Tiny Reviews: JVIM March/April 2017

These tiny reviews cover autonomous spinal walking, degenerative myelopathy, narcolepsy due to a pituitary tumor, cranial meningocele, and myelomalacia.


Autonomous spinal walking in paraplegic dogs

Dr. Gallucci et al, published an interesting study to evaluate the number of thoracolumbar paraplegic dogs without pain perception that developed an autonomous spinal walking (SW) gait after a period of intensive physical rehabilitation training. Attention was focused on the identification of potential parameters (age, weight, type and site of lesion, duration of clinical signs, hospitalization during physiotherapy, onset of physiotherapy) associated with involuntary pelvic limb motor function.  They found that 48 (59%) of 81 dogs undergoing intensive physiotherapy gained SW ability.  Median time to regain SW was 75.5 days.  Younger age, lighter weight (<7.8 kg) and an earlier start to physiotherapy were positively associated with SW.  Veterinarians and owners, facing a catastrophic event such as an acute spinal cord injury leading to paraplegia without pain perception, should be aware of the possibility that their pets can develop SW gait with early intensive physiotherapy.

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Degenerative myelopathy

Because there is no definitive antemortem diagnostic test for canine degenerative myelopathy (DM), veterinary and human medical researchers at the University of Missouri-Columbia evaluated CSF and serum levels of phosphorylated neurofilament heavy (pNF-H) as a diagnostic marker. pNF-H is an abundant structural protein of myelinated motor axons and is a promising biomarker of nervous system damage and disease.  Fifty-three DM affected dogs were compared to 27 asymptomatic, 7 asymptomatic at-risk dogs and 12 DM mimic dogs.  They found that compared to control dogs, median CSF pNF-H was increased in all stages of DM with an 80.4% sensitivity and 93.6% specificity.  No differences in serum pNF-H concentrations were found between control and DM dogs.  Further study of a larger group of DM mimic dogs is necessary to validate the overall specificity of increased CSF pNF-H to DM.

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Interesting cause of narcolepsy-cataplexy in a Dachshund

Researchers at the University of Tennessee reported on a case of pituitary macrotumor causing narcolepsy-cataplexy in a 6 year old Dachshund.  The dog developed an acute onset of 30-40 second collapse after the initiation of feeding. Syncope was ruled out and an MRI showed a contrast enhancing pituitary tumor consistent with a macroadenoma.  The test for the hypocretin receptor 2 gene mutation identified in a family of narcoleptic Dachshunds was negative.  The dog’s signs resolved with radiation therapy.  Nine months following the radiation therapy, the dog developed pituitary dependent hyperadrenocorticism and was treated with trilostane.  It was suspected that the cause of this dog’s narcolepsy-cataplexy was a dysfunction of one or more nuclei caudal to the hypothalamus involved with wakefulness.

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Cranial meningocele or meningoencephalocele

Dr. Lazzerini et al., published on the Clinical Features, Imaging Characteristics, and Long Term Outcome of Dogs with Cranial Meningocele (MC) or Meningoencephalocele (MEC).  The records of 22 client-owned dogs were reviewed.  Most affected dogs were presented at a young age (median, 6.5 months; range, 1 month – 8 years). The most common presenting complaints were seizures and behavioral abnormalities. Intranasal MEC was most common followed by parietal MC. Magnetic resonance imaging identified meningeal enhancement of the protruded tissue in 77% of the cases. Porencephaly was seen in all cases with parietal MC.  Surgery was not performed in any affected dog. Seventeen patients were treated medically, and seizures were adequately controlled with anti-epileptic drugs in 10 dogs. Dogs with intranasal MEC and mild neurologic signs had a fair prognosis with medical treatment.  Although uncommon, MC and MEC should be considered as a differential diagnosis in young dogs presenting with seizures or alterations in behavior.  Medical treatment is a valid option with a fair prognosis when the neurologic signs are mild.

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Myelomalacia

Veterinary researchers at the Portoni Rossi Veterinary Hospital in Bologna, Italy, reported on the prevalence and risk factors of ascending/descending myelomalacia (ADMM) in non-ambulatory dogs with surgically treated thoracolumbar intervertebral disc herniation (TL-IVDH).  Six hundred and fifty-two dogs were evaluated post-op.  The prevalence of ADMM was 0% in dogs with neurological signs graded 1 or 2 at admission or before magnetic resonance imaging (MRI) or surgical procedures, 0.6% in dogs with neurological signs graded 3, 2.7% in dogs with neurological signs graded 4, and 14.5% in dogs with neurological signs graded 5.  Age (<5.8 years), neurological status (grade 5), site of disk herniation (L5-L6), duration of clinical signs before becoming non-ambulatory (<24 hours), detection of intramedullary T2-weighted (T2W) hyperintensity, and a T2 length ratio >4.57 were significant risk factors in the univariate analysis for development of ADMM.  The factors identified in this study may be useful for the prediction of ADMM.

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