Interpretation of cerebrospinal fluid analysis from recumbent cows using different thresholds of red blood cell count.

BACKGROUND: Hemodilution of the cerebrospinal fluid (CSF) could confound interpretation of results. Accurately predicting total nucleated cells count (TNCC) and total protein concentration (TPC) attributable to hemodilution is difficult. OBJECTIVE: To determine the effects of hemodilution on TPC and TNCC in bovine CSF. METHODS: Retrospective review of CSF analysis results of downer dairy cows treated at Centre hospitalier universitaire vétérinaire between January 2006 and December 2014. Descriptive statistics were performed using 3 scenarios. RESULTS: Among the 235 samples included, red blood cell (RBC) count (RBCC) ranged from 0 to 869 220 RBC/µL (median = 6.6), TPC ranged from 0.04 to 6.51 g/L (median = 0.27), and TNCC ranged from 0 to 7500 cell/µL (median = 1.1). Among the 157 samples that had <30 RBC/µL (a threshold used in other species), TPC and TNCC varied between 0.13 and 1.06 g/L (median = 0.27) and between 0 and 31.4 cell/µL (median = 0.6), respectively. Eighty-four samples had TPC <0.25 g/L and TNCC ≤4.5 cell/µL. Among those 84 samples, RBCC varied between 0 and 1290 RBC/µL (median = 4.7). In 20 samples, TNCC was 0 with a variation in RBCC between 0 and 840 RBC/µL (median = 3.9). No strong correlations between RBCC and TNCC and TPC were found. CONCLUSIONS: A cutoff around 200 RBC/µL is proposed as clinically meaninful in bovine CSF. Results between 200 and 1290 RBC/µL are equivocal.

Survival and prognostic indicators in downer dairy cows presented to a referring hospital: A retrospective study (1318 cases).

BACKGROUND: Downer cow syndrome, a common problem in dairy cattle, represents a diagnostic and therapeutic challenge for the attending veterinarian. Identifying prognostic indicators and assessing the odds of survival may improve the accuracy of the clinician's prognosis at the time of diagnosis. OBJECTIVE: To describe a population of downer dairy cows referred to a hospital and investigate predictors of outcome. ANIMALS: Recumbent adult dairy cows (cows unable or unwilling to stand without help) treated at a referral hospital. METHODS: Data at the time of admission were collected from medical records of downer dairy cows treated at the Centre Hospitalier Universitaire Vétérinaire between 1994 and 2016. Simple and multivariable logistic regression analyses were performed to assess the association of predictors with the outcome. RESULTS: Among 1318 cows included, 727 (55%) cows were discharged, and 591 (45%) cows died or were euthanized. Cows with longer time of recumbency before referral (odds ratio [OR] = 3.6), tachycardia (100-120 beats per minute [bpm], OR = 1.93; >120 bpm, OR = 2.92), tachypnea (OR = 1.76), hypothermia (OR = 2.08), anemia (OR = 3.30), neutropenia (OR = 1.7), high aspartate aminotransferase activity (500-1000 U/L, OR = 2.16; >1000 U/L, OR = 6.69), and increased serum creatinine concentration (OR = 1.75) had higher odds of nonsurvival. CONCLUSIONS AND CLINICAL IMPORTANCE: These findings may help the practitioner to consider treatment options and decide if referral is likely beneficial based on the odds of success. Early recognition of low chance of survival may facilitate an early decision for euthanasia.

Survival associated with cerebrospinal fluid analysis in downer adult dairy cows: A retrospective study (2006-2014).

BACKGROUND: Threshold values for total nucleated cell count (TNCC) and protein concentration in cerebrospinal fluid (CSF) of downer dairy cows suggestive of a spinal cord lesion were recently published. OBJECTIVES: Determine short- and long-term survival of downer cows that underwent CSF analysis using the reported threshold values. Evaluate the prognostic value of these threshold values to predict short- and long-term survival. ANIMALS: Two hundred and fourteen downer adult dairy cows that underwent CSF analysis during hospitalization at the Centre Hospitalier Universitaire Vétérinaire (CHUV) of the Université de Montréal. METHODS: Retrospective study. Medical records of downer adult dairy cows presented to the hospital between January 2006 and October 2014 for which CSF analysis results were available were studied. Short-term (discharge from hospital) and long-term (completion of lactation) survival were determined and compared in accordance with CSF TNCC and protein concentration, using a Chi-square test. RESULTS: Cows with CSF TNCC and/or protein concentration above the threshold values had a significantly lower short-term survival rate (P = .02). The odds of nonsurvival of cows with one or both CSF values above the threshold values was 2.16 times higher than the odds for cows with values under the threshold values. CSF TNCC >4.5 cells/µL had sensitivity and specificity of 17.3% (95% CI: 10.7%-25.7%) and 92.3% (95% CI: 85.4%-96.6%), respectively, for predicting short-term nonsurvival. CSF protein concentration >0.39 g/L had sensitivity and specificity of 20.9% (95% CI: 13.7%-29.7%) and 91.4% (95% CI: 84.2%-96.0%), respectively. CONCLUSIONS: CSF analysis above threshold values used in this study is associated with increased odds of short-term nonsurvival.