: Ten geriatric dogs (mean age: 12.7 years) and three 9-month-old dogs serving as controls for histological analysis. METHODS: Observational study. Auditory thresholds were determined by recording brainstem responses (BERA) to toneburst auditory stimuli (1, 2, 4, 8, 12, 16, 24, and 32 kHz). After euthanasia and perfusion fixation, the temporal bones were harvested and processed for histological examination of the cochleas. The numbers of outer hair cells (OHCs) and inner hair cells (IHCs) were counted and the spiral ganglion cell (SGC) packing density and stria vascularis cross-sectional area (SVCA) were determined. RESULTS: A combination of cochlear lesions was found in all geriatric dogs. There were significant reductions (P .001) in OHC (42%, 95% confidence interval [CI]; 24-64%) and IHC counts (21%, 95% CI; 62-90%) and SGC packing densities (323, 95% CI; 216-290) in the basal turn, SVCA was smaller in all turns. The greatest reduction in auditory sensitivity was at 8-32 kHz. CONCLUSIONS AND CLINICAL IMPORTANCE: ARHL in this specific population of geriatric dogs was comparable histologically to the mixed type of ARHL in humans. The predominance of histological changes in the basal cochlear turn was consistent with the large threshold shifts observed in the middle- to high-frequency region.

Effects of aging on brainstem responses to toneburst auditory stimuli: a cross-sectional and longitudinal study in dogs.

BACKGROUND: It is assumed that the hearing of dogs becomes impaired with advancing age, but little is known about the prevalence and electrophysiologic characteristics of presbycusis in this species. HYPOTHESIS: As in humans, hearing in dogs becomes impaired with aging across the entire frequency range, but primarily in the high-frequency area. This change can be assessed quantitatively by brainstem-evoked response audiometry (BERA). ANIMALS: Three groups of 10 mixed-breed dogs with similar body weights but different mean ages were used. At the start of the study, the mean age was 1.9 years (range, 0.9-3.4) in group I, 5.7 years (3.5-7) in group II, and 12.7 years (11-14) in group III. METHODS: In a cross-sectional study, the BERA audiograms obtained with toneburst stimuli were compared among the 3 groups. In a longitudinal study, changes in auditory thresholds of group II dogs were followed for 7 years. RESULTS: Thresholds were significantly higher in group III than in groups I and II at all frequencies tested, and higher in group II than in group I at 4 kHz. The audiograms in group II indicated a progressive increase in thresholds associated with aging starting around 8-10 years of age and most pronounced in the middle- to high-frequency region (8-32 kHz). CONCLUSIONS AND CLINICAL IMPORTANCE: Age-related hearing loss in these dogs started around 8-10 years of age and encompassed the entire frequency range, but started and progressed most rapidly in the middle- to high-frequency area. Its progression can be followed by BERA with frequency-specific stimulation.

The rat vertex-middle latency auditory-evoked potential as indicator of anaesthetic depth: a comparison with evoked-reflex testing.

We investigated whether components from the rat Vx-MLAEP could be used to assess depth of anaesthesia induced by propofol. Propofol decreased MLAEP amplitudes and increased latencies. We propose that the P(16)-N(22) wave in the rat MLAEP is similar to the human P1, and that recovery of this wave during propofol anaesthesia correlates with behavioural measures of the regaining of consciousness.

CMAPs in pharyngeal and hyoid muscles evoked by nucleus solitarius stimulation in dogs.

Electrical stimulation of the solitary nucleus with a single pulse of 150 to 500 microA caused visible contractions of the muscles involved in swallowing but did not activate the central pattern generator for swallowing. Electromyographically there were short bursts of activity characterized by an onset of activity within 1 to 7 ms, a duration of 14 to 26 ms, and an amplitude of 10 to 4,800 microV. The CMAPs were recorded in the pharyngeal and hyoid muscles on both the ipsilateral and the contralateral sides of the stimulated solitary nucleus. Across all five pairs of muscles in which the recordings were made the latencies of the CMAPs in the contralateral muscles were significantly greater and the amplitudes significantly lower, but the durations were not significantly different. Bilateral activation of the muscles by unilateral stimulation may not result in symmetrical contraction of the pharyngeal muscles.

Effect of superior laryngeal nerve transection on pharyngeal muscle contraction timing and sequence of activity during eating and stimulation of the nucleus solitarius in dogs.

The effect of unilateral or bilateral transection of the superior laryngeal nerve on the electromyographic activity in the hyopharyngeal, thyropharyngeal, and cricopharyngeal muscles was studied in 10 dogs during eating and during unilateral electrical stimulation of the solitary nucleus. In all groups of dogs, after unilateral or bilateral transection, there were some swallowing actions in which the sequence of activity in the pharyngeal muscles was disturbed during eating and during stimulation of the solitary nucleus. In the dogs in which the transection was unilateral, this fraction was 18% in the ipsilateral muscles during eating and 7% in the contralateral muscles. After bilateral transection it was 8% in the left muscles and 16% in the right muscles. The fractions were not significantly different when swallowing was evoked by stimulation of the solitary nucleus. Swallowing actions having a normal sequence of activity in these dogs were compared with those in a group of eight dogs in which the superior laryngeal nerves were intact. Contraction timing was not significantly different during eating, but during stimulation of the solitary nucleus the timing was significantly shorter than in the dogs with intact nerves. It was concluded that superior laryngeal nerve transection modulates the central pattern generator for pharyngeal swallowing in dogs.

Effect of stimulating peripheral and central neural pathways on pharyngeal muscle contraction timing during swallowing in dogs.

The effect of stimulating peripheral and central neural pathways on the electromyographic activity in the hyopharyngeal, thyropharyngeal, and cricopharyngeal muscles was studied in eight dogs during 1) eating, 2) unilateral electrical stimulation of the superior laryngeal nerve, and 3) unilateral electrical stimulation of the solitary nucleus. The duration of pharyngeal swallowing was significantly shorter during eating than during stimulation of the solitary nucleus in the anesthetized dog (mean difference 127 ms, SEM 9, n = 15). The duration of pharyngeal swallowing was significantly shorter during eating than during stimulation of the superior laryngeal nerve in the awake dog (mean difference 84 ms, SEM 13, n = 9). The duration of pharyngeal swallowing during stimulation of the superior laryngeal nerve under anesthesia was significantly shorter than during stimulation of the solitary nucleus under anesthesia (mean difference 58 ms, SEM 18, n = 9). The difference in duration of pharyngeal swallowing during stimulation of the superior laryngeal nerve between the awake state and during anesthesia was not significant (mean 19 ms, SEM 14, n = 9). It was concluded that stimulation of peripheral and central neural pathways resulted in different pharyngeal muscle contraction timing during swallowing in dogs.

Evidence for recurrent laryngeal nerve contribution in motor innervation of the human cricopharyngeal muscle.

OBJECTIVE: To study the functional motor nerve supply of the upper esophageal sphincter in humans. STUDY DESIGN: Intraoperative electromyographic study. METHODS: The contribution of the recurrent laryngeal nerve and the pharyngeal plexus in the motor nerve innervation of the cricopharyngeal muscle and the inferior pharyngeal constrictor muscle was examined intraoperatively. RESULTS: Electromyography showed that there is a considerable overlap in the innervation of the cricopharyngeal muscle and the inferior pharyngeal constrictor muscle. The recurrent laryngeal nerve functionally contributes to the motor innervation of the cricopharyngeal muscle in all patients and contributes to the motor innervation of the inferior pharyngeal constrictor muscle in most patients. The pharyngeal plexus functionally contributes to the motor innervation of the inferior pharyngeal constrictor muscle but does not always contribute to the motor innervation of the cricopharyngeal muscle. CONCLUSIONS: This is the first report which provides evidence that the recurrent laryngeal nerve functionally contributes to the motor innervation of the cricopharyngeal and inferior pharyngeal constrictor muscle. Furthermore, this study shows that intraoperative electromyography in humans is a feasible method to analyze the physiology of the motor innervation of the upper esophageal sphincter.

Middle-latency auditory-evoked potential in acepromazine-sedated dogs.

The middle-latency auditory-evoked potential (MLAEP) has been investigated as means of monitoring anesthesia in dogs. The goals of this study were to develop a technique to record MLAEPs in awake dogs and to determine the effects of sedation. The MLAEP was recorded in 12 dogs with and without sedation with acepromazine. Three needle electrodes were inserted SC. Click stimuli were delivered biaurally. Signal acquisition, averaging, and analysis were performed by software developed in-house. Signals were recorded for 128 milliseconds, and the responses to 1,024 stimuli were averaged. The waveforms from 10 recordings were averaged, and the amplitudes and latencies of peaks that could be consistently identified were measured. Data measured were compared by means of a paired 2-sided Student's t-test. Interpretable MLAEPs were recorded in 10 of the 12 dogs. Three peaks were consistently identified (Pa, Nb, and Pb). The latencies of these peaks were significantly (P = .032, .035, and .028, respectively) shorter in awake (mean +/- SD milliseconds) (Pa = 18.85 +/- 1.36, Nb = 30.50 +/- 3.55, and Pb = 47.70 +/- 5.53) than in sedated (Pa = 22.40 +/- 3.88, Nb = 35.75 +/- 6.77, and Pb = 55.30 +/- 10.55) dogs. The Pb amplitude was not significantly different (2.51 +/- 1.30 microV awake and 2.19 +/- 1.10 microV sedated). This study demonstrates that acepromazine sedation causes changes in MLAEP.

Click and low-, middle-, and high-frequency toneburst stimulation of the canine cochlea.

A method was developed to deliver tonebursts ranging in frequency from 1 to 32 kHz for frequency-specific assessment of the canine cochlea. Brainstem auditory-evoked responses (early latency responses, 0-10 ms) to a click (CS) and to 1-, 2-, 4-, 8-, 12-, 16-, 24-, and 32-kHz toneburst stimulations (TS) were compared at 80-dB sound pressure level stimulus (SPL) intensity in 10 adult dogs. All stimulations yielded a 5-7 positive wave pattern, with the exception of the 1-kHz TS, which evoked a frequency-following response (FFR). Thresholds were lowest for the CS and the 12- and 16-kHz TS. All individual peak latencies for TS were significantly (P < or = .05) longer than for CS. Peak I latencies were significantly (P < or = .05) shorter for the 12- and 16-kHz TS than for the other TS. Interpeak latencies I-V were significantly (P < or = .05) longer for the 4- to 32-kHz TS than for CS. Differences in interpeak latencies I-III were not significant. Amplitudes of waves I and V were significantly (P < or = .05) lower for TS than for CS, except for higher wave V amplitude (P < or = .05) at 2- and 32-kHz TS. Peak I-V amplitude ratios were significantly (P < or = .05) higher for the 2-, 4-, 16-, 24-, and 32-kHz TS and lower for the 8- and 12-kHz TS, compared to CS. We conclude that reproducible information on frequency specificity of the canine cochlea can be obtained by TS. This report provides a normative database for parameters needed to evaluate frequency-specific hearing loss in dogs.

Contributions of the glossopharyngeal nerve and the pharyngeal branch of the vagus nerve to the swallowing process in dogs.

The separate contributions of the glossopharyngeal nerve and the pharyngeal branch of the vagus nerve to the innervation of the pharyngeal muscles were studied first in 10 canine cadavers by dissection of the pharyngeal plexus and the pharyngeal muscles. In 10 other dogs, the parent trunks and 1st division of the glossopharyngeal nerve and the pharyngeal branch of the vagus nerve were electrically stimulated. The evoked stimulation potentials were recorded from the stylopharyngeal, hyopharyngeal, thyropharyngeal, and cricopharyngeal muscles. One of the parent trunks was then transected, and the effects on the swallowing process were observed clinically and by contrast videofluorography. Denervation potentials resulting from nerve transection were recorded in the soft palate, the hyopharyngeal, thyropharyngeal, and cricopharyngeal muscles. The pharyngeal plexus was composed of branches originating from the glossopharyngeal nerve and the pharyngeal branch of the vagus nerve. In most dogs, the pharyngeal muscles and the soft palate were innervated ipsilaterally by both nerves. The swallowing process was more severely disturbed after bilateral transection of the pharyngeal branch of the vagus nerve than after bilateral transection of the glossopharyngeal nerve.

Continuous electromyographic recordings of pharyngeal muscle activity in normal and previously denervated muscles in dogs.

Continuous electromyographic recordings of pharyngeal muscle activity were made in 5 clinically normal control dogs and in 7 dogs 3 years after partial denervation of the pharyngeal muscles. Electromyographic recordings were made of the sequence of actions of each muscle and of the combined muscle activity, at rest and during swallowing of food. During 30-second periods, the recordings were digitalized and stored on diskette for further analysis. All control dogs had a distinct pattern of muscle activity during swallowing, the onset being in a constant order (hyopharyngeal, thyropharyngeal, and cricopharyngeal) and bilaterally synchronous. While eating, each dog had about 5 to 12 short periods of synchronous activity in each muscle, between the swallowing actions. During the resting period, there were longer periods of activity, which were synchronous with respiration. In each denervated dog, there were normal and irregular swallowing actions. Swallowing activity was recognized, but the sequence of hyopharyngeal, thyropharyngeal, and cricopharyngeal muscle activity was irregular and different from that in control dogs. Partial denervation of the pharyngeal muscles does not seriously impair motor activity of the muscles, but does alter the sequence of activity in the pharyngeal muscles during swallowing.

Electromyography of the pelvic diaphragm and anal sphincter in dogs with perineal hernia.

The innervation of the levator ani and coccygeal muscles and the external anal sphincter was studied by anatomic dissection in 6 clinically normal male dogs and by electrical stimulation in 5 clinically normal male dogs. Variations in innervation occasionally were found that were comparable to those reported in previous studies. Electromyographic recordings were made from the levator ani and coccygeal muscles and from the anal sphincter in 40 dogs during perineal hernia repair. Spontaneous potentials of 4 types were found in 35 dogs: fibrillation potentials, positive sharp waves, complex repetitive discharges, and fasciculations. Biopsy specimens of the cranial part of the levator ani muscle were taken in 12 dogs during perineal hernia repair. Histologic examination revealed atrophy in 7 specimens. Spontaneous potentials were recorded from all muscles with histologic evidence of atrophy. All examinations of the levator ani muscle concerned the cranial part of this muscle, because the caudal part was absent in all 40 dogs. From combined results of electromyography and histologic examination, it was concluded that atrophy of the muscles of the pelvic diaphragm, which develops in some dogs with perineal hernia, is likely to be of neurogenic origin. Nerve damage is localized in the sacral plexus proximal to the muscular branches of the pudendal nerve or in the muscular branches separately.

Comparison of volume-conducted far-field short-latency glossopharyngeal nerve evoked potentials recorded from the scalp with similarly obtained near-field potentials from the solitary nucleus in dogs.

In 11 dogs, potentials recorded from the scalp and from the solitary nucleus after stimulation of the glossopharyngeal nerve were compared. The far-field potentials recorded from the scalp consisted of negativity, with peak latency of 2.10 to 3.45 milliseconds (mean, 2.93 milliseconds), followed by positivity, with peak latency of 3.20 to 5.95 milliseconds (mean, 4.86 milliseconds) and duration of 4.65 to 6.95 milliseconds (mean, 5.70 milliseconds). The near-field potentials recorded from the solitary nucleus consisted of positivity, with peak latency of 2.15 to 2.70 milliseconds (mean, 2.45 milliseconds), followed by negativity, with peak latency of 4.05 to 5.05 milliseconds (mean, 4.39 milliseconds) and duration of 4.45 to 5.80 milliseconds (mean, 5.21 milliseconds). Comparison of the far-field potentials (n = 10) with the near-field potentials (n = 5) indicated that polarity of the waves was reversed and that the first peak's latency was slightly (approx 0.5 milliseconds) longer in the scalp-recorded far-field potentials. Neither the difference in latency of the second peak nor the difference in its duration, measured from the onset of the potentials to the return to the baseline of the activity, was significant. The results strongly suggest that the response in the solitary nucleus evoked by electrical stimulation of the glossopharyngeal nerve is the source of at least part of the scalp-recorded responses to stimulation of the same nerve. The scalp-recorded far-field potentials could, therefore, be characterized as volume conducted from the evoked response in the solitary nucleus.

EEG evaluation of reflex testing as assessment of depth of pentobarbital anaesthesia in the rat.

Electroencephalography (EEG) was applied to evaluate the validity of the paw pinch reflex as an indicator of anaesthetic depth in rats which are anaesthetized with a single intraperitoneal dose of pentobarbital. After induction of the anaesthesia, characterized by the rapid loss of the animals' ability to maintain upright posture, the EEG of 10 out of 11 rats was dominated by paroxysmal (burst suppression) activity, associated with unconsciousness. In seven out of 11 rats, the paw pinch reflex was lost after onset of paroxysmal electroencephalographic activity. However, the paw pinch reflex remained present in four out of 11 animals, demonstrating that the response is independent of cortical activity. In five out of seven rats, the EEG still showed paroxysmal activity when the paw pinch reflex was regained. However, in two other rats the EEG returned to a pattern similar to that shown by awake animals, 4 and 21 min respectively, before the reflex was regained. These data indicate that in the pentobarbital-anaesthetized rat, presence of the paw pinch reflex is not related to the level of depression of electrical activity in the cerebral cortex, and consequently is probably not related to the level of consciousness. Based upon these findings it is concluded that the paw pinch reflex is unreliable as a sole indicator of anaesthetic depth.

Diseases of the larynx.

The procedure for examining the patient with laryngeal disease depends largely upon the degree to which its respiration is impaired. Laryngoscopy and electromyography are the principal diagnostic tools. Common laryngeal diseases, diagnoses, and treatments are discussed.

Otoscopy, rhinoscopy, and bronchoscopy in small animal clinics.

Otoscopy, rhinoscopy, and bronchoscopy are indispensable techniwues in ear, nose, and throat clinics and in diseases of the trachea and the bronchial tree. The quality of the instruments used in these techniques is of primary importance. The endoscopic procedures, the instruments used, and the indications for the examinations are discussed.

Ototoxicity of the antiseptic combination chlorhexidine/cetrimide (Savlon): effects on equilibrium and hearing.

Literature concerning the ototoxicity of the antiseptic combination chlorhexidine/cetrimide (Savlon) is reviewed. The ototoxic effects are illustrated by the results of our own experiments in guinea pigs. The impetus for this article was the observation of vestibular dysfunction in 15 clinical cases (12 dogs and 3 cats), in 8 of which it was confirmed that the ear canal had been rinsed with this drug combination in the presence of a ruptured tympanic membrane.

Functional anatomy and neural regulation of the lower urinary tract in female dogs: a review.

A review of the literature of the functional anatomy and neural regulation of the lower urinary tract is presented. The two main functions of the lower urinary tract are the storage and the periodic elimination of urine. The smooth muscle of the bladder exhibits intermittent contractions as the bladder adapts its capacity to increasing volumes and it exhibits sustained contractions associated with relaxation of the external sphincter to effect micturition. During storage, tension receptors in the bladder wall initiate external sphincter contraction (somatic), internal sphincter contraction (sympathetic), detrusor inhibition, and parasympathetic ganglion inhibition (sympathetic). The storage phase can be switched to the micturition phase either voluntarily or involuntarily. Neuroanatomical and electrophysiological studies reveal that medial and lateral cell groups in the dorsolateral pons may be regarded as micturition and storage control centres, respectively.

Experiences with the silicone T-tube in man and dog.

Silicone T-tubes are particularly useful for long-term stenting of the laryngotracheal airway. Silicone is useful when non-autogenous non-reactive soft material is wanted for use in the human and animal body. Two case reports illustrate the use of the silicone T-tube.