Development of a reliable clinical assessment tool for meningoencephalitis in dogs: The neurodisability scale.

BACKGROUND: Meningoencephalitis of unknown origin (MUO) comprises a group of debilitating inflammatory diseases affecting the central nervous system of dogs. Currently, no validated clinical scale is available for the objective assessment of MUO severity. OBJECTIVES: Design a neurodisability scale (NDS) to grade clinical severity and determine its reliability and whether or not the score at presentation correlates with outcome. ANIMALS: One hundred dogs with MUO were included for retrospective review and 31 dogs were subsequently enrolled for prospective evaluation. METHODS: Medical records were retrospectively reviewed for 100 dogs diagnosed with MUO to identify the most frequent neurological examination findings. The NDS was designed based on these results and evaluated for prospective and retrospective use in a new population of MUO patients (n = 31) by different groups of independent blinded assessors, including calculation of interobserver agreement and association with outcome. RESULTS: The most common clinical signs in MUO patients were used to inform categories for scoring in the NDS: seizure activity, ambulatory status, posture and cerebral, cerebellar, brainstem, and visual functions. The intraclass correlation coefficient (ICC) for prospective use of the NDS was 0.83 (95% confidence interval [CI], 0.68-0.91) indicating good agreement, and moderate agreement was found between prospective and retrospective assessors (ICC, 0.71; 95% CI, 0.56-0.83). No association was found between NDS score and long-term outcome. CONCLUSIONS AND CLINICAL IMPORTANCE: The NDS is a novel clinical measure for objective assessment of neurological dysfunction and showed good reliability when used prospectively in MUO patients but, in this small population, no association with outcome could be identified.

Complications associated with cerebrospinal fluid collection in dogs.

BACKGROUND: This study aimed to identify complications associated with cerebrospinal fluid (CSF) collection in dogs. METHODS: This was a prospective, observational multicentre study using data collected from 102 dogs undergoing CSF collection for the investigation of neurological disease. CSF was collected from the cerebellomedullary cistern (CMC), lumbar subarachnoid space (LSAS) or both sites. Pre-, intra- and postprocedural data were collected. Descriptive statistics were performed to outline complications associated with CSF collection. RESULTS: CSF sampling was attempted on 108 occasions, and CSF was acquired on 100 occasions (92.6%). Collection from the CMC was more likely to be successful than that from the LSAS. No dogs exhibited neurologic deterioration following CSF collection. There was no significant difference between pre- and post-CSF collection short-form Glasgow composite measure pain scores in ambulatory dogs (p = 0.13). LIMITATIONS: The scarcity of complications limited the ability to quantify the incidence of some potential complications reported elsewhere. CONCLUSIONS: Our results may be used to inform clinicians and owners that CSF sampling is associated with a low frequency of complications when performed by trained personnel.

Idiopathic generalised tremor syndrome in dogs.

BACKGROUND: Idiopathic generalised tremor syndrome (IGTS) causes tremor and often vestibulocerebellar signs. Previous publications on IGTS in dogs are restricted to case reports or lack exclusion of structural causes. METHODS: Medical records of 75 dogs diagnosed with IGTS that had undergone magnetic resonance imaging (MRI) of the brain were collected retrospectively. RESULTS: Crossbreeds were affected most commonly (41.3%), followed by West Highland white terriers (14.7%) and cocker spaniels (10.7%). A higher proportion of females were affected than males (68.0%). Median age of the affected dogs was 17 months (range 6-121 months), and median bodyweight was 9.15 kg (range 2.9-26 kg). All dogs presented with tremors and most experienced concomitant neurological signs (93.3%). Seventeen (22.7%) were hyperthermic and 31 (41.3%) had gastrointestinal signs. MRI of the brain was normal in most of the cases, and cerebrospinal fluid analysis frequently revealed mild pleocytosis. All animals were treated with prednisolone, and 39 (51.3%) also received diazepam. Median follow-up time was 13 months (range 0-134 months). The overall outcome was good, although 16 (21.3%) patients were reported to have relapsing clinical signs and 10 (13.2%) patients experienced persistent mild clinical signs. CONCLUSIONS: IGTS should be suspected in any dog with generalised tremor and vestibulocerebellar signs with younger and smaller dogs more commonly affected.

Epidemiology of recurrent seizure disorders and epilepsy in cats under primary veterinary care in the United Kingdom.

BACKGROUND: Little epidemiological evaluation of recurrent seizure disorders in cats currently exists in veterinary literature. OBJECTIVES: To report the prevalence and risk factors for recurrent seizure disorders (RSD) and epilepsy in cats presented to primary care veterinary practices in the United Kingdom (UK). ANIMALS: A total of 285 547 cats under veterinary care during 2013 presenting to 282 primary care clinics in the UK. METHODS: Cohort study using multivariable logistic regression modeling for risk factor analysis. RESULTS: There were 458 confirmed RSD cases, giving a 1-year period prevalence of 0.16% (95% confidence interval [CI], 0.15-0.18). A subset of 114 (24.89%) cases was recorded as having epilepsy, giving a 1-year period prevalence of 0.04% (95% CI, 0.03-0.5). Increasing age was significantly associated with increasing odds of RSD. Breed, sex, neuter status, and body weight were not associated with RSD. Epilepsy was most frequently diagnosed in adult to middle-aged cats. Cats aged 3.0 to <6.0 years had 3.32 times higher odds of epilepsy diagnosis compared to cats <3.0 years of age. Insured cats were more likely to be diagnosed with epilepsy compared to noninsured cats. CONCLUSIONS AND CLINICAL IMPORTANCE: Although less common than in dogs, RSD and epilepsy still comprise an important disorder group in the UK cat population. Aging is a significant risk factor for these disorders in cats.