Reprogramming the Canine Glioma Microenvironment with Tumor Vaccination plus Oral Losartan and Propranolol Induces Objective Responses

Purpose

Malignant gliomas have a highly immune suppressive tumor microenvironment (TME) which renders them largely unresponsive to conventional therapeutics. Therefore, the present study evaluated a therapeutic protocol designed overcome the immune barrier by combining myeloid cell targeted immunotherapy with tumor vaccination.

Experimental Design

We utilized a spontaneously occurring canine glioma model to investigate an oral TME modifying immunotherapy in conjunction with cancer stem cell (CSC) vaccination. Dogs were treated daily with losartan (monocyte migration inhibitor) and propranolol (myeloid-derived suppressor cell depleting agent) plus anti-CSC vaccination on a bi-weekly then monthly schedule. Tumor volume was monitored by MRI and correlated with patient immune responses.

Results

Ten dogs with histologically confirmed gliomas were enrolled into a prospective, open-label clinical trial to evaluate the immunotherapy protocol. Partial tumor regression was observed in 2 dogs, while 6 dogs experienced stable disease, for an overall clinical benefit rate of 80%. Overall survival times (median = 351 days) and progression-free intervals (median = 163 days) were comparable to prior studies evaluating surgical debulking followed by immunotherapy. Dogs with detectable anti-CSC antibody responses had an increased overall survival time relative to dogs that did not generate antibody responses (vaccine responder MST = 500 days; vaccine non-responder MST = 218 days; p = 0.02).

Conclusions

These findings suggest that combining myeloid cell targeted oral immunotherapy with tumor vaccination can generate objective tumor responses, even in the absence of conventional therapy. Overall, this approach has promise as a readily implemented therapeutic strategy for use in brain cancer patients.

Brucella canis discospondylitis in 33 dogs

Objective

To describe the clinical and imaging findings of 33 dogs with Brucella canis discospondylitis (BDS).

Animals

33 client owned dogs from four veterinary specialty hospitals within Colorado and Arizona with at least one positive B. canis test and spinal diagnostic imaging.

Procedures

Retrospective review of signalment, physical and neurological examination findings, laboratory results, B. canis serology, and diagnostic imaging of 33 dogs with BDS. All imaging was reviewed by a board-certified veterinary neurologist. Radiographs were reviewed by a board-certified veterinary radiologist blinded to MRI and CT findings.

Results

31/33 (94%) dogs were <5 years old (median = 2.5 years, mean = 2.9 years, range 0.5–10 years). 21/29 (72%) dogs had signs of nonspecific pain, spinal pain, or lameness for >3 months (median = 6 months, mean = 8.2 months, range 5 days−4 years). Fever was seen in only 4/28 (14%) dogs. Multifocal lesions were evident on radiographs in 21/29 (72%) dogs and MRI in 12/18 (67%) dogs. Smooth, round, central end-plate lysis, defined as “hole punch” lesions, were identified radiographically in 25/29 (86%) dogs. Vertebral physitis or spondylitis without discitis was evident on MRI in 7/18 (39%) dogs.

Clinical relevance

Dogs with BDS typically present at a young age with a long duration of clinical signs. Identification of radiographic “hole punch” lesions and MRI evidence of vertebral physitis, spondylitis, and paravertebral inflammation without discitis should increase suspicion for BDS. BDS may be increasing in frequency in the southwestern United States, and dogs with signs of chronic spinal pain and/or lameness should be screened for B. canis.

Use of Handheld Raman Spectroscopy for Intraoperative Differentiation of Normal Brain Tissue From Intracranial Neoplasms in Dogs

The aim of this study was to assess feasibility and accuracy of a hand-held, intraoperative Raman spectroscopy device as a neuronavigation aid to accurately detect neoplastic tissue from adjacent normal gray and white matter. Although Raman spectra are complicated fingerprints of cell signature, the relative shift corresponding to lipid and protein content (2,845 and 2,930 cm−1, respectively), can provide a rapid assessment of whether tissue is normal white or gray matter vs. neoplasia for real-time guidance of tumor resection. Thirteen client-owned dogs were initially enrolled in the study. Two were excluded from final analysis due to incomplete data acquisition or lack of neoplastic disease. The diagnoses of the remaining 11 dogs included six meningiomas, two histiocytic sarcomas, and three gliomas. Intraoperatively, interrogated tissues included normal gray and/or white matter and tumor. A total of five Raman spectra readings were recorded from the interrogated tissues, and samples were submitted for confirmation of Raman spectra by histopathology. A resultant total of 24 samples, 13 from neoplastic tissue and 11 from normal gray or white matter, were used to calculate sensitivity and specificity of Raman spectra compared to histopathology. The handheld Raman spectroscopy device had sensitivity of 85.7% and specificity of 90% with a positive predictive value of 92.3% and negative predictive value of 81.6%. The Raman device was feasible to use intraoperatively with rapid interpretation of spectra. Raman spectroscopy may be useful for intraoperative guidance of tumor resection.

International veterinary canine dyskinesia task force ECVN consensus statement: Terminology and classification

Movement disorders are a heterogeneous group of clinical syndromes in humans and animals characterized by involuntary movements without changes in consciousness. Canine movement disorders broadly include tremors, peripheral nerve hyperexcitability disorders, paroxysmal dyskinesia, and dystonia. Of these, canine paroxysmal dyskinesias remain one of the more difficult to identify and characterize in dogs. Canine paroxysmal dyskinesias include an array of movement disorders in which there is a recurrent episode of abnormal, involuntary, movement. In this consensus statement, we recommend standard terminology for describing the various movement disorders with an emphasis on paroxysmal dyskinesia, as well as a preliminary classification and clinical approach to reporting cases. In the clinical approach to movement disorders, we recommend categorizing movements into hyperkinetic vs hypokinetic, paroxysmal vs persistent, exercise‐induced vs not related to exercise, using a detailed description of movements using the recommended terminology presented here, differentiating movement disorders vs other differential diagnoses, and then finally, determining whether the paroxysmal dyskinesia is due to either inherited or acquired etiologies. This consensus statement represents a starting point for consistent reporting of clinical descriptions and terminology associated with canine movement disorders, with additional focus on paroxysmal dyskinesia. With consistent reporting and identification of additional genetic mutations responsible for these disorders, our understanding of the phenotype, genotype, and pathophysiology will continue to develop and inform further modification of these recommendations.

Phenotypic characterization of PIGN-associated paroxysmal dyskinesia in Soft-coated wheaten terriers and preliminary response to acetazolamide therapy

A hereditary movement disorder in Soft coated wheaten terriers (SCWT) has been associated with a mutation in PIGN which encodes an enzyme involved in synthesis of glycosylphosphatidylinositol (GPI). The objective of this study was to describe and classify the clinical phenotype and assess therapeutic response. Twenty-five SCWT and related dogs homozygous for PIGN:c.398C>T with paroxysmal dyskinesia were available for inclusion. Medical records and video recordings of 17 dogs were evaluated in a retrospective case series. Affected dogs had episodes of involuntary, hyperkinetic movements and dystonia. Median age of onset was 2.5 years. A typical episode consisted of rapid, irregular hyperflexion and extension of the pelvic limbs with some degree of truncal dystonia. A mild episode consisted of spontaneous flexion of one pelvic limb while walking which could resemble a lameness. Episodes lasted several minutes to several hours and occurred up to 10 times/day or more. They were not associated with exercise or fasting but were sometimes triggered by excitement or stress. Acetazolamide therapy improved nine of 11 dogs, in seven cases abolishing episodes. Five of 17 dogs treated with other agents had mild improvement with clonazepam (n = 2), levetiracetam (n = 1), or phenobarbital (n = 2). Paroxysmal dyskinesias must be differentiated from seizure disorders since they often respond to different therapies. The SCWT phenotype consisted predominantly of hyperkinesia, and can respond dramatically to acetazolamide. GPI anchors proteins to the cell surface including carbonic anhydrase IV which modulates synaptic pH in the brain. Altered activity of this enzyme may be the target of acetazolamide therapy.

Randomized blinded controlled clinical trial to assess the effect of oral cannabidiol administration in addition to conventional antiepileptic treatment on seizure frequency in dogs with intractable idiopathic epilepsy

OBJECTIVE

To assess the effect of oral cannabidiol (CBD) administration in addition to conventional antiepileptic treatment on seizure frequency in dogs with idiopathic epilepsy.

DESIGN

Randomized blinded controlled clinical trial.

ANIMALS

26 client-owned dogs with intractable idiopathic epilepsy.

PROCEDURES

Dogs were randomly assigned to a CBD (n = 12) or placebo (14) group. The CBD group received CBD-infused oil (2.5 mg/kg [1.1 mg/lb], PO) twice daily for 12 weeks in addition to existing antiepileptic treatments, and the placebo group received noninfused oil under the same conditions. Seizure activity, adverse effects, and plasma CBD concentrations were compared between groups.

RESULTS

2 dogs in the CBD group developed ataxia and were withdrawn from the study. After other exclusions, 9 dogs in the CBD group and 7 in the placebo group were included in the analysis. Dogs in the CBD group had a significant (median change, 33%) reduction in seizure frequency, compared with the placebo group. However, the proportion of dogs considered responders to treatment (≥ 50% decrease in seizure activity) was similar between groups. Plasma CBD concentrations were correlated with reduction in seizure frequency. Dogs in the CBD group had a significant increase in serum alkaline phosphatase activity. No adverse behavioral effects were reported by owners.

CONCLUSIONS AND CLINICAL RELEVANCE

Although a significant reduction in seizure frequency was achieved for dogs in the CBD group, the proportion of responders was similar between groups. Given the correlation between plasma CBD concentration and seizure frequency, additional research is warranted to determine whether a higher dosage of CBD would be effective in reducing seizure activity by ≥ 50%.

A pilot study of optical neuronavigation-guided brain biopsy in the horse using anatomic landmarks and fiducial arrays for patient registration

Background

Optical neuronavigation‐guided intracranial surgery has become increasingly common in veterinary medicine, but its use has not yet been described in horses.

Objectives

To determine the feasibility of optical neuronavigation‐guided intracranial biopsy procedures in the horse, compare the use of the standard fiducial array and anatomic landmarks for patient registration, and evaluate surgeon experience.

Animals

Six equine cadaver heads.

Methods

Computed tomography images of each specimen were acquired, with the fiducial array rigidly secured to the frontal bone. Six targets were selected in each specimen. Patient registration was performed separately for 3 targets using the fiducial array, and for 3 targets using anatomic landmarks. In lieu of biopsy, 1 mm diameter wire seeds were placed at each target. Postoperative images were coregistered with the planning scan to calculate Euclidian distance from the tip of the seed to the target.

Results

No statistical difference between registration techniques was identified. The impact of surgeon experience was examined for each technique using a Mann‐Whitney U test. The experienced surgeon was significantly closer to the intended target (median = 2.52 mm) than were the novice surgeons (median = 6.55 mm) using the fiducial array (P = .001). Although not statistically significant (P = .31), for the experienced surgeon the median distance to target was similar when registering with the fiducial array (2.47 mm) and anatomic landmarks (2.58 mm).

Conclusions and Clinical Importance

Registration using both fiducial arrays and anatomic landmarks for brain biopsy using optical neuronavigation in horses is feasible.

Onscreen-guided resection of extra-axial and intra-axial forebrain masses through registration of a variable-suction tissue resection device with a neuronavigation system

OBJECTIVES

To describe a novel surgical technique in which neuronavigation is used to guide a tissue resection device during excision of forebrain masses in locations difficult to visualize optically.

STUDY DESIGN

Short case series.

ANIMALS

Six dogs and one cat with forebrain masses (five neoplastic, two nonneoplastic) undergoing excision with a novel tissue resection device and veterinary neuronavigation system.

METHODS

The animals and resection instrument were coregistered to the neuronavigation system. Surgery was guided by real-time onscreen visualization of the resection instrument position relative to the preoperative MR images. Surgical outcome was evaluated by calculating residual tumor volume according to postoperative MRI.

RESULTS

The technique was technically simple and led to the collection of diagnostic tissue samples in all cases. Postoperative MRI was available in six cases, two with gross-total resection, three with near-total resection, and one with subtotal resection.

CONCLUSION

Neuronavigation-guided resection of intra-axial and extra-axial brain masses with the resection device resulted in gross-total or near-total resection in five of six animals with tumors otherwise difficult to visualize. Risk of brain shift limited absolute reliance on navigation images.

CLINICAL SIGNIFICANCE

Real-time neuronavigation assistance is a feasible method for guidance and successful resection of brain masses that are poorly visualized because of intra-axial or deep location, tumor appearance, or hemorrhage.

Comparative Molecular Life History of Spontaneous Canine and Human Gliomas

Sporadic gliomas in companion dogs provide a window on the interaction between tumorigenic mechanisms and host environment. We compared the molecular profiles of canine gliomas with those of human pediatric and adult gliomas to characterize evolutionarily conserved mammalian mutational processes in gliomagenesis. Employing whole-genome, exome, transcriptome, and methylation sequencing of 83 canine gliomas, we found alterations shared between canine and human gliomas such as the receptor tyrosine kinases, TP53 and cell-cycle pathways, and IDH1 R132. Canine gliomas showed high similarity with human pediatric gliomas per robust aneuploidy, mutational rates, relative timing of mutations, and DNA-methylation patterns. Our cross-species comparative genomic analysis provides unique insights into glioma etiology and the chronology of glioma-causing somatic alterations.

The effects of neurectomy and hibernation on bone properties and the endocannabinoid system in marmots (Marmota flaviventris)

Hibernators have adapted a physiological mechanism allowing them to undergo long periods of inactivity without experiencing bone loss. However, the biological mechanisms that prevent bone loss are unknown. Previous studies found meaningful changes, between active and hibernating marmots, in the endocannabinoid system of many tissues, including bone. Cannabinoid receptors (CB1 and CB2) have divergent localization in bone. CB1 is predominately found on sympathetic nerve terminals, while CB2 is more abundant on bone cells and their progenitors. This study aimed to determine the contribution of innervation on endocannabinoid regulation of bone properties in hibernating (during torpor) and non-hibernating yellow-bellied marmots. Neurectomy, a model for disuse osteoporosis, was performed unilaterally in both hibernating and active marmots. Endocannabinoid concentrations were measured in bone marrow, cortical, and trabecular regions from fourth metatarsals of both hindlimbs using microflow chromatography-tandem quadrupole mass spectrometry. Trabecular bone architectural properties of fifth metatarsals were evaluated using micro-computed tomography. There were ligand-specific increases with neurectomy in active, but not hibernating, marmots. Trabecular bone architectural properties were not affected by neurectomy during hibernation, but did show some minor negative changes in active marmots. These findings suggest protection from bone loss in hibernating rodents is peripherally rather than centrally regulated. Furthermore, findings suggest even active marmots with normal metabolism are partially protected from disuse induced bone loss compared to laboratory rodents. Understanding the mechanism hibernators use to maintain bone density may guide development for novel bone loss prevention therapies.

Surgical decompression, with or without adjunctive therapy, for palliative treatment of primary vertebral osteosarcoma in dogs

Vertebral osteosarcoma (OSA) is the most common primary vertebral tumor in dogs, however studies examining the survival time after surgical decompression of these tumors are limited. There is also limited information regarding the benefit of adjunctive treatments such as radiation therapy or chemotherapy in these patients. The goal of this study was to determine survival time of dogs with primary vertebral OSA after palliative decompressive surgery alone and combined with radiation therapy and/or chemotherapy. Records from 22 client-owned dogs diagnosed with primary vertebral OSA and treated with decompressive surgery were collected retrospectively from eight referral institutions. Survival time was assessed for dogs treated with surgery alone as well as dogs who received adjunctive radiation therapy and/or chemotherapy. Median survival time in the 12 dogs treated with surgery alone was 42 days (range: 3-1333 days). The three dogs treated with surgery and chemotherapy had a median survival time of 82 days (range: 56-305 days). Only one dog was treated with surgery and radiation therapy; this dog survived 101 days. Six dogs were treated with surgery, radiation therapy and chemotherapy; these dogs had a median survival time of 261 days (range: 223-653 days). Cause of death in all cases that survived the initial postoperative period was euthanasia secondary to confirmed or suspected tumor regrowth. The results of this study suggest that definitive radiation therapy, possibly combined with concurrent chemotherapy, significantly improves survival in dogs treated with palliative decompressive surgery for vertebral OSA and should be the treatment of choice in selected cases.

Consensus recommendations on standardized magnetic resonance imaging protocols for multicenter canine brain tumor clinical trials

The National Cancer Institute Comparative Brain Tumor Consortium, Patient Outcomes Working Group, propose a consensus document in support of standardized magnetic resonance imaging protocols for canine brain tumor clinical trials. The intent of this manuscript is to address the widely acknowledged need to ensure canine brain tumor imaging protocols are relevant and have sufficient equivalency to translate to human studies such that: (1) multi-institutional studies can be performed with minimal inter-institutional variation, and (2) imaging protocols are consistent with human consensus recommendations to permit reliable translation of imaging data to human clinical trials. Consensus recommendations include pre- and postcontrast three-dimensional T1-weighted images, T2-weighted turbo spin echo in all three planes, T2*-weighted gradient recalled echo, T2-weighted fluid attenuated inversion recovery, and diffusion weighted imaging/diffusion tensor imaging in transverse plane; field of view of ≤150 mm; slice thickness of ≤2 mm, matrix ≥ 256 for two-dimensional images, and 150 or 256 for three-dimensional images.

Clinical Phenotype of Musladin-Lueke Syndrome in 2 Beagles

Musladin‐Lueke syndrome (MLS), previously termed Chinese Beagle syndrome, is an autosomal‐recessive connective tissue disorder characterized by extensive fibrosis of the skin and joints that was first identified in Beagles in the 1970s. Recent research identified a founder mutation (c.660C>T; p.R221C) in the ADAMTSL2 gene in Beagles with MLS. Here, we report the detailed clinical phenotype and laboratory findings in 2 Beagles affected with MLS. We discuss these findings in relation to the human disorder geleophysic dysplasia (GD), which also arises from recessive ADAMTSL2 mutations, and recent findings in Adamtsl2‐deficient mice.

Magnetic Resonance Imaging Appearance and Mechanism of Action of Five Hemostatic Agents Used in Neurosurgery

OBJECTIVE

To describe the magnetic resonance (MR) image appearance of 5 hemostatic agents placed in the brain, and to review their clinical application.

STUDY DESIGN

Descriptive ex vivo and in vivo study.

ANIMALS

Canine cadavers (n=4), client-owned dogs (n=4).

METHODS

Heads from 4 canine cadavers were used, each with 5 hemostatic agents placed in specific locations in the brain. Hemostatic agents were used in their native form in 2 cadaveric brains, and in 2 others the materials were saturated with fresh whole blood prior to placement to mimic application in a field of active hemorrhage. The heads underwent MR imaging and the images were reviewed. Postoperative MRI images from 4 dogs undergoing brain tumor resection were retrospectively reviewed and compared to the images from the cadavers. All clinical cases and cadaveric specimens underwent surgical closure prior to MR imaging including placement of titanium mesh over the craniotomy defect with a dural graft of porcine small intestinal submucosa (SIS) sealed with Tisseel (fibrin sealant).

RESULTS

The SIS and Tisseel used in the dural graft were consistently indistinguishable from the surrounding tissues on MR images. The MR imaging appearance of the remaining 4 hemostatic agents (Gelfoam, Avitene, Surgicel, and Floseal) placed on the surface or in the parenchyma of canine brain, varied with MR sequence weighting and blood saturation.

CONCLUSION

Accurate evaluation of the degree of brain tumor resection on postoperative MR images requires careful differentiation between hemorrhage, residual tumor, and hemostatic agents implanted.

Creation of an NCI comparative brain tumor consortium: informing the translation of new knowledge from canine to human brain tumor patients

On September 14-15, 2015, a meeting of clinicians and investigators in the fields of veterinary and human neuro-oncology, clinical trials, neuropathology, and drug development was convened at the National Institutes of Health campus in Bethesda, Maryland. This meeting served as the inaugural event launching a new consortium focused on improving the knowledge, development of, and access to naturally occurring canine brain cancer, specifically glioma, as a model for human disease. Within the meeting, a SWOT (strengths, weaknesses, opportunities, and threats) assessment was undertaken to critically evaluate the role that naturally occurring canine brain tumors could have in advancing this aspect of comparative oncology aimed at improving outcomes for dogs and human beings. A summary of this meeting and subsequent discussion are provided to inform the scientific and clinical community of the potential for this initiative. Canine and human comparisons represent an unprecedented opportunity to complement conventional brain tumor research paradigms, addressing a devastating disease for which innovative diagnostic and treatment strategies are clearly needed.

Vaccination for invasive canine meningioma induces in situ production of antibodies capable of antibody-dependent cell-mediated cytotoxicity

Malignant and atypical meningiomas are resistant to standard therapies and associated with poor prognosis. Despite progress in the treatment of other tumors with therapeutic vaccines, this approach has not been tested preclinically or clinically in these tumors. Spontaneous canine meningioma is a clinically meaningful but underutilized model for preclinical testing of novel strategies for aggressive human meningioma. We treated 11 meningioma-bearing dogs with surgery and vaccine immunotherapy consisting of autologous tumor cell lysate combined with toll-like receptor ligands. Therapy was well tolerated, and only one dog had tumor growth that required intervention, with a mean follow up of 585 days. IFN-γ-elaborating T cells were detected in the peripheral blood of 2 cases, but vaccine-induced tumor-reactive antibody responses developed in all dogs. Antibody responses were polyclonal, recognizing both intracellular and cell surface antigens, and HSP60 was identified as one common antigen. Tumor-reactive antibodies bound allogeneic canine and human meningiomas, showing common antigens across breed and species. Histologic analysis revealed robust infiltration of antibody-secreting plasma cells into the brain around the tumor in posttreatment compared with pretreatment samples. Tumor-reactive antibodies were capable of inducing antibody-dependent cell-mediated cytotoxicity to autologous and allogeneic tumor cells. These data show the feasibility and immunologic efficacy of vaccine immunotherapy for a large animal model of human meningioma and warrant further development toward human trials.

Hand-gesture-based sterile interface for the operating room using contextual cues for the navigation of radiological images

This paper presents a method to improve the navigation and manipulation of radiological images through a sterile hand gesture recognition interface based on attentional contextual cues. Computer vision algorithms were developed to extract intention and attention cues from the surgeon's behavior and combine them with sensory data from a commodity depth camera. The developed interface was tested in a usability experiment to assess the effectiveness of the new interface. An image navigation and manipulation task was performed, and the gesture recognition accuracy, false positives and task completion times were computed to evaluate system performance. Experimental results show that gesture interaction and surgeon behavior analysis can be used to accurately navigate, manipulate and access MRI images, and therefore this modality could replace the use of keyboard and mice-based interfaces.

Canine intervertebral disc fenestration using a vacuum-assisted tissue resection device

OBJECTIVE

Describe the use and feasibility of a novel vacuum-assisted tissue resection device (VRD) for canine intervertebral disc fenestration, and compare the effectiveness of manual fenestration to the VRD.

STUDY DESIGN

Randomized prospective study.

ANIMALS

Canine cadavers (n = 15).

METHODS

A cadaveric lumbar spine study was performed to compare the use of manual fenestration to a novel VRD for intervertebral disc fenestration. Both fenestration groups were compared to a control group. Effectiveness of fenestration was assessed by calculating a ratio of remaining nuclear weight postfenestration to total nuclear volume. Fenestrated discs with lower ratios were indicative of greater removal of nucleus pulposus.

RESULTS

There was a statistically significant reduction in mean ratio (±SD) of remaining nuclear weight to volume with both fenestration groups compared to controls (0.39 ± 0.07; P < .001). There was an improved ratio using the VRD (0.23 ± 0.09) compared to manual fenestration (0.30 ± 0.10); this was not statistically significant (P = .069). It was technically difficult to fenestrate the disc spaces at L5-L6 and L6-L7 because of location and anatomy, resulting in a statistically significant increase in the median ratio of nuclear weight-to-volume ratios in both manual and VRD fenestration groups when compared to the more cranial L4-L5 disc spaces, 0.32 ± 0.08, and 0.35 ± 0.08 versus 0.25 ± 0.13 at L4-L5 (P = .026 and P = .004, respectively).

CONCLUSIONS

The VRD is a feasible instrument for canine intervertebral disc fenestration. It is at least as effective as manual fenestration, and provides additional safety features.

Serum D-lactate concentrations in cats with gastrointestinal disease

BACKGROUND

Increased D-lactate concentrations cause neurological signs in humans with gastrointestinal disease.

HYPOTHESIS/OBJECTIVES

To determine if serum D-lactate concentrations are increased in cats with gastrointestinal disease compared to healthy controls, and if concentrations correlate with specific neurological or gastrointestinal abnormalities.

ANIMALS

Systematically selected serum samples submitted to the Gastrointestinal Laboratory at Texas A&M University from 100 cats with clinical signs of gastrointestinal disease and abnormal gastrointestinal function tests, and 30 healthy cats.

METHODS

Case-control study in which serum D- and L-lactate concentrations and retrospective data on clinical signs were compared between 30 healthy cats and 100 cats with gastrointestinal disease. Association of D-lactate concentration with tests of GI dysfunction and neurological signs was evaluated by multivariate linear and logistic regression analyses, respectively.

RESULTS

All 100 cats had a history of abnormal gastrointestinal signs and abnormal gastrointestinal function test results. Thirty-one cats had definitive or subjective neurological abnormalities. D-lactate concentrations of cats with gastrointestinal disease (median 0.36, range 0.04-8.33 mmol/L) were significantly higher than those in healthy controls (median 0.22, range 0.04-0.87 mmol/L; P = .022). L-lactate concentrations were not significantly different between the 2 groups of cats with gastrointestinal disease and healthy controls. D-lactate concentrations were not significantly associated with fPLI, fTLI, cobalamin, folate, or neurological abnormalities (P > .05).

CONCLUSIONS AND CLINICAL IMPORTANCE

D-lactate concentrations can be increased in cats with gastrointestinal disease. These findings warrant additional investigations into the role of intestinal microbiota derangements in cats with gastrointestinal disease, and the association of D-lactate and neurological abnormalities.

Establishing an academic neurology specialty program: experiences over a five-year period

Veterinary neurology is an expanding specialty field. At the time of this writing, 13 out of 33 (40%) US and Canadian veterinary colleges, and many more veterinary colleges outside of North America, had no active clinical neurology service. New academic programs will likely be established to fill this need, often starting with a single neurologist. Establishing a neurology service with one founding faculty member can be accomplished by developing the program in phases and creating a support network that optimizes faculty strengths and interests. Such an approach allows for the gradual expansion of services and staffing in a manageable way to ultimately provide a full-service program. A description of this development process at Purdue University School of Veterinary Medicine is presented as a case study and model for the establishment of other neurology or specialty services.

Evaluation of an acute focal epidural mass model to characterize the intracranial pressure-volume relationship in healthy Beagles

OBJECTIVE

To characterize the intracranial pressure-volume relationship (ICPVR) in dogs by use of an acute frontal-parietal mass lesion model.

ANIMALS

7 healthy adult female Beagles.

PROCEDURES

Dogs were anesthetized with isoflurane to achieve a surgical plane of anesthesia. A fiberoptic intracranial pressure (ICP) monitor was inserted to a depth of 1 cm in the parenchyma of the right frontal-parietal region of the brain. A Foley balloon-tipped catheter was placed in the epidural space of the left frontal-parietal area through a separate 1-cm burr hole. Baseline measurements were obtained with the balloon deflated. The balloon was then inflated incrementally with 0.5 mL of 0.9% NaCl solution every 10 minutes until ICP exceeded mean arterial blood pressure. Nonlinear regression analysis with 2-factor and 3-factor exponential equations was used to characterize the ICPVR.

RESULTS

The mean baseline ICP was 11 mm Hg, with a 95% confidence interval of 2 to 20 mm Hg. The ICPVR was well characterized by 2-factor or 3-factor exponential equations for all dogs (R² > 0.93). Balloon volumes of > 1. 2 mL were associated with ICP > 20 mm Hg.

CONCLUSIONS AND CLINICAL RELEVANCE

Characterization of the ICPVR may provide clinically useful information regarding the safety of obtaining CSF from the atlanto-occipital space or implantation of brachytherapy catheters and for determining the need for decompressive craniectomy in dogs with acute intracranial disease. High ICP should be suspected in dogs that have an acute frontal-parietal mass lesion estimated to exceed 2% of the brain volume.

Evaluation of minimally invasive excisional brain biopsy and intracranial brachytherapy catheter placement in dogs

OBJECTIVE

To evaluate a technique for minimally invasive excisional brain biopsy and intracranial brachytherapy catheter placement in dogs.

ANIMALS

5 healthy adult female dogs.

PROCEDURES

Computed tomographic guidance was used to plan a biopsy trajectory to a selected area of brain with reference to a localizer grid. The procedure was performed through a 1-cm skin incision and 6-mm burr hole by use of a 9-gauge biopsy device. Five cylindrical samples (3 to 4 mm in diameter and 7 to 12 mm in length) were removed over 5 cycles of the vacuum-assisted tissue excision system, leaving approximately a 2-cm³ resection cavity. A balloon-tipped intracranial brachytherapy catheter was placed through the burr hole into the resection cavity, expanded with saline (0.9% NaCl) solution, and explanted 7 days later.

RESULTS

4 of 5 dogs survived the procedure. The fifth died because of iatrogenic brain damage. Neurologic deficits were unilateral and focal. Twenty-four hours after surgery, all surviving dogs were ambulatory, 2 dogs exhibited ipsiversive circling, 4 had contralateral proprioceptive deficits, 3 had contralateral menace response deficits, 2 had a reduced contralateral response to noxious nasal stimulation, and 1 had dull mentation with intermittent horizontal nystagmus and ventrolateral strabismus. Neurologic status improved throughout the study period. Histologic quality of biopsy specimens was excellent.

CONCLUSIONS AND CLINICAL RELEVANCE

This technique enabled histologic diagnosis from high-quality biopsy specimens obtained through a minimally invasive technique and has potential applications for multimodal treatment of deep brain tumors in dogs.

Characterization and mode of inheritance of a paroxysmal dyskinesia in Chinook dogs

BACKGROUND

Paroxysmal dyskinesias are episodes of abnormal, involuntary movement or muscle tone, distinguished from seizures by the character of the episode and lack of seizure activity on ictal EEG.

HYPOTHESIS

Paroxysmal dyskinesia is an inherited, autosomal recessive disorder in Chinook dogs.

ANIMALS

Families of Chinook dogs with paroxysmal dyskinesia.

METHODS

Pedigrees and medical histories were reviewed for 299 Chinook dogs. A family of 51 dogs was used for analysis. Episodes were classified as seizures, paroxysmal dyskinesia, or unknown, and segregation analysis was performed.

RESULTS

Paroxysmal dyskinesia was identified in 16 of 51 dogs and characterized by an inability to stand or ambulate, head tremors, and involuntary flexion of 1 or multiple limbs, without autonomic signs or loss of consciousness. Episode duration varied from minutes to an hour. Inter-ictal EEGs recorded on 2 dogs with dyskinesia were normal. Three dogs with dyskinesia also had generalized tonic-clonic seizures. One of 51 dogs had episodes of undetermined type. Phenotype was unknown for 6 of 51 dogs, and 28 dogs were unaffected. Segregation was consistent with an autosomal recessive trait.

CONCLUSIONS AND CLINICAL IMPORTANCE

This movement disorder is prevalent in the Chinook breed, and consistent with a partially penetrant autosomal recessive or polygenic trait. Insufficient evidence exists for definitive localization; episodes may be of basal nuclear origin, but atypical seizures and muscle membrane disorders remain possible etiologies. The generalized seizures may be a variant phenotype of the same mutation that results in dyskinesia, or the 2 syndromes may be independent.

Sarcocystis sp. encephalomyelitis in a cat

A 5-month-old male neutered domestic shorthair cat was evaluated for spinal pain, ataxia, and anisocoria. Neuroanatomic localization indicated diffuse or multifocal central nervous system disease. On cerebrospinal fluid analysis, neutrophilic pleocytosis and intracellular protozoal merozoites were observed. The merozoites were oval, 2-4 microm in width and 4-6 microm in length, and had linear arrays of nuclear material concentrated at one pole. Serum was positive for Sarcocystis sp. antibodies and negative for Toxoplasma gondii antibodies. The organism was determined to be either Sarcocystis neurona or Sarcocystis dasypi based on sequence analysis of the internal transcribed spacer 1 ribosomal RNA genomic region. Clinical disease resolved following treatment with 3 different protocols for protozoal infection. This case is the first to demonstrate the antemortem diagnosis and survival of a domestic cat with Sarcocystis sp.-associated encephalomyelitis. Clinicians and cytopathologists should include Sarcocystis sp. as a differential for feline inflammatory central nervous system disease characterized by neutrophilic pleocytosis.

INTRACRANIAL SUBARACHNOID HEMORRHAGE FOLLOWING LUMBAR MYELOGRAPHY IN TWO DOGS

Intracranial subarachnoid hemorrhage is a rare but serious complication of lumbar puncture in humans. Possible sequelae include increased intracranial pressure, cerebral vasospasm, or mass effect, which can result in dysfunction or brain herniation. We describe two dogs that developed intracranial subarachnoid hemorrhage following lumbar myelography. In both dogs, myelography was performed by lumbar injection of iohexol (Omnipaque). Both the dogs underwent uneventful ventral decompressive surgery for disk herniation; however, the dogs failed to recover consciousness or spontaneous respiration following anesthesia. Neurologic assessment in both dogs postoperatively suggested loss of brain stem function, and the dogs were euthanized. There was diffuse subarachnoid hemorrhage and leptomeningeal hemorrhage throughout the entire length of the spinal cord, brain stem, and ventrum of brain. No evidence of infectious or inflammatory etiology was identified. The diagnosis for cause of brain death was acute subarachnoid hemorrhage. Our findings suggest that fatal subarachnoid hemorrhage is a potential complication of lumbar myelography in dogs. The cause of subarachnoid hemorrhage is not known, but may be due to traumatic lumbar tap or idiosyncratic response to contrast medium. Subsequent brain death may be a result of mass effect and increased intracranial pressure, cerebral vasospasm, or interaction between subarachnoid hemorrhage and contrast medium.

SUBLUMBAR ABSCESS AND DISKOSPONDYLITIS IN A CAT

Diskospondylitis is uncommon in cats. We describe a cat with diskospondylitis of the L7-S1 intervertebral disk, and a concurrent sublumbar abscess. Radiographic, computed tomographic and ultrasonographic findings are presented. Aerobic and anaerobic cultures of blood and spinal fluid yielded no growth. Aerobic and anaerobic urine cultures resulted in growth of an Enterococcus sp. and Clostridium perfringens, respectively. The cat was successfully treated with enrofloxacin and amoxicillin/clavulanic acid. Clinical signs resolved completely, and based on follow-up ultrasonography there was no remaining evidence of the sublumbar abscess. Etiologic agents and outcome from other cats with diskospondylitis are reviewed.

Traumatic subarachnoid-pleural fistula in a dog

Subarachnoid-pleural fistula is a rare occurrence in humans as a result of trauma or spinal surgery. Such fistulas commonly remain undiagnosed until sufficient cerebrospinal fluid accumulates in the pleural space to cause respiratory distress. We describe a subarachnoid-pleural fistula in a dog that occurred subsequent to blunt trauma sustained during a fall, with concurrent acute, traumatic intervertebral disc rupture. The extruded disc material penetrated the dura mater, allowing communication between the subarachnoid space and the extrapleural thoracic cavity. Radiographic, myelographic, and computed tomographic (CT) findings are reviewed. Abnormalities noted during myelography included an intradural-extramedullary lesion at T11-T12, with epidural leakage of contrast medium from the region of T12 extending cranially. In images from myelography and CT there was extravasation of contrast medium extending from the subarachnoid and epidural space into the extrapleural thoracic cavity.

Association between lymph node size and metastasis in dogs with oral malignant melanoma: 100 cases (1987-2001)

OBJECTIVE

To determine the association between lymph node size and metastasis and to assess measurement of lymph node size as an accurate and reliable means of tumor staging in dogs with oral malignant melanoma.

DESIGN

Retrospective study.

ANIMALS

100 dogs with histologically confirmed oral malignant melanoma.

PROCEDURE

Clinical records for dogs with oral malignant melanoma were reviewed. Data regarding size and results of cytologic or histologic examination of lymph nodes were evaluated. The association between lymph node size and metastasis was determined.

RESULTS

Forty-seven (47%) dogs, of which 23 (49%) had enlarged mandibular lymph nodes, had no cytologic or histologic evidence of metastasis. Of 53 (53%) dogs with cytologic or histologic evidence of mandibular lymph node metastasis, 37 (70%) had enlarged mandibular lymph nodes, and 16 (30%) had mandibular lymph nodes of normal size. Overall, 16 of the 40 (40%) dogs with normal-sized lymph nodes had microscopic evidence of metastatic disease. Sensitivity and specificity of lymph node size as a predictor of metastasis were 70 and 51%, respectively, and the positive and negative predictive values were 62 and 60%, respectively.

CONCLUSIONS AND CLINICAL RELEVANCE

Although a significant relationship was identified between lymph node size and metastasis to the lymph node, this association did not appear strong enough to be clinically relevant. Results suggest that lymph node size alone is insufficient for accurate clinical staging of oral malignant melanoma in dogs; cytologic or histologic examination of regional lymph nodes should routinely be performed, regardless of size of those nodes.

European animal diseases brought to the New World

Beginning with Columbus' second voyage to the New World in 1493, domesticated animals have been imported to establish herds and flocks for the development of animal agriculture and as mounts for the early explorers. Some of these imports harbored agents of disease that were transmitted to healthy animals during their ocean voyage or to their offspring born in the New World. Some of these diseases were eradicated, others have persisted to the present.

Pasteurella caballi, a new species from equine clinical specimens

The name Pasteurella caballi is proposed for a group of organisms represented by 29 strains isolated from respiratory and other infections in horses. P. caballi strains are gram-negative, oxidase-positive, nonmotile, fermentative rods with the key characteristics of the genus Pasteurella. These strains differed from other Pasteurella species in that all were aerogenic and catalase negative, and some strains produced acid from myo-inositol and L-rhamnose. The levels of DNA relatedness of 28 P. caballi strains with labeled DNA from the proposed type strain averaged 91 and 85% (hydroxyapatite method at 55 and 70 degrees C). P. caballi was 13 to 53% related to strains representing 22 other species of the family Pasteurellaceae. The guanine-plus-cytosine content of the DNA of four strains was 41 to 42 mol%. The type strain is 83851 (=ATCC 49197).

Virulence factors of Escherichia coli isolated from cows with acute mastitis

A total of 184 Escherichia coli isolates recovered from cows with acute mastitis were examined for recognized pathogenic mechanisms and virulence factors commonly found in pathogenic groups of E coli. A modification of the Eng procedure (for detecting complement deficiencies in serum) was used to test for resistance to different animal sera. The Sereny test (for invasiveness), infant mouse test (for heat-stable enterotoxin), and Y-1 adrenal tumor cell assay (for heat-labile enterotoxin) were used. Hemagglutination tests, using rabbit, sheep, and guinea pig RBC, were done with and without added mannose. All of the 184 isolates were serum resistant in all tested sera. None of the isolates was invasive. Only 1 isolate was positive for heat-stable enterotoxin and 2 cultures were positive for heat-labile enterotoxin. Multiple patterns of hemagglutination were observed. The majority of the isolates exhibited both mannose-sensitive and mannose-resistant hemagglutinins with guinea pig and rabbit RBC. A few strains were positive only in mannose-sensitive or mannose-resistant hemagglutination tests. A few strains were negative in all hemagglutination tests. Based on our results, E. coli from cows with acute mastitis lack the virulence factors commonly observed in other E coli groups associated with disease. Serum resistance was the only characteristic that could be related to virulence.

Biochemical and serologic properties of Escherichia coli isolated from cows with acute mastitis

Biochemical and serologic characteristics of 184 Escherichia coli isolates from cows with acute mastitis were determined. Trends or patterns unique to bovine isolates were not observed, except for the frequency of adonitol fermentation, which was positive in 84 (45.6%) of the cultures. Growth on Tergitol-7 agar had 3 types of colony morphologic characteristics; of these, the rough and intermediate textures predominated over those with smooth colony surfaces. A large variety of serovars was detected; the majority occurring as single isolates within a herd. Few K antigens were typeable. Only 2 isolates contained the K99 antigen. Seemingly, E coli organisms isolated from cows with acute mastitis cannot be distinguished as a specific pathogenic group on the basis of biochemical and serotest reactions.

Comparison of Pasteurella multocida serotyping systems

Thirty-two type specific cultures used in four typing systems for serologically classifying Pasteurella multocida were compared as originally described for: (1) Little and Lyon's plate agglutination test; (2) Carter's indirect hemagglutination test, hyaluronidase decapsulation test, and acriflavine reaction; (3) Namioka's plate and tube agglutination tests; and (4) Heddleston's gel diffusion precipitin test. In addition, seven cultures from Robert's five passive protection groups were included. When reference cultures were examined by the typing system from which they were described, the results generally correlated with those results published. However, serotypes determined by one typing system generally did not correlate with serotypes determined by another system. Cultures of a single serotype in one system often represented more than one serotype in another system. Results indicated that cultures with one or two serotyping antigens in common may differ in other antigens. Because of the antigenic complexity of P multocida and the nature of the antigens involved in each test, a reliable correlation or equality between serotypes determined by different typing systems could not be made.