Rodolfo Cappello

Syringohydromyelia in Cavalier King Charles spaniels.

Syringohydromyelia secondary to foramen magnum overcrowding is described in seven Cavalier King Charles spaniels. Clinical signs were consistent with a central spinal cord lesion. The most common signs were persistent scratching at the shoulder region with apparent neck, thoracic limb, or ear pain and thoracic limb lower motor neuron deficits. The diagnosis was made by magnetic resonance imaging. The syringohydromyelia is postulated to be a consequence of an occipital bone malformation resulting in a small caudal fossa and cerebellar herniation. Clinical signs improved but did not completely resolve when the dogs received treatment with corticosteroids or nonsteroidal anti-inflammatory drugs.

Brain and spinal cord haemorrhages associated with Angiostrongylus vasorum infection in four dogs

Multifocal haemorrhages associated with Angiostrongylus vasorum infection were observed in the central nervous system of four dogs with neurological signs including depression, seizures, spinal pain and paresis. In magnetic resonance images the majority of the lesions were isointense or slightly hyperintense in T1-weighted images, hyperintense in T2-weighted images and hypointense in T2*-weighted (gradient echo) images, compatible with haemorrhages more than seven days old. Lesions were found in the brain of three of the dogs and in the spinal cord of two. The cerebrospinal fluid contained high concentrations of protein and evidence of erythrophagia. All the dogs had coagulopathy and pulmonary haemorrhage of varying severity. A vasorum larvae were detected in the faeces of each of the dogs. Neural A vasorum was confirmed at postmortem examination in two dogs.

Characteristics of magnetic resonance images of granulomatous meningoencephalomyelitis in 11 dogs

The characteristics of magnetic resonance imaging (mri) of the brains and spinal cords of 11 dogs with histologically confirmed granulomatous meningoencephalomyelitis (gme) were determined. The lesions were in the brain of eight of the dogs, in the brain and spinal cord of two, and in the spinal cord alone in one dog. A single lesion was present in four of the dogs and multiple lesions were found in six. In one dog with intracranial signs, no visible lesions could be detected on mri. No meningeal enhancement was detected in T1-weighted images post-contrast, or in fluid attenuation inversion recovery (flair) images, but there were histological lesions in the meninges in nine of the dogs. The T2-weighted images and flair sequences were characterised in all cases by hyperintensity, whereas the signal intensity of the lesions on T1-weighted images was variable. After the administration of paramagnetic contrast, some of the lesions showed no enhancement, but others showed marked patterns of enhancement. The lesions in 10 of the dogs were easily identifiable by mri and the images had several unifying characteristics, but they could not be considered disease-specific.

Comparison of cerebral cranium volumes between cavalier King Charles spaniels with Chiari‐like malformation, small breed dogs and Labradors

OBJECTIVES To ascertain whether cavalier King Charles spaniels (CKCSs) have a proportionately smaller caudal fossa compared with other small dogs and with Labradors. To evaluate if cerebellar herniation in CKCS correlates with caudal fossa volume. METHODS In this retrospective study, three-dimensional images were created from magnetic resonance imaging brain series of 117 dogs (split into three groups: CKCS, Labradors and small breeds) from which the volumes of the fossae and brain parenchyma were calculated. These volumes were transformed into percentages of total cranial cavity and parenchyma volumes, respectively. The percentages were statistically compared among the groups. The percentage of herniated cerebellum in the CKCS was compared using linear regression with the caudal fossa and parenchyma percentages. RESULTS Cavalier King Charles spaniels had a proportionately smaller caudal fossa compared with Labradors (P=0.002) but not to small breeds (P=0.103). Their caudal fossa parenchyma was proportionately the same volume as Labradors (P=0.976) but greater than small breeds (P=0.005). No relationship was found for the per cent of cerebellum herniated. CLINICAL SIGNIFICANCE The results support mesoderm insufficiency or craniosynostosis as the pathogenesis of Chiari-like malformation (CM) in CKCS. It presents evidence for overcrowding of the caudal fossa due to a mismatch of brain parenchyma and fossa volumes as to why CKCS and not other small dogs are affected.

Results of magnetic resonance imaging in 14 cats with meningoencephalitis

Medical records and magnetic resonance (MR) images of 14 cats with inflammatory diseases affecting the central nervous system (CNS) were reviewed retrospectively. Cases included eight cats with feline infectious peritonitis and two cats with toxoplasmosis. Abnormalities affecting the CNS were observed in MR images in 10 (71%) cats. Intracranial lesions appeared as slightly hypointense foci in T1-weighted images in two (14%) cats, as hyperintense foci in T2-weighted images in seven (50%) cats and as hyperintense foci after intravenous administration of a gadolinium-based contrast medium in 10 (71%) cats. In six cats with lesions in T1- and/or T2-weighted images, additional lesions were visible in T1-weighted images obtained after gadolinium-based contrast medium administration. In three cats, lesions were visible only after contrast medium administration. In our study, MR imaging (MRI) did not appear to detect all cases of CNS inflammation in the population of cats with inflammatory cerebrospinal fluid (CSF); however, MRI adds information about the sites and morphology of intracranial lesions that should help to distinguish between neoplasia and inflammatory conditions and, possibly, between different inflammatory conditions.

Clinical and pathological observations in English cocker spaniels with primary metabolic vitamin E deficiency and retinal pigment epithelial dystrophy

Fifteen English cocker spaniels with confirmed vitamin E deficiency were examined physically, ophthalmologically and neurologically. Eleven of them had clinical signs of neurological dysfunction which included ataxia, proprioceptive deficits, abnormal spinal reflexes and muscle weakness. In the two dogs examined histopathologically there was central neuronal fibre degeneration with prominent neuroaxonal dystrophy, particularly within the sensory relay nuclei of the brainstem, and one of the dogs had severe intestinal lipofuscinosis.

Dermatomyositis in five Shetland sheepdogs in the United Kingdom

Five cases of dermatomyositis in four Shetland sheepdog puppies and one adult bitch are described. The dogs all had well-defined patches of scaling, crusting and alopecia over the muzzle, periorbital skin and distal limbs, and the tail, perineum and pinnae were affected in some of them. The affected puppies were all sired by the same stud dog. The affected adult bitch was unrelated to the puppies. Three of the four dogs tested had high serum creatine kinase concentrations and electromyographic abnormalities were detected in three of the four dogs tested. The histological changes observed in the skin of four of the dogs strongly supported the diagnosis of dermatomyositis, and in the fifth dog they were compatible with this diagnosis. Two of the puppies were euthanased shortly after being diagnosed. In the other two puppies and the adult the disease remains stable and non-progressive 15 to 18 months after diagnosis. The sire of the four affected puppies has been used extensively because it was considered to be genetically clear of collie eye anomaly.

Nodo-paranodopathy, internodopathy and cleftopathy: Target-based reclassification of Guillain–Barré-like immune-mediated polyradiculoneuropathies in dogs and cats

Recent views on Guillain-Barré syndrome (GBS) question the accuracy of classification into axonal and demyelinating subtypes that represent convergent neurophysiological phenotypes rather than immunological targets. Instead it has been proposed to clarify the primarily affected fibre subunit in nerve biopsies. As nerve biopsies rarely are part of routine work-up in human patients we evaluated tissues taken from companion animals affected by GBS-like polyradiculoneuropathy to screen for distribution of immune cells, targeted fibre components and segregating non-inflammatory lesions. We identified that immune responses were directed either at Schmidt-Lanterman clefts, the paranode-node complex or both. Based on infiltrative and non-inflammatory changes, four subtypes and/or stages were distinguished, some of which indicate localisation of primary target antigens while others represent convergent late stage pictures, as a consequence to epitope spreading. The impact of histological subtyping onto clinical management and prognosis remains to be evaluated in future clinical trials. Natural development and clinical manifestation of large animal dysimmune neuropathy may reflect human Guillain-Barré syndrome more accurately than experimental models and therefore provide complementary clues for translational research.

Vertebral epidermoid cyst causing hemiparesis in a dog

DERMOID and epidermoid cysts are congenital inclusion cysts that arise from cutaneous ectodermal tissue trapped in the brain or spine as a result of incomplete cleavage of neural ectoderm from cutaneous ectoderm at the time of closure of the neural tube (Kanev and Park 1995, Smirniotopoulos and Chiechi 1995). Both types of cyst are lined by centrally keratinising, stratified squamous epithelium supported by connective tissue stroma. Epidermoid cysts are similar to non-congenital follicular cysts in the dermis, and contain desquamated epithelial cells that break down into keratin and cholesterol. The dermoid cyst wall is more complex because it also contains adnexal structures, such as sebaceous and apocrine glands and hair follicles. Dermoid cysts may be distinguished grossly from epidermoid cysts because they contain hairs, glandular tissue and fat. Intracranial and spinal dermoid or epidermoid cysts have been reported sporadically in dogs (Mawdesley-Thomas and Hague 1970, Kornegay and Gorgacz 1982, HowardMartin and Bowles 1988, Kawaminami and others 1991, Platt and others 1999, Targett and others 1999, Tshamala and Moens 2000). Affected animals may be young at the time of diagnosis, which reflects the congenital nature of these lesions; however, the diagnosis may also be made in older animals, because some lesions grow very slowly and may not be recognised until they are large. Neurological signs occur as a result of compression of the adjacent neural structures. This short communication describes the clinical and radiographic signs and the surgical findings in a dog with a vertebral epidermoid cyst causing progressive paraparesis. A five-year-old female boxer dog had gradually progressive signs of pelvic limb ataxia over a period of six months. Empirical treatment with 5 mg prednisolone once daily was associated with a reduction in signs. Radiographs made by the referring veterinarian showed possible sclerosis affecting the dorsal lamina of T13, and myelography revealed an extradural lesion at this site that displaced the spinal cord to the left and obstructed the flow of contrast medium. The dog was referred for further diagnostic work-up and treatment. Neurologically, the dog was moderately ataxic with reduced proprioception affecting the pelvic limbs; the right pelvic limb was affected more than the left. There was evidence of pain on palpation of the thoracolumbar region. The right patellar and cranial tibial reflexes were slightly increased. Radiographs of the spine revealed a focal lucent lesion affecting the pedicle and dorsal lamina of T13 (Fig 1). The margins of the lesions were smooth and relatively well defined; adjacent bone appeared sclerotic. Computed x-ray tomo graphy (CT) showed the extent of the lesion more clearly: it also affected the vertebral body, and marked sclerosis affected the adjacent right pedicle and dorsal lamina (Fig 2). The average (sd) attenuation of the lesion was 47 (81) Hounsfield units (HU); the wide sd suggested the presence of a lipid component. Recognition that the spinal cord was displaced to the left was possible because of the presence of slight dural ossification in some CT images. No contrast medium was administered. The lesion was surgically removed by a right hemilaminectomy. A friable, grey-green mass covered by a thin membrane was discovered, which could be dissected from the adjacent bone. Once the mass was removed, the underlying bone appeared smooth and regular. The dog was discharged the day after surgery and the owner was given instructions to impose strict rest. Bacterial and fungal cultures of the resected tissue produced no growth. Histological examination of the multiple tissue fragments showed acanthotic and hyperkeratinised, pigmented, stratified squamous epithelium adjacent to bone (Fig 3). Keratin was orthokeratotic. There was no inflammation and melanophages were rare. These features supported a diagnosis of an epidermoid cyst. The differential diagnosis of a pilomatricoma was considered unlikely because of the absence of basal cell proliferation. The lack of inflammation suggested that the cyst was intact before surgery. The dog was re-examined four weeks after surgery; signs of spinal pain were reduced, but the dog had a similar degree of ataxia as when it was first examined. Seven months after surgery, the dog showed no signs of pain but remained mildly ataxic. The epidermoid cyst described here represents an unusual finding because of its location, the extent of the bone Veterinary Record (2006) 158, 865-867

Ventral stabilization of thoracic kyphosis through bilateral intercostal thoracotomies using SOP (String of Pearls) plates contoured after a 3-dimensional print of the spine

OBJECTIVE To describe a novel vertebral body stabilization and report its outcome in dogs with thoracic kyphosis and secondary myelopathy. STUDY DESIGN Case series. ANIMALS Six pugs with thoracic kyphosis and secondary myelopathy. METHODS Medical records (2012-2017) of dogs with chronic progressive pelvic limb ataxia and ambulatory proprioceptive paraparesis due to thoracic kyphosis were reviewed. Dogs were evaluated via MRI and computed tomography. A 3-dimensional print of the kyphotic vertebral segment was used to precontour the SOP (String of Pearls) plates. Bilateral double, dorsal intercostal thoracotomies were performed to place precontoured SOP on the vertebral bodies. Long-term (6-16 months) clinical outcome was determined on the basis of neurological scoring (NS) and owner questionnaire. RESULTS The only intraoperative complication consisted of a lung laceration due to preexisting adhesions. Postoperative complications included seroma formation (n = 2) and incidental radiographic evidence of screw breakage (n = 2). NS at presentation ranged between 2 and 4 and improved to 1 at long-term follow-up in all dogs but 1 (NS = 2). All owners felt that their dog had excellent quality of life at follow-up. CONCLUSION In spite of the challenging local anatomy, all dogs undergoing vertebral stabilization with SOP placement experienced a good clinical outcome. CLINICAL SIGNIFICANCE Stabilization of vertebral bodies with precontoured SOP placed through bilateral thoracotomies may be considered as a treatment option for dogs with thoracic kyphosis and secondary myelopathy.