Phenobarbital or potassium bromide as an add-on antiepileptic drug for the management of canine idiopathic epilepsy refractory to imepitoin.

Imepitoin has recently been approved in Europe for the management of dogs with idiopathic epilepsy. Currently, there is no evidence-based information available on the efficacy of antiepileptic drugs used as additions to the therapeutic regimen in dogs with idiopathic epilepsy that are not well controlled with imepitoin. The goal of this study was to evaluate the efficacy of phenobarbital or potassium bromide (KBr) as add-on antiepileptic drugs for controlling dogs refractory to a maximum dose of imepitoin (30 mg/kg twice daily). The study was performed as a prospective, randomised, controlled clinical trial. The efficacy of phenobarbital and KBr was evaluated by comparing monthly seizure frequency (MSF), monthly seizure day frequency (MSDF), the presence of cluster seizures during a retrospective 2-month period with a prospective follow-up of 6 months, and the overall responder rate. Twenty-seven dogs were included in the study, 14 dogs in the phenobarbital group and 13 dogs in the KBr group. Both median MSF and MSDF decreased in the phenobarbital group (both P = 0.001) and in the KBr group (P = 0.004 and P = 0.003, respectively). Overall, the number of dogs with cluster seizures decreased (P = 0.0005). The responder rate was 79% vs. 69% in the phenobarbital and KBr groups, respectively. We conclude that phenobarbital or KBr add-on treatment decreases median MSF and MSDF in epileptic dogs refractory to a maximum dose of imepitoin. Combination therapy was generally well tolerated and resulted in an improvement in seizure management in the majority of the dogs.

Evaluation of the effect of oral omeprazole on canine cerebrospinal fluid production: A pilot study.

Administration of omeprazole by ventriculo-cisternal perfusion or intravenously has been shown to decrease cerebrospinal fluid (CSF) production in dogs and rabbits. Oral omeprazole has consequently been recommended to reduce CSF production in dogs with conditions in which clinical signs may be attributable to an accumulation of CSF in the central nervous system (e.g. hydrocephalus, syringomyelia). The albumin quotient (QAlb), the ratio between CSF and serum albumin concentration, has been proposed as a reliable means to evaluate CSF production; decreasing CSF production should cause an increase in QAlb. The aims of this study were to assess the effect of oral administration of omeprazole on QAlb in dogs and to compare two methods to assess CSF albumin concentration. Fifteen healthy Beagle dogs received omeprazole (1.2 mg/kg/day) orally for 14 days; CSF and blood were obtained before and after treatment. CSF albumin concentrations were evaluated by nephelometry and high-resolution protein electrophoresis. Regardless of the method used for measuring albumin, QAlb did not change significantly following oral omeprazole administration, suggesting that CSF production in healthy dogs may not be affected by chronic oral therapy with omeprazole.

Diffuse idiopathic skeletal hyperostosis of the spine in a nine-year-old cat.

A nine-year-old intact female domestic shorthair cat was evaluated for paraparesis, ataxia and severe spinal hyperaesthesia. Neurological examination indicated a T3-L3 spinal cord segment lesion. Computed tomography of the thoracolumbar and lumbosacral vertebral column was performed. This showed contiguous smooth new bone formation ventral and lateral to the vertebrae extending from the cranial thoracic area to the lumbosacral junction and appearing similar to canine diffuse idiopathic skeletal hyperostosis. There was also marked dorsolateral stenosis of the vertebral canal at the level of T4-T5 because of degenerative changes of the facet joints. To the authors' knowledge, this is the first published report of feline diffuse idiopathic skeletal hyperostosis.

Recording of cord dorsum potentials in calves.

Cord dorsum potentials are sensory evoked potentials being used to assess proximal sensory nerve, dorsal nerve root and spinal cord dorsal horn function. The purpose of the present study was to establish normal values for onset latency, peak latency and peak-to-peak amplitude of cord dorsum potentials after saphenous nerve stimulation in 15 healthy calves. Under general anesthesia, the saphenous nerve was stimulated in the periphery and cord dorsum potentials were recorded from the interarcuate space L3-L4, L4-L5, L5-L6 and L6-S1. Cord dorsum potentials were easily recorded at the different recording sites and consisted of a large negative peak followed by a long latency positive phase. The largest responses were recorded at the L5-L6 interarcuate space. Body temperature significantly influenced peak-to-peak amplitude. Onset latency prolonged with increasing limb length.

Bilateral obturator neuropathy caused by an intrapelvic fibrosarcoma with myofibroblastic features in a dog.

A nine-year-old female Rottweiler presented with a 6-week history of progressive impairment of hindlimb adduction. Clinical examination showed abduction of both hind legs when walking on a smooth surface, pain at the medial surface of the left thigh, and an intrarectal palpable mass at the pelvic floor. Electromyography demonstrated fibrillation potentials in the adductor muscles on both sides. Pelvic radiographs showed severe osteolysis of the ischium. Gross post-mortem examination following euthanasia disclosed a large retroperitoneal mass, invading the obturator foramina and compressing both obturator nerves. Histopathological examination revealed a high-grade anaplastic sarcoma. Immunohistochemically, the tumour cells labelled positively for vimentin and alpha-smooth muscle actin, hence the tumour was considered a "myofibroblastic fibrosarcoma". This unique case report describes a novel cause of obturator neuropathy in veterinary medicine. To date, clinical descriptions of obturator nerve lesions have been limited to pelvic fractures in small animals and following difficult labour in large animals.

Clinical and electrophysiological characterization of myokymia and neuromyotonia in Jack Russell Terriers.

BACKGROUND: Generalized myokymia and neuromyotonia (M/NM) in Jack Russell Terriers (JRTs) is related to peripheral nerve hyperexcitability syndrome in humans, a symptom complex resulting from diverse etiologies. OBJECTIVE: Clinical and electrodiagnostic evaluation is used to narrow the list of possible etiological diagnoses in JRTs with M/NM. ANIMALS: Nine healthy JRTs and 8 affected JRTs. METHODS: A prospective study was conducted comparing clinical and electrophysiological characteristics in 8 JRTs affected by M/NM with 9 healthy JRT controls. RESULTS: All affected dogs except 1 had clinical signs typical of hereditary ataxia (HA). In 6 dogs, neuromyotonic discharges were recorded during electromyogram. Motor nerve conduction studies showed an axonal neuropathy in only 1 affected dog. Compared with controls, brainstem auditory-evoked potentials (BAEP) showed prolonged latencies (P<.05) accompanied by the disappearance of wave components in 3 dogs. Onset latencies of tibial sensory-evoked potentials (SEP) recorded at the lumbar intervertebral level were delayed in the affected group (P<.001). The BAEP and SEP results of the only neuromyotonic dog without ataxia were normal. CONCLUSIONS AND CLINICAL IMPORTANCE: The BAEP and spinal SEP abnormalities observed in JRTs with M/NM were associated with the presence of HA. Therefore, these electrophysiological findings presumably arise from the neurodegenerative changes characterizing HA and do not directly elucidate the pathogenesis of M/NM. An underlying neuronal ion channel dysfunction is thought to be the cause of M/NM in JRTs.

Muscle potentials evoked by magnetic stimulation of the sciatic nerve in unilateral sciatic nerve dysfunction.

Magnetic stimulation of the sciatic nerve and subsequent recording of the muscle-evoked potential (MEP) was performed in eight dogs and three cats with unilateral sciatic nerve dysfunction. Localisation of the lesion in the sciatic nerve was based on the history, clinical neurological examination and on results of electromyography examination. Aetiology of the sciatic nerve lesion was diverse. A significant difference was found in MEP between the normal and the affected limbs. In addition, absence of conscious pain sensation, absence of voluntary motor function and a poor outcome seemed associated with the inability to evoke an MEP in the affected limb.

Inspiratory stridor secondary to palatolingual myokymia in a Maltese dog.

A nine-year-old male Maltese dog was presented with an eight-month history of inspiratory stridor leading to exertional dyspnoea and cyanosis. Myokymic contractions in the palatolingual muscles were noticed and confirmed by electromyography. Brain computer tomography-scan showed ventricular dilatation. Cerebrospinal fluid analysis revealed a slightly elevated protein level. Treatment with slow-release phenytoin was unsuccessful and symptoms gradually worsened over the next nine months. At post-mortem examination a small pituitary adenoma was found. Apart from a single canine report of facial myokymia, this is the only other description of spontaneous focal myokymia in animals. Palatolingual myokymia has only been reported in one human being. Although the co-occurrence with a pituitary adenoma might be incidental, a paraneoplastic pathogenetic mechanism is proposed. Its unique clinical presentation adds a new, albeit uncommon, syndrome to the differential diagnosis of upper airway complaints in dogs.

Clinical evaluation of 51 dogs treated conservatively for disc-associated wobbler syndrome.

OBJECTIVES: To evaluate the clinical evolution and potential risk factors of 51 dogs treated conservatively for disc-associated wobbler syndrome. METHODS: Medical records of dogs treated conservatively for disc-associated wobbler syndrome were reviewed, and owners were contacted regarding clinical evolution and survival of their animals. Relationships between age, treatment before diagnosis, type of neurological signs, results of medical imaging and outcome were determined. RESULTS: Fifty-one dogs underwent conservative treatment for disc-associated wobbler syndrome. A successful outcome was achieved in 45 per cent (23 of 51) of the patients. Median follow-up period was 18.5 months, and median survival time was 47 months. In 85 per cent of the dogs in which euthanasia was performed because of disc-associated wobbler syndrome, this was carried out in the first year after diagnosis. Outcome score was influenced by type of neurological signs and additional radiographic and/or myelographic abnormalities. Outcome score was not significantly associated with age, number of protruded intervertebral discs, occurrence, type and results of treatment before diagnosis. CLINICAL SIGNIFICANCE: Conservative treatment of disc-associated wobbler syndrome is associated with a guarded prognosis. It can be considered in cases where all four limbs are not affected and no additional radiographic and/or myelographic abnormalities are detected.

Hemifacial spasm associated with an intracranial mass in two dogs.

Two dogs were presented with hemifacial spasm. Computed tomography images of both the dogs revealed an intracranial mass. In the first dog, a lesion at the level of the medulla oblongata was thought to cause primary irritation of the facial nucleus, with consequently permanent contraction of the ipsilateral facial muscles. In the second dog, a mass seemingly arising from the middle cranial fossa presumably isolated the facial motor neurons from upper motor neuron control, which resulted in hemifacial spasm as a result of loss of inhibitory interneuronal activity.