Anita Shea

Idiopathic Epilepsy in the Italian Spinone in the United Kingdom: Prevalence, Clinical Characteristics, and Predictors of Survival and Seizure Remission

Background There is lack of data on idiopathic epilepsy (IE) in the Italian Spinone (IS). Objectives To estimate the prevalence of IE in the IS in the United Kingdom (UK) and to investigate predictors of survival and seizure remission. Animals The target population consisted of 3331 IS born between 2000 and 2011 and registered with the UK Kennel Club (KC). The owners of 1192 dogs returned phase I questionnaire. Sixty‐three IS had IE. Methods Population survey. The owners of all UK KC‐registered IS were invited to complete the phase I questionnaire. Information from the phase I questionnaire and veterinary medical records was used to identify IS with IE and obtain data on treatment and survival. Additional information was obtained from owners of epileptic IS who completed the phase II questionnaire. Results The prevalence of IE in the IS in the UK was estimated as 5.3% (95% CI, 4.03–6.57%). Survival time was significantly shorter in IS euthanized because of poorly controlled IE compared with epileptic IS that died of unrelated disorders (P = 0.001). Survival was significantly longer in IS with no cluster seizures (CS) (P = 0.040) and in IS in which antiepileptic medication was initiated after the second seizure rather than after ≥3 seizures (P = 0.044). Seizure remission occurred only in 3 IS. Conclusions and Clinical Importance The prevalence of IE in IS (5.3%) is higher than in dogs (0.6%) in the UK. Idiopathic epilepsy in IS has a severe phenotype. Antiepileptic medication initiation after the second seizure and aggressive treatment of CS may improve survival.

Outcome comparison in dogs with a presumptive diagnosis of thoracolumbar fibrocartilaginous embolic myelopathy and acute non-compressive nucleus pulposus extrusion

Dogs with fibrocartilaginous embolic myelopathy (FCEM) or acute non-compressive nucleus pulposus extrusion (ANNPE) are reported to have a fair prognosis; however, persistent motor/autonomic deficits are possible. Specific MRI patterns have been suggested to differentiate these diseases although never been validated with histopathology in large studies. The aim of this retrospective study was to evaluate if these MRI patterns are associated with different clinical outcomes in dogs with peracute non-progressive T3-L3 myelopathy. Two hundred and one dogs were included. Outcome data were obtained via medical records and telephone questionnaires. MRIs were blindly reviewed by three board-certified observers, obtaining substantial to almost perfect interobserver agreement on diagnoses (κ=0.635–0.828). Presumptive ANNPE and FCEM were diagnosed in 157 and 44 dogs , respectively. Ambulatory function was regained in 99 per cent of cases, with persistent motor deficits in 83.6 per cent and 92.5 per cent of dogs with presumptive ANNPE and FCEM, respectively. The presumptive diagnosis was not associated with motor function recovery, recovery times or urinary continence. Faecal incontinence was five times more likely in dogs with presumptive ANNPE (23 per cent) compared with presumptive FCEM (7.5 per cent). Distinguishing between MRI patterns of presumptive ANNPE or FCEM in dogs with peracute non-progressive T3-L3 myelopathy may help predict the risk of developing faecal incontinence.

Clinicopathologic Features and Magnetic Resonance Imaging Findings in 24 Cats With Histopathologically Confirmed Neurologic Feline Infectious Peritonitis

Background Feline infectious peritonitis (FIP) is the most common infectious central nervous system (CNS) disease in the cat and is invariably fatal. Improved means of antemortem diagnosis is required to facilitate clinical decision making. Information regarding the magnetic resonance imaging (MRI) findings of neurologic FIP currently is limited, resulting in the need for better descriptions to optimize its use as a diagnostic tool. Objective To describe the clinicopathologic features and MRI findings in cases of confirmed neurologic FIP. Animals Twenty‐four client‐owned cats with histopathologic confirmation of neurologic FIP. Methods Archived records from 5 institutions were retrospectively reviewed to identify cases with confirmed neurologic FIP that had undergone antemortem MRI of the CNS. Signalment, clinicopathologic, MRI, and histopathologic findings were evaluated. Results Three distinct clinical syndromes were identified: T3‐L3 myelopathy (3), central vestibular syndrome (7), and multifocal CNS disease (14). Magnetic resonance imaging abnormalities were detected in all cases, including meningeal contrast enhancement (22), ependymal contrast enhancement (20), ventriculomegaly (20), syringomyelia (17), and foramen magnum herniation (14). Cerebrospinal fluid was analysed in 11 cases; all demonstrated a marked increase in total protein concentration and total nucleated cell count. All 24 cats were euthanized with a median survival time of 14 days (range, 2–115) from onset of clinical signs. Histopathologic analysis identified perivascular pyogranulomatous infiltrates, lymphoplasmacytic infiltrates, or both affecting the leptomeninges (16), choroid plexuses (16), and periventricular parenchyma (13). Conclusions and Clinical Importance Magnetic resonance imaging is a sensitive means of detecting neurologic FIP, particularly in combination with a compatible signalment, clinical presentation, and CSF analysis.

Clinical features and disease progression of L-2-hydroxyglutaric aciduria in 27 Staffordshire bull terriers

To describe the development of clinical signs (CS) and outcome of L-2-hydroxyglutaric aciduria (L-2-HGA), owners of 119 Staffordshire bull terriers positive for the known L-2-hydroxyglutarate dehydrogenase autosomal-recessive mutations were requested to complete a questionnaire regarding their pets CS. Questionnaires were returned for 27 dogs, all with neurological abnormalities—not all questions were answered in all cases. The mean age of CS onset was 12 months (range 2.5–60). Gait dysfunction was reported in 26/26 dogs, with stiffness of all four limbs the most common (24/26) and earliest recognised abnormality. Kyphosis (19/26), body and/or head tremors (19/26) and hypermetria (15/26) were frequent. Behavioural changes were present in 24/27 dogs; most commonly staring into space (21/24), signs of dementia (17/24) and loss of training (15/24). Eighteen dogs demonstrated paroxysmal seizure-like/dyskinetic episodes. Nineteen (70 per cent) dogs were alive at a mean survival time of 76.6 months (12–170) after onset of CS. L-2-HGA was the cause of euthanasia in six dogs. Euthanasia occurred at a mean survival time of 44 months (8.5–93) after onset of CS, with 2/8 dogs euthanased within 12 months. L-2-HGA is considered a progressive neurological disease; however, CS can be successfully managed with affected dogs potentially living a normal lifespan.

Recurrent cerebrovascular accidents caused by intravascular lymphoma in a dog

An eight-year-old, neutered male labrador was presented with recent recurrent vestibular episodes. MRI was consistent with multiple lacunar ischaemic infarcts in the thalamus and medulla oblongata. The imaging diagnosis was supported by a markedly elevated D-dimer concentration. Despite a comprehensive diagnostic workup (including fine needle cytology of cutaneous and subcutaneous nodules, complete bloodwork, urinalysis, thoracic and abdominal imaging, cerebrospinal fluid analysis, serial blood pressure measurements, echocardiography, electrocardiography and brainstem auditory evoked response testing), no underlying cause was found. After a partial response to 2  mg/kg clopidogrel once a day and 1  mg/kg prednisolone once a day, the dog acutely deteriorated and repeated MRI of the brain revealed an intra-axial haemorrhagic mass. Euthanasia was elected and postmortem examination revealed the presence of an intravascular null-cell lymphoma, exclusively in the central nervous system. Intravascular lymphoma is rare, difficult to diagnose ante-mortem and reports in veterinary literature are few.

Spontaneous non-traumatic tension pneumocephalus in a dog with a nasal meningoencephalocele

A 1.5-year-old neutered male Border collie was presented with acute onset left forebrain signs and unilateral nasal discharge 14 months after MRI diagnosis of nasal meningoencephalocele. Subsequent MRI revealed intraventricular pneumocephalus with a gas-filled tract extending to the rostral aspect of the intranasal brain parenchyma. Transient clinical improvement was noted with medical management, with euthanasia eight months post diagnosis due to deteriorating neurological status. The diagnoses of intraventricular pneumocephalus and frontoethmoidal meningoencephalocele were confirmed post mortem. This is the first reported case of non-traumatic tension pneumocephalus in a dog and the first report of pneumocephalus associated with a nasal meningoencephalocele in a dog.

Nevus of Ota (oculodermal melanocytosis) in a dog

A 5-year-old, female, spayed Rhodesian Ridgeback presented with ocular melanocytosis and skin hyperpigmentation involving the distribution of the first and second divisions of the trigeminal nerve on the right side of the face. The dermatomal pattern of the hyperpigmentation was similar to nevus of Ota or oculodermal melanocytosis reported in humans. This condition has been associated with increased risk of developing secondary glaucoma and melanoma transformation in skin, ocular, orbital tissues, and the central nervous system. The clinical investigation and description of oculodermal melanocytosis (nevus of Ota) are presented for the first time in the dog.

Clinical and genetic characterisation of dystrophin-deficient muscular dystrophy in a family of Miniature Poodle dogs

Four full-sibling intact male Miniature Poodles were evaluated at 4–19 months of age. One was clinically normal and three were affected. All affected dogs were reluctant to exercise and had generalised muscle atrophy, a stiff gait and a markedly elevated serum creatine kinase activity. Two affected dogs also showed poor development, learning difficulties and episodes of abnormal behaviour. In these two dogs, investigations into forebrain structural and metabolic diseases were unremarkable; electromyography demonstrated fibrillation potentials and complex repetitive discharges in the infraspinatus, supraspinatus and epaxial muscles. Histopathological, immunohistochemical and immunoblotting analyses of muscle biopsies were consistent with dystrophin-deficient muscular dystrophy. DNA samples were obtained from all four full-sibling male Poodles, a healthy female littermate and the dam, which was clinically normal. Whole genome sequencing of one affected dog revealed a >5 Mb deletion on the X chromosome, encompassing the entire DMD gene. The exact deletion breakpoints could not be experimentally ascertained, but we confirmed that this region was deleted in all affected males, but not in the unaffected dogs. Quantitative polymerase chain reaction confirmed all three affected males were hemizygous for the mutant X chromosome, while the wildtype chromosome was observed in the unaffected male littermate. The female littermate and the dam were both heterozygous for the mutant chromosome. Forty-four Miniature Poodles from the general population were screened for the mutation and were homozygous for the wildtype chromosome. The finding represents a naturally-occurring mutation causing dystrophin-deficient muscular dystrophy in the dog.

Neurogenic urinary retention in cats following severe cluster seizures

Case series summary Four cats that presented with severe cluster seizures developed neurogenic urinary retention in the postictal phase. None of the cats had previous seizures. Micturition was reported as normal in all cats for 3 or more years before seizure onset. All cats required a continuous rate infusion of propofol to control the seizure activity. In all cats manual bladder expression was performed every 8 h until recovery of normal micturition. One cat was started on phenoxybenzamine to reduce internal urethral sphincter tone. All cats recovered normal micturition within 4 weeks of the last cluster of seizures. Relevance and novel information Transient neurogenic urinary retention has not previously been reported in cats or dogs following severe cluster seizures. Urinary retention should be considered a potential postictal deficit, requiring prompt recognition and treatment to avoid urinary tract infection and detrusor muscle atony.

Evaluation of quality of life of carers of Italian spinoni with idiopathic epilepsy

The carers of all UK Kennel Club registered Italian spinoni (IS) born between January 1, 2000 and December 31, 2011 were invited to participate in the study. The carers of 47 of 63 IS diagnosed with idiopathic epilepsy (IE) returned the questionnaire, which included numerous questions on various aspects of IE including the effect of IE on the dogs carers quality of life. Median epileptic seizure number in the three months before study end or death was five epileptic seizures, 72 per cent of dogs had cluster seizures, 94 per cent of dogs were administered one or more antiepileptic medications and 36 per cent of dogs were euthanased due to poorly controlled IE. Seventy-one per cent and 65 per cent of the participants were moderately to extremely worried about the frequency and severity of their dogs epileptic seizures, respectively. Caring for an IS with IE caused conflict with the carers work, education or daily activity often or very often in 50 per cent of the participants. Overall the limitations on the carers life due to caring for an IS with IE were considered as very to extremely bothersome in 29 per cent of the participants, a little to moderately bothersome in 40 per cent of the participants and not at all bothersome in 31 per cent of the participants.