Initial management of epileptic seizures in dogs by first opinion practitioners
Matthew Green and others, Dovecote Veterinary Hospital, Castle Donnington, Leicestershire
Detailed assessment of canine epilepsy patients will usually involve costly procedures such as magnetic resonance imaging, which are likely to be available only at referral practices. The authors investigated the initial management of epilepsy cases by primary centres. They examined the electronic health records from 517 cases of dogs under six years of age with generalised epileptic seizures, recorded on the SAVSNET database. They found first opinion practitioners rarely prescribed anti-seizure medication following a single event, in accordance with international recommendations. Meanwhile, less than half those patients with cluster seizures received medication. In 20 percent of dogs that had a single seizure, there were no repeat events.
Challenges in the management of neurology cases in the emergency room
Franziska Meyer and others, University of Bern, Switzerland
Neurology cases have long been recognised as a source of anxiety for medical students and non-specialist physicians, leading to the term “neurophobia” being coined to describe this effect. The authors investigated the attitudes of veterinary emergency and critical clinicians towards neurology cases and the perceptions of neurology specialists and resident trainees of the confidence of their ECC colleagues in handling such patients. An internet survey was completed by 192 ECC specialists/residents and 104 neurology specialists/residents. In the former group, 52 percent of respondents acknowledged that they found neurology cases “slightly challenging”, while 85 percent of neurology specialists/residents felt that their ECC colleagues found these cases “moderately” to “extremely challenging”.
Associations between vital signs on admission and brain herniation in cats
Jiwoong Her and others, Auburn University, Alabama
Brain herniation is caused by the shifting of brain structures across anatomical boundaries as a result of rising intracranial pressure. If left untreated, it may result in a life-threatening neurological emergency. The authors investigated whether admission vitals correlated with the presence of brain herniation, diagnosed by magnetic resonance imaging. They found no association between heart rate and blood pressure on admission and brain herniation. Cats with such lesions did show a significantly lower level of consciousness in their Modified Glasgow Coma Scale (MGCS) scores but this clinical feature is not directly attributable to, or predictive of, herniation.
Consensus view on the management of canine acute intervertebral disc injury
Natasha Olby and others, North Carolina State University, Raleigh
Although thoracolumbar intervertebral disc extrusion is the most common cause of acute paraparesis and paraplegia in dogs, there is no consensus on the appropriate management of the condition. The authors formed an expert panel to summarise current knowledge of disc extrusion and offer evidence-based recommendations on its treatment. They also highlight gaps in understanding of canine vertebral disc disease, including the appropriate timing for surgical decompression, the expected outcomes from surgical versus medical management in more mildly affected dogs and the impact of durotomy on locomotor outcomes.
Skin desensitisation following tibial perineural analgesia in equine lameness investigations
Nicholas Bellitto and others, University of Glasgow
Loss of skin sensation in the corresponding dermatome is typically used to indicate the efficacy of nerve blocks that are used as diagnostic aids when assessing lameness in horses. However, loss of skin sensation as an indicator of tibial nerve desensitisation has not been properly validated and anecdotally it has been described as unreliable. The authors investigated the efficacy of tibial perineural analgesia following mepivacaine hydrochloride injections in seven lame horses tested using a handheld digital algometer. They found a significant positive correlation between the time of loss of skin sensation at the heel bulbs and the timing of lameness resolution, showing that it can reliably indicate when there is an effective nerve block.
Post-operative outcomes in 21 dogs treated for degenerative lumbosacral stenosis
Hirofumi Tanoue and others, Nippon Life Science University, Musashino, Japan
Degenerative lumbosacral stenosis is a condition of medium to large-breed dogs involving a narrowing of the spinal canal as a result of degenerative changes in the discs, bones and soft tissues of the lumbosacral junction. The authors report the outcomes in 21 cases treated by combined surgery, comprising dorsal laminectomy and dorsal fixation using screws and polymethyl methacrylate (PMMA). In each case, clinical signs were alleviated, proprioceptive deficits were improved from three months after surgery and there was no recurrence of clinical signs during an observation period of up to 36 months.
Stereotactic radiation treatment of a pituitary mass in a rabbit
Paula Rodriguez and others, University of California, Davis
A nine-year-old neutered female Holland Lop rabbit presented with an abnormally positioned right eyelid, first noticed two weeks previously. Computed tomography (CT) imaging identified a parasellar pituitary mass. Stereotactic radiation therapy was initiated, delivering three fractions of 8Gy over three days. A progressive decrease in the size of the pituitary mass was detected on follow-up CT examinations after 6 and 18 months. Radiation therapy should be considered an appropriate treatment option in rabbits with pituitary tumours and the protocol described here could be used as a reference for future cases.
Spontaneous resolution of disc-associated spinal cord compression in a dog
Sam Khan and others, University of Cambridge
A seven-year-old Miniature Dachshund was presented with a four day history of acute, painful, non-ambulatory paraparesis and urinary incontinence. Neurological examinations, including magnetic resonance imaging, demonstrated disc material impinging on the spinal cord at the L5 level. Due to financial constraints, the dog was treated conservatively. However, improvements in clinical signs were apparent during examinations three and seven days later and by 12 weeks the clinical findings were near normal. The frequency of spontaneous resolution of disc compression in dogs is unknown since most cases either do not undergo suitable imaging or will receive immediate surgical treatment.