Late-onset cerebellar abiotrophy in a Labrador Retriever.

CASE REPORT: A 5-year-old female spayed Labrador Retriever was examined for a hindlimb gait abnormality. Initial neurological examination was consistent with vestibular dysfunction. Over the course of 1 year, signs progressed to reflect cerebellar ataxia, vertical nystagmus and delayed postural reactions in all limbs. At the initial examination, subjective evaluation of magnetic resonance imaging scan of the brain was considered normal. Repeat imaging at 1 year after initial examination revealed a reduction in the size of the cerebellum. Retrospectively, the size of the cerebellum on the initial MRI was small when assessed using an objective measurement algorithm. Postmortem histopathological evaluation of the brain showed diffuse degeneration of Purkinje cell neurones with secondary granule cell loss in the cerebellum, in addition to pigment inclusions in brainstem neurones. CONCLUSION: The clinical history and clinicopathological data are consistent with late-onset cerebellar abiotrophy, which has not previously been described in this breed.

Pathology and diagnostic options of lower limb compartment syndrome.

BACKGROUND: The indication of surgical treatment in lower limb compartment syndrome mostly depends on the clinical signs which can be often uncertain, resulting in delayed insufficient intervention. AIM: The aim of the study was to evaluate the progression of compartment syndrome by measuring of intracompartmental pressure and monitoring of decreased tissular oxygenation, indicating an insufficient secondary microcirculation. MATERIALS AND METHODS: 16 patients were examined in our study (12 males, 4 females, mean age: 62.7+/-9.5 years), who underwent acute lower limb revascularization surgery for a critical (lasting more than 4 hours) limb ischemia. The indications were: 5 iliac artery embolizations and 11 femoral artery occlusions. After revascularization, on the second postoperative day, we detected significant lower limb edema and swelling of several grade. To monitor the elevated intracompartmental pressure (ICP) and to evaluate the extremital circulation, we used KODIAG pressure meter and the tissular oxygen saturation (StO2) was measured by near-infrared-spectroscopy. RESULTS: In 12 cases the ICP exceeded the critical 40 mmHg. In these patients the average StO2 was 50-53%, in spite of complete recanalization. In these cases we made urgent, semi-open fasciotomy. In 4 cases, where the clinical aspect showed compartment syndrome, the measured parameters did not indicate a surgical intervention (ICP: 25-35 mmHg, StO2: around normal). SUMMARY: A novel approach in our examination is that, besides empirical therapeutic guidelines generally applied in clinical practice, we established an objective, parameter-based ("evidence based medicine") surgical indication strategy for the lower limb compartment syndrome. Our parameter results produced by the above pressure and saturation measurements help the clinicians to decide between conservative and operative treatment of the disease.