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InFocus

A look through the latest literature: neurology

Our monthly summary of the latest academic publications, answering the question “what’s new?” in this month’s spotlight topic of veterinary neurology

Necrotising meningoencephalitis in Pugs resembling human multiple sclerosis

Rebecca Windsor and others, Ethos Discovery, Woburn, Massachusetts

Necrotising meningoencephalitis is an autoimmune neuroinflammatory disease of dogs. It causes chronic disability and death in dogs and closely resembles the fulminant form of multiple sclerosis in humans. The condition is normally identified when the clinical signs are severe and the pathological changes well advanced. The authors describe studies on a variant of this condition seen in Pugs wherein clinical changes are apparent at an earlier stage and disease progression is more insidious. They suggest that this early onset condition may provide opportunities for clinical interventions before the appearance of irreversible neurological damage. They highlight the parallels between the conditions in human and canine patients and suggest that these findings may assist the development of effective treatments in both species.

American Journal of Veterinary Research, 85, 1-9

Management of status epilepticus and cluster seizures in cats and dogs

Marios Charalambous and others, University of Veterinary Medicine, Hannover, Germany

Status epilepticus and cluster seizures are common neurological emergencies in companion animal practice and are associated with high morbidity and mortality. They present a significant challenge to practitioners because of their complex pathophysiology, the rapid progression of drug resistance and their self-sustaining character. The authors describe a consensus statement on the management of these conditions in canine and feline patients drawn up by board-certified specialists for the American College of Veterinary Internal Medicine (ACVIM). They state that effective control of these conditions is dependent on an early, rapid and stage-based treatment approach using ACVIM-recommended therapies and appropriate management of the various complications and underlying causes.

Journal of Veterinary Internal Medicine, 38, 19-40

Comparison of canine cognitive decline and Alzheimer’s disease in humans

Joel Ehrenzweig and Robert Hunter, Veterinary Health Research Center, Midlothian, Virginia

Alzheimer’s disease is the leading cause of dementia in older adult humans. Alongside the limited number of available treatment options, the absence of a suitable research model has ensured that efforts to find novel therapies have been unproductive. The authors evaluate the clinical, biochemical, pathological and behavioural features of canine cognitive decline in relation to the changes seen in human patients. They highlight the potential value of the canine disease as part of a One Health initiative to improve the quality of life for patients from both species. The proposed Dogs Overcoming Geriatric Memory and Aging (DOGMA) study to be conducted in veterinary practices aims to gather essential baseline data on blood biomarkers and biometric behaviour in older dogs.

Journal of the American Veterinary Medical Association, 261, 1-8

Head tilt as an indicator of cervical or paraspinal disease in dogs

Theofanis Liatis and Steven De Decker, Royal Veterinary College, London

A head tilt is strongly associated with vestibular dysfunction in the veterinary literature, but in human medicine, this particular symptom can be linked to a much wider range of conditions. The authors describe a series of 15 canine cases in which a head tilt occurred in connection with cervical spine or paraspinal disease but with an absence of intracranial abnormalities. They identified a range of different lesions, including post-operative complications of spinal nerve root mass removal, intervertebral disc extrusion and cervical paraspinal myositis. In the majority of these dogs, the signs were caused by abnormalities affecting the C1 to C3 dorsal spinal cord segments, but in some cases, they occurred in connection with more caudal spinal lesions.

Journal of Small Animal Practice, 65, 56-65

Using a frameless optical neuro-navigation system as a guide for craniotomies in dogs

Sarah Gutmann and others, Leipzig University, Germany

Optical neuro-navigation systems using infrared light to create a virtual reality image of the brain allow the surgeon to track instruments in real time. In an experimental cadaver study, the authors examined the accuracy of a frameless optical neuro-navigation system as a guide for craniotomies in dogs. They determined the difference between the planned and drilled target point coordinates on the skull surface and in the brain based on successive computed tomography scans. They found the accuracy of this system comparable to that of other devices used in veterinary neurological procedures. They suggest that the application of optical neuro-navigation systems can help minimise the surgical access needed to the brain and reduce the resultant surgical trauma while also reducing operating time.

Acta Veterinaria Scandinavica, 65, 54

Comparison of different imaging modality findings in retrobulbar meningioma cases

Amit Sidhu and Antonia DeJesus, The Animal Medical Center, New York City

Meningioma is the most common tumour reported in the cranium of dogs. Patients with retrobulbar lesions have been successfully treated with a combination of surgical excision of the affected globe and associated tissues and radiotherapy. Survival times of up to four and a half years have been reported. The authors describe the imaging characteristics of 15 cases of retrobulbar meningioma in dogs using computed tomography, magnetic resonance imaging and ultrasound imaging. Consistent findings included partial mineralisation, conical to ovoid shape, location surrounding the optic nerve, expansion of the extraocular muscle cone and cranial cavity extension along the optic nerve or through regional lysis.

Veterinary Radiology and Ultrasound, 64, 1044-1054

Once-a-day oral phenobarbital treatment for presumptive idiopathic epilepsy in cats

Abtin Mojarradi and others, IVC Evidensia Referrals, Helsingborg, Sweden

Phenobarbital delivered orally twice daily is the standard treatment for cats with recurrent seizures, but dosing an uncooperative patient can be distressing for both the cat and its owner. Up to 80 percent of owners report difficulties in orally medicating their cat; this negatively affects compliance. The authors report a study on nine patients using a once-daily formulation of the same agent. Seizure remission was achieved in eight cats and good control was possible in the ninth. Although once-daily treatment appears to be a satisfactory alternative to the standard treatment regimen, its safety and efficacy should be tested in a larger-scale trial.

Journal of Feline Medicine and Surgery, 25

The role of neuroinflammation in canine epilepsy

Eva-Lotta von Rueden and others, Ludwig-Maximilians University, Munich, Germany

Over the past decade, studies in human patients with epilepsy have demonstrated that neuroinflammatory processes are involved in epilepsy development and play a crucial role in the neuronal hyperexcitability that underlies these seizures. The authors review the evidence from preclinical and clinical studies in human patients and assess the state of knowledge of similar neuroinflammatory processes in canine epilepsy. They suggest that there may be a basis for considering the dog as “a translational species between bench and bedside for the identification of new treatment strategies and novel drug candidates to treat not only canine but also human epilepsy”.

The Veterinary Journal, 298-299

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