Brigitte A. Brisson

Intervertebral Disc Disease in Dogs

Intervertebral disc herniation is a common cause of neurologic dysfunction in dogs. This article reviews the anatomy, pathophysiology, diagnostic imaging, treatment options, and prognosis for canine cervical and thoracolumbar intervertebral disc disease. The extensive literature pertinent to intervertebral disc disease is reviewed with the goal of summarizing the information available to help clinicians in their decision making.

Characterization of canine embryonic stem cell lines derived from different niche microenvironments.

Embryo-derived stem cells hold enormous potential for producing cell-based transplantation therapies, allowing high-throughput drug screening and delineating early embryonic development. However, potential clinical applications must first be tested for safety and efficacy in preclinical animal models. Due to physiological and genetic parity to humans, the domestic dog is widely used as a clinically relevant animal model for cardiovascular, neurodegenerative, orthopedic, and oncologic diseases. Therefore, we established numerous putative canine embryonic stem cell (cESC) lines by immunodissection of the inner cell mass (ICM), which we termed OVC.ID.1-23, and by explant outgrowths from whole canine blastocysts, named OVC.EX.1-16. All characterized lines were immunopositive for OCT4, SOX2, NANOG, SSEA-3, and SSEA-4; displayed high telomerase and alkaline phosphatase (ALP) activities; and were maintained in this state up to 37 passages ( approximately 160 days). Colonies from OVC.EX lines showed classic domed hESC-like morphology surrounded by a ring of fibroblast-like cells, whereas all OVC.ID lines exhibited a mixed cell colony of tightly packed cESCs surrounded by a GATA6+/CDX2- hypoblast-derived support layer. Spontaneous serum-only differentiation without feeder layers demonstrated a strong lineage selection associated with the colony niche type, and not the isolation method. Upon differentiation, cESC lines formed embryoid bodies (EB) comprised of cells representative of all germinal layers, and differentiated into cell types of each layer. Canine ESC lines such as these have the potential to identify differences between embryonic stem cell line derivations, and to develop or to test cell-based transplantation therapies in the dog before attempting human clinical trials.

Comparison of the effect of single-site and multiple-site disk fenestration on the rate of recurrence of thoracolumbar intervertebral disk herniation in dogs

OBJECTIVE To prospectively assess whether multiple-site disk fenestration decreases the incidence of recurrent thoracolumbar intervertebral disk herniation (IVDH), compared with single-site disk fenestration, in small-breed dogs treated for IVDH. DESIGN Randomized controlled clinical trial. ANIMALS 207 client-owned dogs. PROCEDURES Dogs undergoing decompressive surgery of the spinal cord because of thoracolumbar IVDH between 2001 and 2004 were randomly assigned to receive single-site disk fenestration at the level of surgical decompression (n = 103) or multiple-site disk fenestration of all disks from T11 through L4 (104). Follow-up consisted of complete reevaluation of patients, telephone surveys, and further surgery if signs indicative of recurrence occurred. RESULTS 189 dogs were available for long-term follow-up: 95 dogs in the single-site disk fenestration group and 94 in the multiple-site disk fenestration group. Twenty-four dogs developed 28 confirmed episodes of recurrent thoracolumbar IVDH. The rate for first-time recurrence was 12.7% (24/189). First-time recurrence rates for single-and multiple-site disk fenestration groups were 17.89% (17/95) and 7.45% (7/94), respectively. Dogs undergoing single-site disk fenestration were significantly more likely to have recurrent thoracolumbar IVDH than were dogs undergoing multiple-site disk fenestration. Disk mineralization at the time of first surgery was associated with recurrence, and 87.5% (21/24) of recurrences occurred at a disk space adjacent to or 1 disk away from the initial lesion. Regardless of disk fenestration group, 22 of 24 (91.7%) recurrences occurred at a nonfenestrated disk space. CONCLUSIONS AND CLINICAL RELEVANCE Multiple-site disk fenestration decreased the rate of recurrent IVDH in small-breed dogs, compared with the use of single-site disk fenestration.

Accuracy, intermethod agreement, and inter-reviewer agreement for use of magnetic resonance imaging and myelography in small-breed dogs with naturally occurring first-time intervertebral disk extrusion

OBJECTIVE To determine accuracy, intermethod agreement, and inter-reviewer agreement for multisequence magnetic resonance imaging (MRI) and 2-view orthogonal myelography in small-breed dogs with first-time intervertebral disk (IVD) extrusion. DESIGN Prospective evaluation study. ANIMALS 24 dogs with thoracolumbar IVD extrusion. PROCEDURES Each dog underwent MRI and myelography. Images obtained with each modality were independently evaluated and assigned standardized scores in a blinded manner by 3 reviewers. Results were compared with surgical findings. Inter-reviewer and intermethod agreements were assessed via κ statistics. Accuracy was assessed as the percentage of dogs for which ≥ 2 of 3 reviewers recorded findings identical to those determined surgically. RESULTS Inter-reviewer agreement was substantial for site (κ = 0.70) and side of IVD extrusion (κ = 0.62) in T2-weighted magnetic resonance images and was substantial for site (κ = 0.72) and fair for side of extrusion (κ = 0.37) in myelographic images. Agreement for site between each modality and surgical findings was near perfect (κ = 0.94 and 0.88 for MRI and myelography, respectively). Intermethod agreement was substantial for site (κ = 0.71) and moderate for side of extrusion (κ = 0.40). Accuracy of MRI for site and side was 100% when results for T1-weighted, T2-weighted, and contrast-enhanced T1-weighted sequences were combined. Accuracy of myelography was 90.9% and 54.5% for site and side, respectively. CONCLUSIONS AND CLINICAL RELEVANCE Agreement between imaging results and surgical findings for identification of IVD extrusion sites in small-breed dogs was similar for MRI and myelography. However, MRI appeared to be more accurate than myelography and allowed evaluation of extradural compressive mass composition.

An evaluation of B-mode and color Doppler ultrasonography for detecting periovulatory events in the bitch

When determining optimal breeding time in the bitch, specific periovulatory events must be identified. The main objectives were to relate ultrasonographic changes in ovarian blood flow, follicle/corpora lutea count and echotexture to periovulatory events, and to assess the efficacy of each for identifying these events. Twelve Beagle (N = 3), Beagle-cross (N = 2) and hound-cross (N = 7) bitches (body weight range, 7.5-27.5 kg) were examined daily from the onset of proestrus to approximately 4 days post-LH peak. Follicle and corpora lutea count and echotexture analyses were performed using B-mode ultrasound and ovarian blood flow analysis was performed using color Doppler ultrasound. Serum LH concentrations were analyzed by validated RIA. There was an increase (P < 0.05) in ovarian blood flow from the day of the preovulatory LH peak (605 pixels; confidence interval, 397-856), to 1 day after this peak (1092 pixels; confidence interval, 724-1535), enabling detection of the preovulatory LH peak. There were no significant changes in follicle/corpora lutea echotexture relative to days from the preovulatory LH peak. There were significant decreases in follicle/corpora lutea number between Days -1 and 3; Days -1 and 4; and Days 0 and 3, relative to the preovulatory LH peak. We concluded that color Doppler ultrasound performed once daily was more accurate in identifying the preovulatory LH peak than B-mode ultrasound and enabled prospective determination of ovulation.

Cystic ectopic lingual thyroid tissue in a male cat

CASE DESCRIPTION-A 6-year-old neutered male cat was examined because of a 4-week history of abnormal sounds while drinking and a previously noted mass at the base of the tongue. CLINICAL FINDINGS-Oral examination revealed a 1-cm-diameter midline cystic mass on the dorsal aspect of the base of the tongue at the junction of the rostral two-thirds and caudal third of the tongue. Complete blood count and serum biochemical analysis revealed no clinically relevant abnormalities, and serum total thyroxine and free thyroxine (determined by equilibrium dialysis) concentrations were within the reference range. TREATMENT AND OUTCOME-The fluid in the cystic mass was aspirated, and the remaining deflated mass was marsupialized. Histologic and immunohistochemical examination of sections of the excised mass revealed ectopic thyroid tissue. The cat recovered uneventfully from the surgery, clinical signs resolved, and the cat remained euthyroid with no recurrence of the mass as of 8 months after surgery. CLINICAL RELEVANCE-This is the first known reported case of ectopic lingual thyroid tissue in a male cat. In humans, the most common site of ectopic thyroid tissue is at the base of the tongue and the condition is disproportionately found in females, compared with males. In humans with ectopic lingual thyroid tissue, the patient often lacks any other functional thyroid tissue. However, the cat of this report remained euthyroid after mass resection.

Comparison between manual aspiration via polyethylene tubing and aspiration via a suction pump with a suction trap connection for performing bronchoalveolar lavage in healthy dogs.

OBJECTIVE To compare the diagnostic quality of bronchoalveolar lavage (BAL) fluid acquired from healthy dogs by manual aspiration via polyethylene tubing (MAPT) and via suction pump aspiration (SPA) with a suction trap connection. ANIMALS 12 healthy adult Beagles. PROCEDURES BAL was performed with bronchoscopic guidance in anesthetized dogs. The MAPT was performed with a 35-mL syringe attached to polyethylene tubing wedged in a bronchus via the bronchoscopes biopsy channel. The SPA was performed with 5 kPa of negative pressure applied to the bronchoscopes suction valve via a suction trap. The MAPT and SPA techniques were performed in randomized order on opposite caudal lung lobes of each dog. Two 1 mL/kg lavages were performed per site. Samples of BAL fluid were analyzed on the basis of a semiquantitative quality scale, percentage of retrieved fluid, and total nucleated and differential cell counts. Results were compared with Wilcoxon signed rank tests. RESULTS Percentage of BAL fluid retrieved (median difference, 16.2%), surfactant score (median difference, 1), and neutrophil count (median difference, 74 cells/μL) were significantly higher for SPA than for MAPT. A higher BAL fluid epithelial cell score was obtained via MAPT, compared with that for samples obtained via SPA (median difference, 1). CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that in healthy dogs, SPA provided a higher percentage of BAL fluid retrieval than did MAPT. The SPA technique may improve the rate of diagnostic success for BAL in dogs, compared with that for MAPT. Further evaluation of these aspiration techniques in dogs with respiratory tract disease is required.

Comparison between computed tomography, fluoroscopy, and ultrasonography for guiding percutaneous injection of the canine intervertebral disc.

A minimally invasive method for delivering injectable therapeutic agents would be desirable for the treatment of intervertebral disc disease in dogs. The purpose of this study was to compare computed tomography (CT), ultrasonography (US), and fluoroscopy modalities for guiding percutaneous injection into canine intervertebral discs. Intervertebral discs of 14 dog cadavers were injected with a gelified ethanol therapeutic agent. Successful injectate placement and injectate leakage were determined based on necropsy inspection of discs. Injection into the nucleus pulposus was successful in 55 of 78 (71%) of all injected discs. Injections guided using CT and fluoroscopy were significantly more successful than US-guided injections. Odds of successful injection without leakage were greater for CT vs. US (P = 0.0026) but there was no significant difference between CT and fluoroscopy (P = 0.0620). Injection success rates did not differ among vertebral sites or dog cadavers of varying weights. Forty-nine (63%) of injection sites had injectate leakage outside the disc and 10 of these involved structures within the vertebral canal. The highest rate of injection success with the least amount of leakage was achieved with CT guidance. Findings indicated that CT, fluoroscopy, and US are feasible modalities for guiding percutaneous injection of a gelified ethanol therapeutic agent into the canine intervertebral disc, with moderate to high success rates for different regions of the spine. However, a moderately high rate of injectate leakage occurred outside of the disc and this should be taken into consideration for future safety and efficacy studies.

Feasibility of percutaneous catheterization and embolization of the thoracic duct in dogs

OBJECTIVE To develop and determine the feasibility of a novel minimally invasive technique for percutaneous catheterization and embolization of the thoracic duct (PCETD) in dogs and to determine thoricic duct TD pressure at rest and during short-term balloon occlusion of the cranial vena cava (CrVC). ANIMALS Fifteen 7- to 11-month-old healthy mixed-breed dogs. PROCEDURES Efferent intestinal lymphangiography was performed, and the cisterna chyli was punctured with a trochar needle percutaneously under fluoroscopic guidance. When access was successful, a guide wire was directed into the TD through the needle and a vascular access sheath was advanced over the guide wire. Thoracic duct pressure was measured at rest and during acute balloon occlusion of the CrVC. The TD was then embolized cranial to the diaphragm with a combination of microcoils and cyanoacrylate or ethylene vinyl alcohol. RESULTS Successful puncture of the cisterna chyli with advancement of a wire into the TD was possible in 9 of 15 dogs, but successful catheterization was possible in only 5 of 9 dogs. Acute balloon occlusion of the CrVC led to a substantial TD pressure increase in 4 of 4 dogs, and embolization of the TD was successful in 4 of 4 dogs. CONCLUSIONS AND CLINICAL RELEVANCE PCETD can successfully be performed in healthy dogs; however, this minimally invasive technique cannot currently be recommended for routine treatment of chylothorax, in part because of the technically demanding nature of the procedure. An increase in jugular venous pressure led to an increase in TD pressure, potentially predisposing some dogs to developing chylothorax.

Comparison of Manual and Suction Pump Aspiration Techniques for Performing Bronchoalveolar Lavage in 18 Dogs with Respiratory Tract Disease

Background Different aspiration techniques to retrieve bronchoalveolar lavage fluid (BALF) affect sample quality in healthy dogs. Studies evaluating these techniques in dogs with respiratory disease are lacking. Objectives To compare sample quality of BALF acquired by manual aspiration (MA) and suction pump aspiration (SPA). Animals Eighteen client‐owned dogs with respiratory disease. Methods Randomized, blinded prospective clinical trial. Manual aspiration was performed with a 35‐mL syringe attached directly to the bronchoscope biopsy channel and SPA was performed with a maximum of 50 mmHg negative pressure applied to the bronchoscope suction valve using the suction trap connection. Both aspiration techniques were performed in each dog on contralateral lung lobes, utilizing 2 mL/kg lavage volumes per site. Samples of BALF were analyzed by percentage of retrieved infusate, total nucleated cell count (TNCC), differential cell count, semiquantitative assessment of slide quality, and diagnosis score. Data were compared by paired Students t‐test, Wilcoxon signed‐rank test, chi‐squared test, and ANOVA. Cohens kappa coefficient was used to assess agreement. Results The percentage of retrieved BALF (P = .001) was significantly higher for SPA than MA. Substantial agreement was found between cytologic classification of BALF obtained with MA and SPA (kappa = 0.615). There was no significant difference in rate of definitive diagnosis achieved with cytologic assessment between techniques (P = .78). Conclusions and Clinical Importance Suction pump aspiration, compared to MA, improved BALF retrieval, but did not significantly affect the rate of diagnostic success of bronchoalveolar lavage (BAL) in dogs with pulmonary disease.