G. C. Skerritt

Feline cerebrovascular disease: clinical and histopathologic findings in 16 cats.

Sixteen cats with cerebrovascular disease confirmed via histology to be of nontraumatic and nonneoplastic origins are described. In addition, the anatomy of the arterial supply of the cats brain is reviewed. It is suggested that this unique arterial design may influence the incidence of cerebrovascular accidents in this species. Of the 16 cats reviewed, seven cats had ischemic infarctions, five had hemorrhagic infarctions, and four were diagnosed with intracranial hemorrhage. The median age was 8 yr and 9.5 yr in cats with infarctions and intracranial hemorrhages, respectively. Clinical signs were severe, acute, consistent with the localization of the cerebrovascular lesion, and influenced by underlying pathology. Four cats with infarction showed lateralized neurologic signs. Four cats with infarctions were diagnosed with pulmonary disease antemortem and three cats had hyperthyroidism. Cerebrospinal fluid analysis and computed tomography scans were available in two cats. None of the infarctions were grossly visible. All cats with hemorrhagic infarcts had severe liver pathology and nephritis was identified in four cats. Hypoxia was a feature in four cats and one cat suffered cardiac failure. In conclusion, the clinical picture is influenced by the type of cerebrovascular disease, the localization of the intracranial lesions, and any underlying pathology.

Acute neurological signs as the predominant clinical manifestation in four dogs with Angiostrongylus vasorum infections in Denmark

Four dogs with acute neurological signs caused by haemorrhages in the central nervous system were diagnosed with Angiostrongylus vasorum infection as the underlying aetiology. Two dogs presented with brain lesions, one dog with spinal cord lesions and one with lesions in both the brain and spinal cord. Only one dog presented with concurrent signs of classical pulmonary angiostrongylosis (respiratory distress, cough), and only two dogs displayed overt clinical signs of haemorrhages. Results of coagulation assays were inconsistent. Neurological signs reflected the site of pathology and included seizures, various cranial nerve deficits, vestibular signs, proprioceptive deficits, ataxia and paraplegia. One dog died and three were euthanised due to lack of improvement despite medical treatment. This emphasises canine angiostrongylosis as a potential cause of fatal lesions of the central nervous system and the importance of including A. vasorum as a differential diagnosis in young dogs with acute neurological signs in Denmark.

Survival and clinical outcome of dogs with ischaemic stroke

The objectives of the present study were to investigate survival time, possible predictors of survival and clinical outcome in dogs with ischaemic stroke. A retrospective study of dogs with a previous diagnosis of ischaemic stroke diagnosed by magnetic resonance imaging (MRI) was performed. The association between survival and the hypothesised risk factors was examined using univariable exact logistic regression. Survival was examined using Kaplan-Meier and Cox regression. Twenty-two dogs were identified. Five dogs (23%) died within the first 30days of the stroke event. Median survival in 30-day survivors was 505days. Four dogs (18%) were still alive by the end of the study. Right-sided lesions posed a significantly increased risk of mortality with a median survival time in dogs with right-sided lesions of 24days vs. 602days in dogs with left sided lesions (P=0.006). Clinical outcome was considered excellent in seven of 17 (41%) 30-day survivors. Another seven 30-day survivors experienced new acute neurological signs within 6-17months of the initial stroke event; in two of those cases a new ischaemic stroke was confirmed by MRI. In conclusion, dogs with ischaemic stroke have a fair to good prognosis in terms of survival and clinical outcome. However, owners should be informed of the risk of acute death within 30days and of the possibility of new neurological events in survivors. Mortality was increased in dogs with right-sided lesions in this study.

Spontaneous ischaemic stroke in dogs: clinical topographic similarities to humans.

Translation of experimental stroke research into the clinical setting is often unsuccessful. Novel approaches are therefore desirable. As humans, pet dogs suffer from spontaneous ischaemic stroke and may hence offer new ways of studying genuine stroke injury mechanisms.

Syringosubarachnoid shunt as a management for syringohydromyelia in dogs

OBJECTIVE To evaluate retrospectively the efficacy of syringosubarachnoid shunt for the management of syringohydromyelia/syringomyelia. METHODS Eleven dogs diagnosed with syringohydromyelia/syringomyelia by magnetic resonance imaging associated with Chiari-like malformation underwent placement of a syringosubarachnoid shunt at the cervical (nine dogs) or lumbar (two dogs) spinal cord. In one dog, a suboccipital decompression (foramen magnum decompression) was performed 4 months before inserting a syringosubarachnoid shunt. All dogs were evaluated neurologically a few hours after surgery, 2 weeks and 6 months postoperatively. Retrospectively, cases were assigned a preoperative and postoperative pain score. RESULTS There were no intra- or peri-operative complications. One dog (9%) was euthanased 5 weeks after surgery. Progressive neurological improvement was observed in nine dogs (81·8%) 2 weeks and 6 months postoperatively. No clinical improvement was seen in another dog (9%). One dog (9%) had replacement of the syringosubarachnoid shunt. Seven dogs (63·6%) were still alive 1 to 4 years (mean, 2·6 years) after surgery. CLINICAL SIGNIFICANCE Placement of a syringosubarachnoid shunt in the presence of a sufficiently large syrinx appears to be beneficial in dogs with Chiari-like malformation and associated syringohydromyelia/syringomyelia.

Non-enhancing confirmed oligodendroglioma in three dogs

Recently, we encountered three adult neutered male brachycephalic dogs (one bull mastiff, one Dogue de Bordeaux and one boxer, mean age: eight years) with neurologic dysfunction resulting from intracranial histopathologically confirmed oligodendrogliomas. Magnetic resonance imaging (MRI) scans (VetMR Grande, 0·35 tesla, Esaote, Genova, Italy) of the brains revealed no enhancement on T1-weighted postcontrast (T1W-PC) images. In two cases, preand postcontrast fluid attenuated inversion recovery (FLAIR) sequences were carried out and no enhancement was visualised. Postcontrast images were acquired immediately after intravenous injection of 0·1 mmol/kg of gadolinium diethylenetriaminepenta-acetic acid dimeglumine (Magnevist, Schering AG, Germany). T2-weighting was considered the most sensitive sequence to detect and grossly localise the brain tumour. However, T2-weighted images, although showing increased signal intensity, could not be considered representative of the brain neoplasms because they did not clearly differentiate between tumour and oedema. Contrast enhancement is an important feature in locating and characterising intracranial lesions and it has been found to be significantly associated with canine and feline brain tumours (Cherubini and others 2005). On T1W-PC images, canine oligodendrogliomas typically exhibit a marked to mild heterogeneous enhancement sometimes characterised by a ring-like pattern (Kraft and others 1997, Snyder and others 2006, Young and others 2010). Over the past 20 years, there have been only five confirmed canine oligodendrogliomas showing no enhancement on T1W-PC images (Snyder and others 2006, Young and others 2010). In human beings and dogs, FLAIR sequence has been shown to be superior to contrast-enhanced T1-weighted imaging in demonstrating low-contrast lesions (Ercan and others 2004, Falzone and others 2008, Cha 2009). However, in this study, the FLAIR was not a useful technique and did not help in further characterisation of the brain lesions. In addition, there are no studies assessing the value of FLAIR sequence for canine oligodendrogliomas. We report these cases to show that oligodendrogliomas may not reveal contrast enhancement and to emphasise the importance of further brain tumour studies, based on the correlation between gross anatomy, grade of malignancy and MRI findings (Young and others 2010), subject to the development of new MRI techniques that may facilitate the visualisation of non-enhancing lesions.

New UK vet school

THE British Veterinary Hospitals Association (BVHA) congratulates the President of the BVA on his timely response to the news that the University of Surrey plans to open a new veterinary school in 2014 ( VR , November 3, 2012, vol 171, p 434). We agree that the increased number of graduates that would be expected in 2019 will result in too many veterinary surgeons …