William B. Thomas

T9-T10 intervertebral disc herniation in three dogs

B E. Wilkens et al. — Fri, 03 May 2013 06:20:17 PDT

Herniation of the T9-T10 intervertebral disc was diagnosed in three Dachshunds with acute paraplegia. The clinical diagnosis and surgical management of T9-T10 disc herniation are similar to that in the more common sites of disc herniation.

Magnetic resonance imaging appearance of intracranial hemorrhage secondary to cerebral vascular malformation in a dog

William B. Thomas et al. — Fri, 03 May 2013 06:20:16 PDT

A 14-year-old dog developed an acute onset of depression, disorientation, left hemiparesis,left hemianopia, left facial hypoesthesia, and a tendency to turn to the right. Based on these findings, a lesion affecting the right forebrain was suspected. Magnetic resonance imaging showed a mass within the right cerebral hemisphere resulting in compression of the right lateral ventricle and shifting the longitudinal fissure to the left. The lesion was hyperintense on T1-weighted images and hyperintense with focal regions of hypointensity on proton density-, and T2-weighted images, consistent with a subacute hemorrhage. At necropsy, there was a hematoma in the parietal portion of the right cerebral hemisphere. The hemorrhage was surrounded by numerous thin-walled veins, most likely a venous malformation. Magnetic resonance imaging of intracranial hemorrhage is reviewed.

Evaluation of plasma diazepam and nordiazepam concentrations following administration of diazepam intravenously or via suppository per rectum in dogs

C W. Probst et al. — Fri, 03 May 2013 06:18:43 PDT

Objective-To evaluate the pharmacokinetics of diazepam administered per rectum via compounded (ie, not commercially available) suppositories and determine whether a dose of 2 mg/kg in this formulation would result in plasma concentrations shown to be effective for control of status epilepticus or cluster seizures (ie, 150 to 300 ng/mL) in dogs within a clinically useful interval (10 to 15 minutes). Animals-6 healthy mixed-breed dogs. Procedures-Dogs were randomly assigned to 2 groups of 3 dogs each in a crossover-design study. Diazepam (2 mg/kg) was administered IV or via suppository per rectum, and blood samples were collected at predetermined time points. Following a 6- or 7-day washout period, each group received the alternate treatment. Plasma concentrations of diazepam and nordiazepam were analyzed via reversed phase high-performance liquid chromatography. Results-Plasma concentrations of diazepam and nordiazepam exceeded the targeted range ≤ 3 minutes after IV administration in all dogs. After suppository administration, targeted concentrations of diazepam were not detected in any dogs, and targeted concentrations of nordiazepam were detected after 90 minutes (n = 2 dogs) or 120 minutes (3) or were not achieved (1). Conclusions and Clinical Relevance-On the basis of these results, administration of 2 mg of diazepam/kg via the compounded suppositories used in the present study cannot be recommended for emergency treatment of seizures in dogs.

Clinical and Imaging Findings in Five Dogs with Intracranial Blastomycosis (Blastomyces dermatiditis)

Silke Hecht et al. — Fri, 03 Aug 2012 06:17:24 PDT

Fungal infections affecting the central nervous system are rare. The purpose of this study was to describe clinical and imaging findings in dogs with intracranial blastomycosis (Blastomyces dermatiditis). The radiology database was searched retrospectively for patients with a diagnosis of intracranial blastomycosis which had computed tomography performed as part of their diagnostic work-up. Medical records and imaging studies were reviewed. Five dogs met the inclusion criteria. Major presenting complaints were stertor/nasal discharge (n=2), exophthalmos (n=1), and seizures (n=2). Clinical and laboratory findings were variable. Computed tomographic examination revealed a single contrast-enhancing intra-axial mass (n=1), a nasal mass disrupting the cribriform plate (n=3), and an intracranial mass extending into the orbit and nasal cavity (n=1). Findings in intracranial blastomycosis in dogs are variable, and the disease may mimic other inflammatory disorders or neoplasia.

Evaluation of levetiracetam as adjunctive treatment for refractory canine epilepsy: a randomized, placebo-controlled, crossover trial

K R. Munana et al. — Thu, 03 May 2012 13:09:57 PDT

BACKGROUND: There is little evidence-based information available to guide treatment of refractory epilepsy in dogs. The antiepileptic drug levetiracetam (LEV) is administered to dogs, although its safety and efficacy are unknown. OBJECTIVE: To evaluate the safety and efficacy of LEV as adjunctive therapy for refractory epilepsy in dogs. ANIMALS: Thirty-four client-owned dogs with idiopathic epilepsy. METHODS: Randomized, blinded trial involving dogs resistant to phenobarbital and bromide. Dogs received LEV (20 mg/kg PO q8h) or placebo for 16 weeks, and after a 4-week washout were crossed over to the alternate treatment for 16 weeks. Owners kept records on seizure frequency and adverse events. Hemogram, chemistry profile, urinalysis, and serum antiepileptic drug concentrations were evaluated at established intervals. RESULTS: Twenty-two (65%) dogs completed the study. Weekly seizure frequency during the 1st treatment period decreased significantly during LEV administration relative to baseline (1.9 ± 1.9 to 1.1 ± 1.3, P = .015). The reduction in seizures with LEV was not significant when compared to placebo (1.1 ± 1.3 versus 1.5 ± 1.7, P = .310). The most common adverse event was ataxia, with no difference in incidence between LEV and placebo (45 versus 18%, P = .090). No changes in laboratory parameters were identified and owners reported an improved quality of life (QOL) with LEV compared to placebo (QOL score 32.7 ± 4.3 versus 29.4 ± 4.5, P = .028). CONCLUSIONS AND CLINICAL IMPORTANCE: Adjunctive treatment with LEV appears safe in epileptic dogs. Efficacy of LEV over placebo was not demonstrated, although the power of the study was limited. Further evaluation of LEV as treatment for epilepsy in dogs is warranted.

Myelography vs. computed tomography in the evaluation of acute thoracolumbar intervertebral disk extrusion in chondrodystrophic dogs

Silke Hecht et al. — Mon, 29 Aug 2011 08:52:42 PDT

Myelography and/or computed tomography (CT) are commonly used to evaluate acute intervertebral disk extrusion in chondrodystrophic dogs. The purpose of this study was to evaluate the sensitivity of myelography and two different CT protocols in determining level and lateralization of acute thoracolumbar intervertebral disk extrusion in comparison with surgical findings, investigate interobserver variability, and determine examination duration times. Results of conventional CT, helical CT, and myelography were compared with surgical findings in 19 chondrodystrophic dogs with acute thoracolumbar intervertebral disk extrusion. Agreement among investigators was determined for different imaging modalities, and examination times were recorded. In the diagnosis of level of disk extrusion there was agreement of myelography, conventional CT, and helical CT with surgical findings in 94.7%, 100%, and 94.7% of dogs, respectively (P = 0.144). In the diagnosis of level and lateralization of disk extrusion there was agreement of myelography, conventional CT, and helical CT with surgical findings in 78.9%, 87.4%, and 85.3% of dogs, respectively (P = 0.328). Interobserver agreement was very good for all imaging modalities (myelography K = 0.87; conventional CT K = 0.86; helical CT K = 0.95). There were significant differences in median examination duration times between helical CT (4 min), conventional CT (8 min), and myelography (32 min) (P < 0.001). Both helical and conventional CT appear to be accurate for evaluation of acute thoracolumbar intervertebral disk extrusion in chondrodystrophic dogs and are faster to perform than myelography.

Magnetic Resonance Imaging Susceptibility Artifacts Due to Metallic Foreign Bodies

Silke Hecht et al. — Mon, 29 Aug 2011 08:52:41 PDT

Susceptibility artifacts due to metallic foreign bodies may interfere with interpretation of magnetic resonance (MR) imaging studies. Additionally, migration of metallic objects may pose a risk to patients undergoing MR imaging. Our purpose was to investigate prevalence, underlying cause, and diagnostic implications of susceptibility artifacts in small animal MR imaging and report associated adverse effects. MR imaging studies performed in dogs and cats between April 2008 and March 2010 were evaluated retrospectively for the presence of susceptibility artifacts associated with metallic foreign bodies. Studies were performed using a 1.0 T scanner. Severity of artifacts was graded as 0 (no interference with area of interest), 1 (extension of artifact to area of interest without impairment of diagnostic quality), 2 (impairment of diagnostic quality but diagnosis still possible), or 3 (severe involvement of area of interest resulting in nondiagnostic study). Medical records were evaluated retrospectively to identify adverse effects. Susceptibility artifacts were present in 99/754 (13.1%) of MR imaging studies and were most common in examinations of the brachial plexus, thorax, and cervical spine. Artifacts were caused by identification microchips, ballistic fragments, skin staples/suture material, hemoclips, an ameroid constrictor, and surgical hardware. Three studies were nondiagnostic due to the susceptibility artifact. Adverse effects were not documented.

Cerebral Blastomyces dermatitidis infection in a cat

J R. Smith et al. — Mon, 29 Aug 2011 08:52:39 PDT

CASE DESCRIPTION: An 8-year-old domestic shorthair cat was evaluated because of signs of depression, circling, and visual deficits. CLINICAL FINDINGS: The cat had no cutaneous lesions, and results of an ophthalmologic examination and thoracic radiography were within reference limits. Computed tomography of the brain revealed a mass lesion involving the right parietal, temporal, and occipital lobes; the mass was in broad-based contact with the skull and smoothly marginated and had strong homogenous enhancement after contrast agent administration. During craniectomy, samples of the mass were collected for cytologic and histopathologic evaluations and microbial culture. A diagnosis of Blastomyces dermatitidis-associated meningoencephalitis with secondary pyogranulomatous inflammation was made. TREATMENT AND OUTCOME: Amphotericin B (0.25 mg/kg [0.11 mg/lb], IV) was administered on alternate days (cumulative dose, 1.75 mg/kg [0.8 mg/lb]). To minimize the risk of nephrotoxicosis, assessments of serum biochemical variables (urea nitrogen and creatinine concentrations) and urinalyses were performed at intervals. The third dose of amphotericin B was postponed 48 hours because the cat became azotemic. The cat subsequently received fluconazole (10 mg/kg [4.5 mg/lb], PO, q 12 h) for 5.5 months. Six months after discontinuation of that treatment, the cat appeared healthy and had no signs of relapse. CLINICAL RELEVANCE: Brain infection with B dermatitidis is typically associated with widespread disseminated disease. The cat of this report had no evidence of systemic disease. Blastomycosis of the CNS should be considered as a differential diagnosis for brain lesions in cats from areas in which B dermatitidis is endemic.

Diagnosis and surgical treatment of a Chiari I-like malformation in an African lion (Panthera leo)

S L. McCain et al. — Mon, 29 Aug 2011 08:52:37 PDT

A 13-mo-old intact male African lion (Panthera leo) presented with a 3-mo history of lethargy, ventral flexion of the neck, abnormal vocalization, and ataxia. Hemogram and serum biochemistries were within normal limits except for the presence of hypokalemia (2.7 mEq/L) and hypochloridemia (108 mEq/L). When no improvement was noted with oral potassium gluconate supplementation, a computed tomography scan of the brain and skull was performed, and no abnormalities were noted. However, magnetic resonance imaging detected occipital bone thickening, crowding of the caudal cranial fossa with cerebellar compression and herniation, and cervical syringohydromyelia, which was consistent with a Chiari I-like malformation. Foramen magnum decompression was performed to relieve the compression of the cerebellum. The animal recovered well with subsequent resolution of clinical signs. Hypovitaminosis A has been proposed previously as the underlying etiology for this malformation in lions with similar clinical presentations. This lion's serum and liver vitamin A concentrations were low (100 ng/ml and 25.31 microg/g, respectively) compared to concentrations reported for domestic carnivores and support hypovitaminosis A as the underlying cause of this animal's Chiari I-like malformation.

Large anaplastic spinal B-cell lymphoma in a cat

Bente Flatland et al. — Mon, 29 Aug 2011 08:52:35 PDT

A 5-year-old female spayed domestic shorthair cat was presented for evaluation of tetraparesis. The neurologic lesion was localized to the cervical spinal segment (C1-C6). A left axillary mass was identified, and the results of fine needle aspiration cytology indicated malignant round cell neoplasia of possible histiocytic origin. The cells were large, had marked anisocytosis and anisokaryosis, occasional bi- and multinucleation, and cytoplasmic vacuolation. Euthanasia was performed due to the poor prognosis associated with severe, progressive neurologic signs and a malignant neoplasm. Postmortem examination revealed spinal cord compression and an extradural mass at the C1-C2 spinal segment, with neoplastic cells in the adjacent vertebral bodies, surrounding skeletal muscle, left axillary lymph node, and bone marrow from the right femur. The initial histologic diagnosis was anaplastic sarcoma, but immunohistochemical results indicated the cells were CD20+ and CD45R+ and CD3-, compatible with a diagnosis of B-cell lymphoma. CD79a staining was nonspecific and uninterpretable. Weak to moderate CD18 positivity and E-cadherin positivity were also observed. Clonality of the B-cell population could not be demonstrated using PCR testing for antigen receptor gene rearrangement. To the authors' knowledge, this is the first reported case of a feline spinal anaplastic B-cell lymphoma exhibiting bi- and multinucleated cells. The prognostic significance of this cell morphology and immunophenotype is unknown.

Malignant mediastinal extra-adrenal paraganglioma with spinal cord invasion in a dog

Scott A. Rizzo et al. — Mon, 29 Aug 2011 08:52:33 PDT

A 1.5-year-old castrated, male, mixed-breed dog was evaluated because of a 2-week history of lethargy, stiffness, and progressive paraparesis. Spinal radiographs, myelography, and computed tomography of the region showed a locally invasive mass involving the thoracic wall. Upon necropsy, an encapsulated, fluctuant mass was noted attached to the right dorsal body wall in the region of the fifth to seventh thoracic vertebra. Churukian-Schenk staining revealed positive granules within the neoplastic cell cytoplasm and immunohistochemistry was positive for expression for cytoplasmic neuron-specific enolase and synaptophysin. Chromogranin A and S100 expression were found to be negative. Immunohistochemistry and silver staining did not allow further differentiation of the tumor, and the diagnosis remains consistent with either a chromaffin paraganglioma or a nonchromaffin paraganglioma (chemodectoma) with some production of catecholamines. Extra-adrenal paragangliomas are rare neoplasms in dogs but should be considered as a possible differential diagnosis for a primary paraspinal thoracic mass.