Prevalence, clinical presentation, prognosis, and outcome of 17 dogs with spinal shock and acute thoracolumbar spinal cord disease.

OBJECTIVE: To describe the prevalence, signalment, clinical features, etiology, and outcome in dogs with acute thoracolumbar disease and suspected spinal shock. DESIGN: Retrospective clinical case study (2005-2010). SETTING: Private specialty practice. ANIMALS: Medical records of 263 dogs with thoracolumbar spinal magnetic resonance imaging were reviewed. If decreased or absent withdrawal reflexes were present in 1 or both pelvic limbs, in the absence of a spinal lesion in the lumbosacral intumescence, dogs were diagnosed with spinal shock. Dogs with suspected or confirmed spinal neoplasia, myelomalacia, or meningomyelitis were excluded. Seventeen of 263 dogs (6%) met inclusion criteria. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Thoracic lesions were significantly more likely to result in spinal shock when compared to lumbar lesions (P = 0.03). Fibrocartilaginous embolism was the most commonly diagnosed etiology (7 of 17 dogs), and was more common in the thoracic spine compared to in the lumbar spine (P = 0.10). Six of 17 dogs (35%) were diagnosed with intervertebral disk herniation; 4 of 17 dogs (24%) with suspected acute noncompressive nucleus pulposus extrusion. Two dogs were lost to follow-up. Fourteen of 15 (93%) dogs had improved or normal reflexes by 60 days post injury. CONCLUSIONS: Although the prevalence of spinal shock was low, it should be considered in any dog presenting with an acute history of thoracolumbar spinal injury with reduced or absent reflexes in the pelvic limbs. The presence of spinal shock should not dissuade a veterinarian from pursuing appropriate diagnostic testing and therapy for the underlying etiology.

Efficacy of glucocorticoid monotherapy for treatment of canine meningoencephalomyelitis of unknown etiology: a prospective study in 16 dogs.

Canine non-infectious, inflammatory meningoencephalomyelitis is termed meningoencephalomyelitis of unknown etiology (MUE) and may affect dogs of any age, breed or gender. Treatment with immunosuppressive medication has been widely reported, however no prospective clinical trials with a standard glucocorticoid monotherapy are available. The objectives were to compare the cerebrospinal fluid (CSF) analysis at diagnosis and after treatment with a standard glucocorticoid (GC) dose and to determine the survival time in dogs with MUE. We hypothesized that abnormal CSF findings would normalize in dogs with MUE, and survival time would be longer than previously reported for glucocortocoid therapy alone. Inclusion criteria were: (1) normal minimum database, (2) no GC use within 5 days, (3) magnetic resonance imaging performed, (4) negative infectious disease titres, and (5) abnormal CSF analysis. All dogs received GC therapy at 1 mg/kg per os q 12 h. Responders had normal CSF analysis at 1 month. Sixteen dogs met the inclusion criteria. Median total nucleated cell count (TNCC) and protein concentration at time of diagnosis were 39 cells/µL (0-1400 cells/µL), and 49 mg/dL (25-293 mg/dL), respectively. Median TNCC and protein concentration at 1 month were 1 cell/µL (0-120 cells/µL), and 24 mg/dL (13-175 mg/dL), respectively. Seven of 16 dogs (44%) were responders. There was no significant difference in survival between the CSF responders and CSF non-responders (P = 0.85). Overall median survival was 602 days (45-654 days). This study supports using GC therapy in dogs with MUE.

Evaluation of therapeutic phenobarbital concentrations and application of a classification system for seizures in cats: 30 cases (2004-2013).

OBJECTIVE: To determine the percentage of cats with a phenobarbital (PB) concentration between 15 and 45 µg/mL that had a ≥ 50% reduction in the number of seizures and to investigate applicability of the 2011 International League Against Epilepsy (ILAE) classification system in cats. DESIGN: Retrospective case series. ANIMALS: 30 cats with suspected or confirmed epilepsy. PROCEDURES: Medical records for 2004 to 2013 at 3 veterinary hospitals were searched. Information collected included signalment, duration of observation before treatment, frequency of seizures before PB administration, seizure phenotype, dose of PB, serum PB concentration, number of seizures after PB administration, duration of follow-up monitoring, and survival time. A modified 2011 ILAE classification system was applied to all cats. RESULTS: Seizure control was achieved in 28 of 30 (93%) cats with a serum PB concentration of 15 to 45 µg/mL. This comprised 10 of 11 cats with structural epilepsy, 14 of 15 cats with unknown epilepsy, and 4 of 4 cats with presumptive unknown epilepsy. Thirteen cats had no additional seizures after initiation of PB treatment. CONCLUSIONS AND CLINICAL RELEVANCE: Seizure control was achieved in most cats with a serum PB concentration between 15 and 45 µg/mL, regardless of the cause of the seizures. A modified 2011 ILAE classification was applied to cats with seizures and enabled classification of cats without specific genetic testing and without identified structural or inflammatory disease. This classification system should be incorporated into veterinary neurology nomenclature to standardize communication between veterinarians and improve comparisons among species.

Imaging diagnosis--hyperostosis associated with meningioma in a dog.

A 5-year-old neutered male Beagle mix dog had a 5-day history of generalized tonic-clonic seizures. Before the seizures, the dog had a 1-2-month history of progressive right hemiparesis. In computed tomography images, a presumed extraaxial mass with hyperostosis and destruction of the skull covering the mass were identified. Surgical excision was performed and the histopathologic diagnosis was meningioma. Hyperostosis is frequently associated with feline meningioma, but this report documents that hyperostosis may also occur secondary to meningioma in the dog.