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Jeffery ND, Rossmeisl JH, Harcourt-Brown TR, Granger N, Ito D, Foss K, Chase D. Randomized Controlled Trial of Durotomy as an Adjunct to Routine Decompressive Surgery for Dogs With Severe Acute Spinal Cord Injury. Neurotrauma Rep 2024; 5:128-138. [PMID: 38414780 PMCID: PMC10898236 DOI: 10.1089/neur.2023.0129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024] Open
Abstract
Although many interventions for acute spinal cord injury (SCI) appear promising in experimental models, translation directly from experimental animals to human patients is a large step that can be problematic. Acute SCI occurs frequently in companion dogs and may provide a model to ease translation. Recently, incision of the dura has been highlighted in both research animals and human patients as a means of reducing intraspinal pressure, with a view to improving perfusion of the injured tissue and enhancing functional recovery. Observational clinical data in humans and dogs support the notion that it may also improve functional outcome. Here, we report the results of a multi-center randomized controlled trial of durotomy as an adjunct to traditional decompressive surgery for treatment of severe thoracolumbar SCI caused by acute intervertebral disc herniation in dogs. Sample-size calculation was based on the proportion of dogs recovering ambulation improving from an expected 55% in the traditional surgery group to 70% in the durotomy group. Over a 3.5-year period, we enrolled 140 dogs, of which 128 had appropriate duration of follow-up. Overall, 65 (51%) dogs recovered ambulation. Recovery in the traditional decompression group was 35 of 62 (56%) dogs, and in the durotomy group 30 of 66 (45%) dogs, associated with an odds ratio of 0.643 (95% confidence interval: 0.320-1.292) and z-score of -1.24. This z-score indicates trial futility to reach the target 15% improvement over traditional surgery, and the trial was terminated at this stage. We conclude that durotomy is ineffective in improving functional outcome for severe acute thoracolumbar SCI in dogs. In the future, these data can be compared with similar data from clinical trials on duraplasty in human patients and will aid in determining the predictive validity of the "companion dog model" of acute SCI.
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Affiliation(s)
- Nick D. Jeffery
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA
| | - John H. Rossmeisl
- Department of Small Animal Clinical Sciences, VA-MD College of Veterinary Medicine, Blacksburg, Virginia, USA
| | | | | | - Daisuke Ito
- Nihon University College of Bioresource Sciences Department of Veterinary Medicine, Fujisawa, Japan
| | - Kari Foss
- Department of Veterinary Clinical Medicine, University of Illinois Urbana–Champaign, Champaign, Illinois, USA
| | - Damian Chase
- Veterinary Specialists Aotearora, Auckland, New Zealand
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2
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Vanhaesebrouck A, Van Poucke M, Stee K, Granger N, Ives E, Van Soens I, Cornelis I, Bossens K, Peelman L, Van Ham L, Bhatti SFM. Generalized myokymia, or neuromyotonia, or both in dogs with or without spinocerebellar ataxia. J Vet Intern Med 2023; 37:2310-2314. [PMID: 37905444 PMCID: PMC10658559 DOI: 10.1111/jvim.16892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 09/20/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND KCNJ10 and CAPN1 variants cause "spinocerebellar" ataxia in dogs, but their association with generalized myokymia and neuromyotonia remains unclear. OBJECTIVE To investigate the association between KCNJ10 and CAPN1 and myokymia or neuromyotonia, with or without concurrent spinocerebellar ataxia. ANIMALS Thirty-three client-owned dogs with spinocerebellar ataxia, myokymia neuromytonia, or a combination of these signs. METHODS Genetic analysis of a cohort of dogs clinically diagnosed with spinocerebellar ataxia, myokymia or neuromyotonia. KCNJ10 c.627C>G and CAPN1 c.344G>A variants and the coding sequence of KCNA1, KCNA2, KCNA6, KCNJ10 and HINT1 were sequenced using DNA extracted from blood samples. RESULTS Twenty-four Jack Russell terriers, 1 Jack Russell terrier cross, 1 Dachshund and 1 mixed breed with spinocerebellar ataxia were biallelic (homozygous) for the KCNJ10 c.627C>G variant. Twenty-one of those dogs had myokymia, neuromyotonia, or both. One Parson Russell terrier with spinocerebellar ataxia alone was biallelic for the CAPN1 c.344G>A variant. Neither variant was found in 1 Jack Russell terrier with ataxia alone, nor in 3 Jack Russell terriers and 1 Yorkshire terrier with myokymia and neuromyotonia alone. No other causal variants were found in the coding sequence of the investigated candidate genes in these latter 5 dogs. CONCLUSION The KCNJ10 c.627C>G variant, or rarely the CAPN1 c.344G>A variant, was confirmed to be the causal variant of spinocerebellar ataxia. We also report the presence of the KCNJ10 c.627C>G variant in the Dachshund breed. In dogs with myokymia and neuromyotonia alone the reported gene variants were not found. Other genetic or immune-mediated causes should be investigated to explain the clinical signs of these cases.
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Affiliation(s)
| | - Mario Van Poucke
- Department of Veterinary and Biosciences, Faculty of Veterinary SciencesGhent UniversityMerelbekeBelgium
| | - Kimberley Stee
- Small Animal Department, Faculty of Veterinary SciencesGhent UniversityMerelbekeBelgium
| | | | - Edward Ives
- Anderson Moores Veterinary SpecialistsWinchesterUK
| | - Iris Van Soens
- Companion Animal Clinic, Department of Clinical Sciences, Faculty of Veterinary MedicineUniversity of LiègeLiegeBelgium
| | - Ine Cornelis
- Small Animal Department, Faculty of Veterinary SciencesGhent UniversityMerelbekeBelgium
| | | | - Luc Peelman
- Department of Veterinary and Biosciences, Faculty of Veterinary SciencesGhent UniversityMerelbekeBelgium
| | - Luc Van Ham
- Small Animal Department, Faculty of Veterinary SciencesGhent UniversityMerelbekeBelgium
| | - Sofie F. M. Bhatti
- Small Animal Department, Faculty of Veterinary SciencesGhent UniversityMerelbekeBelgium
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3
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Vandenberghe H, Granger N, Roberts E. Calls for Border collie study participants. Vet Rec 2023; 193:287. [PMID: 37800497 DOI: 10.1002/vetr.3529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Affiliation(s)
- Hélène Vandenberghe
- Bristol Vet Specialists, Unit 10, More Plus, Central Park, Madison Wy, Severn Beach, Bristol, BS35 4ER
| | - Nicolas Granger
- Bristol Vet Specialists, Unit 10, More Plus, Central Park, Madison Wy, Severn Beach, Bristol, BS35 4ER
| | - Emma Roberts
- Bristol Vet Specialists, Unit 10, More Plus, Central Park, Madison Wy, Severn Beach, Bristol, BS35 4ER
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Donaldson N, Grego T, Lancashire H, Prager J, Granger N, Metcalfe B, Taylor J. A Multielectrode Nerve Cuff for Chronic Velocity Selective Recording in a sheep model. Annu Int Conf IEEE Eng Med Biol Soc 2023; 2023:1-4. [PMID: 38083201 DOI: 10.1109/embc40787.2023.10340779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Supra-sacral spinal cord injury (SCI) causes loss of bladder fullness sensation and bladder over-activity, leading to retention and incontinence respectively. Velocity selective recording (VSR) of nerve roots innervating the bladder might enable identification of bladder activity. A 10-electrode nerve cuff for sacral nerve root VSR was developed and tested in a sheep model during acute surgeries and chronic implantation for 6 months. The cuff performed well, with 5.90±1.90 kΩ electrode, and <~800 Ω tissue impedance after 189 days implantation with a stable device and tissues. This is important information for assessing the feasibility of chronic VSR.Clinical Relevance-This demonstrates the manufacturing and performance of a neural interface for chronic monitoring of bladder nerve afferents with applications in urinary incontinence and retention management following SCI.
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Jeffery N, Granger N. New insights into the treatment of meningoencephalomyelitis of unknown origin since 2009: A review of 671 cases. Front Vet Sci 2023; 10:1114798. [PMID: 37008358 PMCID: PMC10050685 DOI: 10.3389/fvets.2023.1114798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 02/17/2023] [Indexed: 03/17/2023] Open
Abstract
“Meningoencephalomyelitis of unknown origin” (MUO)—a collective term for a group of clinically-indistinguishable (but pathologically distinct) autoimmune diseases of the CNS—has become increasingly commonly recognized throughout the world. In the 1960s−1980s the focus was primarily on the pathological description of these conditions and, largely anecdotally, their response to glucocorticoids. The subsequent availability of magnetic resonance imaging for companion animals led to a focus on imaging characteristics and response of MUO to various immunosuppressive medications. Previous reviews have not found clear evidence of superiority of any specific treatment regimen. Here, we review outcomes in a further 671 dogs treated with various combinations of glucocorticoids and immunosuppressive drugs and reported since 2009, aiming to determine whether recommendations can be drawn from the material published during more recent decades. We observe that: (i) there is more complete information on outcome of MUO-affected dogs solely receiving glucocorticoids and these reports provide evidence to undermine the dogma that MUO inevitably requires treatment with glucocorticoids plus an immunosuppressive drug; (ii) there is far more information on the pharmacokinetics of cytarabine delivered by a variety of routes, revealing that previous dosing and duration of administration in dogs with MUO may not have been optimal; and, (iii) there is a large number of cases that could be available for entry into multi-institutional randomized controlled trials. Finally, we suggest new research avenues that might aid future clinical trials in MUO through improved understanding of etiological triggers and individual patterns of immune response, such as the impact of the gut microbiome, the potential of CSF flow cytometry, and the establishment of robust clinical scores for evaluation of treatment success.
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Affiliation(s)
- Nick Jeffery
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX, United States
- *Correspondence: Nick Jeffery
| | - Nicolas Granger
- Bristol Vet Specialists, CVS Referrals & Bristol Translational Health Sciences, University of Bristol, Bristol, United Kingdom
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Halstead SK, Jackson M, Bianchi E, Rupp S, Granger N, Menchetti M, Galli G, Freeman P, Kaczmarska A, Bhatti SFM, Brocal J, José‐López R, Tipold A, Gutierrez Quintana R, Ives EJ, Liatis T, Nessler J, Rusbridge C, Willison HJ, Rupp A. Serum anti-GM2 and anti-GalNAc-GD1a ganglioside IgG antibodies are biomarkers for immune-mediated polyneuropathies in cats. J Peripher Nerv Syst 2023; 28:32-40. [PMID: 36573790 PMCID: PMC10946849 DOI: 10.1111/jns.12529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 12/28/2022]
Abstract
Recent work identified anti-GM2 and anti-GalNAc-GD1a IgG ganglioside antibodies as biomarkers in dogs clinically diagnosed with acute canine polyradiculoneuritis, in turn considered a canine equivalent of Guillain-Barré syndrome. This study aims to investigate the serum prevalence of similar antibodies in cats clinically diagnosed with immune-mediated polyneuropathies. The sera from 41 cats clinically diagnosed with immune-mediated polyneuropathies (IPN), 9 cats with other neurological or neuromuscular disorders (ONM) and 46 neurologically normal cats (CTRL) were examined for the presence of IgG antibodies against glycolipids GM1, GM2, GD1a, GD1b, GalNAc-GD1a, GA1, SGPG, LM1, galactocerebroside and sulphatide. A total of 29/41 IPN-cats had either anti-GM2 or anti-GalNAc-GD1a IgG antibodies, with 24/29 cats having both. Direct comparison of anti-GM2 (sensitivity: 70.7%; specificity: 78.2%) and anti-GalNAc-GD1a (sensitivity: 70.7%; specificity: 70.9%) antibodies narrowly showed anti-GM2 IgG antibodies to be the better marker for identifying IPN-cats when compared to the combined ONM and CTRL groups (P = .049). Anti-GA1 and/or anti-sulphatide IgG antibodies were ubiquitously present across all sample groups, whereas antibodies against GM1, GD1a, GD1b, SGPG, LM1 and galactocerebroside were overall only rarely observed. Anti-GM2 and anti-GalNAc-GD1a IgG antibodies may serve as serum biomarkers for immune-mediated polyneuropathies in cats, as previously observed in dogs and humans.
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Affiliation(s)
- Susan K. Halstead
- Neuroimmunology Laboratories, School of Infection and ImmunityUniversity of GlasgowGlasgowUK
| | - Mark Jackson
- School of Cancer SciencesUniversity of GlasgowBearsdenUK
| | - Ezio Bianchi
- Department of Veterinary ScienceUniversity of ParmaParmaItaly
| | | | - Nicolas Granger
- Queen Mother Hospital for Animals, Royal Veterinary CollegeUniversity of LondonHatfieldUK
- CVS ReferralsBristol Veterinary SpecialistsBristolUK
| | - Marika Menchetti
- Neurology and Neurosurgery DivisionSan Marco Veterinary Clinic and LaboratoryVeggianoItaly
| | - Greta Galli
- Neurology and Neurosurgery DivisionSan Marco Veterinary Clinic and LaboratoryVeggianoItaly
| | - Paul Freeman
- Queens Veterinary School Hospital, Dept of Veterinary MedicineUniversity of CambridgeCambridgeUK
| | - Adriana Kaczmarska
- Small Animal Hospital, School of Biodiversity, One Health and Veterinary MedicineUniversity of GlasgowGlasgowUK
| | - Sofie F. M. Bhatti
- Small Animal Department, Faculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| | | | | | - Andrea Tipold
- Department of Small Animal Medicine and SurgeryUniversity of Veterinary Medicine FoundationHannoverGermany
| | - Rodrigo Gutierrez Quintana
- Small Animal Hospital, School of Biodiversity, One Health and Veterinary MedicineUniversity of GlasgowGlasgowUK
| | | | - Theofanis Liatis
- Queen Mother Hospital for Animals, Royal Veterinary CollegeUniversity of LondonHatfieldUK
- Small Animal Hospital, School of Biodiversity, One Health and Veterinary MedicineUniversity of GlasgowGlasgowUK
| | - Jasmin Nessler
- Department of Small Animal Medicine and SurgeryUniversity of Veterinary Medicine FoundationHannoverGermany
| | - Clare Rusbridge
- School of Veterinary MedicineThe University of SurreyGuildfordUK
| | - Hugh J. Willison
- Neuroimmunology Laboratories, School of Infection and ImmunityUniversity of GlasgowGlasgowUK
| | - Angie Rupp
- Division of Pathology, Public Health and Disease Investigation, School of Biodiversity, One Health and Veterinary MedicineUniversity of GlasgowGlasgowUK
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Vandenberghe H, Baiker K, Nye G, Escauriaza L, Roberts E, Granger N, Reeve L. Diagnostic features of type II fibrinoid leukodystrophy (Alexander disease) in a juvenile Beagle dog. J Vet Intern Med 2023; 37:670-675. [PMID: 36799664 DOI: 10.1111/jvim.16655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 02/03/2023] [Indexed: 02/18/2023] Open
Abstract
A 3-month-old female entire Beagle presented with a progressive history of caudotentorial encephalopathy. Reactive encephalopathies were ruled out and tests for the most common infectious diseases agents were negative. Magnetic resonance imaging of the brain using a 1.5 Tesla scanner showed diffuse, bilateral, T2-weighted and T2-weighted-FLAIR hyperintense, T1-weighted hypointense, noncontrast-enhancing lesions involving the white matter of the cerebellum, brainstem, spinal cord, and forebrain to a lesser extent. There was cerebellar enlargement. Abnormalities were not detected on cerebrospinal fluid examination. Given the progressive nature of the disease and suspected poor prognosis the dog was euthanized. Histopathological analysis of the brain was consistent with fibrinoid leukodystrophy, also known as Alexander disease. Based on the classification used in humans, this is a description of MRI of a case of type II Alexander disease in veterinary medicine, with characteristics different to other described leukoencephalopathies in dogs.
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Affiliation(s)
| | - Kerstin Baiker
- School of Veterinary Medicine and Sciences, University of Nottingham Sutton Bonington Campus, Leicestershire, UK
| | - George Nye
- Highcroft Veterinary Referrals, Bristol, UK
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8
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McBride R, Parker E, Garabed RB, Olby NJ, Tipold A, Stein VM, Granger N, Hechler AC, Yaxley PE, Moore SA. Response to letter regarding "Developing a predictive model for spinal shock in dogs with spinal cord injury". J Vet Intern Med 2023; 37:402. [PMID: 36705230 PMCID: PMC10061160 DOI: 10.1111/jvim.16633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 01/09/2023] [Indexed: 01/28/2023] Open
Affiliation(s)
- Rebecca McBride
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, Ohio, USA
| | - Elizabeth Parker
- Department of Veterinary Preventive Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Rebecca B Garabed
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, Ohio, USA
| | - Natasha J Olby
- Department of Clinical Sciences, College of Veterinary Medicine, Raleigh, North Carolina, USA
| | - Andrea Tipold
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine, Hannover, Germany
| | - Veronika Maria Stein
- Department of Clinical Veterinary Sciences, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Nicolas Granger
- Department of Small Animal Clinical Sciences, School of Veterinary Sciences, University of Bristol, Bristol, UK
| | - Ashley C Hechler
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, Ohio, USA
| | - Page E Yaxley
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, Ohio, USA
| | - Sarah A Moore
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, Ohio, USA
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9
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Gilman O, Escauriaza L, Ogden D, Vandenberghe H, Roper D, Oxley B, Granger N. Thoracolumbar Spinal Stabilization with Three Dimensional-Printed Drill Guides and Pre-Contoured Polyaxial Bone Plates. Vet Comp Orthop Traumatol 2023; 36:46-52. [PMID: 36414002 DOI: 10.1055/s-0042-1756514] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The aim of this study was to report new preoperative and intraoperative techniques performed for canine thoracic or lumbar spine kyphosis stabilization using three-dimensional-printed patient-specific drill guides, polyaxial titanium bone plates and drill stops, and to determine the accuracy of screw placement using these techniques. STUDY DESIGN Retrospective study, five client-owned dogs. RESULTS Three-dimensional-printed patient-specific drill guides and drill stops allowed safe drilling and screw placement in all of the cases, with (i) 84% of the screws graded as I (ideal placement) and 16% as IIa, IIIa or IIIb according to the modified Zdichavsky classification (partial penetration of medial pedicle wall, partial penetration of lateral pedicle wall and full penetration of lateral pedicle wall respectively), (ii) mean mediolateral deviation of ± 4.06 degrees (standard deviation: 8.21 degrees) compared to planned trajectories and (iii) variation in screw depth of ± 2.29mm (standard deviation: 3.07mm) compared to planned depth. CONCLUSION We believe that the techniques presented here for thoracic spinal stabilization in dogs show promise; they allowed safe placement of screws along planned trajectories and depth; they also removed the need to use polymethylmethacrylate, while the use of titanium offers the possibility to repeat magnetic resonance imaging in these cases with chronic spinal conditions.
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Affiliation(s)
- Oliver Gilman
- Bristol Veterinary Specialists at Highcroft, CVS Referrals, United Kingdom
| | - Leticia Escauriaza
- Bristol Veterinary Specialists at Highcroft, CVS Referrals, United Kingdom
| | - Dan Ogden
- Bristol Veterinary Specialists at Highcroft, CVS Referrals, United Kingdom
| | | | - Darren Roper
- Bristol Veterinary Specialists at Highcroft, CVS Referrals, United Kingdom
| | | | - Nicolas Granger
- Bristol Veterinary Specialists at Highcroft, CVS Referrals, United Kingdom
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Escauriaza L, Fenn J, McCue J, Roper D, Vandenberghe H, Nye G, Oxley B, Granger N. A 3-Dimensional Printed Patient-Specific Surgical Guide to Facilitate Transsphenoidal Hypophysectomy in Dogs. Front Vet Sci 2022; 9:930856. [PMID: 35795781 PMCID: PMC9251581 DOI: 10.3389/fvets.2022.930856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 05/23/2022] [Indexed: 12/03/2022] Open
Abstract
Objective Hypophysectomy in dogs is a difficult surgery that requires specific learning and training. We aimed to evaluate the accuracy of a 3-dimensional printed patient-specific surgical guide to facilitate choosing the entry point in the basisphenoid bone before approaching the sella turcica during transsphenoidal hypophysectomy in dogs. Methods Two canine cadavers and 8 dogs undergoing transsphenoidal hypophysectomy for Cushing's disease treatment, involving design and fabrication of a 3-dimensional printed guide. The ideal entry point in the basisphenoid bone outer cortical layer was determined in each dog pre-operatively; its anatomical location was described with a set of measurements then compared to post-operative computed tomography measures describing the location of the outer cortical window created in the basisphenoid bone. Results Several guide designs were proposed, and a consensus reached based on surgeons' experience performing hypophysectomy. The device chosen could be applied to the size and shape of skulls encountered in this case series. The pre-planned measurements were comparable to post-operative measurement (there was also no statistical difference), with median of differences <0.1 mm, which we judged as clinically acceptable. Clinical Significance Hypophysectomy in dogs is a challenging procedure that has a learning curve and needs to be performed by specialist neurosurgeons. We propose that a low-profile 3-dimensional printed surgical guide can aid the specialist neurosurgeon to locate the burring site of the outer cortical layer of the basisphenoid bone at a pre-defined location and with good accuracy. It does not alleviate the need to understand the anatomy of the region and to know how to create a slot within the basisphenoid bone, which remains essential to enter the sella turcica. This device could help specialist veterinary neurosurgeons wishing to be trained to perform hypophysectomy.
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Affiliation(s)
- Leticia Escauriaza
- Neurology Department, Bristol Veterinary Specialists at Highcroft, CVS Referrals, Bristol, United Kingdom
| | - Joe Fenn
- Department of Clinical Science and Services, Royal Veterinary College, Hertfordshire, United Kingdom
| | - John McCue
- Animal Medical Centre, New York, NY, United States
| | - Darren Roper
- Neurology Department, Bristol Veterinary Specialists at Highcroft, CVS Referrals, Bristol, United Kingdom
| | - Helene Vandenberghe
- Neurology Department, Bristol Veterinary Specialists at Highcroft, CVS Referrals, Bristol, United Kingdom
| | - George Nye
- Neurology Department, Bristol Veterinary Specialists at Highcroft, CVS Referrals, Bristol, United Kingdom
| | | | - Nicolas Granger
- Neurology Department, Bristol Veterinary Specialists at Highcroft, CVS Referrals, Bristol, United Kingdom
- *Correspondence: Nicolas Granger
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11
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Prager J, Fenn J, Plested M, Escauriaza L, Merwe TVD, King B, Chari D, Wong LF, Granger N. Transplantation of encapsulated autologous olfactory ensheathing cell populations expressing chondroitinase for spinal cord injury: A safety and feasibility study in companion dogs. J Tissue Eng Regen Med 2022; 16:788-798. [PMID: 35686704 PMCID: PMC9542194 DOI: 10.1002/term.3328] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/08/2022] [Accepted: 05/24/2022] [Indexed: 11/08/2022]
Abstract
Spinal cord injury (SCI) can cause irreversible paralysis, with no regenerative treatment clinically available. Dogs with natural SCI present an established model and can facilitate translation of experimental findings in rodents to people. We conducted a prospective, single arm clinical safety study in companion dogs with chronic SCI to characterize the feasibility of intraspinal transplantation of hydrogel-encapsulated autologous mucosal olfactory ensheathing cell (mOEC) populations expressing chondroitinase ABC (chABC). mOECs and chABC are both promising therapies for SCI, and mOECs expressing chABC drive greater voluntary motor recovery than mOECs alone after SCI in rats. Canine mOECs encapsulated in collagen hydrogel can be matched in stiffness to canine SCI. Four dogs with complete and chronic loss of function caudal to a thoraco-lumbar lesion were recruited. After baseline measures, olfactory mucosal biopsy was performed and autologous mOECs cultured and transduced to express chABC, then hydrogel-encapsulated and percutaneously injected into the spinal cord. Dogs were monitored for 6 months with repeat clinical examinations, spinal MRI, kinematic gait and von Frey assessment. No adverse effects or significant changes on neurological examination were detected. MRI revealed large and variable lesions, with no spinal cord compression or ischemia visible after hydrogel transplantation. Owners reported increased pelvic-limb reflexes with one dog able to take 2-3 unsupported steps, but gait-scoring and kinematic analysis showed no significant improvements. This novel combination approach to regeneration after SCI is therefore feasible and safe in paraplegic dogs in a clinical setting. A randomised-controlled trial in this translational model is proposed to test efficacy.
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Affiliation(s)
- Jon Prager
- Clinical Science and Services, The Royal Veterinary College, London, UK.,Bristol Veterinary School, University of Bristol, Bristol, UK
| | - Joe Fenn
- Clinical Science and Services, The Royal Veterinary College, London, UK
| | - Mark Plested
- Clinical Science and Services, The Royal Veterinary College, London, UK
| | | | | | - Barbora King
- Clinical Investigation Centre, The Royal Veterinary College, London, UK
| | - Divya Chari
- Neural Tissue Engineering Group, Keele School of Medicine, Keele University, Keele, UK
| | | | - Nicolas Granger
- Clinical Science and Services, The Royal Veterinary College, London, UK.,Highcroft Veterinary Referrals, CVS, Bristol, UK
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12
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Sadrafshari S, Metcalfe B, Donaldson N, Granger N, Prager J, Taylor J. The Design of a Low Noise, Multi-Channel Recording System for Use in Implanted Peripheral Nerve Interfaces. Sensors (Basel) 2022; 22:3450. [PMID: 35591140 PMCID: PMC9099588 DOI: 10.3390/s22093450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 04/18/2022] [Accepted: 04/23/2022] [Indexed: 02/04/2023]
Abstract
In the development of implantable neural interfaces, the recording of signals from the peripheral nerves is a major challenge. Since the interference from outside the body, other biopotentials, and even random noise can be orders of magnitude larger than the neural signals, a filter network to attenuate the noise and interference is necessary. However, these networks may drastically affect the system performance, especially in recording systems with multiple electrode cuffs (MECs), where a higher number of electrodes leads to complicated circuits. This paper introduces formal analyses of the performance of two commonly used filter networks. To achieve a manageable set of design equations, the state equations of the complete system are simplified. The derived equations help the designer in the task of creating an interface network for specific applications. The noise, crosstalk and common-mode rejection ratio (CMRR) of the recording system are computed as a function of electrode impedance, filter component values and amplifier specifications. The effect of electrode mismatches as an inherent part of any multi-electrode system is also discussed, using measured data taken from a MEC implanted in a sheep. The accuracy of these analyses is then verified by simulations of the complete system. The results indicate good agreement between analytic equations and simulations. This work highlights the critical importance of understanding the effect of interface circuits on the performance of neural recording systems.
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Affiliation(s)
- Shamin Sadrafshari
- Department of Electronic and Electrical Engineering, University of Bath, Bath BA2 7AY, UK; (B.M.); (J.T.)
| | - Benjamin Metcalfe
- Department of Electronic and Electrical Engineering, University of Bath, Bath BA2 7AY, UK; (B.M.); (J.T.)
| | - Nick Donaldson
- Department of Medical Physics and Bioengineering, University College London, London WC1E 6BT, UK;
| | - Nicolas Granger
- Department of Clinical Science and Services, The Royal Veterinary College, Hawkshead Lane, Brookmans Park, Hatfield AL9 7TA, UK; (N.G.); (J.P.)
| | - Jon Prager
- Department of Clinical Science and Services, The Royal Veterinary College, Hawkshead Lane, Brookmans Park, Hatfield AL9 7TA, UK; (N.G.); (J.P.)
| | - John Taylor
- Department of Electronic and Electrical Engineering, University of Bath, Bath BA2 7AY, UK; (B.M.); (J.T.)
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13
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Parsons K, Langley-Hobbs S, Warren-Smith C, Southerden P, Granger N, Meakin L. Rostral mandibulectomy for the management of trismus in a cat. JFMS Open Rep 2022; 8:20551169221074948. [PMID: 35251676 PMCID: PMC8891855 DOI: 10.1177/20551169221074948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Case summary A 5-year-old domestic shorthair cat was evaluated for weight loss and poor coat condition due to an inability to open its mouth (trismus) following head trauma 2 months previously. Contrast CT, electromyography and temporal muscle biopsy identified findings consistent with muscle atrophy, denervation and degeneration. Conservative treatment failed to improve the trismus so a rostral mandibulectomy was performed. Following surgery, the patient resumed normal grooming behaviour and was able to eat soft food unaided. The cat re-presented 5 months postoperatively at which time its body condition had improved; however, episodes of sneezing had been noted. An oronasal fistula was diagnosed and treated successfully with a silicon nasal septum button. Follow-up at 30 months reported an excellent outcome. Relevance and novel information Management of trismus with rostral mandibulectomy may be associated with a good return to function, including prehension and ingestion of food, and restoration of normal grooming activity. Rostral mandibulectomy could be considered for animals with trismus for other aetiologies such as masticatory myositis where other management options are not available.
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Affiliation(s)
- Kevin Parsons
- Langford Vets, Bristol Veterinary School, University of Bristol, Bristol, UK
| | | | | | | | | | - Lee Meakin
- Langford Vets, Bristol Veterinary School, University of Bristol, Bristol, UK
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14
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Halstead SK, Gourlay DS, Penderis J, Bianchi E, Dondi M, Wessmann A, Musteata M, Le Chevoir M, Martinez-Anton L, Bhatti SFM, Volk H, Mateo I, Tipold A, Ives E, Pakozdy A, Gutierrez-Quintana R, Brocal J, Whitehead Z, Granger N, Pazzi P, Harcourt-Brown T, José-López R, Rupp S, Schenk HC, Smith P, Gandini G, Menchetti M, Mortera-Balsa V, Rusbridge C, Tauro A, Cozzi F, Deutschland M, Tirrito F, Freeman P, Lowrie M, Jackson MR, Willison HJ, Rupp A. Serum anti-GM2 and anti-GalNAc-GD1a IgG antibodies are biomarkers for acute canine polyradiculoneuritis. J Small Anim Pract 2022; 63:104-112. [PMID: 34791652 DOI: 10.1111/jsap.13439] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 08/13/2021] [Accepted: 09/19/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES A previous single-country pilot study indicated serum anti-GM2 and anti-GA1 anti-glycolipid antibodies as potential biomarkers for acute canine polyradiculoneuritis. This study aims to validate these findings in a large geographically heterogenous cohort. MATERIALS AND METHODS Sera from 175 dogs clinically diagnosed with acute canine polyradiculoneuritis, 112 dogs with other peripheral nerve, cranial nerve or neuromuscular disorders and 226 neurologically normal dogs were screened for anti-glycolipid antibodies against 11 common glycolipid targets to determine the immunoglobulin G anti-glycolipid antibodies with the highest combined sensitivity and specificity for acute canine polyradiculoneuritis. RESULTS Anti-GM2 anti-glycolipid antibodies reached the highest combined sensitivity and specificity (sensitivity: 65.1%, 95% confidence interval 57.6 to 72.2%; specificity: 90.2%, 95% confidence interval 83.1 to 95.0%), followed by anti-GalNAc-GD1a anti-glycolipid antibodies (sensitivity: 61.7%, 95% confidence interval 54.1 to 68.9%; specificity: 89.3%, 95% confidence interval 82.0 to 94.3%) and these anti-glycolipid antibodies were frequently present concomitantly. Anti-GA1 anti-glycolipid antibodies were detected in both acute canine polyradiculoneuritis and control animals. Both for anti-GM2 and anti-GalNAc-GD1a anti-glycolipid antibodies, sex was found a significantly associated factor with a female to male odds ratio of 2.55 (1.27 to 5.31) and 3.00 (1.22 to 7.89), respectively. Anti-GalNAc-GD1a anti-glycolipid antibodies were more commonly observed in dogs unable to walk (OR 4.56, 1.56 to 14.87). CLINICAL SIGNIFICANCE Anti-GM2 and anti-GalNAc-GD1a immunoglobulin G anti-glycolipid antibodies represent serum biomarkers for acute canine polyradiculoneuritis.
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Affiliation(s)
- S K Halstead
- Neuroimmunology Laboratory, Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, G12 8TA, UK
| | - D S Gourlay
- Neuroimmunology Laboratory, Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, G12 8TA, UK
| | - J Penderis
- Vet Extra Neurology, Broadleys Veterinary Hospital, Stirling, FK7 7LE, UK
| | - E Bianchi
- Department of Veterinary Science, University of Parma, 43126, Parma, Italy
| | - M Dondi
- Department of Veterinary Science, University of Parma, 43126, Parma, Italy
| | - A Wessmann
- Neurology and Neurosurgery Service, Pride Veterinary Centre, Pride Park, Derby, DE24 8HX, UK
| | - M Musteata
- Neurology Service, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, Iași, 700489, Romania
| | - M Le Chevoir
- Department of Neurology and Neurosurgery, University of Melbourne, Werribee, Victoria, 3030, Australia
| | - L Martinez-Anton
- Chestergates Veterinary Specialists, Telford Court, Chestergates, CH1 6LT, UK
| | - S F M Bhatti
- Small Animal Department, Small Animal Teaching Hospital, Faculty of Veterinary Medicine, Ghent University, 9820, Merelbeke, Belgium
| | - H Volk
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, 30559, Hannover, Germany
| | - I Mateo
- Servicio de Neurología, Hospital Clínico Veterinario - Universidad Alfonso X el Sabio, Madrid, Spain
| | - A Tipold
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, 30559, Hannover, Germany
| | - E Ives
- Anderson Moores Veterinary Specialists, Hursley, Winchester, SO21 2LL, UK
| | - A Pakozdy
- University Hospital for Small Animals, University of Veterinary Medicine, Vienna, Austria
| | | | - J Brocal
- Wear Referrals Veterinary Hospital, Bradbury, Stockton-on-Tees, TS21 2ES, UK
| | - Z Whitehead
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, 0110, South Africa
| | - N Granger
- The Royal Veterinary College, University of London, Hatfield, Hertfordshire, UK.,CVS Referrals, Bristol Veterinary Specialists at Highcroft, Bristol, UK
| | - P Pazzi
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, 0110, South Africa
| | - T Harcourt-Brown
- Langford Veterinary Services, School of Veterinary Sciences, University of Bristol, Lower Langford, BS40 5DU, UK
| | - R José-López
- School of Veterinary Medicine, University of Glasgow, Glasgow, G61 1QH, UK
| | - S Rupp
- Tierklinik Hofheim, 65719, Hofheim, Germany
| | - H C Schenk
- Tierklinik Lüneburg, 21337, Lüneburg, Germany
| | - P Smith
- Hamilton Specialist Referrals, Cressex Business Park, High Wycombe, HP12 3SD, UK
| | - G Gandini
- Department of Veterinary Medical Sciences, University of Bologna, 40064, Ozzano dell'Emilia, Italy
| | - M Menchetti
- Neurology and Neurosurgery Division, San Marco Veterinary Clinic, Veggiano, Italy
| | - V Mortera-Balsa
- North Downs Specialist Referrals, 3&4 The Brewerstreet Dairy Business Park, Bletchingley, Surrey, RH1 4QP, UK
| | - C Rusbridge
- Neurology Section, Fitzpatrick Referrals, Godalming, Surrey, GU2 7AL, UK.,School of Veterinary Medicine, Faculty of Health & Medical Sciences, University of Surrey, Guildford, Surrey, GU2 7AL, UK
| | - A Tauro
- Chestergates Veterinary Specialists, Telford Court, Chestergates, CH1 6LT, UK
| | - F Cozzi
- Clinica Neurologica Veterinaria, 20148, Milan, Italy
| | | | - F Tirrito
- Clinica Neurologica Veterinaria, 20148, Milan, Italy
| | - P Freeman
- The Queen's Veterinary School Hospital, Cambridge, CB3 0ES, UK
| | - M Lowrie
- Dovecote Veterinary Hospital, Castle Donington, Derby, DE74 2LJ, UK
| | - M R Jackson
- Institute of Cancer Sciences, University of Glasgow, Bearsden, G61 1QH, UK
| | - H J Willison
- Neuroimmunology Laboratory, Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, G12 8TA, UK
| | - A Rupp
- School of Veterinary Medicine, University of Glasgow, Glasgow, G61 1QH, UK
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15
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McBride R, Parker E, Garabed RB, Olby NJ, Tipold A, Stein VM, Granger N, Hechler AC, Yaxley PE, Moore SA. Developing a predictive model for spinal shock in dogs with spinal cord injury. J Vet Intern Med 2022; 36:663-671. [PMID: 35001437 PMCID: PMC8965241 DOI: 10.1111/jvim.16352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 12/10/2021] [Accepted: 12/21/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Reduced pelvic limb reflexes in dogs with spinal cord injury typically suggests a lesion of the L4-S3 spinal cord segments. However, pelvic limb reflexes might also be reduced in dogs with a T3-L3 myelopathy and concurrent spinal shock. HYPOTHESIS/OBJECTIVES We hypothesized that statistical models could be used to identify clinical variables associated with spinal shock in dogs with spinal cord injuries. ANIMALS Cohort of 59 dogs with T3-L3 myelopathies and spinal shock and 13 dogs with L4-S3 myelopathies. METHODS Data used for this study were prospectively entered by partner institutions into the International Canine Spinal Cord Injury observational registry between October 2016 and July 2019. Univariable logistic regression analyses were performed to assess the association between independent variables and the presence of spinal shock. Independent variables were selected for inclusion in a multivariable logistic regression model if they had a significant effect (P ≤ .1) on the odds of spinal shock in univariable logistic regression. RESULTS The final multivariable model included the natural log of weight (kg), the natural log of duration of clinical signs (hours), severity (paresis vs paraplegia), and pelvic limb tone (normal vs decreased/absent). The odds of spinal shock decreased with increasing weight (odds ratio [OR] = 0.28, P = .09; confidence interval [CI] 0.07-1.2), increasing duration (OR = 0.44, P = .02; CI 0.21-0.9), decreased pelvic limb tone (OR = 0.04, P = .003; CI 0.01-0.36), and increased in the presence of paraplegia (OR = 7.87, P = .04; CI 1.1-56.62). CONCLUSIONS AND CLINICAL IMPORTANCE A formula, as developed by the present study and after external validation, could be useful for assisting clinicians in determining the likelihood of spinal shock in various clinical scenarios and aid in diagnostic planning.
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Affiliation(s)
- Rebecca McBride
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, Ohio, USA
| | - Elizabeth Parker
- Department of Veterinary Preventive Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Rebecca B Garabed
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, Ohio, USA
| | - Natasha J Olby
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Andrea Tipold
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine, Hannover, Germany
| | - Veronika Maria Stein
- Department of Clinical Veterinary Sciences, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Nicolas Granger
- Department of Small Animal Clinical Sciences, School of Veterinary Sciences, University of Bristol, Bristol, United Kingdom
| | - Ashley C Hechler
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, Ohio, USA
| | - Page E Yaxley
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, Ohio, USA
| | - Sarah A Moore
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, Ohio, USA
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16
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Escauriaza L, Reeve L, Hahn H, Granger N, Vandenberghe H. Brucella Canis
discospondylitis in a dog imported into the United Kingdom from Romania. Vet Record Case Reports 2021. [DOI: 10.1002/vrc2.175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
| | - Lizzie Reeve
- Neurology, Highcroft Veterinary Referrals, Neurology Bristol UK
| | - Harriet Hahn
- Neurology, Highcroft Veterinary Referrals, Neurology Bristol UK
| | - Nicolas Granger
- Neurology, Highcroft Veterinary Referrals, Neurology Bristol UK
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17
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Vandenberghe H, Escauriaza L, Nye G, Teague M, Granger N. Postvaccination encephalomyelitis in German pinschers. Vet Rec 2021; 188:231-232. [PMID: 33739527 DOI: 10.1002/vetr.333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Helene Vandenberghe
- Highcroft Veterinary Referrals, 615 Wells Road, Whitchurch, Bristol, BS14 9BE
| | - Leticia Escauriaza
- Highcroft Veterinary Referrals, 615 Wells Road, Whitchurch, Bristol, BS14 9BE
| | - George Nye
- Highcroft Veterinary Referrals, 615 Wells Road, Whitchurch, Bristol, BS14 9BE
| | - Molly Teague
- Highcroft Veterinary Referrals, 615 Wells Road, Whitchurch, Bristol, BS14 9BE
| | - Nicolas Granger
- Highcroft Veterinary Referrals, 615 Wells Road, Whitchurch, Bristol, BS14 9BE
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18
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Prager J, Ito D, Carwardine DR, Jiju P, Chari DM, Granger N, Wong LF. Delivery of chondroitinase by canine mucosal olfactory ensheathing cells alongside rehabilitation enhances recovery after spinal cord injury. Exp Neurol 2021; 340:113660. [PMID: 33647272 DOI: 10.1016/j.expneurol.2021.113660] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 02/21/2021] [Accepted: 02/24/2021] [Indexed: 01/11/2023]
Abstract
Spinal cord injury (SCI) can cause chronic paralysis and incontinence and remains a major worldwide healthcare burden, with no regenerative treatment clinically available. Intraspinal transplantation of olfactory ensheathing cells (OECs) and injection of chondroitinase ABC (chABC) are both promising therapies but limited and unpredictable responses are seen, particularly in canine clinical trials. Sustained delivery of chABC presents a challenge due to its thermal instability; we hypothesised that transplantation of canine olfactory mucosal OECs genetically modified ex vivo by lentiviral transduction to express chABC (cOEC-chABC) would provide novel delivery of chABC and synergistic therapy. Rats were randomly divided into cOEC-chABC, cOEC, or vehicle transplanted groups and received transplant immediately after dorsal column crush corticospinal tract (CST) injury. Rehabilitation for forepaw reaching and blinded behavioural testing was conducted for 8 weeks. We show that cOEC-chABC transplanted animals recover greater forepaw reaching accuracy on Whishaw testing and more normal gait than cOEC transplanted or vehicle control rats. Increased CST axon sprouting cranial to the injury and serotonergic fibres caudal to the injury suggest a mechanism for recovery. We therefore demonstrate that cOECs can deliver sufficient chABC to drive modest functional improvement, and that this genetically engineered cellular and molecular approach is a feasible combination therapy for SCI.
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Affiliation(s)
- Jon Prager
- Bristol Veterinary School, University of Bristol, Bristol, UK; The Royal Veterinary College, University of London, Hatfield, UK
| | - Daisuke Ito
- Bristol Medical School, University of Bristol, Bristol, UK; School of Veterinary Medicine, Nihon University, Japan
| | | | - Prince Jiju
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Divya M Chari
- Neural Tissue Engineering, Keele School of Medicine, Keele University, Keele, UK
| | - Nicolas Granger
- The Royal Veterinary College, University of London, Hatfield, UK
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19
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McFadzean WJM, Macfarlane P, Granger N, Murrell JC. Influence of peri-incisional epaxial muscle infiltration with bupivacaine pre- or post-surgery on opioid administration in dogs undergoing thoraco-lumbar hemilaminectomy. Vet J 2021; 270:105622. [PMID: 33641804 DOI: 10.1016/j.tvjl.2021.105622] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 12/02/2020] [Accepted: 01/18/2021] [Indexed: 01/03/2023]
Abstract
This study investigated the influence of bupivacaine infiltration before or after hemilaminectomy on peri-operative opioid requirement in dogs. Thirty dogs undergoing T3-L3 hemilaminectomy were randomly assigned to receive peri-incisional infiltration of bupivacaine 2 mg/kg into the epaxial muscles before surgery (Group A), at wound closure (Group B), or no infiltration (Group C). Anaesthesia comprised dexmedetomidine 4 mcg/kg and methadone 0.3 mg/kg IV (premedication), alfaxalone IV (induction), and isoflurane in oxygen (maintenance). All dogs received meloxicam SC/PO prior to induction of general anaesthesia. Response to surgery, defined as a change in autonomic physiological variables >20% above baseline, was treated with fentanyl 2.5 mcg/kg boluses, followed by a continuous rate infusion of fentanyl at 5 mcg/kg/h. The Glasgow Composite Pain Score-Short Form (GCPS-SF) was performed before premedication and at regular intervals until 24 h postoperatively. Methadone 0.2 mg/kg analgesia was given IV if GCPS-SF was ≥5/20. Number of intraoperative, postoperative and total analgesic interventions were recorded. Analgesic interventions were analysed using a chi-squared test using a Pocock approach and statistical significance was set at P < 0.029. The number of intra-operative analgesic interventions in Group A (median, 0; range, 0-2), was significantly lower than in Group B (median, 3; range, 0-5) and Group C (median, 3; range, 0-5; P = 0.019). Regarding postoperative interventions, there were significantly fewer in Group A (median, 0; range, 0-1) and Group B (median, 0; range, 0-1) than in Group C (median, 1; range, 0-2; P = 0.047). Group A (median, 0; range, 0-3), had significantly fewer total analgesic interventions than Group B (median, 3; range, 0-6) and Group C (median, 4; range, 1-7; P = 0.014). Bupivacaine reduced peri-operative opioid administration and pre-surgical peri-incisional infiltration yielded the greatest benefit.
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Affiliation(s)
- W J M McFadzean
- School of Veterinary Sciences, University of Bristol, Bristol, Somerset, UK.
| | - P Macfarlane
- School of Veterinary Sciences, University of Bristol, Bristol, Somerset, UK
| | - N Granger
- School of Veterinary Sciences, University of Bristol, Bristol, Somerset, UK
| | - J C Murrell
- School of Veterinary Sciences, University of Bristol, Bristol, Somerset, UK
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20
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Escauriaza L, Vandenberghe H, Barberet V, Granger N. What Is Your Neurologic Diagnosis? J Am Vet Med Assoc 2021; 258:43-46. [PMID: 33314978 DOI: 10.2460/javma.258.1.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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21
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Abstract
Spinal cord injury in companion dogs can lead to urinary and fecal incontinence or retention, depending on the severity, and localization of the lesion along the canine nervous system. The bladder and gastrointestinal dysfunction caused by lesions of the autonomic system can be difficult to recognize, interpret and are easily overlooked. Nevertheless, it is crucial to maintain a high degree of awareness of the impact of micturition and defecation disturbances on the animal's condition, welfare and on the owner. The management of these disabilities is all the more challenging that the autonomic nervous system physiology is a complex topic. In this review, we propose to briefly remind the reader the physiology of micturition and defecation in dogs. We then present the bladder and gastrointestinal clinical signs associated with sacral lesions (i.e., the L7-S3 spinal cord segments and nerves) and supra-sacral lesions (i.e., cranial to the L7 spinal cord segment), largely in the context of intervertebral disc herniation. We summarize what is known about the natural recovery of urinary and fecal continence in dogs after spinal cord injury. In particular we review the incidence of urinary tract infection after injury. We finally explore the past and recent literature describing management of urinary and fecal dysfunction in the acute and chronic phase of spinal cord injury. This comprises medical therapies but importantly a number of surgical options, some known for decades such as sacral nerve stimulation, that might spark some interest in the field of spinal cord injury in companion dogs.
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Affiliation(s)
- Nicolas Granger
- The Royal Veterinary College, University of London, Hertfordshire, United Kingdom.,CVS Referrals, Bristol Veterinary Specialists at Highcroft, Bristol, United Kingdom
| | - Natasha J Olby
- Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, NC, United States
| | - Yvette S Nout-Lomas
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, United States
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22
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Lewis MJ, Granger N, Jeffery ND. Emerging and Adjunctive Therapies for Spinal Cord Injury Following Acute Canine Intervertebral Disc Herniation. Front Vet Sci 2020; 7:579933. [PMID: 33195591 PMCID: PMC7593405 DOI: 10.3389/fvets.2020.579933] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 09/04/2020] [Indexed: 11/13/2022] Open
Abstract
Some dogs do not make a full recovery following medical or surgical management of acute canine intervertebral disc herniation (IVDH), highlighting the limits of currently available treatment options. The multitude of difficulties in treating severe spinal cord injury are well-recognized, and they have spurred intense laboratory research, resulting in a broad range of strategies that might have value in treating spinal cord-injured dogs. These include interventions that aim to directly repair the spinal cord lesion, promote axonal sparing or regeneration, mitigate secondary injury through neuroprotective mechanisms, or facilitate functional compensation. Despite initial promise in experimental models, many of these techniques have failed or shown mild efficacy in clinical trials in humans and dogs, although high quality evidence is lacking for many of these interventions. However, the continued introduction of new options to the veterinary clinic remains important for expanding our understanding of the mechanisms of injury and repair and for development of novel and combined strategies for severely affected dogs. This review outlines adjunctive or emerging therapies that have been proposed as treatment options for dogs with acute IVDH, including discussion of local or lesion-based approaches as well as systemically applied treatments in both acute and subacute-to-chronic settings. These interventions include low-level laser therapy, electromagnetic fields or oscillating electrical fields, adjunctive surgical techniques (myelotomy or durotomy), systemically or locally-applied hypothermia, neuroprotective chemicals, physical rehabilitation, hyperbaric oxygen therapy, electroacupuncture, electrical stimulation of the spinal cord or specific peripheral nerves, nerve grafting strategies, 4-aminopyridine, chondroitinase ABC, and cell transplantation.
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Affiliation(s)
- Melissa J Lewis
- Department of Veterinary Clinical Sciences, Purdue University College of Veterinary Medicine, West Lafayette, IN, United States
| | - Nicolas Granger
- The Royal Veterinary College, University of London, Hertfordshire, United Kingdom.,CVS Referrals, Bristol Veterinary Specialists at Highcroft, Bristol, United Kingdom
| | - Nick D Jeffery
- Department of Small Animal Clinical Sciences, Texas A & M College of Veterinary Medicine and Biomedical Sciences, College Station, TX, United States
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23
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Moore SA, Tipold A, Olby NJ, Stein V, Granger N. Current Approaches to the Management of Acute Thoracolumbar Disc Extrusion in Dogs. Front Vet Sci 2020; 7:610. [PMID: 33117847 PMCID: PMC7521156 DOI: 10.3389/fvets.2020.00610] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 07/28/2020] [Indexed: 12/15/2022] Open
Abstract
Intervertebral disc extrusion (IVDE) is one of the most common neurologic problems encountered in veterinary clinical practice. The purpose of this manuscript is to provide an overview of the literature related to treatment of acute canine thoracolumbar IVDE to help construct a framework for standard care of acute canine thoracolumbar IVDE where sufficient evidence exists and to highlight opportunities for future prospective veterinary clinical research useful to strengthen care recommendations in areas where evidence is low or non-existent. While there exist a number of gaps in the veterinary literature with respect to standards of care for dogs with acute thoracolumbar IVDE, recommendations for standard care can be made in some areas, particularly with respect to surgical decompression where the currently available evidence supports that surgery should be recommended for dogs with nonambulatory paraparesis or worse. While additional information is needed about the influence on timing of decompression on outcome in dogs that are deep pain negative for longer than 48 h duration, there is no evidence to support treatment of the 48 h time point as a cut off beyond which it becomes impossible for dogs to achieve locomotor recovery. Surgical decompression is best accomplished by either hemilaminectomy or mini-hemilaminectomy and fenestration of, at a minimum, the acutely ruptured disc. Adjacent discs easily accessed by way of the same approach should be considered for fenestration given the evidence that this substantially reduces future herniation at fenestrated sites. Currently available neuroprotective strategies such as high does MPSS and PEG are not recommended due to lack of demonstrated treatment effect in randomized controlled trials, although the role of anti-inflammatory steroids as a protective strategy against progressive myelomalacia and the question of whether anti-inflammatory steroids or NSAIDs provide superior medical therapy require further evaluation.
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Affiliation(s)
- Sarah A Moore
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, OH, United States
| | - Andrea Tipold
- Department Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hanover, Germany
| | - Natasha J Olby
- Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, NC, United States
| | - Veronica Stein
- Division of Clinical Neurology, Department for Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Nicolas Granger
- The Royal Veterinary College, University of London, Hatfield, United Kingdom.,CVS Referrals, Bristol Veterinary Specialists at Highcroft, Bristol, United Kingdom
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Farré Mariné A, Granger N, Bertolani C, Mascort Boixeda J, Shelton GD, Luján Feliu-Pascual A. Long-term outcome of Miniature Schnauzers with genetically confirmed demyelinating polyneuropathy: 12 cases. J Vet Intern Med 2020; 34:2005-2011. [PMID: 32738000 PMCID: PMC7517849 DOI: 10.1111/jvim.15861] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 07/01/2020] [Accepted: 07/01/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND A demyelinating polyneuropathy with focally folded myelin sheaths was reported in 3 Miniature Schnauzers in France in 2008 and was predicted to represent a naturally occurring canine homologue of Charcot-Marie-Tooth (CMT) disease. A genetic variant of MTRM13/SBF2 has been identified as causative in affected Miniature Schnauzers with this polyneuropathy. OBJECTIVE To provide data on the long-term progression in affected Miniature Schnauzers from Spain confirmed with the MTRM13/SBF2 genetic variant. ANIMALS Twelve Miniature Schnauzers presented between March 2013 and June 2019. METHODS Only dogs presented with consistent clinical signs and homozygous for the MTRM13/SBF2 genetic variant were included. Clinical signs, age of onset and presentation, time from onset to presentation, treatment, outcome, and time from diagnosis to final follow-up were retrospectively reviewed. RESULTS The hallmark clinical signs at the time of presentation were regurgitation with radiologically confirmed megaesophagus (11/12) and aphonic bark (11/12) with or without obvious neuromuscular weakness despite electrodiagnostic evidence of appendicular demyelinating polyneuropathy. Age of onset and clinical presentation were 3-18 and 4-96 months, respectively. Treatment was mostly symptomatic and consisted of head elevation during meals, antacids, prokinetics, bethanechol, sildenafil, mirtazapine, or some combination of these. During the follow-up period (7-73 months), clinical signs were unchanged in (11/12) cases with aspiration pneumonia developing occasionally (6/12) and being the cause of death in 1 dog. CONCLUSIONS AND CLINICAL IMPORTANCE Demyelinating polyneuropathy of Miniature Schnauzers tends to remain stable over the long term leading to a good prognosis with preventive feeding measures and symptomatic treatment to control aspiration pneumonia.
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Affiliation(s)
| | - Nicolas Granger
- CVS Referrals, Bristol Veterinary Specialists at Highcroft, Bristol, UK.,The Royal Veterinary College, University of London, Hatfield, UK
| | | | | | - G Diane Shelton
- Department of Pathology, School of Medicine, University of California and Comparative Neuromuscular Laboratory, San Diego, California, USA
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Prager J, Adams CF, Delaney AM, Chanoit G, Tarlton JF, Wong LF, Chari DM, Granger N. Stiffness-matched biomaterial implants for cell delivery: clinical, intraoperative ultrasound elastography provides a 'target' stiffness for hydrogel synthesis in spinal cord injury. J Tissue Eng 2020; 11:2041731420934806. [PMID: 32670538 PMCID: PMC7336822 DOI: 10.1177/2041731420934806] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 05/21/2020] [Indexed: 12/14/2022] Open
Abstract
Safe hydrogel delivery requires stiffness-matching with host tissues to avoid
iatrogenic damage and reduce inflammatory reactions. Hydrogel-encapsulated cell
delivery is a promising combinatorial approach to spinal cord injury therapy,
but a lack of in vivo clinical spinal cord injury stiffness
measurements is a barrier to their use in clinics. We demonstrate that
ultrasound elastography – a non-invasive, clinically established tool – can be
used to measure spinal cord stiffness intraoperatively in canines with
spontaneous spinal cord injury. In line with recent experimental reports, our
data show that injured spinal cord has lower stiffness than uninjured cord. We
show that the stiffness of hydrogels encapsulating a clinically relevant
transplant population (olfactory ensheathing cells) can also be measured by
ultrasound elastography, enabling synthesis of hydrogels with comparable
stiffness to canine spinal cord injury. We therefore demonstrate
proof-of-principle of a novel approach to stiffness-matching hydrogel-olfactory
ensheathing cell implants to ‘real-life’ spinal cord injury values; an approach
applicable to multiple biomaterial implants for regenerative therapies.
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Affiliation(s)
- Jon Prager
- Bristol Veterinary School, University of Bristol, Bristol, UK.,The Royal Veterinary College, University of London, Hatfield, UK
| | - Christopher F Adams
- Cellular and Neural Engineering Group, Institute for Science and Technology in Medicine, Keele University, Keele, UK
| | - Alexander M Delaney
- Cellular and Neural Engineering Group, Institute for Science and Technology in Medicine, Keele University, Keele, UK
| | | | - John F Tarlton
- Bristol Veterinary School, University of Bristol, Bristol, UK
| | | | - Divya M Chari
- Cellular and Neural Engineering Group, Institute for Science and Technology in Medicine, Keele University, Keele, UK
| | - Nicolas Granger
- The Royal Veterinary College, University of London, Hatfield, UK
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Taylor J, Sadrafshari S, Donaldson N, Granger N, Prager J, Metcalfe B. The Effects of the Presence of Multiple Conduction Velocities in the Analysis of Electrically-Evoked Compound Action Potentials (eCAPs). Annu Int Conf IEEE Eng Med Biol Soc 2020; 2020:3477-3480. [PMID: 33018752 DOI: 10.1109/embc44109.2020.9175953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
New methods for the analysis of electrically-evoked compound action potentials (eCAPs) are described. Mammalian nerves tend to have broad multi-modal distributions of fibre diameters, which translates into a spread of conduction velocities. The method of velocity selective recording (VSR) is unable to distinguish between this spectral spread and the transfer function of the system. The concept of the velocity impulse function (VIF) is introduced as a tool to differentiate between these signal and system attributes. The new methods enable separate estimates of velocity spectral broadening and signal-to-noise ratio (SNR) to be obtained.
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Metcalfe B, Granger N, Prager J, Sadrafshari S, Grego T, Taylor J, Donaldson N. Selective Recording of Urinary Bladder Fullness from the Extradural Sacral Roots . Annu Int Conf IEEE Eng Med Biol Soc 2020; 2020:3873-3876. [PMID: 33018846 DOI: 10.1109/embc44109.2020.9176038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Managing the urinary bladder is of primary importance to clinicians and patients after trauma to the spinal cord. Sacral Anterior Root Stimulators that control the bladder have been available as clinical technology for many years, however these devices cannot measure the fullness of the urinary bladder or detect the onset of reflex voiding. In order to address this fundamental limitation, it is necessary to develop a method for recording the neural signals that encode bladder fullness. This paper presents a proof of concept technique for recording bladder afferents from the extradural sacral roots using a multiple electrode cuff. Results are provided from acute in-vivo experiments performed in sheep.
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Jeffery ND, Mankin JM, Ito D, Boudreau CE, Kerwin SC, Levine JM, Krasnow MS, Andruzzi MN, Alcott CJ, Granger N. Extended durotomy to treat severe spinal cord injury after acute thoracolumbar disc herniation in dogs. Vet Surg 2020; 49:884-893. [PMID: 32277768 DOI: 10.1111/vsu.13423] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 10/29/2019] [Accepted: 03/16/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To report recovery of ambulation of dogs treated with extended thoracolumbar durotomy for severe spinal cord injury caused by intervertebral disc herniation. STUDY DESIGN Descriptive cohort. ANIMALS Twenty-six consecutive paraplegic dogs presented with loss of deep pain sensation after acute thoracolumbar intervertebral disc herniation. METHODS Each dog underwent routine diagnostic assessment and surgery for removal of extradural herniated intervertebral disc, followed by a four-vertebral body length durotomy centered on the herniated disc. Each dog was followed up until it was able to walk 10 steps without assistance or until 6 months after surgery. RESULTS Sixteen of 26 dogs recovered to walk unaided (all but one also recovered fecal and urinary continence), and six dogs did not; four dogs were lost to follow-up. One dog was euthanized because of signs consistent with progressive myelomalacia. There was no evidence of detrimental effects of durotomy within the period of study. Using Bayesian analysis, we found a point estimate of successful outcome of 71% with 95% credible interval from 52% to 87%. CONCLUSION Extended durotomy seemed to improve the outcome of dogs in our case series without increase in morbidity. CLINICAL SIGNIFICANCE Extended durotomy appears safe and may improve the outcome of dogs with severe thoracolumbar mixed contusion and compressive injuries associated with acute intervertebral disc extrusion.
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Affiliation(s)
- Nick D Jeffery
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas
| | - Joe M Mankin
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas
| | - Daisuke Ito
- Division of Veterinary Neurology, School of Veterinary Medicine, Nihon University, Fujisawa, Kanagawa, Japan
| | - C Elizabeth Boudreau
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas
| | - Sharon C Kerwin
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas
| | - Jon M Levine
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas
| | - Maya S Krasnow
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas
| | - Melissa N Andruzzi
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas
| | - Cody J Alcott
- Veterinary Specialty Center of Tucson, Tucson, Arizona
| | - Nicolas Granger
- CVS Referrals, Bristol Veterinary Specialists at Highcroft, Bristol, United Kingdom.,The Royal Veterinary College, University of London, Hatfield, Hertfordshire, United Kingdom
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29
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Granger N, Luján Feliu-Pascual A, Spicer C, Ricketts S, Hitti R, Forman O, Hersheson J, Houlden H. Charcot-Marie-Tooth type 4B2 demyelinating neuropathy in miniature Schnauzer dogs caused by a novel splicing SBF2 (MTMR13) genetic variant: a new spontaneous clinical model. PeerJ 2019; 7:e7983. [PMID: 31772832 PMCID: PMC6875392 DOI: 10.7717/peerj.7983] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 10/02/2019] [Indexed: 01/23/2023] Open
Abstract
Background Charcot-Marie-Tooth (CMT) disease is the most common neuromuscular disorder in humans affecting 40 out of 100,000 individuals. In 2008, we described the clinical, electrophysiological and pathological findings of a demyelinating motor and sensory neuropathy in Miniature Schnauzer dogs, with a suspected autosomal recessive mode of inheritance based on pedigree analysis. The discovery of additional cases has followed this work and led to a genome-wide association mapping approach to search for the underlying genetic cause of the disease. Methods For genome wide association screening, genomic DNA samples from affected and unaffected dogs were genotyped using the Illumina CanineHD SNP genotyping array. SBF2 and its variant were sequenced using primers and PCRs. RNA was extracted from muscle of an unaffected and an affected dog and RT-PCR performed. Immunohistochemistry for myelin basic protein was performed on peripheral nerve section specimens. Results The genome-wide association study gave an indicative signal on canine chromosome 21. Although the signal was not of genome-wide significance due to the small number of cases, the SBF2 (also known as MTMR13) gene within the region of shared case homozygosity was a strong positional candidate, as 22 genetic variants in the gene have been associated with demyelinating forms of Charcot-Marie-Tooth disease in humans. Sequencing of SBF2 in cases revealed a splice donor site genetic variant, resulting in cryptic splicing and predicted early termination of the protein based on RNA sequencing results. Conclusions This study reports the first genetic variant in Miniature Schnauzer dogs responsible for the occurrence of a demyelinating peripheral neuropathy with abnormally folded myelin. This discovery establishes a genotype/phenotype correlation in affected Miniature Schnauzers that can be used for the diagnosis of these dogs. It further supports the dog as a natural model of a human disease; in this instance, Charcot-Marie-Tooth disease. It opens avenues to search the biological mechanisms responsible for the disease and to test new therapies in a non-rodent large animal model. In particular, recent gene editing methods that led to the restoration of dystrophin expression in a canine model of muscular dystrophy could be applied to other canine models such as this before translation to humans.
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Affiliation(s)
- Nicolas Granger
- Royal Veterinary College, University of London, Hatfield, United Kingdom.,Bristol Veterinary Specialists, CVS Referrals, Bristol, United Kingdom
| | | | - Charlotte Spicer
- Department of Molecular Neuroscience, UCL Institute of Neurology & National Hospital for Neurology and Neurosurgery & London, London, United Kingdom
| | - Sally Ricketts
- Kennel Club Genetics Centre, Animal Health Trust, Newmarket, United Kingdom
| | - Rebekkah Hitti
- Kennel Club Genetics Centre, Animal Health Trust, Newmarket, United Kingdom
| | - Oliver Forman
- Kennel Club Genetics Centre, Animal Health Trust, Newmarket, United Kingdom
| | - Joshua Hersheson
- Department of Molecular Neuroscience, UCL Institute of Neurology & National Hospital for Neurology and Neurosurgery & London, London, United Kingdom
| | - Henry Houlden
- Department of Molecular Neuroscience, UCL Institute of Neurology & National Hospital for Neurology and Neurosurgery & London, London, United Kingdom
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Hu HZ, Granger N, Pai SB, Bellamkonda RV, Jeffery ND. Therapeutic efficacy of microtube-embedded chondroitinase ABC in a canine clinical model of spinal cord injury. Brain 2019; 141:1017-1027. [PMID: 29444239 DOI: 10.1093/brain/awy007] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 11/28/2017] [Indexed: 01/26/2023] Open
Abstract
See Moon and Bradbury (doi:10.1093/brain/awy067) for a scientific commentary on this article.Many hundreds of thousands of people around the world are living with the long-term consequences of spinal cord injury and they need effective new therapies. Laboratory research in experimental animals has identified a large number of potentially translatable interventions but transition to the clinic is not straightforward. Further evidence of efficacy in more clinically-relevant lesions is required to gain sufficient confidence to commence human clinical trials. Of the many therapeutic candidates currently available, intraspinally applied chondroitinase ABC has particularly well documented efficacy in experimental animals. In this study we measured the effects of this intervention in a double-blinded randomized controlled trial in a cohort of dogs with naturally-occurring severe chronic spinal cord injuries that model the condition in humans. First, we collected baseline data on a series of outcomes: forelimb-hindlimb coordination (the prespecified primary outcome measure), skin sensitivity along the back, somatosensory evoked and transcranial magnetic motor evoked potentials and cystometry in 60 dogs with thoracolumbar lesions. Dogs were then randomized 1:1 to receive intraspinal injections of heat-stabilized, lipid microtube-embedded chondroitinase ABC or sham injections consisting of needle puncture of the skin. Outcome data were measured at 1, 3 and 6 months after intervention; skin sensitivity was also measured 24 h after injection (or sham). Forelimb-hindlimb coordination was affected by neither time nor chondroitinase treatment alone but there was a significant interaction between these variables such that coordination between forelimb and hindlimb stepping improved during the 6-month follow-up period in the chondroitinase-treated animals by a mean of 23%, but did not change in controls. Three dogs (10%) in the chondroitinase group also recovered the ability to ambulate without assistance. Sensitivity of the dorsal skin increased at 24 h after intervention in both groups but subsequently decreased to normal levels. Cystometry identified a non-significant improvement of bladder compliance at 1 month in the chondroitinase-injected dogs but this did not persist. There were no overall differences between groups in detection of sensory evoked potentials. Our results strongly support a beneficial effect of intraspinal injection of chondroitinase ABC on spinal cord function in this highly clinically-relevant model of chronic severe spinal cord injury. There was no evidence of long-term adverse effects associated with this intervention. We therefore conclude that this study provides strong evidence in support of initiation of clinical trials of chondroitinase ABC in humans with chronic spinal cord injury.
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Affiliation(s)
- Hilary Z Hu
- 1 College of Veterinary Medicine, Iowa State University, 1800 Christensen Drive, Ames IA 50011, USA
| | - Nicolas Granger
- 2 Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire, AL9 7TA, UK
| | - S Balakrishna Pai
- 3 Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University School of Medicine, 313 Ferst Drive, Atlanta, GA 30332, USA
| | - Ravi V Bellamkonda
- 4 Department of Biomedical Engineering, Duke University Pratt School of Engineering, 101 Science Drive, Campus Box 90281, Durham NC 27708, USA
| | - Nick D Jeffery
- 1 College of Veterinary Medicine, Iowa State University, 1800 Christensen Drive, Ames IA 50011, USA
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Adams CF, Delaney AM, Carwardine DR, Tickle J, Granger N, Chari DM. Nanoparticle-Based Imaging of Clinical Transplant Populations Encapsulated in Protective Polymer Matrices. Macromol Biosci 2018; 19:e1800389. [PMID: 30511815 DOI: 10.1002/mabi.201800389] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 11/18/2018] [Indexed: 01/26/2023]
Abstract
A recent clinical trial proves that autologous olfactory mucosal cell (OMC) transplantation improves locomotion in dogs with naturally occurring spinal injuries comparable to human lesions. However, not all dogs respond to the treatment, likely due to the transplantation procedures involving injections of cell suspensions that are associated with cell death, uneven cell distribution, and cell washout. Encapsulating cells in protective hydrogel matrices offers a tissue engineering solution to safely achieve 3D growth of viable transplant cells for implantation into injury sites, to improve regenerative outcomes. It is shown for the first time that canine OMCs (cOMCs) can be propagated with high viability in 3D collagen matrices. Further, a method to incorporate cOMCs pre-labeled with clinical-grade iron oxide nanoparticles into the constructs is described. Intraconstruct labeled cells are visualized using magnetic resonance imaging, offering substantial promise for in vivo tracking of cOMCs delivered in protective matrices.
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Affiliation(s)
- Christopher F Adams
- Cellular and Neural Engineering Group, Institute for Science and Technology in Medicine, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Alexander M Delaney
- Cellular and Neural Engineering Group, Institute for Science and Technology in Medicine, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | | | - Jacqueline Tickle
- Cellular and Neural Engineering Group, Institute for Science and Technology in Medicine, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Nicolas Granger
- The Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire, AL9 7TA, UK
| | - Divya M Chari
- Cellular and Neural Engineering Group, Institute for Science and Technology in Medicine, Keele University, Keele, Staffordshire, ST5 5BG, UK
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Milodowski EJ, Friend EJ, Granger N, Doran ICP. Canine urethral sphincter pressure profile under incremental inflation of an artificial cuff: a cadaver study. J Small Anim Pract 2018; 60:313-318. [PMID: 30430575 DOI: 10.1111/jsap.12961] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 09/07/2018] [Accepted: 09/26/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To determine whether artificial urethral sphincter filling volume is proportional to peak pressure exerted on the urethra. MATERIALS AND METHODS Urethral pressure profilometry was performed in five female, medium-sized, mixed-breed canine cadavers following artificial urethral sphincter placement. Maximum urethral pressure was recorded following sequential incremental inflation of 0.15 mL and compared to baseline pressure and between dogs using two-way analysis of variance. RESULTS Artificial urethral sphincter placement in cadavers was associated with an increase in urethral pressure, which was significantly correlated with inflation volume. The correlation was non-linear and demonstrated considerable individual variation. Maximum urethral pressures after artificial urethral sphincter placement exceeded those reported in conscious continent dogs within a narrow volume range, in which a 0.15 mL infusion more than doubled maximal urethral pressures. CLINICAL SIGNIFICANCE Rapid increases in urethral pressure from the artificial urethral sphincter over a small range of filling volumes (0.15 mL increments) might explain why some clinical cases can become suddenly dysuric following incremental inflations. We suggest that smaller increments of filling (0.05 to 0.1 mL) may achieve finer pressure control.
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Affiliation(s)
- E J Milodowski
- Bristol Veterinary School, Faculty of Health Sciences, University of Bristol, Bristol, BS8 1TD, UK
| | - E J Friend
- Bristol Veterinary Specialists at Highcroft, Bristol, BS14 9BE, UK.,Vale Referrals, The Animal Hospital, Gloucestershire, GL11 6AJ, UK
| | - N Granger
- Bristol Veterinary Specialists at Highcroft, Bristol, BS14 9BE, UK.,The Royal Veterinary College, Hertfordshire, AL9 7TA, UK
| | - I C P Doran
- Bristol Veterinary Specialists at Highcroft, Bristol, BS14 9BE, UK
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Hu H, Jeffery N, Granger N. Somatosensory and motor evoked potentials in dogs with chronic severe thoracolumbar spinal cord injury. Vet J 2018; 237:49-54. [DOI: 10.1016/j.tvjl.2018.05.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 05/07/2018] [Accepted: 05/21/2018] [Indexed: 01/03/2023]
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Barker EN, Dawson LJ, Rose JH, Van Meervenne S, Frykman O, Rohdin C, Leijon A, Soerensen KE, Järnegren J, Johnson GC, O'Brien DP, Granger N. Degenerative Encephalopathy in Nova Scotia Duck Tolling Retrievers Presenting with a Rapid Eye Movement Sleep Behavior Disorder. J Vet Intern Med 2018; 30:1681-1689. [PMID: 27717189 PMCID: PMC5032881 DOI: 10.1111/jvim.14575] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 07/17/2016] [Accepted: 08/10/2016] [Indexed: 11/30/2022] Open
Abstract
Background Neurodegenerative diseases are a heterogeneous group of disorders characterized by loss of neurons and are commonly associated with a genetic mutation. Hypothesis/Objectives To characterize the clinical and histopathological features of a novel degenerative neurological disease affecting the brain of young adult Nova Scotia Duck Tolling Retrievers (NSDTRs). Animals Nine, young adult, related NSDTRs were evaluated for neurological dysfunction and rapid eye movement sleep behavior disorder. Methods Case series review. Results Clinical signs of neurological dysfunction began between 2 months and 5 years of age and were progressive in nature. They were characterized by episodes of marked movements during sleep, increased anxiety, noise phobia, and gait abnormalities. Magnetic resonance imaging documented symmetrical, progressively increasing, T2‐weighted image intensity, predominantly within the caudate nuclei, consistent with necrosis secondary to gray matter degeneration. Abnormalities were not detected on clinicopathological analysis of blood and cerebrospinal fluid, infectious disease screening or urine metabolite screening in most cases. Postmortem examination of brain tissue identified symmetrical malacia of the caudate nuclei and axonal dystrophy within the brainstem and spinal cord. Genealogical analysis supports an autosomal recessive mode of inheritance. Conclusions and Clinical Importance A degenerative encephalopathy was identified in young adult NSDTRs consistent with a hereditary disease. The prognosis is guarded due to the progressive nature of the disease, which is minimally responsive to empirical treatment.
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Affiliation(s)
- E N Barker
- School of Veterinary Sciences, University of Bristol, Langford, UK.
| | - L J Dawson
- IDEXX Laboratories Ltd Wetherby, West Yorkshire, UK
| | - J H Rose
- School of Veterinary Sciences, University of Bristol, Langford, UK
| | | | | | - C Rohdin
- Department of Clinical Sciences, Swedish University of Agricultural Science, Uppsala, Sweden.,Anicura, Albano Small Animal Hospital, Danderyd, Sweden
| | - A Leijon
- Department of Biomedical Sciences and Veterinary Public Health, Section of Pathology, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - K E Soerensen
- Department of Pathology and Wildlife Diseases, National Veterinary Institute (SVA), Uppsala, Sweden
| | - J Järnegren
- Norwegian Institute for Nature Research, Trondheim, Norway
| | - G C Johnson
- Department of Veterinary Medicine & Surgery, University of Missouri, Columbia, MO
| | - D P O'Brien
- Department of Veterinary Medicine & Surgery, University of Missouri, Columbia, MO
| | - N Granger
- School of Veterinary Sciences, University of Bristol, Langford, UK
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Carwardine D, Prager J, Neeves J, Muir EM, Uney J, Granger N, Wong LF. Transplantation of canine olfactory ensheathing cells producing chondroitinase ABC promotes chondroitin sulphate proteoglycan digestion and axonal sprouting following spinal cord injury. PLoS One 2017; 12:e0188967. [PMID: 29228020 PMCID: PMC5724818 DOI: 10.1371/journal.pone.0188967] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 11/16/2017] [Indexed: 11/19/2022] Open
Abstract
Olfactory ensheathing cell (OEC) transplantation is a promising strategy for treating spinal cord injury (SCI), as has been demonstrated in experimental SCI models and naturally occurring SCI in dogs. However, the presence of chondroitin sulphate proteoglycans within the extracellular matrix of the glial scar can inhibit efficient axonal repair and limit the therapeutic potential of OECs. Here we have used lentiviral vectors to genetically modify canine OECs to continuously deliver mammalian chondroitinase ABC at the lesion site in order to degrade the inhibitory chondroitin sulphate proteoglycans in a rodent model of spinal cord injury. We demonstrate that these chondroitinase producing canine OECs survived at 4 weeks following transplantation into the spinal cord lesion and effectively digested chondroitin sulphate proteoglycans at the site of injury. There was evidence of sprouting within the corticospinal tract rostral to the lesion and an increase in the number of corticospinal axons caudal to the lesion, suggestive of axonal regeneration. Our results indicate that delivery of the chondroitinase enzyme can be achieved with the genetically modified OECs to increase axon growth following SCI. The combination of these two promising approaches is a potential strategy for promoting neural regeneration following SCI in veterinary practice and human patients.
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Affiliation(s)
- Darren Carwardine
- School of Veterinary Sciences, University of Bristol, Bristol, United Kingdom
| | - Jonathan Prager
- School of Veterinary Sciences, University of Bristol, Bristol, United Kingdom
| | - Jacob Neeves
- School of Veterinary Sciences, University of Bristol, Bristol, United Kingdom
| | - Elizabeth M. Muir
- Department of Physiology Development and Neuroscience, University of Cambridge, Cambridge, United Kingdom
| | - James Uney
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Nicolas Granger
- School of Veterinary Sciences, University of Bristol, Bristol, United Kingdom
| | - Liang-Fong Wong
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
- * E-mail:
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36
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Laws EJ, Kathrani A, Harcourt-Brown TR, Granger N, Rose JH. 25-Hydroxy vitamin D3 serum concentration in dogs with acute polyradiculoneuritis compared to matched controls. J Small Anim Pract 2017; 59:222-227. [DOI: 10.1111/jsap.12791] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 08/24/2017] [Accepted: 09/19/2017] [Indexed: 12/19/2022]
Affiliation(s)
- E. J. Laws
- School of Veterinary Sciences; University of Bristol, Langford Small Animal Hospital; Langford, Bristol BS405DU UK
| | - A. Kathrani
- The Royal Veterinary College; Hatfield; AL9 7TA UK
| | | | - N. Granger
- Cave Veterinary Specialists, George's Farm Nr Wellington; Wellington, TA21 9LE UK
| | - J. H. Rose
- Fizpatrick Referral Hospital; Godalming, GU07 2QQ UK
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Beffinger M, Schellhammer L, Pantelyushin S, Wall SK, Bienemann A, Granger N, Buch T, vom Berg J. SCDT-41. IN VIVO TESTING OF INTRACRANIAL DELIVERY OF RECOMBINANT HUMAN IL-12 AND IL-12Fc AND FUNCTIONAL ASSESSMENT ON HUMAN, PORCINE AND CANINE PERIPHERAL BLOOD MONONUCLEAR CELLS. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox168.1121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Monteiro SRM, Gallucci A, Rousset N, Freeman PM, Ives EJ, Gandini G, Granger N, Vanhaesebrouck AE. Medical management of spinal epidural empyema in five dogs. J Am Vet Med Assoc 2017; 249:1180-1186. [PMID: 27823364 DOI: 10.2460/javma.249.10.1180] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
CASE DESCRIPTION 5 dogs were examined because of clinical signs of myelopathy, including signs of pain associated with the spinal region and rapidly progressive neurologic deficits. CLINICAL FINDINGS In all dogs, results of MRI were consistent with spinal epidural empyema. Concurrent infectious processes were identified at adjacent or distant sites in all dogs, including diskospondylitis, prostatitis, dermatitis, paraspinal infection following a penetrating injury, urinary tract infection, and pyothorax. Bacteria were isolated from 3 dogs; Escherichia coli was isolated from blood, urine, and prostatic wash samples from 1 dog; a Pasteurella sp was isolated from a percutaneous aspirate from an adjacent infected wound in a second dog; and a Corynebacterium sp was isolated from a thoracic fluid sample from a third dog. For the remaining 2 dogs, results of bacterial culture were negative. TREATMENT AND OUTCOME All dogs showed clinical improvement within 2 weeks after initiation of antimicrobial treatment, and all had an excellent long-term outcome. CLINICAL RELEVANCE In dogs, spinal epidural empyema has previously been regarded as a surgical emergency. Findings for dogs in the present report suggested that, as is the case for humans, selected dogs with spinal epidural empyema may be successfully managed with medical treatment alone.
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Delaney AM, Adams CF, Fernandes AR, Al-Shakli AF, Sen J, Carwardine DR, Granger N, Chari DM. A fusion of minicircle DNA and nanoparticle delivery technologies facilitates therapeutic genetic engineering of autologous canine olfactory mucosal cells. Nanoscale 2017; 9:8560-8566. [PMID: 28613324 DOI: 10.1039/c7nr00811b] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Olfactory ensheathing cells (OECs) promote axonal regeneration and improve locomotor function when transplanted into the injured spinal cord. A recent clinical trial demonstrated improved motor function in domestic dogs with spinal injury following autologous OEC transplantation. Their utility in canines offers promise for human translation, as dogs are comparable to humans in terms of clinical management and genetic/environmental variation. Moreover, the autologous, minimally invasive derivation of OECs makes them viable for human spinal injury investigation. Genetic engineering of transplant populations may augment their therapeutic potential, but relies heavily on viral methods which have several drawbacks for clinical translation. We present here the first proof that magnetic particles deployed with applied magnetic fields and advanced DNA minicircle vectors can safely bioengineer OECs to secrete a key neurotrophic factor, with an efficiency approaching that of viral vectors. We suggest that our alternative approach offers high translational potential for the delivery of augmented clinical cell therapies.
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Affiliation(s)
- Alexander M Delaney
- Cellular and Neural Engineering Group, Institute for Science and Technology in Medicine, Keele University, Keele, Staffordshire ST5 5BG, UK.
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Laws EJ, Harcourt-Brown TR, Granger N, Rose JH. An exploratory study into factors influencing development of acute canine polyradiculoneuritis in the UK. J Small Anim Pract 2017; 58:437-443. [PMID: 28463414 DOI: 10.1111/jsap.12683] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 11/21/2016] [Accepted: 11/28/2016] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To investigate whether the development of acute canine polyradiculoneuritis is associated with various putative risk factors. MATERIALS AND METHODS Retrospective case-control study with conditional logistic regression analysis from a referral hospital population in the UK where controls were matched for year of presentation. RESULTS Forty-three cases were identified with acute canine polyradiculoneuritis and 86 controls were selected. Jack Russell terriers and West Highland white terriers were found to have a significantly greater odds of developing acute canine polyradiculoneuritis compared to a mixed baseline group of dogs. The odds of developing acute canine polyradiculoneuritis were greater in the autumn and winter compared to spring. Vaccination, rural/urban habitation, sex, neuter status and age were not associated with development of acute canine polyradiculoneuritis in our population of dogs. CLINICAL SIGNIFICANCE Breed and season were associated with development of acute canine polyradiculoneuritis. However, this is a small sample and so this observation needs confirmation in further studies and other factors may also be involved. Nevertheless, these findings may be important in further understanding the aetiopathogenesis of this condition.
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Affiliation(s)
- E J Laws
- School of Veterinary Sciences, University of Bristol, Langford Small Animal Hospital, Bristol, BS405DU, UK
| | | | - N Granger
- School of Veterinary Sciences, University of Bristol, Bristol, UK
| | - J H Rose
- School of Veterinary Sciences, University of Bristol, Bristol, UK
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Mortera-Balsa V, van Oostrom H, Yeamans C, Gutierrez-Quintana R, Penderis J, Granger N. Suspected air embolism through the thoracic ventral internal vertebral venous plexus during hemilaminectomy in dogs. J Small Anim Pract 2017; 58:355-358. [PMID: 28394460 DOI: 10.1111/jsap.12665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 05/31/2016] [Accepted: 05/31/2016] [Indexed: 01/05/2023]
Abstract
Venous air embolism entering via the ventral internal vertebral venous plexus was suspected during thoracic spinal surgery in two dogs. In both cases, air was seen bubbling from a pool of blood on the floor of the vertebral canal accompanied by sudden cardiopulmonary disturbances: low end-tidal carbon dioxide pressure, tachycardia and reduction in oxygen in the blood. One dog became dyspnoeic and one died.
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Affiliation(s)
- V Mortera-Balsa
- School of Veterinary Sciences, Small Animal Hospital, University of Bristol, Langford, BS40 5DU, UK
| | - H van Oostrom
- School of Veterinary Sciences, Small Animal Hospital, University of Bristol, Langford, BS40 5DU, UK
| | - C Yeamans
- School of Veterinary Sciences, Small Animal Hospital, University of Glasgow, Glasgow, G61 1QH, UK
| | - R Gutierrez-Quintana
- School of Veterinary Sciences, Small Animal Hospital, University of Glasgow, Glasgow, G61 1QH, UK
| | - J Penderis
- Vet Extra Neurology, Broadleys Veterinary Hospital, Stirling, FK7 7LE, UK
| | - N Granger
- School of Veterinary Sciences, Small Animal Hospital, University of Bristol, Langford, BS40 5DU, UK
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Shaw TA, De Risio L, Laws EJ, Rose JH, Harcourt-Brown TR, Granger N. Prognostic Factors Associated with Recovery of Ambulation and Urinary Continence in Dogs with Acute Lumbosacral Spinal Cord Injury. J Vet Intern Med 2017; 31:825-831. [PMID: 28370379 PMCID: PMC5435038 DOI: 10.1111/jvim.14702] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 01/27/2017] [Accepted: 02/27/2017] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Limited information is available about prognostic factors for recovery after spinal cord injury (SCI) to the L4-S3 segments. Previous research suggests that L4-S3 SCI does not have a worse prognosis than T3-L3 SCI. HYPOTHESIS/OBJECTIVES To elucidate prognostic factors for regaining urinary continence and ambulation in dogs with L4-S3 SCI and compare prognosis to T3-L3 SCI. ANIMALS/METHODS A retrospective study on 61 nonambulatory dogs with L4-S3 SCI, matched to dogs with T3-L3 SCI, compared 3 weeks after onset. Prognostic factors explored using logistic regression and used for matching: nonchondrodystrophic dogs >15 kg versus dogs that were chondrodystrophic or <15 kg; compressive versus noncompressive lesions; presence versus absence of conscious pain perception (CPP); and lower vs upper motor neuron (LMN/UMN) incontinence. RESULTS Fewer L4-S3 dogs regained continence compared to T3-L3 dogs (64 vs 85%, P = .0033), but no difference existed for regaining ambulation (66 vs 75%, P = .1306). In L4-S3 SCI dogs, fewer dogs regained continence with loss of CPP (P < .001), LMN incontinence (P = .004), and noncompressive lesions (P = .006). Negative prognostic factors for regaining ambulation included absent CPP (P < .001) and large nonchondrodystrophic breed (P = .022). CONCLUSIONS AND CLINICAL IMPORTANCE Dogs with L4-S3 SCI have a poorer short-term prognosis than do dogs with T3-L3 SCI. Dogs with L4-S3 SCI had a poor prognosis with loss of CPP, or noncompressive lesions combined with LMN incontinence. Small-breed or chondrodystrophic dogs with retained CPP, compressive lesions, and UMN incontinence had an excellent prognosis. These findings may help guide decision-making in L4-S3 SCI.
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Affiliation(s)
- T A Shaw
- School of Veterinary Sciences, University of Bristol, Langford, North Somerset, UK
| | - L De Risio
- Centre for Small Animal Studies, Animal Health Trust, Kentford, Newmarket, Suffolk, UK
| | - E J Laws
- School of Veterinary Sciences, University of Bristol, Langford, North Somerset, UK
| | - J H Rose
- Fitzpatrick Referrals, Halfway Lane, Eashing, Surrey, UK
| | - T R Harcourt-Brown
- School of Veterinary Sciences, University of Bristol, Langford, North Somerset, UK
| | - N Granger
- Cave Veterinary Specialists, George's Farm, West Buckland, Nr. Wellington, Somerset, UK
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Schellhammer L, Beffinger M, Parshenkov A, Becher B, Bienemann A, Granger N, Buch T, vom Berg J. P06.09 In vitro assessment of human IL-12Fc function on porcine and canine peripheral blood mononuclear cells. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Moore SA, Granger N, Olby NJ, Spitzbarth I, Jeffery ND, Tipold A, Nout-Lomas YS, da Costa RC, Stein VM, Noble-Haeusslein LJ, Blight AR, Grossman RG, Basso DM, Levine JM. Targeting Translational Successes through CANSORT-SCI: Using Pet Dogs To Identify Effective Treatments for Spinal Cord Injury. J Neurotrauma 2017; 34:2007-2018. [PMID: 28230415 DOI: 10.1089/neu.2016.4745] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Translation of therapeutic interventions for spinal cord injury (SCI) from laboratory to clinic has been historically challenging, highlighting the need for robust models of injury that more closely mirror the human condition. The high prevalence of acute, naturally occurring SCI in pet dogs provides a unique opportunity to evaluate expeditiously promising interventions in a population of animals that receive diagnoses and treatment clinically in a manner similar to persons with SCI, while adhering to National Institutes of Health guidelines for scientific rigor and transparent reporting. In addition, pet dogs with chronic paralysis are often maintained long-term by their owners, offering a similarly unique population for study of chronic SCI. Despite this, only a small number of studies have used the clinical dog model of SCI. The Canine Spinal Cord Injury Consortium (CANSORT-SCI) was recently established by a group of veterinarians and basic science researchers to promote the value of the canine clinical model of SCI. The CANSORT-SCI group held an inaugural meeting November 20 and 21, 2015 to evaluate opportunities and challenges to the use of pet dogs in SCI research. Key challenges identified included lack of familiarity with the model among nonveterinary scientists and questions about how and where in the translational process the canine clinical model would be most valuable. In light of these, we review the natural history, outcome, and available assessment tools associated with canine clinical SCI with emphasis on their relevance to human SCI and the translational process.
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Affiliation(s)
- Sarah A Moore
- 1 Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine , Columbus Ohio.,2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI)
| | - Nicolas Granger
- 2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,3 Faculty of Health Sciences, University of Bristol , Langford, North Somerset, United Kingdom
| | - Natasha J Olby
- 2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,4 Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University , Raleigh, North Carolina.,5 Comparative Medicine Institute, North Carolina State University , Raleigh, North Carolina
| | - Ingo Spitzbarth
- 2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,6 Department of Pathology, University of Veterinary Medicine , Hannover, Germany .,7 Center for Systems Neuroscience , Hannover, Germany
| | - Nick D Jeffery
- 2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,8 Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University , College Station, Texas
| | - Andrea Tipold
- 2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,7 Center for Systems Neuroscience , Hannover, Germany.,9 Department of Small Animal Medicine and Surgery, University of Veterinary Medicine , Hannover, Germany
| | - Yvette S Nout-Lomas
- 2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,10 College of Veterinary Medicine and Biomedical Sciences, Colorado State University , Fort Collins, Colorado
| | - Ronaldo C da Costa
- 1 Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine , Columbus Ohio.,2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI)
| | - Veronika M Stein
- 2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,11 Department of Clinical Veterinary Sciences, University of Bern , Bern, Switzerland
| | - Linda J Noble-Haeusslein
- 2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,12 Departments of Physical Therapy and Rehabilitation Sciences and Neurological Surgery, University of California , San Francisco, San Francisco, California
| | - Andrew R Blight
- 2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,13 Acorda Therapeutics, Inc. Ardsley, New York
| | - Robert G Grossman
- 2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,14 Department of Neurosurgery, Houston Methodist Neurological Institute , Houston, Texas
| | - D Michele Basso
- 2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,15 School of Health and Rehabilitation Sciences, The Ohio State University , Columbus, Ohio
| | - Jonathan M Levine
- 2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,8 Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University , College Station, Texas
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Abstract
OBJECTIVE To determine the effectiveness of manual bladder expression in paraplegic dogs by comparing urine volumes measured by use of intermittent catheterization and ultrasonography. ANIMALS 36 paraplegic dogs. PROCEDURES 93 measurements of bladder volume were collected for the 36 dogs. Residual urine volume was determined by use of intermittent urethral catheterization and estimated by use of ultrasonography. RESULTS Manual bladder expression voided a mean of 49% of urine from the bladder in this population of dogs. There was no correlation (R2, 0.06) between the effectiveness of manual bladder expression and body weight. Ultrasonographic estimation of bladder volume had good correlation (R2, 0.62) with bladder volume determined by use of intermittent bladder catheterization, but clinically unacceptable variation for predicting actual bladder volume (mean difference, 22 mL; 95% confidence interval, -96 to 139 mL). CONCLUSIONS AND CLINICAL RELEVANCE Manual bladder expression was ineffective at completely emptying urine from the bladder of paraplegic dogs, but the effectiveness of the procedure was not affected by body weight. Manual bladder expression would likely be a useful procedure to prevent increases in pressure within the bladder. Ultrasonographic estimation of bladder volume could be a useful predictor of actual bladder volume, but it was susceptible to wide variations among dogs, and results should therefore be interpreted with caution.
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Granger N, Hidalgo A, Leperlier D, Gnirs K, Thibaud JL, Delisle F, Blot S. Successful treatment of cervical spinal epidural empyema secondary to grass awn migration in a cat. J Feline Med Surg 2017; 9:340-5. [PMID: 17449314 DOI: 10.1016/j.jfms.2007.01.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2007] [Indexed: 11/17/2022]
Abstract
Spinal epidural empyema (SEE) represents a severe pyogenic infection of the epidural space. Clinical signs of the disease are non-specific – increased body temperature, intense neck pain, neurological signs of a transverse myelopathy – and can lead to severe and permanent neurological deficits. This report describes the diagnosis and successful surgical treatment of cervical SEE secondary to grass awn migration in a cat. Although it is uncommon, this disease should be suspected in cats with progressive myelopathy. Early diagnosis and emergency surgery combined with antibiotic therapy are required to allow a complete recovery.
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Affiliation(s)
- Nicolas Granger
- Neurology Unit, National Veterinary School of Alfort, France.
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Hu HZ, Granger N, Jeffery ND. Pathophysiology, Clinical Importance, and Management of Neurogenic Lower Urinary Tract Dysfunction Caused by Suprasacral Spinal Cord Injury. J Vet Intern Med 2016; 30:1575-1588. [PMID: 27527382 PMCID: PMC5032886 DOI: 10.1111/jvim.14557] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 06/30/2016] [Accepted: 07/06/2016] [Indexed: 12/24/2022] Open
Abstract
Management of persistent lower urinary tract dysfunction resulting from severe thoracolumbar spinal cord injury can be challenging. Severe suprasacral spinal cord injury releases the spinal cord segmental micturition reflex from supraspinal modulation and increases nerve growth factor concentration in the bladder wall, lumbosacral spinal cord, and dorsal root ganglion, which subsequently activates hypermechanosensitive C-fiber bladder wall afferents. Hyperexcitability of bladder afferents and detrusor overactivity can cause urine leaking during the storage phase. During urine voiding, the loss of supraspinal control that normally coordinates detrusor contraction with sphincter relaxation can lead to spinal cord segmental reflex-mediated simultaneous detrusor and sphincter contractions or detrusor-sphincter dyssynergia, resulting in inefficient urine voiding and high residual volume. These disease-associated changes can impact on the quality of life and life expectancy of spinal-injured animals. Here, we discuss the pathophysiology and management considerations of lower urinary tract dysfunction as the result of severe, acute, suprasacral spinal cord injury. In addition, drawing from experimental, preclinical, and clinical medicine, we introduce some treatment options for neurogenic lower urinary tract dysfunction that are designed to: (1) prevent urine leakage arising because of detrusor overactivity during bladder filling, (2) preserve upper urinary tract integrity and function by reducing intravesical pressure and subsequent vesicoureteral reflux, and (3) prevent urinary tract and systemic complications by treating and preventing urinary tract infections.
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Affiliation(s)
- H Z Hu
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA
| | - N Granger
- School of Veterinary Sciences, University of Bristol, Langford House, Langford, North Somerset, UK
| | - N D Jeffery
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA.
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Carwardine D, Wong LF, Fawcett JW, Muir EM, Granger N. Canine olfactory ensheathing cells from the olfactory mucosa can be engineered to produce active chondroitinase ABC. J Neurol Sci 2016; 367:311-8. [PMID: 27423610 DOI: 10.1016/j.jns.2016.06.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 06/01/2016] [Accepted: 06/03/2016] [Indexed: 11/26/2022]
Abstract
A multitude of factors must be overcome following spinal cord injury (SCI) in order to achieve clinical improvement in patients. It is thought that by combining promising therapies these diverse factors could be combatted with the aim of producing an overall improvement in function. Chondroitin sulphate proteoglycans (CSPGs) present in the glial scar that forms following SCI present a significant block to axon regeneration. Digestion of CSPGs by chondroitinase ABC (ChABC) leads to axon regeneration, neuronal plasticity and functional improvement in preclinical models of SCI. However, the enzyme activity decays at body temperature within 24-72h, limiting the translational potential of ChABC as a therapy. Olfactory ensheathing cells (OECs) have shown huge promise as a cell transplant therapy in SCI. Their beneficial effects have been demonstrated in multiple small animal SCI models as well as in naturally occurring SCI in canine patients. In the present study, we have genetically modified canine OECs from the mucosa to constitutively produce enzymatically active ChABC. We have developed a lentiviral vector that can deliver a mammalian modified version of the ChABC gene to mammalian cells, including OECs. Enzyme production was quantified using the Morgan-Elson assay that detects the breakdown products of CSPG digestion in cell supernatants. We confirmed our findings by immunolabelling cell supernatant samples using Western blotting. OECs normal cell function was unaffected by genetic modification as demonstrated by normal microscopic morphology and the presence of the low affinity neurotrophin receptor (p75(NGF)) following viral transduction. We have developed the means to allow production of active ChABC in combination with a promising cell transplant therapy for SCI repair.
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Affiliation(s)
- Darren Carwardine
- University of Bristol, School of Veterinary Sciences, Regenerative Medicine Laboratory, Biomedical Science Building, University Walk, Bristol BS8 1TD, United Kingdom.
| | - Liang-Fong Wong
- University of Bristol, School of Clinical Sciences, Regenerative Medicine Laboratory, Biomedical Science Building, University Walk, Bristol BS8 1TD, United Kingdom.
| | - James W Fawcett
- University of Cambridge, Department of Clinical Neurosciences, Cambridge Centre for Brain Repair, E.D. Adrian Building, Forvie Site, Robinson Way, Cambridge CB2 0PY, United Kingdom.
| | - Elizabeth M Muir
- University of Cambridge, Department of Physiology Development and Neuroscience, Anatomy Building, Downing St, Cambridge CB2 3DY, United Kingdom.
| | - Nicolas Granger
- University of Bristol, School of Veterinary Sciences, Langford House, Langford, North Somerset BS40 5DU, United Kingdom.
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Jeffery ND, Barker AK, Hu HZ, Alcott CJ, Kraus KH, Scanlin EM, Granger N, Levine JM. Factors associated with recovery from paraplegia in dogs with loss of pain perception in the pelvic limbs following intervertebral disk herniation. J Am Vet Med Assoc 2016; 248:386-94. [DOI: 10.2460/javma.248.4.386] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Mhlanga-Mutangadura T, Johnson GS, Schnabel RD, Taylor JF, Johnson GC, Katz ML, Shelton GD, Lever TE, Giuliano E, Granger N, Shomper J, O'Brien DP. A mutation in the Warburg syndrome gene, RAB3GAP1, causes a similar syndrome with polyneuropathy and neuronal vacuolation in Black Russian Terrier dogs. Neurobiol Dis 2015; 86:75-85. [PMID: 26607784 DOI: 10.1016/j.nbd.2015.11.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2015] [Revised: 11/13/2015] [Accepted: 11/18/2015] [Indexed: 11/30/2022] Open
Abstract
An autosomal recessive disease of Black Russian Terriers was previously described as a juvenile-onset, laryngeal paralysis and polyneuropathy similar to Charcot Marie Tooth disease in humans. We found that in addition to an axonal neuropathy, affected dogs exhibit microphthalmia, cataracts, and miotic pupils. On histopathology, affected dogs exhibit a spongiform encephalopathy characterized by accumulations of abnormal, membrane-bound vacuoles of various sizes in neuronal cell bodies, axons and adrenal cells. DNA from an individual dog with this polyneuropathy with ocular abnormalities and neuronal vacuolation (POANV) was used to generate a whole genome sequence which contained a homozygous RAB3GAP1:c.743delC mutation that was absent from 73 control canine whole genome sequences. An additional 12 Black Russian Terriers with POANV were RAB3GAP1:c.743delC homozygotes. DNA samples from 249 Black Russian Terriers with no known signs of POANV were either heterozygotes or homozygous for the reference allele. Mutations in human RAB3GAP1 cause Warburg micro syndrome (WARBM), a severe developmental disorder characterized by abnormalities of the eye, genitals and nervous system including a predominantly axonal peripheral neuropathy. RAB3GAP1 encodes the catalytic subunit of a GTPase activator protein and guanine exchange factor for Rab3 and Rab18 respectively. Rab proteins are involved in membrane trafficking in the endoplasmic reticulum, axonal transport, autophagy and synaptic transmission. The neuronal vacuolation and membranous inclusions and vacuoles in axons seen in this canine disorder likely reflect alterations of these processes. Thus, this canine disease could serve as a model for WARBM and provide insight into its pathogenesis and treatment.
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Affiliation(s)
| | - Gary S Johnson
- Department of Veterinary Pathobiology, University of Missouri, Columbia, USA
| | - Robert D Schnabel
- Division of Animal Sciences, University of Missouri, Columbia, USA; Informatics Institute, University of Missouri, Columbia, USA
| | - Jeremy F Taylor
- Division of Animal Sciences, University of Missouri, Columbia, USA
| | - Gayle C Johnson
- Department of Veterinary Pathobiology, University of Missouri, Columbia, USA
| | - Martin L Katz
- Mason Eye Institute, University of Missouri, Columbia, USA
| | - G Diane Shelton
- Department of Pathology, University of California, San Diego, La Jolla, USA
| | - Teresa E Lever
- Department of Otolaryngology, University of Missouri, Columbia, USA
| | - Elizabeth Giuliano
- Department of Veterinary Medicine & Surgery, University of Missouri, Columbia, USA
| | - Nicolas Granger
- School of Veterinary Sciences, University of Bristol, Langford House, Langford, Somerset BS40 5DU, UK
| | - Jeremy Shomper
- Department of Veterinary Medicine & Surgery, University of Missouri, Columbia, USA
| | - Dennis P O'Brien
- Department of Veterinary Medicine & Surgery, University of Missouri, Columbia, USA.
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