A retrospective case-control study evaluating systemic blood pressure and heart rate in dogs with brain herniation under general anesthesia.

OBJECTIVE: To examine whether increased systemic arterial blood pressure (ABP) and decreased heart rate (HR) under inhalant anesthesia were suggestive of the Cushing reflex (CR) in dogs with neurological diseases based on magnetic resonance imaging (MRI) findings. STUDY DESIGN: Retrospective case-control study. ANIMALS: A sample of 137 client-owned dogs admitted to two veterinary teaching hospitals for diagnosis and patient care owing to suspected intracranial disease from 2005 to 2020. All dogs underwent general anesthesia for MRI of the brain. METHODS: Based on MRI study reports, dogs were divided into three study groups: group A, dogs with suspected brain herniation; group B, dogs with an abnormal MRI finding but without suspicion of herniation; and group C, dogs with structurally unremarkable brains (control). Initial evaluation by an anesthesiologist resulted in 58 cases selected for further review based on suspicion of having intracranial hypertension, as indicated by ABP and HR changes under anesthesia. Anesthetic records were randomized and independently reviewed by three board-certified anesthesiologists blinded to MRI diagnosis who allocated each dog into one of three groups: 1) likely to have CR; 2) unlikely to have CR; or 3) insufficient data for determination. RESULTS: Of the 58 cases evaluated, nine were considered likely to have CR and 48 were considered unlikely to have CR. In one case, the anesthesiologists were unable to determine whether CR occurred. Of the nine dogs with likely CR, three had an MRI diagnosis of intracranial herniation. The remaining six dogs suspected of CR belonged to the normal brain group. CONCLUSIONS AND CLINICAL RELEVANCE: The ABP and HR changes associated with CR are not reliably associated with brain herniation in dogs undergoing general anesthesia.

DORSAL LAMINECTOMY TO RELIEVE SPINAL CORD COMPRESSION IN A CAPTIVE SYRIAN BEAR (URSUS ARCTOS SYRIACUS).

A 19-yr-old captive male Syrian bear ( Ursus arctos syriacus) presented with a right hind limb lameness that progressed to nonambulatory paraparesis over the course of 2 wk. When night enclosure confinement and a short course of glucocorticoids and antibiotics did not lead to improvement, radiographs were performed, followed by cerebrospinal fluid analysis and myelography, revealing a dynamic spinal cord compression at the level of T2-T3. Dorsal laminectomy of both T2 and T3 was performed to allow decompression. The bear recovered uneventfully with first sign of neurological improvement apparent at 10 days postoperatively. Following 6 mo of rehabilitation the bear was walking and using his hind limbs normally.

Reversible paralysis and loss of deep pain sensation after topical intrathecal morphine administration following durotomy.

OBJECTIVE: To report 2 dogs that developed temporary pelvic limb paralysis with loss of deep pain sensation after topical intrathecal morphine administration during spinal surgery. STUDY DESIGN: Clinical report. ANIMALS: Dogs (n = 2). METHODS: A 5-year-old castrated male French Bulldog with a subarachnoid diverticulum at T9-T10 and a 9.5-year-old castrated male Belgian Shepherd dog with a herniated disc at T12-T13 and intradural component, had Gelfoam soaked with morphine placed over the dura mater defect. RESULTS: Pelvic limb paralysis and loss of deep pain sensation was noticed immediately after recovery from anesthesia. After intravenous naloxone administration, both dogs immediately regained ambulation and normal pain sensation; however the effect was temporary lasting only a few hours. Permanent resolution of clinical signs occurred 24 hours after surgery. CONCLUSIONS: Topical intrathecal morphine administration resulted in temporary pelvic limb paralysis and loss of deep pain sensation. This route of administration should be used cautiously until further determination of the efficacy and adverse effects associated with topical intrathecal morphine administration.

Taenia multiceps brain cyst removal in two wild Nubian ibex (Capra nubianas).

Two wild adult Nubian ibex (Capra nubiana) were captured and admitted to the Hebrew University Veterinary Teaching Hospital with various neurologic signs, including alerted mentation, head tilt, and pathologic nystagmus. The lesion in the central nervous system was localized to the forebrain in one ibex and to the cerebellum of the other. Both ibex's were diagnosed with brain cyst using computed tomography (CT). Craniectomy was performed to remove the cysts, and both animals returned to their natural environment after a rehabilitation period. Parasitologic examination revealed cysts of Taenia multiceps coenurus. This is the first report to describe the neurologic signs, CT findings, surgical procedure, and follow-up postsurgery information in wild Capra nubiana.

Successful treatment of acute respiratory distress syndrome in 2 dogs.

Acute respiratory distress syndrome (ARDS) was diagnosed in 2 dogs with acute dyspnea. Short-term positive pressure ventilation and intense critical and nursing care were provided. Both dogs improved and were discharged. Few reports describe successful recovery from ARDS. Due to advances in positive pressure ventilation and improvement in the supportive care of critically ill veterinary patients, the prognosis for ARDS may improve.

Epidural Fat and Perineural Adipose Tissue Septic Emboli Mimicking Peripheral Nerve Sheath Tumor in a Dog.

Summary. A 9-year-old 35.6 kg (90 lb) female neutered German Shepherd dog was admitted due to progression of tetraparesis. The dog presented pyrexia, mild leukocytosis, and nonambulatory tetraparesis with decreased general proprioception and withdrawal in all the limbs, with the front limbs more severely affected. Magnetic resonance imaging revealed T2-weighted image (WI) hyperintense, contrast-enhancing lesion at the level of the C6-C8 spinal nerves, and epidural fat, suspected to be an infiltrative neoplasm. Medical treatments during hospitalization included glucocorticoids, antibiotics, and supportive care. Euthanasia was elected 4 days later due to financial constraints, despite clinical improvement. Postmortem findings revealed septic emboli (SE) in the epidural fat exiting the canal and following the tract of the spinal nerve roots and nerves. Staphylococcus pseudintermedius was identified as the causative agent. Although the incidence of SE without severe systemic disease is considered low in dogs, it should be considered in the differential diagnosis of focal intraspinal disease.

Relationship between admission vitals and brain herniation in 32 cats: a retrospective study.

OBJECTIVES: The aim of the study was to evaluate whether any admission vitals correlated with the presence of brain herniation diagnosed via MRI in cats presenting with neurologic signs. METHODS: Medical records at two veterinary university referral centers were reviewed to identify cats that underwent brain MRI between 2010 and 2019. A control group of cats with intracranial lesions without concurrent brain herniation was analyzed for comparison. Data relating to signalment, vitals on admission, abnormalities observed on initial neurologic examination, underlying etiology, advanced imaging findings and outcome were reviewed. A Modified Glasgow Coma Scale (MGCS) score was determined retrospectively based on initial neurologic examination. Logistic regressions were performed to investigate the relationship between each risk factor and the odds of brain herniation as diagnosed on MRI. RESULTS: Thirty-two cats with brain herniation and 44 cats with abnormal brain MRI without evidence of herniation (as a control group) based on MRI findings were included. Cats with intracranial neoplasia vs other diagnoses were found to be at increased risk of herniation (odds ratio [OR] 4.8, 95% confidence interval [CI] 1.8-13.8; P = 0.001). The odds of herniation increased with age (OR 1.1, 95% CI 1.01-1.2; P = 0.031). Cats with herniation had a significantly lower level of consciousness in their MGCS score (P <0.0001) than cats without herniation. There was no significant difference in either motor activity or brainstem reflexes between the groups (P >0.05). CONCLUSIONS AND RELEVANCE: Admission heart rate and blood pressure were not associated with brain herniation. Cats with herniation were presented with a significantly lower level of consciousness in their MGCS score; however, this clinical feature cannot be directly attributable to and predictive of herniation. Older cats with intracranial neoplasia are more likely to have brain herniation.

Intermediate syndrome of chlorpyriphos toxicity (Polaris) in a caracal (Caracal caracal).

A 5-yr-old spayed female caracal (Caracal caracal) was presented with complaints of acute onset of mental dullness, ataxia, and ventroflexion of 24-hr duration. The animal's garden territory was sprayed a day earlier with an organophosphate (OP) insecticide (chlorpyriphos-methyl). The caracal was treated for OP toxicosis and mildly improved. It was discharged a day later at the owner's request, although clinical signs did not resolve. During the following week, the caracal was confined to prevent further toxin exposure but did not improve and was presented 8 days later with similar clinical signs. Serum butyril-cholinesterase activity was markedly low. The relatively long interval from OP exposure, along with the duration of clinical signs, suggested an intermediate syndrome of OP toxicity. The caracal was treated symptomatically and progressively improved. It was discharged after 8 days of hospitalization and made full recovery 30 days later. This is the first report of OP toxicity in a caracal, suspected to progress to an intermediate syndrome of OP poisoning.

Resolution of persistent pneumothorax by use of blood pleurodesis in a dog after surgical correction of a diaphragmatic hernia.

CASE DESCRIPTION: A 15-kg (33-lb) pregnant female mixed-breed dog of unknown age was referred because of a 10-day history of difficulty breathing. CLINICAL FINDINGS: Physical examination findings were dyspnea, tachypnea, decreased bronchovesicular sounds (bilateral), muffled heart sounds, and abdominal distention with palpable fetuses. Hematologic abnormalities included anemia, leukocytosis, and thrombocytosis. Abnormalities detected during serum biochemical analysis included decreases in concentrations of albumin, sodium, triglycerides, and total calcium and increases in activities of alkaline phosphatase, alanine aminotransferase, gamma-glutamyltransferase, aspartate aminotransferase, lactate dehydrogenase, and creatine kinase. Thoracic radiography revealed a diaphragmatic hernia with fetuses and a soft tissue or fluid opacity within the thoracic cavity. TREATMENT AND OUTCOME: Exploratory celiotomy, ovariohysterectomy, partial sternotomy, placement of a right-sided thoracostomy tube, and herniorrhaphy were performed. After surgery, pneumothorax developed, and the thoracostomy tube was used to remove pleural effusion and free air. The pneumothorax did not resolve after continuous drainage of the thoracic cavity for 4 days. Autologous blood pleurodesis was performed by infusion of 80 mL (6 mL/kg [2.73 mL/lb]) of whole blood. The pneumothorax resolved immediately after injection of the blood. CONCLUSIONS AND CLINICAL RELEVANCE: Blood pleurodesis was used for resolution of pneumothorax in a dog after correction of a diaphragmatic hernia. Blood pleurodesis may provide a simple, safe, and inexpensive medical treatment for resolution of persistent (duration>5 days) pneumothorax when surgery is not an option.

Use of gas chromatography-mass spectrometry for definitive diagnosis of synthetic cannabinoid toxicity in a dog.

OBJECTIVE: To report the use of gas chromatography-mass spectrometry to confirm a diagnosis of synthetic cannabis toxicosis in a dog and to describe the clinical course of the intoxication. CASE SUMMARY: An 11-year-old neutered female Boxer dog was referred due to acute onset of vomiting, ataxia, dull mentation, and delirium that progressed to generalized seizures, unresponsive to diazepam. Prior to presentation, the dog was found lying down, minimally responsive with vomitus around it. A chewed bag containing dried plant material was found next to the dog. The dog was anesthetized and ventilated with positive pressure for 16 hours, and eventually made a full recovery. Gas chromatography-mass spectrometry analysis of the plant material and a plasma sample from the dog revealed presence of the synthetic cannabinoid N-[(1S)-1-(aminocarbonyl)-2-methylpropyl]-1-(cyclohexylmethyl)-1H-indazole-3-carboxamide, also known as AB-CHMINACA, a relatively new illegal synthetic cannabinoid, known by the local forensic police department as a drug of recreational abuse. NEW OR UNIQUE INFORMATION PROVIDED: Reports of synthetic cannabinoid toxicosis in dogs are scarce and are based on urine test kits for tetrahydrocannabinol that have not been validated in the veterinary literature. This is the first report to describe utilization of gas chromatography-mass spectrometry on canine plasma to reach a definitive diagnosis.

Retrospective evaluation of the use of autologous blood-patch treatment for persistent pneumothorax in 8 dogs (2009-2012).

OBJECTIVE: To describe the clinical course, outcome and success rate of 8 dogs with persistent pneumothorax treated with autologous blood-patch pleurodesis (ABP). DESIGN: Retrospective case series. SETTING: University teaching hospital ANIMALS: Eight client-owned dogs. INTERVENTION: Non-coagulated blood was aseptically collected from the jugular vein and injected immediately into the pleural cavity of dogs with persistent pneumothorax. MEASUREMENTS AND MAIN RESULTS: The procedure was successful in 7 of 8 dogs. The median duration of pneumothorax until the ABP was performed was 4 days (range 2-6 days). Pneumothorax resolved immediately after 1 treatment in 4 dogs. Pleurodesis was repeated once in 3 dogs, and twice in 1 case after which it resolved in 3 of the 4 dogs. Out of a total of 13 ABP procedures performed in 8 dogs, 5 (62.5%) were successful after 1 procedure and the success rate increased to 87.5% after additional procedures. One dog failed ABP and was euthanized 3 days later due to continued deterioration and a hospital acquired pneumonia. Mild to moderate complications occurred in 2 other dogs and resolved in both. CONCLUSIONS: ABP is a simple, inexpensive, and relatively safe procedure which can be considered in dogs with persistent pneumothorax that have failed conservative or surgical management. Infections following ABP were documented in 2 of the 8 dogs and resolved in 1 dog.