Multiple myeloma and primary erythrocytosis in a dog.

A 13-year-old spayed female mixed breed dog was referred for impaired ambulation, limb tremors, back pain, hypergammaglobulinemia on cellulose acetate electrophoresis, and mild proteinuria. Conventional radiology and magnetic resonance imaging (MRI) suggested multifocal neoplastic bone lesions. At the referral examination, lameness and bright red mucous membranes were observed. Severe erythrocytosis, a monoclonal peak in the ß-2 globulin detected by capillary zone electrophoresis, severe proteinuria, bone marrow infiltration of plasma cells, and low serum erythropoietin concentrations were reported. The final diagnosis was multiple myeloma associated with severe primary erythrocytosis. This presentation in a dog is interesting because the combination of both disorders is rare in humans and has not been reported in dogs. Key clinical message: Although rare, multiple myeloma and primary erythrocytosis can occur together in dogs.

Myélome multiple et érythrocytose primaire chez un chien. Une chienne de race mixte stérilisée âgée de 13 ans a été référée pour troubles de la marche, tremblements des membres, maux de dos, hypergammaglobulinémie à l'électrophorèse sur acétate de cellulose et protéinurie légère. La radiologie conventionnelle et l'imagerie par résonance magnétique (IRM) suggéraient des lésions osseuses néoplasiques multifocales. Lors de l'examen de référence, une boiterie et des muqueuses rouge vif ont été observées. Une érythrocytose sévère, un pic monoclonal de la globuline ß-2 détecté par électrophorèse capillaire, une protéinurie sévère, une infiltration de la moëlle osseuse par des plasmocytes et de faibles concentrations sériques d'érythropoïétine ont été rapportés. Le diagnostic final était un myélome multiple associé à une érythrocytose primaire sévère. Cette présentation chez un chien est intéressante car l'association des deux conditions est rare chez l'homme et n'a pas été rapportée chez le chien.Message clinique clé :Bien que rares, le myélome multiple et l'érythrocytose primaire peuvent survenir simultanément chez le chien.(Traduit par Dr Serge Messier).

Adult autologous mesenchymal stem cells for the treatment of suspected non-infectious inflammatory diseases of the canine central nervous system: safety, feasibility and preliminary clinical findings.

BACKGROUND: Non-infectious inflammatory diseases of the canine central nervous system (CNS) are common idiopathic disorders grouped under the term meningoencephalomyelitis of unknown origin (MUO). Ante mortem diagnosis is achieved via assessment of clinical signs, magnetic resonance imaging (MRI), and cerebrospinal fluid (CSF) analysis, but the definitive diagnosis needs histopathological examination. MUO are mostly considered as autoimmune CNS disorders, so that suppressing the immune reaction is the best management method for patients. Mesenchymal stem cells (MSCs) are under investigation to treat autoimmune and degenerative disorders due to their immunomodulatory and regenerative properties. This study aims to verify the safety, feasibility, and efficacy of MSCs treatment in canine idiopathic autoimmune inflammatory disorders of the CNS. METHODS: Eight dogs presented with acute onset and rapid progression of multifocal neurological signs were selected to the study. In all patients' physical and neurological examinations, MRI and CSF analyses were performed. Clinical diagnosis in all cases was MUO. All selected dogs responded initially to immunosuppressive drugs (prednisone and a combination of prednisolone and cytosine arabinoside) but developed undesirable side effects. For all eight dogs, the owners considered euthanasia but accepted cell therapy as a last possibility. Autologous bone marrow MSCs (BMMSCs), isolated, cultured, and expanded, were administered by intrathecal (IT) injection in the cisterna magna intravenously (IV) and by intra-arterial (IA) injection in the right carotid artery. Adverse effects and clinical response were monitored for 6 months up to 2-year follow-up. RESULTS: The use of autologous BMMSCs in dogs with MUO was safe for IT, IV, and IA injections. No major short- or long-term adverse effects were registered. All the dogs presented early improvement in their general and neurological conditions, with particular effect on cervical pain. The group of dogs treated by IT+IA administration showed a shorter time of reaction to therapy compared to the group treated by IT+IV administration. CONCLUSIONS: MSCs treatment in dogs affected by MOU is safe and feasible. A larger group of dogs is needed to confirm these results as well as CNS histology in order to better understand the underlying mechanisms.

Clinical and diagnostic imaging findings in an Italian wolf (Canis lupus italicus) with discospondylitis.

An adult male Italian wolf (Canis lupus italicus) was presented with an abnormal gait. Neurologic examination showed thoracic kyphosis, paraparesis, decreased proprioception in the pelvic limbs, and normal spinal reflexes. Neurologic symptoms suggested a thoracolumbar spinal cord lesion. Pathologic findings included leukocytosis. Spinal radiographs revealed ventral spondylosis of T4/T5/T6, a poorly defined intervertebral disc space, and mild lysis of the vertebral margins. Multiple metallic foreign bodies were seen in the thoracic wall. Magnetic resonance imaging of the spine detected increased signal intensity on fluid sensitive sequences of the vertebral bodies, the intervertebral disc, and surrounding soft tissues. These findings were interpreted as active discospondylitis at T4/T5. Medical therapy included antibiotic and analgesic treatment as well as movement restriction. Follow-up at 4 wk showed significant clinical and radiologic improvement. Discospondylitis should be included in the differential diagnosis in wolves with paresis.

Suspected neurotoxicity due to Clostridium perfringens type B in a tiger (Panthera tigris).

A 4-yr-old tiger (Panthera tigris) was referred with acute onset of severe abnormal consciousness. Neurological evaluation showed normal palpebral and corneal reflexes, normal pupil diameter with normal direct and consensual papillary light reflex, and absent menace response bilaterally. Diffuse forebrain lesion or focal lesion affecting the ascending reticular activating system was suspected. Complete blood examination and cerebrospinal fluid analysis were normal. Magnetic resonance imaging of the brain showed an empty sella as the only result. Clostridium perfringens 10(4) to 10(7) colony-forming units/g were detected in fecal flora samples. Multiplex polymerase chain reaction assay identified serotype B counts with production of epsilon toxin. This toxin specifically accumulates in the central nervous system, where it causes acute neurological signs in humans, domestic animals, and wildlife. In this communication, the acute onset of neurological signs without evidence of trauma, vascular, metabolic, or inflammatory diseases may be caused by neurotoxicity due to C. perfringens.

Microcystic meningioma of the fourth ventricle in a dog.

A 5-year-old female cross-breed dog was presented with a 1-month history of progressive changes in the posture of the head and in the gait. At neurological examination the dog showed a central vestibular syndrome lateralized to the left. MRI showed a space occupying lesion within the fourth ventricle, characterized by iso- to hypointensity in T1 and hyperintensity in T2 with a heterogeneous contrast uptake. Histologically, a neoplasia composed of meningothelial cells forming compact whorls with slight atypia, and stellate cells delimitating microcysts containing eosinophilic fluid was observed. Neoplastic cells were positive for vimentin and negative for GFAP and FVIII. A diagnosis of intraventricular microcystic meningioma was achieved. Intraventricular meningiomas in dogs are rarely encountered and reports of meningiomas within the fourth ventricle have not yet been described. Although choroid plexus tumor is the most frequent neoplasia localized in the fourth ventricle, intraventricular meningioma should be included in the differential diagnoses.

Fibromatosis in a young Bernese Mountain Dog: clinical, imaging, and histopathological findings.

A young, intact, male Bernese Mountain Dog was presented to the animal hospital for lameness and diffuse thickening of the soft tissue in the right hind limb. Magnetic resonance imaging revealed multiple, multilobular, space-occupying lesions within and between the muscles of the right femur. Biopsies taken from the lesions revealed an infiltrative mass composed mainly of collagen fibers and a low density of benign-appearing fibroblasts. These findings were compatible with a diagnosis of a fibromatosis. Taking the age of onset into account, infantile fibromatosis was most likely. A deep fibromatosis, similar to that seen in adults, could not be excluded based on histology.

Modified temporal approach for a rostro-temporal basal meningioma in a cat.

An 11-year-old neutered female domestic shorthair indoor cat was presented to our hospital for treatment of a left-sided rostro-temporal basal meningioma. Focal seizures in the facial muscles had been observed sporadically for 1 year. Two weeks prior to presentation the cat had developed generalised seizures and was treated with symptomatic anticonvulsive treatment. Focal facial seizures, especially on the right side, persisted after medical therapy. From the computed tomography scan, a basal meningioma was suspected by the treating veterinarian. A left-sided suprazygomatical temporobasal approach to the zygomatic arch was chosen because it causes less soft tissue damage. After craniotomy, durotomy and gentle dorsal retraction of the left piriform lobe, the meningioma was removed. Postoperative magnetic resonance imaging confirmed complete excision of the tumour. One day after surgery the cat was alert and a left-sided facial nerve palsy was noticed. Otherwise the neurological examination was normal. Anticonvulsive and eye moistening therapy was continued for 3 months. Six months after surgery the cat was clinically normal without any recurrence of seizures.

Laser-Doppler measurements of spinal cord blood flow changes during hemilaminectomy in chondrodystrophic dogs with disk extrusion.

OBJECTIVES: (1) To assess spinal cord blood flow (SCBF) during surgical treatment of disk extrusion in dogs and (2) to investigate associations between SCBF, clinical signs, presurgical MRI images, and 24-hour surgical outcome. STUDY DESIGN: Cohort study. ANIMALS: Chondrodystrophic dogs with thoracolumbar disk extrusion (n=12). METHODS: Diagnosis was based on clinical signs and MRI findings, and confirmed at surgery. Regional SCBF was measured intraoperatively by laser-Doppler flowmetry before, immediately after surgical spinal cord decompression, and after 15 minutes of lavaging the lesion. Care was taken to ensure a standardized surgical procedure to minimize factors that could influence measurement readings. RESULTS: A significant increase in intraoperative SCBF was found in all dogs (Wilcoxon's signed-rank test; P=.05) immediately after spinal cord decompression and after 15 minutes. Changes in SCBF were not associated with duration of clinical signs; initial or 24-hour neurologic status; or degree of spinal cord compression assessed by MRI. CONCLUSION: SCBF increases immediately after spinal cord decompression in dogs with disk herniation; however, increased SCBF was not associated with a diminished 24-hour neurologic status. CLINICAL RELEVANCE: An increase in SCBF does not appear to be either associated with the degree of spinal cord compression or of a magnitude sufficient to outweigh the benefit of surgical decompression by resulting in clinically relevant changes in 24-hour outcome.

Accuracy of the withdrawal reflex for localization of the site of cervical disk herniation in dogs: 35 cases (2004-2007).

OBJECTIVE: To evaluate the accuracy of neurologic examination versus magnetic resonance imaging (MRI) in localization of cervical disk herniation and evaluate the usefulness of withdrawal reflex testing in dogs. DESIGN: Retrospective case series. ANIMALS: 35 client-owned dogs with a single-level cervical disk herniation as determined via MRI. PROCEDURES: 1 of 2 board-certified neurologists performed a complete neurologic examination in each dog. Clinical signs of a cervical lesion included evidence of neck pain and tetraparesis. The withdrawal reflex was used for neuroanatomic localization (C1-C5 or C6-T2). Agreement between results of neurologic and MRI examinations was determined. RESULTS: Agreement between neurologic and MRI diagnoses was 65.8%. In 11 dogs in which the lesion was clinically localized to the C6-T2 segment on the basis of a decreased withdrawal reflex in the forelimbs, MRI revealed an isolated C1-C5 disk lesion. In 1 dog, in which the lesion was suspected to be at the C1-C5 level, MRI revealed a C6-T2 lesion. Cranial cervical lesions were significantly associated with an incorrect neurologic diagnosis regarding site of the lesion. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that the withdrawal reflex in dogs with cervical disk herniation is not reliable for determining the affected site and that a decreased withdrawal reflex does not always indicate a lesion from C6 to T2.

Ventral intraspinal cysts associated with the intervertebral disc: magnetic resonance imaging observations in seven dogs.

OBJECTIVE: To report clinical and diagnostic imaging features, and outcome after surgical treatment of ventral intraspinal cysts in dogs. STUDY DESIGN: Retrospective study. ANIMALS: Dogs (n=7) with ventral intraspinal cysts. METHODS: Clinical signs, magnetic resonance imaging (MRI) findings and surgical findings of 7 dogs and histologic findings (1 dog) with intraspinal cysts associated with the intervertebral disc were reviewed. RESULTS: Ventral intraspinal cyst is characterized by: (1) clinical signs indistinguishable from those of typical disc herniation; (2) an extradural, round to oval, mass lesion with low T1 and high T2 signal intensity on MRI, compatible with a liquid-containing cyst; (3) cyst is in close proximity to the intervertebral disc; and (4) MRI signs of disc degeneration. Although the exact cause is unknown, underlying minor disc injury may predispose to cyst formation. CONCLUSION: Intraspinal cysts have clinical signs identical to those of disc herniation. Given the close proximity of the cyst to the corresponding disc and the similarity of MRI findings to discal cysts in humans, we propose the term "canine discal cyst" to describe this observation. CLINICAL RELEVANCE: Discal cysts should be considered in the differential choices for cystic extradural compressing lesions.