Case report: Focal heterotopic ossification in paravertebral muscles as a cause of neurogenic lameness in a dog.

This case report describes a 17-month-old Pudelpointer with recurring motor impairment localized to the left thoracic limb. A neurological exam highlighted lameness in that limb, accompanied by pre-scapular swelling. Radiographs and magnetic resonance imaging detected an osseous structure in soft tissues close to the fifth cervical vertebra, and subsequent surgery uncovered adjacent cervical spinal nerve impingement. Histology of the bony structure revealed heterotopic ossification in paravertebral muscles. Mild bone re-formation at the operating site was detected after a 2-year period, but the patient was asymptomatic. This article reports the first case of heterotopic ossification with spinal nerve entrapment in a dog and adds a new differential diagnosis to the causes of neurogenic lameness in dogs.

Accuracy of low-field magnetic resonance imaging for differentiating intervertebral disc extrusions and protrusions at the lumbosacral disc space in dogs.

Introduction/Purpose: MRI features differentiating extrusion from protrusion in thoracolumbar discs have been published, however little specifically evaluates the lumbosacral disc. The high prevalence of degenerative changes in apparently normal animals complicates assessment of this region and features relevant elsewhere in the spine may not apply. The aims of this study were to determine the accuracy of MRI in differentiating IVDE and IVDP at the lumbosacral disc space in dogs and determine which MRI characteristics discriminate between IVDE and IVDP. Method: MRI examinations from dogs with surgically confirmed IVDE or IVDP at the lumbosacral disc space were collected retrospectively (2011-2019). Two radiologists independently recorded a diagnosis of IVDE or IVDP, gave a confidence rating, and evaluated specific MRI features. Univariable statistical analysis was performed to identify which MRI characteristics might help distinguish IVDE from IVDP. Results: 117 dogs with lumbosacral IVDE (n = 16) or IVDP (n = 101) were included. Features associated with IVDE were in concordance with previous studies and included interruption of the dorsal annulus, suspected epidural hemorrhage, dispersed (rather than confined) intervertebral disc herniation on T2W sagittal images, lateralized intervertebral disc herniation and displacement of the cauda equina. Overall diagnostic accuracy was 68.8% and interobserver agreement was fair (κ = 0.37), which is lower than has been reported in thoracolumbar disc herniation, but accuracy increased to 85.3% with substantially improved agreement (κ = 0.87) in "confident" diagnoses. Discussion/Conclusion: MRI characteristics used in differentiating thoracolumbar IVDE and IVDP can be extrapolated to the lumbosacral intervertebral disc space, but diagnostic accuracy in low-field MRI is lower than previously reported in herniations involving the thoracolumbar spine.

A case series of 37 surgically managed, paraplegic, deep pain negative French bulldogs, with thoracolumbar intervertebral disc extrusion, from two English referral centres.

Background: Thoracolumbar intervertebral disc extrusions (TL-IVDEs) are a common spinal disorder in dogs, especially within chondrodystrophic breeds. Loss of deep pain perception is a well-documented negative prognostic indicator in dogs with TL-IVDE. The objectives of this study were to report the rate of return of deep pain perception and independent ambulation in surgically treated, paraplegic, deep pain perception negative French bulldogs with TL-IVDEs. Methods: A retrospective case series of deep pain perception negative dogs with TL-IVDE presenting to two referral centres between 2015 and 2020 was conducted. Medical and MRI records were reviewed, including the following quantitative MRI changes: lesion length, extent of spinal cord swelling and severity of spinal cord compression. Results: Thirty-seven French bulldogs met the inclusion criteria, with 14 of 37 (38%) regaining deep pain perception by the time of discharge (median hospitalisation 10.0 days [interquartile range 7.0-15.5 days]) with two dogs independently ambulatory (6%). Ten of the 37 dogs were euthanased during hospitalisation. Significantly fewer dogs (3/16, 19%) with L4-S3 lesions regained deep pain perception compared to 11 of 21 (52%) of dogs with T3-L3 lesions (p = 0.048). Quantitative MRI changes were not associated with the return of deep pain perception. After discharge, with a median 1-month follow-up period, an additional three dogs regained deep pain perception and five dogs became independently ambulatory (17/37 [46%] and 7/37 [19%], respectively). Conclusions and clinical importance: This study adds support to the contention that the recovery of French bulldogs with TL-IVDE from surgery is poor compared with other breeds; further prospective, breed-controlled studies are indicated.

The Olfactory Bulb in Companion Animals-Anatomy, Physiology, and Clinical Importance.

The Olfactory Bulb is a component of the Olfactory System, in which it plays an essential role as an interface between the peripheral components and the cerebral cortex responsible for olfactory interpretation and discrimination. It is in this element that the first selective integration of olfactory stimuli occurs through a complex cell interaction that forwards the received olfactory information to higher cortical centers. Considering its position in the organizational hierarchy of the olfactory system, it is now known that changes in the Olfactory Bulb can lead to olfactory abnormalities. Through imaging techniques, it was possible to establish relationships between the occurrence of changes secondary to brain aging and senility, neurodegenerative diseases, head trauma, and infectious diseases with a decrease in the size of the Olfactory Bulb and in olfactory acuity. In companion animals, this relationship has also been identified, with observations of relations between the cranial conformation, the disposition, size, and shape of the Olfactory Bulb, and the occurrence of structural alterations associated with diseases with different etiologies. However, greater difficulty in quantitatively assessing olfactory acuity in animals and a manifestly smaller number of studies dedicated to this topic maintain a lack of concrete and unequivocal results in this field of veterinary sciences. The aim of this work is to revisit the Olfactory Bulb in companion animals in all its dimensions, review its anatomy and histological characteristics, physiological integration in the olfactory system, importance as a potential early indicator of the establishment of specific pathologies, as well as techniques of imaging evaluation for its in vivo clinical exploration.

Retrospective Preliminary Assessment of Routine Follow-Up Low-Field Magnetic Resonance Imaging in Dogs Presumptively Diagnosed With Discospondylitis.

Background: The usefulness of routine follow-up Magnetic Resonance Imaging (MRI-2) in asymptomatic dogs treated for discospondylitis is unknown. Methods: This cross-sectional retrospective study investigated the features of MRI-2 in a heterogeneous group of dogs treated for discospondylitis, and if these were associated with the presence or absence of clinical signs. After comparing initial MRI (MRI-1) and MRI-2, an observer, blinded to the dog's clinical signs, described the MRI-2 findings. The study population was then divided into symptomatic or asymptomatic at the time of MRI-2. Two separate observers subjectively classified the discospondylitis as active or inactive. Repeatability and interobserver agreement were evaluated. Results: A total of 25 dogs were included. At the time of MRI-2 16 (64%) dogs were asymptomatic and 9 (36%) were symptomatic. Based on MRI-2, 20 (80%) and 18 (72%) out of 25 dogs were considered to have active discospondylitis by the first and second observers, respectively. Interobserver agreement was moderate. No MRI-2 features were associated with the clinical status. The subjective classification of inactive discospondylitis was significantly associated with asymptomatic clinical status, but the classification of active discospondylitis was evenly distributed between groups. Conclusion: This study did not identify a meaningful association between the clinical status of dogs treated for presumptive discospondylitis and MRI-2 results. There were no specific MRI-2 features which were associated with the clinical status.

Feline temporal lobe epilepsy: seven cases of hippocampal and piriform lobe necrosis in England and literature review.

CASE SERIES SUMMARY: Seven cases of feline hippocampal and piriform lobe necrosis (FHN) are described, with particular emphasis on clinical, radiographic and histopathological correlations. FHN is an uncommon acute epileptic condition resembling human autoimmune limbic encephalitis and temporal lobe epilepsy. Seizures are typically focal and feature uni- or bilateral orofacial or head twitching, hypersalivation, lip smacking, mydriasis, vocalisation and motionless staring, with inter-ictal behavioural changes such as unprovoked aggression and rapid running. Emerging evidence supports an autoimmune aetiology, although disruption of hippocampal architecture secondary to brain neoplasia has also been recognised. Most commonly, however, the underlying cause remains unknown. Diagnosis is achieved clinically and with brain MRI; electroencephalography and voltage-gated potassium channel-complex autoantibodies are currently the subject of research. Affected cats are frequently refractory to conventional antiepileptic treatment. RELEVANCE AND NOVEL INFORMATION: Following a review of the literature, including potential complicating factors and comparisons with human medicine, the hippocampus and piriform lobe are proposed as the neuroanatomical localisation for focal seizures with orofacial involvement in cats, regardless of aetiology.

Corrigendum: Transient Postural Vestibulo-Cerebellar Syndrome in Three Dogs With Presumed Cerebellar Hypoplasia.

[This corrects the article DOI: 10.3389/fvets.2020.00453.].

Serum C-reactive protein in dogs with paraplegia secondary to acute intervertebral disc extrusion.

BACKGROUND: Apart from the absence of nociception, there is no readily available prognostic test for dogs presenting with paraplegia secondary to acute intervertebral disc extrusion (IVDE). OBJECTIVE: To assess if serum C-reactive protein (CRP) can predict the postoperative outcome in paraplegic dogs undergoing surgery for IVDE and to assess the association between serum CRP and presence/absence of nociception on admission, and serum CRP and presence/absence of intramedullary changes seen on magnetic resonance imaging (MRI). ANIMALS: One hundred dogs that underwent surgery at our hospital between 2018 and 2020 because of acute paraplegia secondary to IVDE and in which serum CRP was measured. METHODS: Retrospective observational cohort study. Dogs were classified as 4 or 5 according to the modified Frankel score (MFS) depending on presence/absence of nociception, respectively. MRI images were reviewed and the T2-weighted hyperintensity: L2 vertebral body length was measured. Postoperative outcome was defined as positive if nociception, ambulation or both returned after decompressive surgery. RESULTS: The median (95% CI) serum CRP was 4 (4-5) and 6 (4-7) mg/L in MSF4 and MSF5, respectively (P = .03). A weak linear relationship (R2  = 0.049, P = .03) was found between CRP and the T2-weighted hyperintensity: L2 vertebral length. Outcome data was available for 85 dogs: CRP was 4 (4-5) and 5 (4-10) mg/L in positive and negative outcome dogs, respectively (P = .32). CONCLUSION AND CLINICAL IMPORTANCE: Serum CRP did not predict outcome after surgery in dogs with paraplegia secondary to IVDE.

MRI Features of Solitary Vertebral Masses in Dogs: 20 Cases (2010-2019).

The objective of the study was to describe the MRI features of cytologically or histologically diagnosed solitary vertebral masses in dogs and identify potential MRI features enabling differentiation between malignant and benign lesions. Patients were divided into malignant and benign groups according to the final diagnosis. Medical records and MRI studies were retrospectively reviewed, and specific imaging features were compared. The malignant group comprised 15 dogs, with 5 dogs included in the benign group. MRI features of the different histopathologic/cytologic types of masses are described. Involvement of the vertebral body, a hyperintense signal on T2-weighted, short tau inversion recovery, T1-weighted, and T1-weighted gradient echo sequences and evidence of cortical destruction were signifi-cantly associated with malignancy (P < .05). Hypointensity on T1-weighted gradient echo sequence was significantly associated with benign masses (P < .05). The presence of bone sclerosis was significantly associated with osteosarcomas compared with other malignant masses (P < .05). Fractures (5 cases) were only seen in the group of malignant masses. This pilot study identifies some MRI features that may help differentiate between malignant and benign solitary vertebral masses. Greater case numbers are needed in future studies.

Myelopathy secondary to an intramedullary arteriovenous malformation in a mature dog.

A 2-year-old crossbreed dog was presented for evaluation of a 6-week history of progressive paraparesis. Magnetic resonance imaging and computed tomography angiography of the thoracic and lumbar spinal cord disclosed multifocal, anomalous, small, vascular structures, distributed throughout the subarachnoid space of the included section of the spinal cord. An additional focal intramedullary lesion was identified extending from T9 to T10 to T12. Histopathological examination confirmed the presence of an intramedullary arteriovenous malformation affecting the thoracic spinal cord and leading to diffuse congestion and focal hemorrhages into the affected spinal cord.

Transient Postural Vestibulo-Cerebellar Syndrome in Three Dogs With Presumed Cerebellar Hypoplasia.

This case study presents a unique transient postural vestibular syndrome in three dogs. The transient postural symptoms present as pronounced vestibulo-cerebellar signs after altering the position of the head. Magnetic resonance imaging findings of the brain suggest caudal cerebellar hypoplasia, affecting vermis, and floccular lobes bilaterally in case 1, and hypoplasia of the nodulus vermis in cases 2 and 3. No progression of clinical signs was reported in minimum of 4 months period.

Low-Field Magnetic Resonance Imaging Findings in 18 Dogs With Presumed Optic Neuritis.

Canine optic neuritis has been attributed to a focal or disseminated form of granulomatous meningoencephalitis (GME) amongst other etiologies. Magnetic resonance imaging (MRI) has been proven to help differentiate the structures within the optic nerve sheath and therefore could aid the diagnosis of optic neuritis in dogs. The objectives of this study were to describe and compare the MRI abnormalities affecting the optic nerve sheath complex and optic chiasm in dogs with clinically suspected optic neuritis as a component of meningoencephalitis of unknown etiology (MUE) or as an isolated form (I-ON). Retrospective evaluation of patient details, clinical signs, cerebrospinal fluid (CSF) analysis, and MRI findings of dogs with clinically suspected optic neuritis between January 2011 and May 2018 was performed. Eighteen dogs met the inclusion criteria. MRI findings included contrast enhancement of both optic nerves (11/18) and optic chiasm (6/18), changes within the CSF volume surrounding the optic nerve (10/18), changes to the optic disc (10/18), changes of size or signal affecting the optic chiasm (10/18), changes in the Short TI inversion recovery (STIR) signal of the optic nerve (7/15), retrobulbar changes (3/18), and concurrent brain lesions (13/18). A variety of subtle MRI features may indicate optic nerve involvement and low-field MRI is a sensitive method to detect changes within the optic nerve sheath complex in dogs with optic neuritis as an isolated form (I-ON) or as an extension of MUE.

MRI in 30 cats with traumatic brain injury.

OBJECTIVES: The aim of this study was to evaluate the MRI findings in cats following traumatic brain injury (TBI), and establish which features identified might correlate with prognosis. METHODS: The magnetic resonance images of 30 cats with clinical signs attributed to the brain following TBI were retrospectively reviewed to assess the imaging features seen and their correlation with outcome. RESULTS: Twenty-one of 30 cats had a good outcome (full recovery or minor ongoing neurological deficits); the other nine either died or had ongoing neurological deficits that significantly affected quality of life. There was evidence of parenchymal injury in only 20/30 cats, including 8/9 that had a poor outcome. The frequency of bilateral or multifocal parenchymal lesions on T2-weighted imaging, and mass effect, particularly caudal transtentorial herniation, was statistically significantly higher in patients with a poorer outcome. Extra-axial haemorrhage was not identified. Concurrent soft tissue injury was noted in all cats, with a poorer prognosis statistically associated with a peripharyngeal pattern of injury and orbital trauma. CONCLUSIONS AND RELEVANCE: The number of cases with MRI-identified brain pathology, the patterns of injuries identified and the specific imaging features that appear to have effects on prognosis differ in this series of cats from those published in similar case series of dogs. Further work is needed to establish if cat-specific guidelines are needed to assess brain MRI following trauma.

Evaluation of T2-weighted versus short-tau inversion recovery sagittal sequences in the identification and localization of canine intervertebral disc extrusion with low-field magnetic resonance imaging.

Sagittal T2-weighted sequences (T2-SAG) are the foundation of spinal protocols when screening for the presence of intervertebral disc extrusion. We often utilize sagittal short-tau inversion recovery sequences (STIR-SAG) as an adjunctive screening series, and experience suggests that this combined approach provides superior detection rates. We hypothesized that STIR-SAG would provide higher sensitivity than T2-SAG in the identification and localization of intervertebral disc extrusion. We further hypothesized that the parallel evaluation of paired T2-SAG and STIR-SAG series would provide a higher sensitivity than could be achieved with either independent sagittal series when viewed in isolation. This retrospective diagnostic accuracy study blindly reviewed T2-SAG and STIR-SAG sequences from dogs (n = 110) with surgically confirmed intervertebral disc extrusion. A consensus between two radiologists found no significant difference in sensitivity between T2-SAG and STIR-SAG during the identification of intervertebral disc extrusion (T2-SAG: 92.7%, STIR-SAG: 94.5%, P = 0.752). Nevertheless, STIR-SAG accurately identified intervertebral disc extrusion in 66.7% of cases where the evaluation of T2-SAG in isolation had provided a false negative diagnosis. Additionally, one radiologist found that the parallel evaluation of paired T2-SAG and STIR-SAG series provided a significantly higher sensitivity than T2-SAG in isolation, during the identification of intervertebral disc extrusion (T2-SAG: 78.2%, paired T2-SAG, and STIR-SAG: 90.9%, P = 0.017). A similar nonsignificant trend was observed when the consensus of both radiologists was taken into consideration (T2-SAG: 92.7%, paired T2-SAG, and STIR-SAG = 97.3%, P = 0.392). We therefore conclude that STIR-SAG is capable of identifying intervertebral disc extrusion that is inconspicuous in T2-SAG, and that STIR-SAG should be considered a useful adjunctive sequence during preliminary sagittal screening for intervertebral disc extrusion in low-field magnetic resonance.

IMAGING DIAGNOSIS - MAGNETIC RESONANCE IMAGING OF INTRACRANIAL INFLAMMATORY FIBROSARCOMA IN A MIXED BREED DOG.

An 8-year-old mixed-breed dog presented with progressive behavioral changes and altered mentation. Magnetic resonance imaging (MRI) of the brain revealed an olfactory and frontal lobe extra-axial mass. The mass exhibited the following MRI signal intensity characteristics: T2W mixed, T1W iso- to hypointense, FLAIR hyperintense, and strong contrast enhancement. The mass was removed with cavitronic ultrasonic surgical aspirator (CUSA) assisted neurosurgery. Based on histopathological appearance and immunohistochemistry, the diagnosis of inflammatory fibrosarcoma was made. To our knowledge, this is the first report describing MRI characteristics of intracranial inflammatory fibrosarcoma in the veterinary literature.

IMAGING DIAGNOSIS-MAGNETIC RESONANCE IMAGING FEATURES OF CRANIOMANDIBULAR OSTEOPATHY IN AN AIREDALE TERRIER.

An Airedale Terrier was presented for evaluation of depression and reluctance to be touched on the head. Magnetic resonance (MR) imaging of the head was performed. The images revealed bone lesions affecting the calvarium at the level of the coronal suture and left mandibular ramus, with focal cortical destruction, expansion, and reactive new bone formation. Skull lesions were hypointense on T1-weighted sequences, hyperintense on T2-weighted sequences, and showed an intense and homogeneous enhancement after gadolinium administration. Reactive new bone formation and periosteal proliferation were confirmed histopathologically. The clinical signs, imaging findings, and histopathological examination were consistent with craniomandibular osteopathy.

Results of magnetic resonance imaging performed within 48 hours after head trauma in dogs and association with outcome: 18 cases (2007-2012).

OBJECTIVE: To review results of MRI performed within 48 hours after head trauma in dogs and identify associations between MRI findings and outcome. DESIGN: Retrospective case series. ANIMALS: 18 dogs that underwent MRI within 48 hours after known head trauma. PROCEDURES: Medical records were reviewed for information on signalment, history, clinical findings, MRI findings, treatment, and outcome. RESULTS: 2 dogs were euthanized, 1 died, and 1 had major persistent deficits. The remaining 14 dogs had a good outcome, including 9 that recovered completely and 5 that had minor persistent deficits. The most common MRI abnormalities were intra-axial changes (n = 13) and extra-axial hemorrhage (13). Intra-axial changes were best seen on T2-weighted and fluid attenuation inversion recovery (FLAIR) images. A mass effect was detected in 9 dogs, 6 of which had a midline shift (mean, 2.18 mm). Three dogs had transtentorial herniation, and 2 had transcranial herniation. Extra-axial hemorrhage was best seen on FLAIR images. The most common location was subdural, with subdural extra-axial hemorrhage most often seen on the same side as the injury. Epidural hemorrhage was seen in 2 dogs. The affected area was larger in these dogs than in dogs with subdural hemorrhage. One dog required surgery and the other was euthanized. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that in dogs with acute (< 48 hours' duration) head trauma, T2-weighted and FLAIR images provided the most diagnostic information. Dogs with injuries affecting the caudal fossa or affecting both the rostral and caudal fossae typically had poorer outcomes.

MRI characteristics of fourth ventricle arachnoid diverticula in five dogs.

Intracranial arachnoid diverticula (cysts) are rare accumulations of cerebrospinal fluid (CSF) within the arachnoid membrane. The purpose of this retrospective study was to describe magnetic resonance imaging (MRI) characteristics of fourth ventricle arachnoid diverticula in a group of dogs. The hospital's medical records were searched for dogs with MRI studies of the brain and a diagnosis of fourth ventricle arachnoid diverticulum. Clinical characteristics were recorded from medical records and MRI studies were reinterpreted by a board-certified veterinary radiologist. Five pediatric dogs fulfilled inclusion criteria. Clinical signs included cervical hyperaesthesia, obtundation, tetraparesis, and/or central vestibular syndrome. In all five dogs, MRI findings were consistent with obstructive hydrocephalus, based on dilation of all ventricles and compression of the cerebellum and brainstem. All five dogs also had cervical syringohydromyelia, with T2-weighted hyperintensity of the gray matter of the cord adjacent to the syringohydromyelia. A signal void, interpreted as flow disturbance, was observed at the mesencephalic aqueduct in all dogs. Four dogs underwent surgical treatment with occipitalectomy and durotomy. A cystic lesion emerging from the fourth ventricle was detected in all four dogs during surgery and histopathology confirmed the diagnosis of arachnoid diverticula. Three dogs made excellent recovery but deteriorated shortly after surgery and were euthanized. Repeat MRI in two dogs revealed improved hydrocephalus but worsening of the syringohydromyelia. Findings from the current study supported theories that fourth ventricle arachnoid diverticula are secondary to partial obstruction of the central canal or lateral apertures and that arachnoid diverticula are developmental lesions in dogs.

Feline ischemic myelopathy and encephalopathy secondary to hyaline arteriopathy in five cats.

Five cats presented with acute-onset neurological signs. Magnetic resonance imaging in four cats showed a T2-weighted hyperintense spinal cord lesion that was mildly contrast-enhancing in three cats. Owing to inflammatory cerebrospinal fluid changes three cats were treated with immunosuppression. One cat was treated with antibiotics. All cats improved initially, but were eventually euthanased owing to the recurrence of neurological signs. Histopathology in all cats showed hyaline degeneration of the ventral spinal artery, basilar artery or associated branches with aneurysmal dilation, thrombosis and ischemic degeneration and necrosis of the spinal cord and brain. Two cats also had similar vascular changes in meningeal vessels. Vascular hyaline degeneration resulting in vascular aneurysmal dilation and thrombosis should be a differential diagnosis in cats presenting with acute central nervous system signs.

Clinical and low-field MRI characteristics of injection site sarcoma in 19 cats.

Magnetic resonance imaging (MRI) has been recommended for staging and surgical planning in cats with injection site sarcomas (ISS). The purpose of this retrospective study was to describe low-field MRI characteristics of confirmed injection site sarcomas in a group of cats. Low-field MR images, thoracic radiographs, histopathology findings, and medical records of cats that fulfilled histological criteria of injection site sarcoma were retrieved and reviewed retrospectively. Presence or absence of tumor mineralization and pulmonary metastases were recorded from thoracic radiographs. Characteristics recorded from low-field MRI studies included tumor number, volume (ellipsoid method), intensity relative to surrounding musculature, homogeneity, regions of signal void (mineralization) or cavitation, degree and pattern of contrast enhancement, tumor margination, presence of a peripheral T2W hyperintense zone, and bone contact. A total of 19 cats met inclusion criteria. Cats with multiple tumors were more likely to have had previous excisional biopsy, and were less likely to undergo definitive surgery. All tumors were hyperintense relative to surrounding musculature on T1W and T2W images. Larger tumors were more likely to exhibit mineralization (P < 0.05). Tumor volume could not predict tumor-free margins at definitive surgery. The majority of tumors showed moderate to marked heterogeneous contrast enhancement. Infiltrative margins and the presence of a peripheral T2W hyperintense zone were more prevalent following excisional biopsy, while cavitation was more prevalent following incisional biopsy. Findings indicated that low-field MRI characteristics of injection site sarcoma may vary widely and may be affected by prior incisional or excisional biopsy.