ABSTRACT
Two dogs developed delayed neurological deterioration after rapid correction of severe hyponatremia. Sequential magnetic resonance imaging showed the development of lesions in the thalamus. One dog was necropsied, and the lesions were characterized by myelinolysis with sparing of axons and neurons. The second dog gradually recovered with no detectable neurological deficits. The syndrome seems analogous to central pontine myelinolysis in human beings. Guidelines for correction of hyponatremia to prevent development of myelinolysis are given.
Subject(s)
Dog Diseases , Hyponatremia/veterinary , Myelinolysis, Central Pontine/veterinary , Sodium Chloride/administration & dosage , Animals , Dog Diseases/diagnostic imaging , Dog Diseases/drug therapy , Dogs , Female , Hyponatremia/complications , Hyponatremia/diagnostic imaging , Hyponatremia/drug therapy , Male , Myelinolysis, Central Pontine/diagnostic imaging , Myelinolysis, Central Pontine/drug therapy , Myelinolysis, Central Pontine/etiology , RadiographyABSTRACT
After treatment for hypoadrenocorticism, an 18-month-old dog exhibited marked ataxia and intermittent muscle tremors, progressing to head pressing, dysphagia, and quadraparesis. Serum sodium increased by 38.9 mmol in 48 hours, suggesting myelinolysis. The dog made a complete recovery after intensive treatment.
Subject(s)
Adrenal Insufficiency/veterinary , Dog Diseases/diagnosis , Myelinolysis, Central Pontine/veterinary , Adrenal Insufficiency/complications , Adrenal Insufficiency/diagnosis , Adrenal Insufficiency/drug therapy , Adrenocorticotropic Hormone , Animals , Diagnosis, Differential , Dog Diseases/drug therapy , Dog Diseases/etiology , Dogs , Fludrocortisone/therapeutic use , Glucocorticoids/therapeutic use , Hyponatremia/complications , Hyponatremia/etiology , Hyponatremia/veterinary , Male , Mineralocorticoids/therapeutic use , Myelinolysis, Central Pontine/diagnosis , Myelinolysis, Central Pontine/etiology , Nervous System Diseases/diagnosis , Nervous System Diseases/etiology , Nervous System Diseases/veterinary , Prednisone/therapeutic use , Treatment OutcomeABSTRACT
A dog developed signs of neurological dysfunction five days after rapid correction of severe electrolyte derangements, including hyponatremia, caused by gastrointestinal parasitism (i.e., trichuriasis). History, laboratory findings, and onset of neurological signs following correction of hyponatremia led to a diagnosis of myelinolysis. Myelinolysis is a noninflammatory, demyelinating brain disease caused by sudden, upward osmotic shifts in central nervous system plasma, often a result of rapid correction of chronic hyponatremia. The pathogenesis is complex, but recovery is possible. Iatrogenic damage due to myelinolysis can be avoided by adherence to therapeutic guidelines for correction of chronic hyponatremia.