Reovirus-associated meningoencephalomyelitis in baboons.

Baboon orthoreovirus (BRV) is associated with meningoencephalomyelitis (MEM) among captive baboons. Sporadic cases of suspected BRV-induced MEM have been observed at Southwest National Primate Research Center (SNPRC) for the past 20 years but could not be confirmed due to lack of diagnostic assays. An immunohistochemistry (IHC)-based assay using an antibody against BRV fusion-associated small transmembrane protein p15 and a conventional polymerase chain reaction (PCR)-based assay using primers specific for BRV were developed to detect BRV in archived tissues. Sixty-eight cases of suspected BRV-induced MEM from 1989 through 2010 were tested for BRV, alphavirus, and flavivirus by IHC. Fifty-nine of 68 cases (87%) were positive for BRV by immunohistochemistry; 1 tested positive for flavivirus (but was negative for West Nile virus and St Louis encephalitis virus by real-time PCR), and 1 virus isolation (VI) positive control tested negative for BRV. Sixteen cases (9 BRV-negative and 7 BRV-positive cases, by IHC), along with VI-positive and VI-negative controls, were tested by PCR for BRV. Three (of 9) IHC-negative cases tested positive, and 3 (of 7) IHC-positive cases tested negative by PCR for BRV. Both IHC and PCR assays tested 1 VI-positive control as negative (sensitivity: 75%). This study shows that most cases of viral MEM among baboons at SNPRC are associated with BRV infection, and the BRV should be considered a differential diagnosis for nonsuppurative MEM in baboons.

Neurological examination of the cat. How to get started.

PRACTICAL RELEVANCE: Neurological diagnosis in veterinary practice can be very challenging, especially as many animals with neurological signs present as emergencies. Nevertheless, even in the absence of specialist facilities for definitively diagnosing neurological disorders, a great deal of information can be gained with some basic knowledge and a logical stepwise approach. CLINICAL CHALLENGES: A lack of initial consideration as to where exactly the problem might be localised within the nervous system, and what kind of disease processes may be in operation there, is the most common cause of failure in the diagnosis of neurological conditions in cats. Too often, this presents a hurdle that pushes the clinician into neglecting the neurological evaluation in favour of making the best guess at which diagnostic tests may achieve a diagnosis. AUDIENCE: This article is aimed at all first opinion practitioners who see cats as, undoubtedly, whatever the presentation, the approach to a suspected neurological case can be daunting for even the calmest and most patient clinician. It will provide the necessary tools to perform and make the most of the neurological examination of the feline patient.

The wobbly cat. Diagnostic and therapeutic approach to generalised ataxia.

PRACTICAL RELEVANCE: Generalised ataxia is one of the most common neurological presentations identified in cats in practice. The causes can be subdivided into three forms on the basis of the neuroanatomical diagnosis: cerebellar, vestibular and sensory (spinal or general proprioceptive) ataxia. The type of ataxia will determine the diagnostic procedures and select the differential diagnoses, and an accurate neuroanatomical diagnosis is therefore essential. The differential diagnosis list can then be further tailored on the basis of patient signalment, clinical presentation and progression. GLOBAL IMPORTANCE: Irrespective of the world region, most of the causes of generalised ataxia in the cat are similar and many have been identified for a number of years (cerebellar hypoplasia has been recognised since the late 19th century). However, it is the advent of new technology, in particular veterinary access to magnetic resonance imaging, which has resulted in particularly rapid advances in our understanding, investigation and management of these different forms of ataxia. AUDIENCE: This article introduces the classification of patients with ataxia on the basis of their clinical presentation, discusses the common differential diagnoses associated with each form, and briefly reviews the more important diseases from a clinical perspective. It is aimed at all veterinarians who treat cats.

The paralyzed cat. Neuroanatomic diagnosis and specific spinal cord diseases.

PRACTICAL RELEVANCE: Although gait disturbance is one of the most common neurological presentations in feline medicine, the clinical approach to the paralyzed cat can be challenging. After excluding orthopedic and cardiovascular diseases that may mimic a neurological condition, the clinician has to address a long list of different diseases that may affect the spinal cord and produce paresis. CLINICAL CHALLENGES: In many cases a definitive cause of spinal weakness in cats is difficult to prove. Even when treatable diseases are identified, the prognosis is very much dependent on the severity of the clinical signs and their chronicity. This review sets out to describe the specific approach, diagnosis and management of cats with spinal cord disease and to outline the most common diseases responsible. PATIENT GROUP: Patients of either gender and all ages and breeds can be affected by spinal cord disease. EVIDENCE BASE: Many diseases affecting the spinal cord of cats, which include fibrocartilaginous embolic myelopathy, intervertebral disc disease, exogenous spinal cord trauma, spinal cord lymphosarcoma and feline infectious peritonitis, are well described in the literature. Many of these descriptions, however, have been based on case reports or series. While there have been several retrospective studies that describe the characteristics and incidence of these diseases in cats, there are no long term treatment trials or outcome studies to assist with prognostic determinations.

The weak cat. Practical approach and common neurological differentials.

PRACTICAL RELEVANCE: Weakness is recognized somewhat infrequently in cats, but is an important manifestation of neurological disease. The clinician must perform a complete neurological examination to determine the neuroanatomic basis for the weakness. As for all species, the neuroanatomic diagnosis allows the clinician to generate an appropriate differential diagnosis, to design a diagnostic plan, to prognosticate, and ultimately to develop a treatment plan. CLINICAL CHALLENGES: The cause(s) of neurological weakness in the cat may be difficult to determine without access to advanced imaging modalities, cerebrospinal fluid analysis or electrodiagnostics. However, an accurate neuroanatomic diagnosis allows the clinician to pursue preliminary anomalous (vertebral anomalies), metabolic (eg, diabetes mellitus, electrolyte abnormalities) and neoplastic differentials via blood work, vertebral column and thoracic radiography, and abdominal ultrasound. Subsequently, referral to a specialty veterinary hospital may be warranted to pursue advanced neurodiagnostics. AUDIENCE: This review provides a framework for generating a neuroanatomic and differential diagnosis in the weak cat. It also discusses the pathogenesis and clinical signs associated with the most common neurological differentials for feline paresis. As such, it is aimed at both primary health care and specialty veterinarians. PATIENT GROUP: The neurological conditions discussed in this review cause weakness in cats of all age groups.

The seizuring cat. Diagnostic work-up and therapy.

PRACTICAL RELEVANCE: Although seizures occur less commonly in cats compared with dogs, they are one of the most common forms of neurological disease in the feline patient. Cats may experience both focal (partial) and generalized seizures and causes are divided into primary disorders, in which there is no underlying cause (ie, idiopathic epilepsy), and secondary disorders. Cats with secondary seizure disorders have either an underlying structural lesion or metabolic disease. PATIENT GROUP: Seizures affect cats of all ages. Cats with idiopathic epilepsy tend to be younger (approximately 3.5 years) than cats with secondary seizure disorders (approximately 8 years). AUDIENCE: This review of feline seizures is directed at all veterinarians who treat cats, both in an emergency setting as well as in general practice. CLINICAL CHALLENGES: Refractory seizures are often a diagnostic and therapeutic challenge. A systematic approach to the seizuring cat is described, easing the task of diagnosing the cause of the seizures. In addition, novel antiepileptics are discussed, which can be used as add-on drugs in challenging feline seizure cases. EVIDENCE BASE: Compared with the canine counterpart, the literature regarding treatment of feline seizures is less established. Recent clinical trials and studies are focusing on new treatment options for feline seizures. Specifically, these studies, some of which are ongoing, have led to the use of levetiracetam, zonisamide and pregabalin as add-on antiepileptics in cases that are refractory to phenobarbital.

Development of the Finnish neurological function testing battery for dogs and its intra- and inter-rater reliability.

BACKGROUND: The Finnish neurological function testing battery for dogs (FINFUN) was developed to meet the increasing demand for objective outcome measures in veterinary physiotherapy. The testing battery should provide consistent, reproducible results and have established face and content validity. Internal consistency and intra- and inter-rater reliability of the FINFUN were also investigated. RESULTS: The FINFUN comprised 11 tasks: lying, standing up from lying, sitting, standing up from sitting, standing, proprioceptive positioning, starting to walk, walking, trotting, walking turns and walking stairs. A score from 0 to 4, (0: unable to perform task, 4: performing task with normal motor function) was given for each task, the maximum score being 44. Twenty-six dogs were filmed when performing the FINFUN. Seven observers scored the performances from the video recordings. The FINFUN was considered to have appropriate face and content validity based on a pilot study, clinical experience and critical reflection of the development process. Its internal consistency was excellent, with no Cronbach's alpha values below 0.922. The intra-rater reliability for total score of experienced observers was almost perfect: 0.999 (observer 1) and 0.994 (observer 2). The inter-rater reliability for both experienced and novice observers' total scores was also almost perfect (0.919-0.993). Analysis of each individual task showed substantial intra-rater and inter-rater agreement for the tasks "lying" and "sitting". CONCLUSIONS: The FINFUN is an objective, valid and reliable tool with standardized scoring criteria for evaluation of motor function in dogs recovering from spinal cord injury.

The neurologic examination and neurodiagnostic techniques for reptiles.

This article will focus on specifics of performing the neurologic examination and neurodiagnostic testing in reptiles, and how these examinations differ from those performed in more conventional species. Physical examination and history are discussed, as well as invasive and noninvasive testing modalities.

The neurological examination and lesion localization in the companion rabbit (Oryctolagus cuniculus).

Completion of a thorough neurological examination of a rabbit is essential for clinicians to determine the location of a neurological problem. Determination of the location of a lesion (whether solitary or multifocal/diffuse) enables a clinician to list the most likely causes of the problem. This article presents the neurological examination of the rabbit, followed by a practical guide to lesion localization in this species.

Clinical neurology of ferrets.

Neurology represents an important specialty within ferret clinical medicine. Veterinarians should become familiar with the unique anatomic and physiologic differences between ferrets to improve their management of theses cases. In addition, veterinarians should use available diagnostic tests to confirm the presence of neurologic diseases. Recent advances in ferret medicine and veterinary neurology offer new capabilities to investigate and treat neurological disease in ferrets.

The avian neurologic examination and ancillary neurodiagnostic techniques: a review update.

The purpose of this article is to guide the avian clinician in the assessment of neurologic function in birds. Physical and neurologic examinations that evaluate cranial nerves, postural reactions, and spinal reflexes identify neurologic dysfunction and the corresponding anatomic location of the lesion. Ancillary diagnostic tests, such as cerebrospinal fluid analysis, diagnostic imaging, muscle and nerve histology, and electrodiagnostics, are tools to confirm and clarify conclusions from the neurologic examination and to identify the cause of disease. Once the disease location and pathologic process have been identified, appropriate treatment and prognosis may be provided.

Principles of neurological imaging of exotic animal species.

Because the central nervous system (CNS) is encased almost entirely in bone, the means by which the clinician can evaluate it are limited. Additionally, the small size of many exotic companion animals further complicates diagnostic evaluation of the brain and spinal cord. Knowledge of the advantages and limitations of different imaging modalities, along with the neuroanatomical localization and assessment of likely causes of disease, will permit the clinician to choose the most appropriate imaging method for the patient. This article discusses the basic imaging principles of radiology, myelography, CT, and MRI of the nervous system of companion exotic animals to aid exotic animal clinicians in selecting imaging modalities and interpreting the results.

Diagnostic techniques and clinicopathologic findings in ruminant neurologic disease.

In ruminant species, cerebrospinal fluid (CSF) collection and analysis provide rapid (in some situations, instant) information to the veterinary clinician investigating a disease problem in the living animal. CSF analysis is particularly useful with respect to confirming the presence of an inflammatory lesion involving the leptomeninges,such as bacterial meningoencephalitis, and in investigating potential compressive lesions of the spinal cord. When correctly performed under local anesthesia, lumbar CSF collection in ruminants is a safe procedure and there are no harmful sequelae. Familiarity with the technique aids high extradural injection of lidocaine or xylazine, which has many applications in farm practice. There are few indications for cisternal CSF collection in food animals.

[Positron emission tomography: diagnostic imaging on a molecular level]. / Positronen-Emissions-Tomographie: Ein bildgebendes Verfahren auf molekularer Ebene.

In human medicine positron emission tomography (PET) is a modern diagnostic imaging method. In the present paper we outline the physical principles of PET and give an overview over the main clinic fields where PET is being used, such as neurology, cardiology and oncology. Moreover, we present a current project in veterinary medicine (in collaboration with the Paul Scherrer Institute and the University Hospital Zurich), where a hypoxia tracer is applied to dogs and cats suffering from spontaneous tumors. Finally new developments in the field of PET were discussed.

Doenças neurológicas em gatos: 155 casos / Neurological diseases in cats: 155 cases

Foi realizado um estudo epidemiológico retrospectivo de gatos com doenças neurológicas atendidos em um Hospital Veterinário Universitário entre 2001 e 2014. O objetivo foi identificar e caracterizar a idade, o sexo, a raça, as doenças neurológicas e classificá-las de acordo com a região anatômica e o acrônimo DINAMIT-V. Foram observados 155 gatos com doenças neurológicas em 13 anos, sendo o diagnóstico confirmado em 112 gatos (72,2%) e presuntivo em 43 (27,8%). Gatos sem raça definida (77,9%) foram os mais comuns, seguido de gatos da raça persa e siamesa. Os locais mais afetados foram medula espinhal entre T3-L3 (28,4%) e tálamo-córtex (24,5%). A maioria dos gatos (43,9%) foi diagnosticada com doença traumática, principalmente trauma de medula espinhal, seguida de doença inflamatória/infecciosa (33,5%). Pode se concluir que a maior prevalência das doenças neurológicas de gatos envolve a medula espinhal e o tálamo-córtex, sendo as traumáticas as mais frequentes. Os dados obtidos podem auxiliar em futuros estudos sobre a frequência e a distribuição das principais doenças neurológicas em gatos.(AU)

A retrospective epidemiological study on neurological disease of cats was performed using data from cats admitted to a Veterinary Teaching Hospital from 2001 to 2014. The aim the study was to determine the age, sex race, and type of neurological disease affecting cats and identify these diseases according to the anatomical region and disease classes, specified under the acronym DINAMIT-V. One hundred and fifty five cats with neurological disease were observed during 13 years; the diagnosis was confirmed in 112 (72.2%) and was presumptive in 43 (27.8%). Mixed breed cats (77.9%) were the most commonly affected, followed by Persian and Siamese cats. The most affected anatomic sites were segments T3-L3 of the spinal cord (28.4%) and thalamic-cortical area (24.5%). Most cats (43.9%), were diagnosed with trauma, mainly spinal cord trauma, followed by inflammatory/infectious disease (33.5%). It is concluded that the neurological disorders in cats have higher prevalence in the spinal cord and thalamic-cortical areas and that the most frequent class of disease is trauma. Data obtained may assist future studies regarding neurological diseases in cats.(AU)

Potencial evocado visual em cães e ovinos / Visual evoked potential in dogs and sheep

O potencial evocado visual (PEV) é técnica eletrodiagnóstica que permite avaliação das vias visuais. O PEV de 20 cães e 20 ovinos adultos, de ambos os sexos, foram obtidos para estudo normativo. Foram utilizados eletrodos de agulha monopolar posicionados em O1 e O2 (ativos), em Fpz (referência comum) e em Cz (terra). O estímulo foi na forma de flash a 1Hz. Dezessete cães e 17 ovinos foram incluídos no estudo, pois apresentaram potenciais auditivos com boa qualidade técnica. Os resultados da avaliação dos dois olhos foram agrupados, totalizando 34 exames em cada espécie. O achado mais consistente em todos os exames foi uma deflexão eletropositiva, com latência média de 55,4ms em cães (P55) e 63,75ms em ovinos (P63). Outras duas ondas eletronegativas também foram identificadas: N31 e N75 em cães; e N42 e N86 em ovinos. A metodologia utilizada neste estudo permitiu obtenção de potenciais visuais com pequena variabilidade, sendo útil para avaliação de animais com suspeita de alteração nas vias visuais centrais.(AU)

The visual evoked potential (VEP) is an electro-diagnostic technique that allows assessment of visual pathways. The VEP from 20 adult dogs and 20 adult sheep of both gender was obtained for normative study. Monopolar electrode needles were placed in O1 and O2 (active), Fpz (common reference) and Cz (ground). The stimuli were flash at 1Hz. Seventeen dogs and 17 sheep were included in the study because they had auditory potentials with good technical quality. The results from both eyes were grouped, totaling 34 results in each species. The most consistent result in all tests was an electropositive deflection, with a mean latency 55.4ms in dogs (P55) and 63.75ms in sheep (P63). Two negative deflections were also identified: N31 and N75 in dogs, and N42 and N86 in sheep. The methodology used in this study allowed to obtain potential similar to those described in other studies, with little variability, and is useful for evaluation of animals with suspected changes in the central visual pathways.(AU)

Acetone precipitation of the scrapie agent results in successful recovery of PrP(Sc) but decreased infectivity.

Bioassay is considered the most sensitive method for evaluating prion inactivation procedures. Because prions are resistant to methods effective at inactivating conventional microorganisms, prion inactivation research has focused on relatively harsh alternatives, such as concentrated sodium hypochlorite or sodium hydroxide. Often, bioassay for residual infectivity in these studies requires dilution or biochemical alteration of the treated sample in order to maintain subject health and survival. Ideally, prions from treated samples could be sufficiently separated from the inactivating agent without alteration of the sample and with negligible loss of infectivity prior to inoculation into the bioassay host. The current study was designed to evaluate acetone precipitation of the disease-associated form of the prion protein (PrP(Sc)) from brain homogenate derived from mice with the RML (Rocky Mountain Laboratory) strain of scrapie. The ability to recover PrP(Sc) was evaluated by Western blot. Dilutions of acetone-precipitated RML-positive brain homogenate were compared to nonprecipitated RML homogenate, resulting in similar PrP(Sc) detection levels down to 0.025 mg equivalents of brain tissue. The impact of the method on infectivity was investigated by bioassay in intracranially inoculated tga20 mice. Additionally, contributions to infectivity from the pellet and supernatant fractions were investigated. Acetone precipitation resulted in a 1-log10 reduction in infectivity. Infectivity could not be reconstituted by the acetone soluble fraction of the infectious sample or uninfected brain. This study demonstrates that PrP(Sc) can successfully be precipitated out of infected brain homogenate using acetone but that there is a reduction in infectivity attributable to the procedure that would need to be considered when evaluating bioassay results.

Correlating magnetic resonance findings with neuropathology and clinical signs in dogs and cats.

The histologic characteristics that are the basis for diagnosis of central nervous system conditions cannot be visualized directly using magnetic resonance (MR) methods, but clinical diagnosis may be based on the frequency and pattern of MR imaging signs, which represent predominantly the gross morphologic features of lesions. Additional quantitative MR measures of myelination, cell swelling, gliosis, and neuronal loss may also be used for more specific characterization of lesions. These measures include magnetization transfer ratio, apparent diffusion coefficient, and the concentrations or ratios of metabolites identified by spectroscopy. Confidence that an MR abnormality is responsible for the clinical signs depends primarily on the degree of correspondence between the site of the lesion and the neuroanatomical localization.