Magnetic resonance imaging and histological classification of intracranial meningiomas in 112 dogs.

BACKGROUND: Intracranial meningiomas are the most common primary brain tumors in dogs. Classification of meningiomas by tumor grade and subtype has not been reported, and the value of magnetic resonance imaging (MRI) characteristics for predicting tumor subtype and grade has not been investigated. HYPOTHESIS: Canine intracranial meningiomas are a heterogenous group of tumors with differing histological subtypes and grades. Prediction of histopathological classification is possible based on MRI characteristics. ANIMALS: One hundred and twelve dogs with a histological diagnosis of intracranial meningioma. METHODS: Retrospective observational study. RESULTS: Meningiomas were overrepresented in the Golden Retriever and Boxer breeds with no sex predilection. The incidence of specific tumor grades was 56% benign (Grade I), 43% atypical (Grade II), and 1% malignant (Grade III). Grade I histological subtypes included meningothelial (43%), transitional (40%), microcystic (8%), psammomatous (6%), and angiomatous (3%). No statistically significant (P < .05) associations were found among tumor subtype or grade and any of the MRI features studied. CONCLUSIONS AND CLINICAL IMPORTANCE: Meningiomas in dogs differ from their counterparts in humans mainly in their higher incidence of atypical (Grade II) tumors observed. MRI characteristics do not allow for prediction of meningioma subtype or grade, emphasizing the necessity of histopathology for antemortem diagnosis. The higher incidence of atypical tumors in dogs may contribute to the poorer therapeutic response in dogs with meningiomas as compared with the response in humans with meningiomas.

Intracranial pressure and cerebral perfusion pressure in clinically normal equine neonates.

Intracranial pressure (ICP) and cerebral perfusion pressure (CPP) were determined in 8 clinically normal neonatal foals. After the foals oriented themselves and nursed the mares, they were sedated as necessary, and local anesthesia was provided for making the skin incisions. Using a technique similar to that used in human beings, an indwelling subdural catheter was placed to measure ICP. Carotid artery catheterization was used to measure arterial blood pressure. Cerebral perfusion pressure was calculated as the difference between mean arterial blood pressure and ICP. Intracranial pressure and CPP readings were taken twice during each 24-hour period, starting at 6 hours of age and continuing through 72 hours of age. Mean (+/- SD) ICP were 5.83 +/- 1.82, 8.81 +/- 2.06, and 9.55 +/- 1.55 mm of Hg (range, 2 to 15 mm of Hg), and mean CPP were 80.19 +/- 10.34, 75.30 +/- 10.86, and 76.80 +/- 12.59 mm of Hg (range, 50 to 109 mm of Hg) for each of the first three 24-hour periods after birth, respectively. All 8 foals had physical and neurologic examinations, CSF analysis, and computerized axial tomography evaluations. The foals manifested normal behavior during the interval of measurements, and adverse effects of the procedure were not detected during the monitoring period. Establishment of normal values for ICP and CPP are important to clinicians who have the opportunity to apply this technique for monitoring and evaluating neonatal foals with signs of CNS dysfunction.

Laryngeal and pharyngeal dysfunction in horses homozygous for hyperkalemic periodic paralysis.

OBJECTIVE: Evaluate histories, clinical signs, and laboratory data of 69 horses homozygous by DNA testing for hyperkalemic periodic paralysis (HPP). DESIGN: Cohort study. SAMPLE POPULATION: 69 of 189 horses testing homozygous for HPP between October 1992 and November 1994. PROCEDURE: Questionnaires addressing signalment, training regimes, medical history, and current status of affected horses were sent to owners, trainers, or attending veterinarians. Data from completed questionnaires were tabulated and evaluated, using descriptive statistics. RESULTS: Sixty-nine (37%) of 189 questionnaires were completed and returned. Clinical episodes of muscle weakness or paralysis varied in severity and frequency from mild muscle fasciculations to recumbency and death. Sixty-three of 68 HPP-affected horses were reported to have had stridor associated with exercise, excitement, stress, or episodes of muscle paralysis. Common endoscopic findings in affected horses included pharyngeal collapse, pharyngeal edema, laryngopalatal dislocation, and laryngeal paralysis. Twelve of 27 horses receiving acetazolamide had decreases in stridor while receiving medication. CLINICAL IMPLICATIONS: Most horses testing homozygous for HPP had clinical signs associated with pharyngeal and laryngeal dysfunction. Hyperkalemic periodic paralysis should be included on a differential list for horses examined for signs of laryngeal or pharyngeal dysfunction or stridor. Treatment with acetazolamide may help to control respiratory tract signs associated with this disease.

Spinal epidural empyema in two dogs.

Extensive, diffuse, epidural spinal cord compression was visualized myelographically in two dogs presented for rapid development of nonambulatory tetraparesis and paraplegia, respectively. Purulent fluid containing bacterial organisms was aspirated percutaneously under fluoroscopic guidance from the epidural space of each dog. One dog responded poorly to aggressive medical therapy, which included installation of an epidural lavage and drainage system. Both dogs were euthanized due to the severe nature of their disorder and the poor prognosis. Spinal epidural empyema (i.e., abscess) is a rare condition in humans and has not been reported previously in the veterinary literature. Spinal epidural empyema should be considered as a differential diagnosis in dogs presenting with painful myelopathies, especially when accompanied by fever.

Intravascular malignant T-cell lymphoma (malignant angioendotheliomatosis) in a cat.

A 7-year-old spayed female Siamese cat was presented with a 7-day history of ataxia, circling to the right, and involuntary micturition and defecation. Cerebrospinal fluid analysis showed increased protein content and relative eosinophilia. At necropsy, there was flattening of the cerebral cortical gyri of the right frontal and parietal lobes, and both kidneys had multiple wedge-shaped cortical indentations. Histologically, the cerebral cortex contained several extensive malacic foci, and the kidneys had multifocal parenchymal degeneration and atrophy. There was multifocal partial to complete thrombosis of renal interlobar arteries and of the right middle cerebral artery and meningeal branches; these thrombi contained large anaplastic round cells, which often invaded the arterial wall. Many smaller vessels within the kidneys and brain were occluded with clusters of similar cells, without thrombosis or vascular wall invasion. The neoplastic round cells had immunohistochemical staining properties of T lymphocytes.

Magnetic resonance imaging and computed tomography characteristics of intracranial intra-arachnoid cysts in 6 dogs.

Magnetic resonance imaging (MRI) and computed tomographic imaging (CT) characteristics of intracranial intra-arachnoid cysts in six dogs are described. Of the six dogs, three were less than one year of age and 4 were males. Five of the six dogs weighed less than 11 kg. Five cysts were located in the quadrigeminal cistern. On CT images, the intracranial intra-arachnoid cysts had sharply defined margins, contained fluid isodense to CSF and did not enhance following i.v. administration of contrast. On MRI images, the intracranial intra-arachnoid cysts were extra-axial, contained fluid isointense with CSF and did not enhance following i.v. contrast. While spinal arachnoid cysts of dogs have been reported in the literature, other than the six dogs contained in this report, intracranial intra-arachnoid cysts have not to our knowledge been described in animals. These six dogs have a similar age, sex, history, clinical signs, CT and MRI findings to those reported in people with intracranial intra-arachnoid cysts.

Reversible magnetic resonance imaging abnormalities in dogs following seizures.

Reversible magnetic resonance (MR) imaging lesions have been described in humans following seizures. This condition has not yet been reported in animals. This paper describes reversible abnormalities identified in 3 dogs using MR imaging that was performed initially within 14 days of the last seizure and follow-up imaging that was performed after 10 to 16 weeks of anticonvulsant therapy. All three dogs had lesions in the piriform/temporal lobes, characterized by varying degrees of hyperintensity on T2-weighted images and hypointensity on T1-weighted images. In one dog, contrast enhancement was evident. On reevaluation, partial resolution occurred in all 3 dogs. In a fourth animal with an olfactory meningioma, similar appearing lesions in the temporal cortex and right and left piriform lobes were identified after seizure activity. A surgical biopsy of the temporal cortex and hippocampus was performed and edema, neovascularization, reactive astrocytosis, and acute neuronal necrosis were evident. These histologic findings are similar to those reported in humans with seizures. Recognizing the potential occurrence of reversible abnormalities in MR images is important in developing a diagnostic and therapeutic plan in canine patients with seizures. Repeat imaging after seizure control may help differentiate between seizure-induced changes and primary multifocal parenchymal abnormalities.

Glioblastoma multiforme: clinical findings, magnetic resonance imaging, and pathology in five dogs.

Although glioblastoma multiforme (GBM), a World Health Organization grade IV astrocytoma, is the most common primary brain tumor in humans, in dogs GBM is relatively rare, accounting for only about 5% of all astrocytomas. This study presents combined clinical, neuroimaging, and neuropathologic findings in five dogs with GBM. The five dogs, aged from 5 to 12 years, were presented with progressive neurologic deficits that subsequent clinical neurologic examination and neuroimaging studies by magnetic resonance imaging (MRI), localized to space occupying lesions in the brain. MRI features of the tumors included consistent peritumoral edema (n = 5), sharp borders (n = 4), ring enhancement (n = 3), heterogenous T2-weighted signal intensity (n = 3), iso- to hypointense T1-weighted images (n = 5), necrosis (n = 5), and cyst formation (n = 2). Two tumors were diagnosed clinically using a computed tomography-guided stereotactic biopsy procedure. At necropsy all the tumors resulted in, on transverse sections, a prominent midline shift and had a variegated appearance due to intratumoral necrosis and hemorrhage. Histologically, they had serpentine necrosis with glial cell pseudopalisading and microvascular proliferation, features which distinguish human GBM from grade III astrocytomas. Immunoreactivity of tumor cells for glial fibrillary acidic protein was strongly positive in all cases, whereas 60% and 40% of the tumors also expressed epidermal growth factor receptor and vascular endothelial growth factor, respectively. These canine GBMs shared many diagnostic neuroimaging, gross, microcopic, and immunoreactivity features similar to those of human GBMs.

Neuronal vacuolation and spinocerebellar degeneration in young Rottweiler dogs.

With the recent epizootic of bovine spongiform encephalopathy in Europe, the differential diagnosis of neuronal vacuolation and spongiform change in other species has become critically important. Four Rottweiler puppies of both sexes, presented at 3-8 months of age, had clinical signs of generalized weakness and ataxia that started at 6 weeks of age. In all pups, neurologic examination detected an ataxia and tetraparesis, most severe in the pelvic limbs, and slowed proprioceptive placing reactions. Subsequently, there was rapid progressive neurologic deterioration, with severe placing deficits, knuckling, severe ataxia, and quadraparesis by 8 months of age. At necropsy, no gross lesions were observed. Microscopic lesions were restricted to the nervous system. The major lesion in all dogs was an intracytoplasmic neuronal vacuolation that was most prominent in the cerebellar roof nuclei and in nuclei of the extrapyramidal system. Similar vacuolation was found in neurons in both dorsal nerve root ganglia, myenteric plexus, and other ganglia of the autonomic nervous system. The single or multiple empty vacuoles were between 1 and 45 microm in diameter. A mild spongiform change was seen in the adjacent neuropil. Purkinje cell vacuolation and degeneration with segmental cell loss was seen in the oldest dog. In ventromedial and dorsolateral areas of the spinal cord white matter, there was mild bilaterally symmetrical axonal degeneration. Immunoblotting and immunocytochemical staining of the brain for protease-resistant scrapie prion protein was negative. All forms of vacuoles were negative for immunohistochemical staining with a variety of lectins. Ultrastructurally, the vacuoles were bound by a single membrane and contained granular material and sometimes membranous profiles. There was mild distension of the cytocavitary network but no unequivocal connection with the vacuoles was found. Axosomatic and axodendritic synapses in affected neurons were intact both ultrastructurally and with synaptophysin immunostaining. The clinicopathologic findings were different from those seen in the other neurologic diseases of Rottweilers. The age of the dogs, distribution and type of the lesions, ultrastructural findings, and negative immunoblotting most likely rule out the possibility of a scrapie agent-associated spongiform encephalopathy. However, the etiology of this new disease was not determined.

Modification and application of a Pelorus Mark III stereotactic system for CT-guided brain biopsy in 50 dogs.

The Pelorus Mark III Stereotactic System is a commercially available device for CT-guided stereotactic brain biopsy in people. With relatively minor modifications, this device was used to safely and accurately perform CT-guided stereotactic brain biopsies in 50 dogs with intracranial lesions. Modifications were necessary to accommodate a 90 degree shift in orientation of the canine head compared to the human head during the imaging phase of the procedure, and to facilitate other phases of the biopsy procedure that are affected by the uneven and variable topography of the canine skull. Description of a typical CT-guided brain biopsy procedure in dogs using the modified Pelorus Mark III Stereotactic System is provided. Accuracy of biopsy needle placement was determined by comparing the x, y and z coordinates of the biopsy target site with the actual coordinates of the needle tip on CT images. Mean needle placement error was 3.5 +/- 1.6 mm. Needle placement error was not significantly related to operator experience, dog size (body weight), or needle path length, however, needle placement error was significantly affected by lesion location.

CT-guided brain biopsy using a modified Pelorus Mark III stereotactic system: experience with 50 dogs.

This report describes the results of CT-guided stereotactic brain biopsies performed on 50 consecutive dogs using a modified Pelorus Mark III Stereotactic System. Based on available histopathologic samples (stereotactic biopsy [n = 50], surgery [n = 17], necropsy [n = 9]) the patient population consisted of 34 dogs with primary brain tumors, 2 with invasive nasal adenocarcinomas, and 13 with non-neoplastic brain lesions. Brain tissue was not obtained from one dog. In 22 dogs a final diagnosis was made from tissue subsequently obtained from surgical resection or at necropsy. The final diagnosis was in agreement with the stereotactic biopsy diagnosis in 20 of these 22 dogs. In 17 other dogs without follow-up, stereotactic biopsy provided a diagnosis of a specific primary brain tumor subtype. Postoperative complications associated with the biopsy procedure were assessed in 41 dogs. The other 9 dogs either went directly to surgery (n = 7) or were killed (n = 2) immediately after the biopsy procedure. Thirty-six dogs recovered without apparent clinical complications. Postoperative clinical complications in the remaining 5 dogs included transient epistaxis (1 dog), transient exacerbation of cerebellar signs (1 dog), obtundation progressing to coma (1 dog), and medically uncontrollable seizures (2 dogs). The latter 3 dogs with severe neurologic complications all had large primary brain tumors and had been receiving high doses of phenobarbital and glucocorticoids to control seizures at the time of biopsy. These results suggest that this CT-guided biopsy procedure can provide an accurate pathologic diagnosis of brain lesions detected by CT and MR neuroimaging. Further refinement of both technique and case selection is expected to reduce the rate of clinical complications and to improve the accuracy of the procedure.

Contrast radiographic findings in canine bacterial discospondylitis: a multicenter, retrospective study of 27 cases.

A multicenter, retrospective study was undertaken to evaluate contrast radiographic findings in canine bacterial discospondylitis. Records and myelograms or epidurograms of 27 patients were obtained from five colleges of veterinary medicine. Fifteen cases (56%) were evaluated as having some degree of spinal cord compression. The majority (73.3%) of the cases had only soft tissue as the compressive mass. The median compression for all cases was 5% of the vertebral canal. No difference was noted for compression based on anatomical site (i.e., cervical versus thoracolumbar versus lumbosacral). No significant correlation between degree of lesion compression and clinical outcome was noted, but there was a trend toward increased mortality with greater compression. There was no correlation between the ambulatory status and the ultimate outcome. Three of the 15 (20%) cases showed vertebral subluxation. Results of this study indicate that static spinal cord compression is not a significant component of the neurological dysfunction associated with bacterial discospondylitis. Identification of vertebral subluxation in some patients may indicate a dynamic lesion that should be evaluated with stress radiography.