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Hanael E, Baruch S, Chai O, Lishitsky L, Blum T, Rapoport K, Ruggeri M, Aizenberg Z, Peery D, Meyerhoff N, Volk HA, De Decker S, Tipold A, Baumgaertner W, Friedman A, Shamir M. Quantitative analysis of magnetic resonance images for characterization of blood-brain barrier dysfunction in dogs with brain tumors. J Vet Intern Med 2023; 37:606-617. [PMID: 36847997 DOI: 10.1111/jvim.16654] [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: 08/18/2022] [Accepted: 02/03/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND Blood-brain barrier (BBB) permeability can be assessed quantitatively using advanced imaging analysis. HYPOTHESIS/OBJECTIVES Quantification and characterization of blood-brain barrier dysfunction (BBBD) patterns in dogs with brain tumors can provide useful information about tumor biology and assist in distinguishing between gliomas and meningiomas. ANIMALS Seventy-eight hospitalized dogs with brain tumors and 12 control dogs without brain tumors. METHODS In a 2-arm study, images from a prospective dynamic contrast-enhanced (DCE; n = 15) and a retrospective archived magnetic resonance imaging study (n = 63) were analyzed by DCE and subtraction enhancement analysis (SEA) to quantify BBB permeability in affected dogs relative to control dogs (n = 6 in each arm). For the SEA method, 2 ranges of postcontrast intensity differences, that is, high (HR) and low (LR), were evaluated as possible representations of 2 classes of BBB leakage. BBB score was calculated for each dog and was associated with clinical characteristics and tumor location and class. Permeability maps were generated, using the slope values (DCE) or intensity difference (SEA) of each voxel, and analyzed. RESULTS Distinctive patterns and distributions of BBBD were identified for intra- and extra-axial tumors. At a cutoff of 0.1, LR/HR BBB score ratio yielded a sensitivity of 80% and specificity of 100% in differentiating gliomas from meningiomas. CONCLUSIONS AND CLINICAL IMPORTANCE Blood-brain barrier dysfunction quantification using advanced imaging analyses has the potential to be used for assessment of brain tumor characteristics and behavior and, particularly, to help differentiating gliomas from meningiomas.
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Affiliation(s)
- Erez Hanael
- The Koret School of Veterinary Medicine, Neurology and Neurosurgery, Hebrew University of Jerusalem, Reehovot, Israel
| | - Shelly Baruch
- The Koret School of Veterinary Medicine, Neurology and Neurosurgery, Hebrew University of Jerusalem, Reehovot, Israel
| | - Orit Chai
- The Koret School of Veterinary Medicine, Neurology and Neurosurgery, Hebrew University of Jerusalem, Reehovot, Israel
| | - Liron Lishitsky
- The Koret School of Veterinary Medicine, Neurology and Neurosurgery, Hebrew University of Jerusalem, Reehovot, Israel
| | - Tal Blum
- The Koret School of Veterinary Medicine, Neurology and Neurosurgery, Hebrew University of Jerusalem, Reehovot, Israel
| | - Kira Rapoport
- The Koret School of Veterinary Medicine, Neurology and Neurosurgery, Hebrew University of Jerusalem, Reehovot, Israel
| | - Marco Ruggeri
- The Koret School of Veterinary Medicine, Neurology and Neurosurgery, Hebrew University of Jerusalem, Reehovot, Israel
| | - Zahi Aizenberg
- The Koret School of Veterinary Medicine, Neurology and Neurosurgery, Hebrew University of Jerusalem, Reehovot, Israel
| | - Dana Peery
- The Koret School of Veterinary Medicine, Neurology and Neurosurgery, Hebrew University of Jerusalem, Reehovot, Israel
| | - Nina Meyerhoff
- School of Veterinary Medicine Hannover, Small Animal Medicine and Surgery, Hannover, Germany
| | - Holger Andreas Volk
- School of Veterinary Medicine Hannover, Small Animal Medicine and Surgery, Hannover, Germany
| | - Steven De Decker
- Department of Clinical Sciences, Royal Veterinary College, University of London, Hertfordshire, UK
| | - Andrea Tipold
- School of Veterinary Medicine Hannover, Small Animal Medicine and Surgery, Hannover, Germany
| | - Wolfgang Baumgaertner
- School of Veterinary Medicine Hannover, Small Animal Medicine and Surgery, Hannover, Germany
| | - Alon Friedman
- Faculty of Medicine, Department of Medical Neuroscience Halifax, Dalhousie University, Nova Scotia, Canada.,Departments of Physiology and Cell Biology, Brain, and Cognitive Sciences, Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Merav Shamir
- The Koret School of Veterinary Medicine, Neurology and Neurosurgery, Hebrew University of Jerusalem, Reehovot, Israel
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Kelmer E, Ohad DG, Shamir MH, Chai O, Lavie S, Sutton GA, Aroch I, Klainbart S. The diagnostic utility of hypophosphatemia for differentiating generalized tonic-clonic seizures from syncope in dogs: A case control study. Vet J 2023; 291:105914. [PMID: 36220539 DOI: 10.1016/j.tvjl.2022.105914] [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: 05/02/2022] [Revised: 09/29/2022] [Accepted: 10/06/2022] [Indexed: 12/24/2022]
Abstract
Transient hypophosphatemia is often detected in humans following generalized tonic-clonic seizures (GTCS), and serum phosphorus concentration (sPi) serves as a marker to differentiate GTCS from syncope. The objective of this retrospective study was to assess the usefulness of hypophosphatemia as a diagnostic marker for GTCS in dogs. Eighty-seven and 26 client-owned dogs with GTCS or syncope, respectively, were enrolled. Dogs were included if the episode occurred ≤ 3 h from presentation, and if sPi and serum creatinine (sCr) were measured. Dogs were excluded if aged < 1 year or if sCr exceeded 176.8 μmol/L. There were no group differences in sCr. Hypophosphatemia (sPi ≤ 0.97 mmol/L) occurred in 28 dogs (32%) in the seizure group, and in no dogs in the syncope group. Median sPi was significantly (P < 0.001) lower in the seizure group (1 mmol/L, [range, 0.31-2.87 mmol/L]) compared to the syncope group (1.35 mmol/L [range, 0.97-2.71 mmol/L]). Furthermore, in dogs presented while seizing (n = 24/87; 28%) median sPi was significantly lower compared to those that were not (0.9 mmol/L [range, 0.3-1.74 mmol/L] vs. 1 mmol/L [range, 0.33-2.18 mmol/L], P = 0.050). ROC analysis of sPi as a marker of GTCS yielded an AUC of 0.757 (95% confidence interval 0.667-0.847), with an optimum cutoff point of 0.97 mmol/L, corresponding to specificity and sensitivity levels of 100% and 44%, respectively. In conclusion, sPi may, in certain cases, serve as an additional diagnostic tool to differentiate GTCS from syncope in dogs. Hypophosphatemia, especially with sPi < 0.97 mmol/L, may be useful in clinical practice to rule in GTCS.
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Affiliation(s)
- E Kelmer
- The Hebrew University Veterinary Teaching Hospital, the Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, P.O. Box 12, Rehovot 76100, Israel.
| | - D G Ohad
- The Hebrew University Veterinary Teaching Hospital, the Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, P.O. Box 12, Rehovot 76100, Israel
| | - M H Shamir
- The Hebrew University Veterinary Teaching Hospital, the Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, P.O. Box 12, Rehovot 76100, Israel
| | - O Chai
- The Hebrew University Veterinary Teaching Hospital, the Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, P.O. Box 12, Rehovot 76100, Israel
| | - S Lavie
- The Hebrew University Veterinary Teaching Hospital, the Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, P.O. Box 12, Rehovot 76100, Israel
| | - G A Sutton
- The Hebrew University Veterinary Teaching Hospital, the Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, P.O. Box 12, Rehovot 76100, Israel
| | - I Aroch
- The Hebrew University Veterinary Teaching Hospital, the Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, P.O. Box 12, Rehovot 76100, Israel
| | - S Klainbart
- The Hebrew University Veterinary Teaching Hospital, the Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, P.O. Box 12, Rehovot 76100, Israel
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Asiag N, Chai O, Yodovner S, Ruggeri M, Rapaport K, Baneth G, Nachum-Biala Y, Konstantin L, Rojas A, Brenner O, Bruchim Y, Shamir MH. Evaluation of a treatment protocol in dogs with intraspinal spirocercosis. J Am Vet Med Assoc 2022; 261:384-390. [PMID: 36476412 DOI: 10.2460/javma.22.09.0401] [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] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To evaluate the efficiency and safety of a doramectin-based treatment protocol in dogs affected by intraspinal spirocercosis (Spirocerca lupi). ANIMALS Client-owned dogs that were admitted to a veterinary hospital during 2021 to 2022 with acute onset of neurological signs and diagnosed with intraspinal spirocercosis. All dogs underwent complete neurological evaluation, CSF analysis, PCR confirmation of CNS S lupi infection, and follow-up evaluation of at least 6 months. PROCEDURES Upon diagnosis, dogs were treated with doramectin at a dose of 400 μg/kg, SC, q 24 h for 3 consecutive days, followed by the same dose once a week for 6 weeks. Prednisone was administered at a dose of 1 mg/kg, PO, q 24 h and tapered every 3 days. Antimicrobial clindamycin was administered at a dose of 12.5 mg/kg, PO, q 12 h for 7 days to reduce the risk of secondary spinal cord infection. Short- and long-term outcomes (1 week to 56 months) were recorded. RESULTS 8 dogs fulfilled the inclusion criteria, 7 of which presented with neurological deficits and 1 with cervical pain. Initiation of treatment was associated with stopping the deterioration in 7 of 8 dogs. Seven dogs improved and 6 recovered ambulation. One dog was euthanized due to lack of improvement. Six of the recovered dogs were still ataxic on the last follow-up examination at 6 to 56 months. No adverse effects of the drug were noted. CLINICAL RELEVANCE Frequent administration of doramectin was found to be safe and effective in preventing neurological deterioration in dogs with intraspinal spirocercosis.
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Affiliation(s)
- Nimrod Asiag
- 1Veterinary Teaching Hospital, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel.,2Veterinary Specialist Referral Tipul Nimratz, Ben Shemen, Israel
| | - Orit Chai
- 2Veterinary Specialist Referral Tipul Nimratz, Ben Shemen, Israel
| | - Sapir Yodovner
- 1Veterinary Teaching Hospital, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | - Marco Ruggeri
- 1Veterinary Teaching Hospital, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | - Kira Rapaport
- 2Veterinary Specialist Referral Tipul Nimratz, Ben Shemen, Israel
| | - Gad Baneth
- 1Veterinary Teaching Hospital, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | - Yaarit Nachum-Biala
- 1Veterinary Teaching Hospital, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | - Lilach Konstantin
- 1Veterinary Teaching Hospital, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | | | | | - Yaron Bruchim
- 2Veterinary Specialist Referral Tipul Nimratz, Ben Shemen, Israel
| | - Merav H Shamir
- 1Veterinary Teaching Hospital, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
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Asiag N, Lapid R, Aizenberg Z, Baneth G, Nachum-Biala Y, Leszkowicz-Mazuz M, Yasur-Landau D, Chai O, Aroch I, Shamir MH. Spinal cord protothecosis causing paraparesis in a dog. J Vet Diagn Invest 2022; 34:684-688. [PMID: 35459409 PMCID: PMC9266501 DOI: 10.1177/10406387221093048] [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: 11/16/2022] Open
Abstract
Protothecosis, an infectious disease caused by the green algae Prototheca zopfii and P. wickerhamii, occurs sporadically in domestic animals and humans. Diagnosis of CNS protothecosis is based on neurologic signs that indicate multifocal nervous system lesions and that follow a period of chronic diarrhea and weight loss, cytologic observation of algae in fecal culture or histopathology, and detection of the agent by PCR assay of infected tissues. Here, we report a case of a paraparetic dog with CNS protothecosis that was diagnosed definitively antemortem using CSF cytology, PCR, and DNA sequencing. A 4-y-old mixed-breed dog developed progressive paraparesis that followed weight loss and diarrhea. CSF analysis revealed marked eosinophilic pleocytosis. Prototheca organisms were detected by microscopic examination of the CSF, and speciated as P. zopfii by CSF PCR and DNA sequencing. Other possible causes of paraparesis were ruled out using computed tomography, serology, and CSF PCR. The dog's condition deteriorated despite treatment, developing forebrain and central vestibular system clinical signs, and it was euthanized at the owner's request. Postmortem examination was declined. Our findings indicate that when CNS protothecosis is suspected, antemortem diagnosis can be made using CSF analysis and a PCR assay.
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Affiliation(s)
- Nimrod Asiag
- Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Roi Lapid
- Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Zahi Aizenberg
- Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Gad Baneth
- Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Yaarit Nachum-Biala
- Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | | | | | - Orit Chai
- Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Itamar Aroch
- Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Merav H Shamir
- Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
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Klainbart S, Grabarnik M, Kelmer E, Chai O, Cuneah O, Segev G, Aroch I. Clinical manifestations, laboratory findings, treatment and outcome of acute organophosphate or carbamate intoxication in 39 cats. Vet Rec 2022; 191:e1633. [PMID: 35437770 DOI: 10.1002/vetr.1633] [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: 06/19/2021] [Revised: 01/17/2022] [Accepted: 03/23/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Organophosphates and carbamates are important sources of intoxication for humans and animals. However, large-scale studies of these intoxications in cats are unavailable. METHODS The medical records of 39 cats presented to a veterinary teaching hospital with acute organophosphate or carbamate intoxication were reviewed retrospectively. RESULTS Mortality in intoxicated cats was 15%. Low respiratory rate and low rectal temperature at presentation were associated with death. Other common clinical signs included weakness, ataxia, apathy, recumbency, anorexia and bradycardia, but these were unassociated with the outcome. The common biochemical abnormalities included decreased serum butyryl-choline esterase activity, acidaemia, hypercarbaemia and total hypocalcaemia, and increased creatine kinase activity and total plasma protein concentration. There were no significant differences in haematological, biochemical and blood gas analytes between survivors and non-survivors. Common medications and treatments included 2-pyridine aldoxime methyl-chloride-pralidoxime (2-PAM) (74%), metoclopramide (64%), antibiotics (64%), diphenhydramine (59%) and atropine sulphate (54%). There were no significant drug and treatment differences between survivors and non-survivors. The secondary complications of the intoxication included pneumonia (10%), acute kidney injury (10%) and pancreatitis (8%). CONCLUSIONS Acute cholinergic crisis due to organophosphate or carbamate intoxication has a fair prognosis in cats. Low respiratory rate and low rectal temperature at presentation were associated with death. The most commonly used specific medications in this study included 2-PAM, diphenhydramine and atropine sulphate.
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Affiliation(s)
- Sigal Klainbart
- Department of Small Animal Emergency and Critical Care, The Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Meital Grabarnik
- Department of Small Animal Emergency and Critical Care, The Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Efrat Kelmer
- Department of Small Animal Emergency and Critical Care, The Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Orit Chai
- Department of Small Animal Neurology, The Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Olga Cuneah
- Department of Toxicology, Kimron Veterinary Institute, Bet Dagan, Israel
| | - Gilad Segev
- Department of Small Animal Internal Medicine, The Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Itamar Aroch
- Department of Small Animal Internal Medicine, The Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
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Hanael E, Baruch S, Chai O, Nir Z, Rapoport K, Ruggeri M, Eizenberg I, Peery D, Friedman A, Shamir MH. Detection of blood‐brain barrier dysfunction using advanced imaging methods to predict seizures in dogs with meningoencephalitis of unknown origin. J Vet Intern Med 2022; 36:702-712. [PMID: 35285550 PMCID: PMC8965229 DOI: 10.1111/jvim.16396] [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: 11/18/2021] [Revised: 02/13/2022] [Accepted: 02/14/2022] [Indexed: 12/01/2022] Open
Abstract
Background The blood‐brain barrier (BBB), which separates the intravascular and neuropil compartments, characterizes the vascular bed of the brain and is essential for its proper function. Recent advances in imaging techniques have driven the development of methods for quantitative assessment of BBB permeability. Hypothesis/Objectives Permeability of the BBB can be assessed quantitatively in dogs with meningoencephalitis of unknown origin (MUO) and its status is associated with the occurrence of seizures. Animals Forty dogs with MUO and 12 dogs without MUO. Methods Retrospective, prospective cohort study. Both dynamic contrast enhancement (DCE) and subtraction enhancement analysis (SEA) methods were used to evaluate of BBB permeability in affected (DCE, n = 8; SEA, n = 32) and control dogs (DCE, n = 6; SEA, n = 6). Association between BBB dysfunction (BBBD) score and clinical characteristics was examined. In brain regions where BBBD was identified by DCE or SEA magnetic resonance imaging (MRI) analysis, immunofluorescent staining for albumin, glial fibrillary acidic protein, ionized calcium binding adaptor molecule, and phosphorylated mothers against decapentaplegic homolog 2 were performed to detect albumin extravasation, reactive astrocytes, activated microglia, and transforming growth factor beta signaling, respectively. Results Dogs with BBBD had significantly higher seizure prevalence (72% vs 19%; P = .01) when compared to MUO dogs with no BBBD. The addition of SEA to routine MRI evaluation increased the identification rate of brain pathology in dogs with MUO from 50% to 72%. Conclusions and Clinical Importance Imaging‐based assessment of BBB integrity has the potential to predict risk of seizures in dogs with MUO.
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Affiliation(s)
- Erez Hanael
- Hebrew University Koret School of Veterinary Medicine‐Veterinary Teaching Hospital Rehovot Israel
| | - Shelly Baruch
- Hebrew University Koret School of Veterinary Medicine‐Veterinary Teaching Hospital Rehovot Israel
| | - Orit Chai
- Hebrew University Koret School of Veterinary Medicine‐Veterinary Teaching Hospital Rehovot Israel
| | - Zohar Nir
- Hebrew University Koret School of Veterinary Medicine‐Veterinary Teaching Hospital Rehovot Israel
| | - Kira Rapoport
- Hebrew University Koret School of Veterinary Medicine‐Veterinary Teaching Hospital Rehovot Israel
| | - Marco Ruggeri
- Hebrew University Koret School of Veterinary Medicine‐Veterinary Teaching Hospital Rehovot Israel
| | - Itzhak Eizenberg
- Hebrew University Koret School of Veterinary Medicine‐Veterinary Teaching Hospital Rehovot Israel
| | - Dana Peery
- Hebrew University Koret School of Veterinary Medicine‐Veterinary Teaching Hospital Rehovot Israel
| | - Alon Friedman
- Departments of Physiology and Cell Biology, Brain, and Cognitive Sciences, Zlotowski Center for Neuroscience Ben‐Gurion University of the Negev Beer Sheva Israel
- Department of Medical Neuroscience, Faculty of Medicine Dalhousie University Halifax NS Canada
| | - Merav H. Shamir
- Hebrew University Koret School of Veterinary Medicine‐Veterinary Teaching Hospital Rehovot Israel
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Hanael E, Chai O, Konstanitin L, Gibeon L, Rapaport K, Ruggeri M, Friedman A, Shamir MH. Telmisartan as an add-on treatment for dogs with refractory idiopathic epilepsy: a nonrandomized, uncontrolled, open-label clinical trial. J Am Vet Med Assoc 2022; 260:735-740. [PMID: 35201995 DOI: 10.2460/javma.20.12.0683] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To evaluate the effect on seizure frequency of add-on telmisartan treatment in dogs with refractory idiopathic epilepsy. ANIMALS 11 client-owned dogs with idiopathic epilepsy and ≥ 2 generalized seizures/mon that were currently being treated with ≥ 2 antiepileptic drugs. PROCEDURES Telmisartan was administered at a dosage of 0.25 to 1 mg/kg, PO, every 12 hours for 4 to 16 months. Seizure frequencies before and during telmisartan treatment were recorded. RESULTS 10 dogs completed the 4-month treatment protocol. One dog was excluded owing to a transient increase in serum creatinine concentration; no adverse effects of telmisartan were observed in the remaining 10 dogs. A reduction in seizure frequency greater than an estimated expected placebo effect of 30% was evident in 7 of the 10 dogs. Long-term (12 to 16 months) follow-up information was available for 6 dogs, of which 4 had a further reduction in seizure frequency. Differences in seizure frequency were not statistically significant. No significant difference was found in serum phenobarbital concentration throughout the treatment period in the 7 dogs that were tested. CLINICAL RELEVANCE Telmisartan has the potential to reduce seizure frequency when administered as an add-on antiepileptic drug in dogs with refractory idiopathic epilepsy. A randomized, double-blind, placebo-controlled trial is needed to determine the true efficacy of telmisartan. On the basis of our results, a sample size of 54 dogs with refractory idiopathic epilepsy would be needed.
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Affiliation(s)
- Erez Hanael
- Veterinary Teaching Hospital, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | - Orit Chai
- Veterinary Teaching Hospital, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | - Lilach Konstanitin
- Veterinary Teaching Hospital, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | | | - Kira Rapaport
- Veterinary Teaching Hospital, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | - Marco Ruggeri
- Veterinary Teaching Hospital, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | - Alon Friedman
- Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer Sheva, Israel.,Department of Medical Neuroscience, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Merav H Shamir
- Veterinary Teaching Hospital, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
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Abstract
Case summary A 9-month-old male neutered domestic shorthair cat presented 2 weeks after castration with a 48 h history of acute-onset lateral recumbency and severe hindlimb rigidity. Physical examination findings included hyperthermia, tachypnoea, hindlimb rigidity and a healed orchidectomy site. Neurological examination of the head and forelimbs was normal; however, there was a spastic, non-ambulatory paraparesis of the hindlimbs, which was more severe on the left. Abnormal findings included mildly elevated serum creatine kinase levels and on electromyography there was bilateral pathological spontaneous activity of the biceps femoris muscles. A tentative diagnosis of tetanus was made based on clinical presentation. Treatment was initiated with tetanus antitoxin, diazepam, metronidazole, buprenorphine and physiotherapy of the hindlimbs. There was an improvement over the following 20 days. Twenty-five days later the cat presented with acute, painful, non-weightbearing lameness of the left hindlimb. Physical examination was suggestive of craniodorsal coxofemoral joint luxation, which was confirmed radiographically. This was treated with analgesia and rest. A marked clinical improvement was observed at the 3-month follow-up. Relevance and novel information To our knowledge, there have been no previously published reports of spontaneous coxofemoral joint luxation as a complication of hindlimb localised tetanus infection in cats. This report suggests that coxofemoral luxation should be considered as a possible complication in young cats with hindlimb localised tetanus.
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Affiliation(s)
- Cecilia-Gabriella Danciu
- Department of Veterinary Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, UK.,Department of Veterinary Preclinical and Clinical Sciences, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania
| | - Joshua Milgram
- Department of Small Animal Surgery, The Koret School of Veterinary Medicine, Rehovot, Israel
| | - Ciprian Andrei Ober
- Department of Veterinary Preclinical and Clinical Sciences, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania
| | - Flaviu Alexandru Tăbăran
- Department of Veterinary Preclinical and Clinical Sciences, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania
| | - Helga Demény
- Department of Veterinary Preclinical and Clinical Sciences, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania
| | - Orit Chai
- Department of Veterinary Neurology and Neurosurgery, The Koret School of Veterinary Medicine, Rehovot, Israel
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Mann O, Peery D, Bader Segev R, Klainbart S, Kelmer E, Sobarzo A, Shub V, Rapoport K, Shamir MH, Chai O. CT findings and the prognostic value of the Koret CT score in cats with traumatic brain injury. J Feline Med Surg 2021; 24:91-97. [PMID: 33847537 PMCID: PMC8807991 DOI: 10.1177/1098612x211005306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The aims of this study were to evaluate associations between abnormal head CT findings and outcome, and to examine the prognostic value of the Koret CT score (KCTS) in cats sustaining acute traumatic brain injury (TBI). METHODS The medical records of cats hospitalised with TBI that underwent head CT scans within 72 h of admission were retrospectively reviewed. CT scans were evaluated independently by a radiologist and a neurologist who were blinded to the outcome. A KCTS and modified Glasgow Coma Scale (MGCS) were assigned to each cat and the association between abnormal CT findings, KCTS, MGCS and outcome were analysed. RESULTS Fourteen cats were included in the study: nine (64.2%) survivors and five (35.7%) non-survivors. Of the nine cats that were discharged, one was a short-term survivor (10 days) and eight (57.1%) were long-term survivors (⩾6 months). Abnormal CT findings included lateral ventricle asymmetry/midline shift (42.8%), intracranial haemorrhage (35.7%), caudotentorial lesions (14.2%) and cranial vault fractures (14.2%), all of which were depressed. Intracranial haemorrhage was found to be significantly and negatively associated with short-term (P = 0.005) and long-term (P = 0.023) survival. KCTS was significantly associated with short-term survival (P = 0.002) and long-term survival (P = 0.004). A KCTS cut-off value of 2 yielded a 100% sensitivity and 100% specificity for short-term survival and 100% sensitivity and 80% specificity for long-term survival. A MGCS cut-off value of ⩾13 was associated with a 100% sensitivity and 100% specificity for short-term survival, and with a 100% sensitivity and 80% specificity for long-term survival. CONCLUSIONS AND RELEVANCE KCTS, performed up to 72 h from injury, can be used as an additional diagnostic tool for the prediction of survival in cats with TBI.
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Affiliation(s)
- Ohad Mann
- Department of Emergency and Critical Care, Koret School of Veterinary Medicine Teaching Hospital, Hebrew University of Jerusalem, Rehovot, Israel
| | - Dana Peery
- Department of Radiology, Koret School of Veterinary Medicine Teaching Hospital, Hebrew University of Jerusalem, Rehovot, Israel
| | - Ronnie Bader Segev
- Department of Emergency and Critical Care, Koret School of Veterinary Medicine Teaching Hospital, Hebrew University of Jerusalem, Rehovot, Israel
| | - Sigal Klainbart
- Department of Emergency and Critical Care, Koret School of Veterinary Medicine Teaching Hospital, Hebrew University of Jerusalem, Rehovot, Israel
| | - Efrat Kelmer
- Department of Emergency and Critical Care, Koret School of Veterinary Medicine Teaching Hospital, Hebrew University of Jerusalem, Rehovot, Israel
| | - Ariel Sobarzo
- The Shraga Segal Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Pre-Clinical Research Center, Health Faculty, Ben Gurion University of the Negev, Beer-Sheva, Israel
| | - Vered Shub
- Emergency and Specialist Veterinary Center, Ben-Shemen Youth Village, Israel
| | - Kira Rapoport
- Department of Neurology and Neurosurgery, Koret School of Veterinary Medicine Teaching Hospital, Hebrew University of Jerusalem, Rehovot, Israel
| | - Merav H Shamir
- Department of Neurology and Neurosurgery, Koret School of Veterinary Medicine Teaching Hospital, Hebrew University of Jerusalem, Rehovot, Israel
| | - Orit Chai
- Department of Neurology and Neurosurgery, Koret School of Veterinary Medicine Teaching Hospital, Hebrew University of Jerusalem, Rehovot, Israel
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10
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Rapoport K, Mateo I, Peery D, Mazaki-Tovi M, Klainbart S, Kelmer E, Ruggeri M, Shamir MH, Chai O. The prognostic value of the Koret CT score in dogs following traumatic brain injury. Vet J 2020; 266:105563. [PMID: 33323172 DOI: 10.1016/j.tvjl.2020.105563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 05/24/2020] [Revised: 10/02/2020] [Accepted: 10/08/2020] [Indexed: 12/28/2022]
Abstract
Traumatic brain injury (TBI) is a common condition in veterinary medicine with relatively high mortality rate. Recently, a study that correlated abnormal computed tomography (CT) findings with outcome in dogs with head trauma established a prognostic scoring system termed Koret CT score (KCTS). The purpose of this study was to evaluate the accuracy of the KCTS in making short- and long-term prognosis in dogs presented within 72 h of TBI. Thirty-five dogs that were admitted to a hospital during 2010-2019 with TBI and were CT-scanned within 72 h of injury were included in the study. Retrospectively collected data included signalment, modified Glasgow Coma Scale score (MGCS), CT findings, and outcome, i.e. short-term (defined as 10 days) and long-term (6 months) survival. CT images were reviewed and the KCTS was calculated for all dogs. Association between KCTS and outcome was examined. A significant negative association was found between KCTS and both short- and long-term survival. The area under receiver operating characteristic curve for KCTS for short- and long-term survival was 0.9 and 0.87, respectively. Furthermore, the probability of survival in the short term was predicated by the KCTS in an almost linear fashion and a score of 3 points or less on the KCTS was associated with survival with 85% sensitivity and 100% specificity. These results validate the prognostic value of the KCTS in dogs with TBI and provide a complementary tool for serial clinical and neurological evaluation.
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Affiliation(s)
- K Rapoport
- Department of Neurology and Neurosugery, Koret School of Veterinary Medicine Teaching Hospital, Hebrew University of Jerusalem, Rehovot 76100, Israel.
| | - I Mateo
- Department of Neurology, Hospital Clínico Veterinario, Universidad Alfonso X el Sabio, Madrid 28691, Spain
| | - D Peery
- Department of Radiology, Koret School of Veterinary Medicine Teaching Hospital, Hebrew University of Jerusalem, Rehovot 76100, Israel
| | - M Mazaki-Tovi
- Department of Internal Medicine, Koret School of Veterinary Medicine Teaching Hospital, Hebrew University of Jerusalem, Rehovot 76100, Israel
| | - S Klainbart
- Department of Emergency and Critical Care, Koret School of Veterinary Medicine Teaching Hospital, Hebrew University of Jerusalem, Rehovot 76100, Israel
| | - E Kelmer
- Department of Emergency and Critical Care, Koret School of Veterinary Medicine Teaching Hospital, Hebrew University of Jerusalem, Rehovot 76100, Israel
| | - M Ruggeri
- Department of Neurology and Neurosugery, Koret School of Veterinary Medicine Teaching Hospital, Hebrew University of Jerusalem, Rehovot 76100, Israel
| | - M H Shamir
- Department of Neurology and Neurosugery, Koret School of Veterinary Medicine Teaching Hospital, Hebrew University of Jerusalem, Rehovot 76100, Israel
| | - O Chai
- Department of Neurology and Neurosugery, Koret School of Veterinary Medicine Teaching Hospital, Hebrew University of Jerusalem, Rehovot 76100, Israel
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11
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Chai O, Mazaki-Tovi M, Klainbart S, Kelmer E, Shipov A, Shamir MH. Serum Concentrations of Neuron-Specific Enolase in Dogs Following Traumatic Brain Injury. J Comp Pathol 2020; 179:45-51. [PMID: 32958147 DOI: 10.1016/j.jcpa.2020.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 04/02/2020] [Revised: 05/15/2020] [Accepted: 06/18/2020] [Indexed: 01/15/2023]
Abstract
The ability to make an accurate prognosis, which is a prerequisite for treatment decisions, is very limited in dogs with traumatic brain injury (TBI). To determine whether serum concentrations of neuron-specific enolase (NSE) have prognostic value in dogs following TBI, we conducted a prospective, observational, controlled clinical study in an intensive care unit of a university teaching hospital. The study population comprised 24 dogs admitted to the hospital within 72 h of a known event of TBI between January 2010 and January 2015, as well as 25 control healthy shelter dogs admitted for elective neutering. Seventeen injured dogs (70%) survived to discharge, four were euthanized and three died within 48 h. Serum samples were obtained from all dogs (in injured dogs, within 72 h of TBI) and NSE concentrations were measured using enzyme-linked immonosorbent assay. Associations between NSE levels and outcome, Modified Glasgow Coma Scale, time to sampling, age or haemolysis scale were determined. Mean serum NSE concentrations were decreased in dogs with TBI compared with healthy controls (19.4 ± 4.14 ng/ml vs. 24.9 ± 4.6 ng/ml, P <0.001). No association was found between serum NSE concentrations and either survival or severity of neurological impairment. A negative correlation was found between serum NSE concentrations and time from trauma to blood collection (r = -0.50, P = 0.022). These results indicate that serum NSE concentration in dogs following TBI is not an effective marker for severity or outcome. Further studies are warranted to standardize serum NSE measurements in dogs and to determine the peak and half-life levels of this potential biomarker.
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Affiliation(s)
- O Chai
- Koret School of Veterinary Medicine, Veterinary Teaching Hospital, Hebrew University of Jerusalem, Rehovot, Israel.
| | - M Mazaki-Tovi
- Koret School of Veterinary Medicine, Veterinary Teaching Hospital, Hebrew University of Jerusalem, Rehovot, Israel
| | - S Klainbart
- Koret School of Veterinary Medicine, Veterinary Teaching Hospital, Hebrew University of Jerusalem, Rehovot, Israel
| | - E Kelmer
- Koret School of Veterinary Medicine, Veterinary Teaching Hospital, Hebrew University of Jerusalem, Rehovot, Israel
| | - A Shipov
- Koret School of Veterinary Medicine, Veterinary Teaching Hospital, Hebrew University of Jerusalem, Rehovot, Israel
| | - M H Shamir
- Koret School of Veterinary Medicine, Veterinary Teaching Hospital, Hebrew University of Jerusalem, Rehovot, Israel
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12
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Hanael E, Veksler R, Friedman A, Bar-Klein G, Senatorov VV, Kaufer D, Konstantin L, Elkin M, Chai O, Peery D, Shamir MH. Blood-brain barrier dysfunction in canine epileptic seizures detected by dynamic contrast-enhanced magnetic resonance imaging. Epilepsia 2020; 60:1005-1016. [PMID: 31032909 DOI: 10.1111/epi.14739] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 06/05/2018] [Revised: 03/28/2019] [Accepted: 04/01/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Dogs with spontaneous or acquired epilepsy exhibit resemblance in etiology and disease course to humans, potentially offering a translational model of the human disease. Blood-brain barrier dysfunction (BBBD) has been shown to partake in epileptogenesis in experimental models of epilepsy. To test the hypothesis that BBBD can be detected in dogs with naturally occurring seizures, we developed a linear dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) analysis algorithm that was validated in clinical cases of seizing dogs and experimental epileptic rats. METHODS Forty-six dogs with naturally occurring seizures of different etiologies and 12 induced epilepsy rats were imaged using DCE-MRI. Six healthy dogs and 12 naive rats served as control. DCE-MRI was analyzed by linear-dynamic method. BBBD scores were calculated in whole brain and in specific brain regions. Immunofluorescence analysis for transforming growth factor beta (TGF-β) pathway proteins was performed on the piriform cortex of epileptic dogs. RESULTS We found BBBD in 37% of dogs with seizures. A significantly higher cerebrospinal fluid to serum albumin ratio was found in dogs with BBBD relative to dogs with intact blood-brain barrier (BBB). A significant difference was found between epileptic and control rats when BBBD scores were calculated for the piriform cortex at 48 hours and 1 month after status epilepticus. Mean BBBD score of the piriform lobe in idiopathic epilepsy (IE) dogs was significantly higher compared to control. Immunohistochemistry results suggested active TGF-β signaling and neuroinflammation in the piriform cortex of dogs with IE, showing increased levels of serum albumin colocalized with glial acidic fibrillary protein and pSMAD2 in an area where BBBD had been detected by linear DCE-MRI. SIGNIFICANCE Detection of BBBD in dogs with naturally occurring epilepsy provides the ground for future studies for evaluation of novel treatment targeting the disrupted BBB. The involvement of the piriform lobe seen using our linear DCE-MRI protocol and algorithm emphasizes the possibility of using dogs as a translational model for the human disease.
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Affiliation(s)
- Erez Hanael
- Hebrew University Koret School of Veterinary Medicine-Veterinary Teaching Hospital, Rehovot, Israel
| | - Ronel Veksler
- Departments of Physiology and Cell Biology, Brain, and Cognitive Sciences, Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Alon Friedman
- Departments of Physiology and Cell Biology, Brain, and Cognitive Sciences, Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer Sheva, Israel.,Department of Medical Neuroscience and Brain Repair Center, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Guy Bar-Klein
- Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Howard Hughes Medical Institute, Chevy Chase, Maryland
| | - Vladimir V Senatorov
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, California
| | - Daniela Kaufer
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, California.,Department of Integrative Biology, University of California, Berkeley, Berkeley, California
| | - Lilach Konstantin
- Hebrew University Koret School of Veterinary Medicine-Veterinary Teaching Hospital, Rehovot, Israel
| | - Maria Elkin
- Hebrew University Koret School of Veterinary Medicine-Veterinary Teaching Hospital, Rehovot, Israel
| | - Orit Chai
- Hebrew University Koret School of Veterinary Medicine-Veterinary Teaching Hospital, Rehovot, Israel
| | - Dana Peery
- Hebrew University Koret School of Veterinary Medicine-Veterinary Teaching Hospital, Rehovot, Israel
| | - Merav H Shamir
- Hebrew University Koret School of Veterinary Medicine-Veterinary Teaching Hospital, Rehovot, Israel
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13
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Klainbart S, Grabernik M, Kelmer E, Chai O, Cuneah O, Segev G, Aroch I. Clinical manifestations, laboratory findings, treatment and outcome of acute organophosphate or carbamate intoxication in 102 dogs: A retrospective study. Vet J 2019; 251:105349. [PMID: 31492383 DOI: 10.1016/j.tvjl.2019.105349] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 10/13/2018] [Revised: 07/25/2019] [Accepted: 07/25/2019] [Indexed: 12/01/2022]
Abstract
Organophosphates (OP) and carbamates are commonly used insecticides and important intoxication sources of humans and animals. Nevertheless, large scale studies of these intoxications in dogs are unavailable. The medical records of dogs presented to a veterinary hospital were reviewed retrospectively. The study included 102 dogs definitely diagnosed with acute OP or carbamate intoxication. The most common presenting clinical signs included muscle tremor, hypersalivation, miosis, weakness, vomiting and diarrhea. Hypersalivation, muscle tremor and tachypnea were significantly (P < 0.05) associated with survival to discharge; while weakness, mental dullness, anorexia, pale mucous membranes and paddling were significantly associated with death. Common laboratory abnormalities included decreased butyrylcholine esterase activity, acidemia, increased total plasma protein, leukocytosis, hypochloridemia, hyperbilirubinemia, increased creatinine and alanine transaminase (ALT), aspartate transaminase (AST) and creatine kinase activities, and prolonged activated partial thromboplastin time (aPTT). Compared to the survivors, the non-survivors showed significantly: higher frequencies of thrombocytopenia, hypocarbemia, prolonged prothrombin time (PT), hypernatremia, hyperkalemia, hypocholesterolemia, hypoproteinemia, hypertriglyceridemia, increased ALT activity and increased urea concentration; lower median concentrations of venous blood bicarbonate, serum chloride and total CO2; and higher medians of PT, serum total bilirubin and urea concentrations, and ALT and AST activities. Intoxicated dogs were commonly treated with diphenhydramine, atropine-sulfate, antibiotics, diazepam and pralidoxime, while some (19.2%) required general anesthesia and mechanical ventilation. The survival rate of dogs treated by gastric lavage was higher (P = 0.041) compared to that of the remaining dogs. Development of respiratory failure and mechanical ventilation requirement were significantly associated (P < 0.001) with death. The mortality rate was 17%.
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Affiliation(s)
- S Klainbart
- Department of Small Animal Emergency and Critical Care, The Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, P.O. Box 12, Rehovot, 761001, Israel; Department of Toxicology, Kimron Veterinary Institute, Bet Dagan, 5025000, Israel; Department of Small Animal Internal Medicine, The Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, P.O. Box 12, Rehovot, 761001, Israel.
| | - M Grabernik
- Department of Small Animal Emergency and Critical Care, The Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, P.O. Box 12, Rehovot, 761001, Israel; Department of Toxicology, Kimron Veterinary Institute, Bet Dagan, 5025000, Israel; Department of Small Animal Internal Medicine, The Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, P.O. Box 12, Rehovot, 761001, Israel
| | - E Kelmer
- Department of Small Animal Emergency and Critical Care, The Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, P.O. Box 12, Rehovot, 761001, Israel; Department of Toxicology, Kimron Veterinary Institute, Bet Dagan, 5025000, Israel; Department of Small Animal Internal Medicine, The Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, P.O. Box 12, Rehovot, 761001, Israel
| | - O Chai
- Department of Small Animal Emergency and Critical Care, The Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, P.O. Box 12, Rehovot, 761001, Israel; Department of Toxicology, Kimron Veterinary Institute, Bet Dagan, 5025000, Israel; Department of Small Animal Internal Medicine, The Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, P.O. Box 12, Rehovot, 761001, Israel
| | - O Cuneah
- Department of Small Animal Neurology, The Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, P.O. Box 12, Rehovot, 761001, Israel; Department of Toxicology, Kimron Veterinary Institute, Bet Dagan, 5025000, Israel; Department of Small Animal Internal Medicine, The Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, P.O. Box 12, Rehovot, 761001, Israel
| | - G Segev
- Department of Small Animal Emergency and Critical Care, The Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, P.O. Box 12, Rehovot, 761001, Israel; Department of Toxicology, Kimron Veterinary Institute, Bet Dagan, 5025000, Israel; Department of Small Animal Internal Medicine, The Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, P.O. Box 12, Rehovot, 761001, Israel
| | - I Aroch
- Department of Small Animal Emergency and Critical Care, The Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, P.O. Box 12, Rehovot, 761001, Israel; Department of Toxicology, Kimron Veterinary Institute, Bet Dagan, 5025000, Israel; Department of Small Animal Internal Medicine, The Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, P.O. Box 12, Rehovot, 761001, Israel
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14
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Ruggeri M, Rojas A, Chai O, Purzyc H, Hanael E, Rapoport K, Barnoon I, Konstantin L, Baneth G, Shamir MH. Detection of Intraspinal Spirocerca lupi in Canine Cerebrospinal Fluid by Polymerase Chain Reaction. J Comp Pathol 2019; 170:105-112. [PMID: 31375154 DOI: 10.1016/j.jcpa.2019.05.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 03/19/2019] [Revised: 05/15/2019] [Accepted: 05/27/2019] [Indexed: 11/24/2022]
Abstract
Aberrant migration of Spirocerca lupi into the spinal cord is an important cause of severe progressive neurological dysfunction in dogs. Although early diagnosis is essential to prevent deterioration, ante-mortem diagnosis of this condition remains challenging. The aim of this study was to evaluate the detection of the 18S ribosomal DNA (rDNA) S. lupi gene in the cerebrospinal fluid (CSF) of presumptively-affected dogs using polymerase chain reaction (PCR). Dogs with a non-compressive spinal cord lesion, pleocytosis with presence of eosinophils in the CSF and a characteristic clinical presentation were included. CSF samples from eight dogs were available for the study, of which seven were definitively diagnosed with intraspinal spirocercosis by PCR of either the CSF samples (6/7) or tissue samples obtained at necropsy examination (3/7), or both (2/7). Of these seven positive cases, only one dog had a negative CSF PCR, indicating a sensitivity of 86% for detecting nematode DNA in the CSF of infected dogs using this PCR protocol. The nematode DNA sequences obtained from the CSF of six dogs and the spinal cord tissue of three dogs were 98-100% identical to the publicly available sequences of S. lupi, confirming the diagnosis. These findings indicate that PCR targeting the 18S rDNA of S. lupi in CSF is useful for the ante-mortem diagnosis of canine intraspinal spirocercosis.
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Affiliation(s)
- M Ruggeri
- Koret School of Veterinary Medicine, Veterinary Teaching Hospital, Hebrew University of Jerusalem, PO Box 12, Rehovot
| | - A Rojas
- Koret School of Veterinary Medicine, Veterinary Teaching Hospital, Hebrew University of Jerusalem, PO Box 12, Rehovot
| | - O Chai
- Koret School of Veterinary Medicine, Veterinary Teaching Hospital, Hebrew University of Jerusalem, PO Box 12, Rehovot
| | - H Purzyc
- Koret School of Veterinary Medicine, Veterinary Teaching Hospital, Hebrew University of Jerusalem, PO Box 12, Rehovot
| | - E Hanael
- Koret School of Veterinary Medicine, Veterinary Teaching Hospital, Hebrew University of Jerusalem, PO Box 12, Rehovot
| | - K Rapoport
- Koret School of Veterinary Medicine, Veterinary Teaching Hospital, Hebrew University of Jerusalem, PO Box 12, Rehovot
| | - I Barnoon
- VetNeuro, Veterinary Specialist Referral Centre Knowledge Farm, Beit Berl, Israel
| | - L Konstantin
- Koret School of Veterinary Medicine, Veterinary Teaching Hospital, Hebrew University of Jerusalem, PO Box 12, Rehovot
| | - G Baneth
- Koret School of Veterinary Medicine, Veterinary Teaching Hospital, Hebrew University of Jerusalem, PO Box 12, Rehovot
| | - M H Shamir
- Koret School of Veterinary Medicine, Veterinary Teaching Hospital, Hebrew University of Jerusalem, PO Box 12, Rehovot.
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15
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Chai O, Harrosh T, Bdolah-Avram T, Mazaki-Tovi M, Shamir MH. Characteristics of and risk factors for intervertebral disk extrusions in Pekingese. J Am Vet Med Assoc 2019; 252:846-851. [PMID: 29553897 DOI: 10.2460/javma.252.7.846] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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
OBJECTIVE To characterize and identify risk factors for intervertebral disk extrusion (IVDE) in Pekingese. DESIGN Retrospective case-control study. ANIMALS 426 Pekingese (81 with confirmed IVDE and 345 without IVDE) admitted to a veterinary teaching hospital from 2005 through 2015. PROCEDURES Medical records were reviewed and data were extracted regarding age, sex, body weight, body condition score, coat color, chief reason for initial evaluation, body system involved, and diagnosis. Survey radiographs of the vertebral column were examined. Data were compared between the confirmed IVDE and non-IVDE groups. RESULTS Confirmed IVDE was uncommon in dogs < 2 years of age (2/81 [2%]). The extrusion was primarily located in the thoracolumbar (n = 57 [70%]) and cervical (22 [27%]) regions; the most common sites were T12-13 and C6-7. The number of radiographically visible calcified disks was significantly greater in the confirmed IVDE versus non-IVDE group, and the presence of calcified disks in the T10-L4 region was associated with increased odds of IVDE (OR, 21.2). Black coat color was significantly more prevalent in the confirmed IVDE versus non-IVDE group and was associated with increased odds of developing IVDE (OR, 1.6). Mean body weight and the proportion of spayed female dogs were significantly greater in the confirmed IVDE versus non-IVDE group. CONCLUSIONS AND CLINICAL RELEVANCE Several risk factors for confirmed IVDE in Pekingese were identified that could be useful for counseling clients about the disease or, with additional research, designing selective breeding programs to reduce the prevalence of IVDE in the breed.
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16
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Aroch I, Baneth G, Salant H, Nachum-Biala Y, Berkowitz A, Shamir M, Chai O. Neospora caninum and Ehrlichia canis co-infection in a dog with meningoencephalitis. Vet Clin Pathol 2018; 47:289-293. [PMID: 29406569 DOI: 10.1111/vcp.12582] [Citation(s) in RCA: 12] [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] [Indexed: 11/26/2022]
Abstract
An 8-year-old mixed-breed dog was presented for acute, progressive weakness and ataxia, inappetence, and weight loss. The patient was mentally normal, but nonambulatory, with a right head tilt, right positional ventral strabismus, and slight head tremors. A neurologic lesion was localized to the cerebellum and right brainstem. Cerebrospinal fluid (CSF) analysis showed a markedly increased protein concentration and mixed pleocytosis, with eosinophil predominance (44%), intracytoplasmic inclusions within eosinophils, consistent with Ehrlichia canis (E canis) morulae, and Toxoplasma gondii (T gondii) or Neospora caninum (N caninum) tachyzoites within eosinophils and monocytes. A serum indirect immunofluorescent antibody test was positive for N caninum (titer 1:12 800) and negative for T gondii. Both blood and CSF PCR results were N caninum- and E canis-positive and T gondii- and Anaplasma phagocytophilum-negative, and blood PCR, but not CSF PCR, was Hepatozoon canis-positive. The dog was treated for 30 days with clindamycin, sulfamethoxazole-trimethoprim, doxycycline, prednisone, and cephalosporin, but did not improve neurologically, and was euthanized. Brain histopathology showed moderate multifocal, subacute meningoencephalitis with necrosis and gliosis. The neurologic disease was mostly attributed to central nervous system (CNS) neosporosis, with the possible contribution of ehrlichiosis, which was likely a manifestation of blood-brain barrier disruption. Hepatozoonosis was probably a result or cause of underlying immunosuppression. To our knowledge, this is the first report of CNSN caninum and E canis co-infection detected by both CSF PCR and cytology and E canis morulae identified within CSF eosinophils.
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Affiliation(s)
- Itamar Aroch
- Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Gad Baneth
- Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Harold Salant
- Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel.,Department of Microbiology and Molecular Genetics, The Kuvin Center for the Study of Infectious and Tropical Diseases, Hebrew University-Hadassah Medical School, Jerusalem, Israel
| | - Yaarit Nachum-Biala
- Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Asaf Berkowitz
- Department of Pathology, Kimron Veterinary Institute, Bet Dagan, Israel
| | - Merav Shamir
- Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Orit Chai
- Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
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17
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Klainbart S, Chai O, Vaturi R, Rapoport K, Aroch I, Shamir MH. Nematode eggs observed in cytology of cerebrospinal fluid diagnostic for intramedullary Spirocerca lupi spinal cord migration. Vet Clin Pathol 2018; 47:138-141. [PMID: 29329490 DOI: 10.1111/vcp.12560] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Spinal spirocercosis due to aberrant Spirocerca lupi nematode migration is an emerging etiology for acute myelitis in dogs in Israel, causing severe, mostly nonsymmetrical hind limb paresis or paralysis, and sometimes tetraparesis or tetraparalysis. So far, incidental identification of parasites during spinal surgery or at necropsy provides the only definite diagnosis, while antemortem diagnosis of this condition has been uncertain. Specifically, antemortem diagnosis is based on the typical clinical presentation of acute, progressive, asymmetrical hind limb paresis or paralysis, with moderate to severe eosinophilic to mixed cerebrospinal fluid (CSF) pleocytosis and increased CSF protein concentration. Exclusion of other differential diagnoses also requires using spinal cord imaging. In this novel report, we document a case of an intradural spinal spirocercosis in a dog, diagnosed antemortem, by detecting S lupi eggs in the CSF, and subsequent treatment, resulting in the resolution of the clinical signs.
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Affiliation(s)
- Sigal Klainbart
- Department of Small Animal Emergency and Critical Care, The Hebrew University Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Orit Chai
- Department of Neurology, The Hebrew University Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Rafael Vaturi
- Department of Small Animal Emergency and Critical Care, The Hebrew University Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Kira Rapoport
- Department of Neurology, The Hebrew University Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Itamar Aroch
- Department of Small Animal Internal Medicine, The Hebrew University Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Merav Hagar Shamir
- Department of Neurology, The Hebrew University Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
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18
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Klainbart S, Bibring U, Strich D, Chai O, Bdolah-Abram T, Aroch I, Kelmer E. Retrospective evaluation of 140 dogs involved in road traffic accidents. Vet Rec 2017; 182:196. [PMID: 29259067 DOI: 10.1136/vr.104293] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 10/19/2017] [Accepted: 11/11/2017] [Indexed: 11/03/2022]
Abstract
This study has retrospectively reviewed the medical records of 140 dogs sustaining road traffic accident (RTA), and has examined the population characteristics, medical history, injury type, physical examination, emergency laboratory tests and radiography findings, the animal trauma triage (ATT) score, the length of hospitalisation, the complications and the outcome. The survival rate was 83.2 per cent. Younger dogs sustained more frequently lung contusions and limb fractures, while larger dogs more frequently suffered limb fractures, and smaller dogs and older ones sustained more frequently pelvic fractures and sacroiliac luxation (P<0.05 for all). Dogs sustaining orthopaedic injuries required longer hospitalisation (P<0.001). The survival rates of non-ambulatory dogs (P<0.001) and those with neurological abnormalities (P<0.001), abnormal body temperature (P=0.001), hyperglycaemia (P=0.026) or hypoproteinaemia (P=0.04) at presentation were lower compared with those in which these were absent. The number of injured body systems was significantly (P<0.001) and positively associated with death. Dogs surviving RTA to presentation to the hospital have a good prognosis for survival to discharge. Older age, and high ATT score, abnormal body temperature, neurological deficits, hyperglycaemia and hypoproteinaemia at presentation, and occurrence of multiorgan trauma are negative prognostic indicators in such dogs.
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Affiliation(s)
- Sigal Klainbart
- Department of Small Animal Emergency and Critical Care, The Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Uri Bibring
- Department of Radiology, The Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Dalia Strich
- Department of Small Animal Emergency and Critical Care, The Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Orit Chai
- Department of Neurology, The Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Tali Bdolah-Abram
- The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Koret School of Veterinary Medicine, Rehovot, Israel
| | - Itamar Aroch
- Small Animal Internal Medicine, The Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Efrat Kelmer
- Department of Small Animal Emergency and Critical Care, The Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
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Chai O, Peery D, Bdolah-Abram T, Moscovich E, Kelmer E, Klainbart S, Milgram J, Shamir MH. Computed tomographic findings in dogs with head trauma and development of a novel prognostic computed tomography–based scoring system. Am J Vet Res 2017; 78:1085-1090. [DOI: 10.2460/ajvr.78.9.1085] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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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20
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Barnoon I, Shamir MH, Aroch I, Bdolah-Abram T, Srugo I, Konstantin L, Chai O. Retrospective evaluation of combined mycophenolate mofetil and prednisone treatment for meningoencephalomyelitis of unknown etiology in dogs: 25 cases (2005-2011). J Vet Emerg Crit Care (San Antonio) 2015; 26:116-24. [DOI: 10.1111/vec.12399] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2013] [Revised: 03/06/2014] [Accepted: 08/13/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Itai Barnoon
- Departments of Neurology, Koret School of Veterinary Medicine; The Hebrew University of Jerusalem; Rehovot 76100 Israel
| | - Merav H. Shamir
- Departments of Neurology, Koret School of Veterinary Medicine; The Hebrew University of Jerusalem; Rehovot 76100 Israel
| | - Itamar Aroch
- Small Animal Internal Medicine, Koret School of Veterinary Medicine; The Hebrew University of Jerusalem; Rehovot 76100 Israel
| | - Tali Bdolah-Abram
- Teaching Services Unit, Koret School of Veterinary Medicine; The Hebrew University of Jerusalem; Rehovot 76100 Israel
| | - Itai Srugo
- Departments of Neurology, Koret School of Veterinary Medicine; The Hebrew University of Jerusalem; Rehovot 76100 Israel
| | - Lilach Konstantin
- Departments of Neurology, Koret School of Veterinary Medicine; The Hebrew University of Jerusalem; Rehovot 76100 Israel
| | - Orit Chai
- Departments of Neurology, Koret School of Veterinary Medicine; The Hebrew University of Jerusalem; Rehovot 76100 Israel
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21
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Chamisha Y, Aroch I, Kuzi S, Srugo I, Bdolah-Abram T, Chai O, Christopher MM, Merbl Y, Rothwell K, Shamir MH. The prognostic value of cerebrospinal fluid characteristics in dogs without deep pain perception due to thoracolumbar disc herniation. Res Vet Sci 2015; 100:189-96. [PMID: 25957960 DOI: 10.1016/j.rvsc.2015.03.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [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: 11/12/2014] [Revised: 02/03/2015] [Accepted: 03/14/2015] [Indexed: 01/12/2023]
Abstract
Providing a pre-operative prognosis for dogs presented with absent deep pain perception (DPP) is extremely challenging, as the overall recovery rates widely vary. This study assesses the possible correlation between the severity of spinal cord injury and CSF cytology in 31 paraplegic dogs presented with absent DPP due to acute thoracolumbar intervertebral disc herniation (TL-IVDH). All dogs underwent surgical decompression immediately following diagnosis. CSF TNCC, macrophage percentage and macrophage to monocyte (MΦ:M) ratio were significantly higher in dogs that failed to regain DPP within 10 days post-operatively and in dogs that failed to regain ambulation at the end of the study period (P< 0.05). MΦ:M of 0.73 and higher corresponded to a sensitivity of 54% and specificity of 100% for prediction of a negative long-term outcome. CSF TNCC, macrophage percentage and MΦ:M ratio effectively predicted regaining DPP and the long-term outcome in dogs that lost DPP due to acute TL-IVDH.
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Affiliation(s)
- Y Chamisha
- Department of Neurology and Neurosurgery, Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 76100, Israel
| | - I Aroch
- Department of Small Animal Internal Medicine, Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 76100, Israel
| | - S Kuzi
- Department of Small Animal Internal Medicine, Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 76100, Israel
| | - I Srugo
- Department of Neurology and Neurosurgery, Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 76100, Israel
| | - T Bdolah-Abram
- Teaching Services Unit, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9190501, Israel
| | - O Chai
- Department of Neurology and Neurosurgery, Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 76100, Israel
| | - M M Christopher
- Department of Pathology, Microbiology and Immunology, School of Veterinary Medicine, University of California, Davis, CA 95616, USA
| | - Y Merbl
- Department of Neurology and Neurosurgery, Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 76100, Israel
| | - K Rothwell
- Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 76100, Israel
| | - M H Shamir
- Department of Neurology and Neurosurgery, Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 76100, Israel.
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22
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Chai O, Milgram J, Shamir MH, Brenner O. Polioencephalomyelopathy in a mixed breed dog resembling Leigh's disease. Can Vet J 2015; 56:59-62. [PMID: 25565716 PMCID: PMC4266058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A 14-month-old mixed-breed dog was presented with acute onset of exercise intolerance that quickly progressed to quadriparesis. Gross and microscopic autopsy findings indicated a type of degenerative polioencephalomyelopathy resembling subacute necrotizing encephalomyelopathy in dogs or Leigh's disease in humans. This syndrome has previously been reported only in purebred dogs.
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Affiliation(s)
- Orit Chai
- Address all correspondence to Dr. Orit Chai; e-mail:
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23
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Espadas I, Chai O, Lindley S, Wessmann A. Caudal lumbar disc disease presenting as ‘praying position’‐like posture and gait. Vet rec case rep 2015. [DOI: 10.1136/vetreccr-2014-000139] [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: 11/03/2022]
Affiliation(s)
- Irene Espadas
- Small Animal Teaching HospitalSchool of Veterinary ScienceUniversity of LiverpoolLeahurst CampusChester High RoadLiverpoolUK
| | - Orit Chai
- Koret School of Veterinary MedicineThe Hebrew University of JerusalemP.O. Box 12RehovotIsrael
| | - Samantha Lindley
- Division of Small Animal Clinical SciencesSchool of Veterinary MedicineCollege of Medical, Veterinary & Life SciencesUniversity of Glasgow464 Bearsden RoadGlasgowUK
| | - Annette Wessmann
- Department of NeurologyPride Veterinary CentreRiverside RoadDerbyUK
- School of Veterinary MedicineUniversity of GlasgowSmall Animal Clinical Sciences464 Bearsden RoadGlasgowUK
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Merbl Y, Sommer A, Chai O, Aroch I, Zimmerman G, Friedman A, Soreq H, Shamir M. Tumor necrosis factor-α and interleukin-6 concentrations in cerebrospinal fluid of dogs after seizures. J Vet Intern Med 2014; 28:1775-81. [PMID: 25308784 PMCID: PMC4895630 DOI: 10.1111/jvim.12462] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2013] [Revised: 06/06/2014] [Accepted: 08/21/2014] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Idiopathic and acquired epilepsy are common in dogs. Up to 30% of these dogs are refractory to pharmacological treatment. Accumulating experimental evidence indicates that brain immune response and presence of inflammatory mediators decrease the threshold for individual seizures and contribute to epileptogenesis. HYPOTHESIS Dogs with seizures have higher cerebrospinal interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) concentrations compared to dogs with no seizures. METHODS A prospective double blinded study; cerebrospinal fluid (CSF) and serum IL-6, TNF-α and total protein (TP) concentrations were measured by a blinded investigator for the study group and CSF IL-6 and TNF-α levels and TP concentrations were measured in the control group (CG). ANIMALS Dogs presented with seizures that had enough CSF collected to allow analysis were included in the study group. Twelve apparently healthy, quarantined, stray dogs served as control (CG). RESULTS Cerebrospinal fluid TNF-α and IL-6 concentrations were significantly higher (P = .011, P = .039) in dogs with seizures (0 ± 70.66, 0.65 ± 10.93 pg/mL) compared to the CG (0 ± 19, 0.73 ± 0.55 pg/mL). When assessing cytokine concentrations of specifically the idiopathic epilepsy (IE) dogs compared to the CG, only TNF-α concentrations (8.66 ± 62, 0 ± 19 pg/mL) were significantly higher (P = .01). CSF TP concentrations were not significantly higher in the study dogs compared to the CG. CONCLUSIONS AND CLINICAL IMPORTANCE Higher TNF-α and IL-6 concentration in the CSF of dogs with naturally occurring seizures. The higher supports the hypothesis that inflammatory processes through certain mediators play a role in the pathogenesis of seizures in dogs.
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Affiliation(s)
- Y. Merbl
- Koret School of Veterinary MedicineHebrew University of JerusalemRehovotIsrael
| | - A. Sommer
- Koret School of Veterinary MedicineHebrew University of JerusalemRehovotIsrael
| | - O. Chai
- Koret School of Veterinary MedicineHebrew University of JerusalemRehovotIsrael
| | - I. Aroch
- Koret School of Veterinary MedicineHebrew University of JerusalemRehovotIsrael
| | - G. Zimmerman
- Edmond and Lily Safra Center of Brain ScienceHebrew University of JerusalemJerusalemIsrael
| | - A. Friedman
- Department of Life SciencesBen‐Gurion University of the NegevBeer ShevaIsrael
| | - H. Soreq
- Edmond and Lily Safra Center of Brain ScienceHebrew University of JerusalemJerusalemIsrael
- Department of Biological ChemistryAlexander Silberman Institute of Life SciencesHebrew University of JerusalemJerusalemIsrael
| | - M.H. Shamir
- Koret School of Veterinary MedicineHebrew University of JerusalemRehovotIsrael
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Chamisha Y, Shamir MH, Merbl Y, Chai O. Reversible paralysis and loss of deep pain sensation after topical intrathecal morphine administration following durotomy. Vet Surg 2014; 44:41-5. [PMID: 24724720 DOI: 10.1111/j.1532-950x.2014.12192.x] [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: 08/01/2013] [Accepted: 02/01/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To report 2 dogs that developed temporary pelvic limb paralysis with loss of deep pain sensation after topical intrathecal morphine administration during spinal surgery. STUDY DESIGN Clinical report. ANIMALS Dogs (n = 2). METHODS A 5-year-old castrated male French Bulldog with a subarachnoid diverticulum at T9-T10 and a 9.5-year-old castrated male Belgian Shepherd dog with a herniated disc at T12-T13 and intradural component, had Gelfoam soaked with morphine placed over the dura mater defect. RESULTS Pelvic limb paralysis and loss of deep pain sensation was noticed immediately after recovery from anesthesia. After intravenous naloxone administration, both dogs immediately regained ambulation and normal pain sensation; however the effect was temporary lasting only a few hours. Permanent resolution of clinical signs occurred 24 hours after surgery. CONCLUSIONS Topical intrathecal morphine administration resulted in temporary pelvic limb paralysis and loss of deep pain sensation. This route of administration should be used cautiously until further determination of the efficacy and adverse effects associated with topical intrathecal morphine administration.
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Affiliation(s)
- Yael Chamisha
- Department of Neurology and Neurosurgery, The Veterinary Teaching Hospital, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
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Chai O, Sommer A, Zimmerman G, Soreq H, Friedman A, Bdolah-Abram T, Aroch I, Shamir MH. Acetylcholinesterase activity in the cerebrospinal fluid of dogs with seizures. Vet J 2013; 198:292-4. [PMID: 23988333 DOI: 10.1016/j.tvjl.2013.06.027] [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: 08/22/2012] [Revised: 05/21/2013] [Accepted: 06/25/2013] [Indexed: 11/27/2022]
Abstract
Recent studies in animal models have focused on the role of cholinergic elements, mainly acetylcholinesterase (AChE) and the 'readthrough' acetylcholinesterase isoform (AChE-R), in seizures. A prospective double-masked study was conducted to assess the activity of AChE and AChE-R in cerebrospinal fluid (CSF) of 26 dogs post-seizure, 28 dogs with intervertebral disc disease (IVDD) and 16 healthy dogs. AChE was also measured in the serum in the post-seizure and IVDD groups. The results showed no significant differences in CSF AChE among the three groups. AChE-R was not detected in any dog and AChE in the serum was similar between groups. This preliminary study provides new information on AChE and AChE-R in the CSF and sera of dogs following naturally-occurring seizures.
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Affiliation(s)
- Orit Chai
- Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot 76100, Israel.
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27
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Barnoon I, Chai O, Srugo I, Peeri D, Konstantin L, Brenner O, Shamir MH. Spontaneous intradural disc herniation with focal distension of the subarachnoid space in a dog. Can Vet J 2012; 53:1191-1194. [PMID: 23633713 PMCID: PMC3474575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Myelo-computed tomography of a paraparetic 14-year-old dog revealed subarachnoid distension with an intradural filling defect above the T13-L1 disc space. T12-L1 hemilaminectomy followed by durotomy allowed removal of a large piece of degenerated disc material that compressed the spinal parenchyma. Full return to function was achieved 10 days post-surgery. The distension was likely secondary to the intradural herniation, and is a rare and distinct finding.
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Affiliation(s)
- Itai Barnoon
- Department of Neurology & Neurosurgery, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Israel.
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Srugo I, Aroch I, Christopher M, Chai O, Goralnik L, Bdolah-Abram T, Shamir M. Association of Cerebrospinal Fluid Analysis Findings with Clinical Signs and Outcome in Acute Nonambulatory Thoracolumbar Disc Disease in Dogs. J Vet Intern Med 2011; 25:846-55. [DOI: 10.1111/j.1939-1676.2011.0739.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Abstract
Thoracolumbar disc herniation was diagnosed in a two-year-old ferret using a myelogram followed by a computed tomography scan. The ferret was paraplegic with no control over urination and defecation. Conservative treatment that included cage rest and passive range of motion exercises for three weeks followed by extensive physiotherapy and hydrotherapy resulted in full recovery two months after the onset of treatment. Although intervertebral disc disease has been reported previously in four ferrets, this is the first report in which a postmyelogram computed tomography was used to demonstrate the herniated disc, and physiotherapy was used as principal treatment modality.
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Affiliation(s)
- I Srugo
- Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
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Gross-Tsubery R, Chai O, Shilo Y, Miara L, Horowitz IH, Shmueli A, Aizenberg I, Hoffman C, Reifen R, Shamir MH. Computed tomographic analysis of calvarial hyperostosis in captive lions. Vet Radiol Ultrasound 2010; 51:34-8. [PMID: 20166390 DOI: 10.1111/j.1740-8261.2009.01617.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Osseous malformations in the skull and cervical vertebrae of lions in captivity are believed to be caused by hypovitaminosis A. These often lead to severe neurologic abnormalities and may result in death. We describe the characterization of these abnormalities based on computed tomography (CT). CT images of two affected and three healthy lions were compared with define the normal anatomy of the skull and cervical vertebrae and provide information regarding the aforementioned osseous malformations. Because bone structure is influenced by various factors other than the aforementioned disease, all values were divided by the skull width that was not affected. The calculated ratios were compared and the most pronounced abnormalities in the affected lions were, narrowing of the foramen magnum, thickening of the tentorium osseus cerebelli and thickening of the dorsal arch of the atlas. CT is useful for detection of the calvarial abnormalities in lions and may be useful in further defining this syndrome.
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Affiliation(s)
- Ruth Gross-Tsubery
- Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot 76100, Israel
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Affiliation(s)
- K Aharonson-Raz
- Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, Saskatchewan S7N 5B4, Canada
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Chai O, Johnston DE, Shamir MH. Bite wounds involving the spine: Characteristics, therapy and outcome in seven cases. Vet J 2008; 175:259-65. [PMID: 17560149 DOI: 10.1016/j.tvjl.2007.01.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2006] [Revised: 11/06/2006] [Accepted: 01/22/2007] [Indexed: 12/15/2022]
Abstract
Medical records of five dogs and two cats with bite wounds to the spine were reviewed. All dogs were bitten in the cervical spine and presented as quadriparetic. Both cats were bitten at the lumbar spine; one was paraparetic and the other paraplegic. Concomitant injuries to structures other than the spine were seen in two cases. Radiographic findings included vertebral fractures in all cases. Medical therapy included antibiotics (7/7), methylprednisolone sodium succinate (4/7) and analgesia (7/7). Five cases underwent minor (4/5) or extensive (1/5) surgical debridement. All cervical fractures were stabilized with fiberglass casts and animals with lumbar injury were cage rested for a month. Six of the cases survived, five of which regained good to excellent ambulatory ability within the first month. Although, the numbers of reported cases are limited, this study shows that adequate surgical debridement and wound drainage combined with external coaptation can be sufficient to manage bite wounds that involve the spine.
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Affiliation(s)
- Orit Chai
- Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Israel.
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Affiliation(s)
- Eran Dvir
- Department of Companion Animal Clinical Studies, Onderstepoort Veterinary Academic Hospital, University of Pretoria, Onderstepoort, Republic of South Africa.
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Dvir E, Perl S, Loeb E, Shklar-Hirsch S, Chai O, Mazaki-Tovi M, Aroch I, Shamir MH. Spinal Intramedullary AberrantSpirocerca lupiMigration in 3 Dogs. J Vet Intern Med 2007. [DOI: 10.1111/j.1939-1676.2007.tb03033.x] [Citation(s) in RCA: 21] [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] [Indexed: 11/29/2022] Open
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Abstract
Eleven cats with signs of cerebellar dysfunction, developed on recovery from a brief and uneventful general anesthesia, were examined at the Koret School of Veterinary Medicine Teaching Hospital (KSVMTH) between 1998 and 2002. Neurological signs included mild to severe ataxia of all 4 limbs, intentional tremor, lack of menace response, and delayed hopping. The cats were of different ages when anesthetized and none had shown any prior signs of neural disease. They were examined 1 day to 4 years after onset of clinical signs, and the neurological deficits remained unchanged in a follow-up period of 6 months to 8 years. Medical and anesthetic records showed that all were Persian cross cats, 7 of them originating in the same city in Israel. Ketamine was the only anesthetic drug that had been used with all cats. It might be that a genetic component predisposes Persian cross cats to nonreversible cerebellar damage after exposure to an anesthetic dose of ketamine.
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Affiliation(s)
- Merav Shamir
- Neurology and Neurosurgery Department, Koret School of Veterinanry Medicine, The Hebrew University of Jerusalem, Rehovot, Israel.
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Reed SE, Gardner PS, Snell JJ, Chai O. United Kingdom scheme for external quality assessment in virology. Part I. General method of operation. J Clin Pathol 1985; 38:534-41. [PMID: 3998188 PMCID: PMC499204 DOI: 10.1136/jcp.38.5.534] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Developments in the United Kingdom national external quality assessment scheme for virology are described. There are about 198 participants (170 in the UK) who are enrolled for examination of any or all of five categories of specimen (distribution types). These are detection of rubella antibody (128 UK participants), detection of hepatitis B surface antigen (130 UK participants), general virus serology (86 UK participants), virus identification (85 UK participants), and electron microscopy (56 UK participants). Specimens of a sixth category (rubella IgM antibody), not yet formally established, have also been distributed to 67 UK participants. Specimens in each distribution type are sent out once or twice a year, and, except for rubella IgM antibody, participants have been given a score of 2, 1, 0 or -1 marks for their reports on each specimen. Their cumulative scores and performance ratings are calculated retrospectively over a 12 month period for each distribution type separately and for combined distributions. The performance rating is defined by the number of standard errors by which the individual's cumulative score differs from the mean for all participants and carries a + or - sign depending on whether the cumulative score lies above or below the mean. Performance ratings have been found generally to be close to the mean in rubella serology and detection of hepatitis B surface antigen but are more variable in virus identification and electron microscopy. Ratings of less than -1.96 are considered to be significantly worse than average and to constitute poor performance.
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