A Review of Fibrocartilaginous Embolic Myelopathy and Different Types of Peracute Non-Compressive Intervertebral Disk Extrusions in Dogs and Cats

This review discusses terminology, pathologic, clinical and magnetic resonance imaging findings, treatment, outcome and prognostic factors of fibrocartilaginous embolic myelopathy (FCEM), acute non-compressive nucleus pulposus extrusion (ANNPE) and intradural/ intramedullary intervertebral disc extrusion (IIVDE). FCEM, ANNPE, and IIVDE have a similar clinical presentation characterised by peracute onset of neurologic dysfunction that is generally non progressive after the initial 24-48 hours. Differentiating between these conditions can be challenging, however certain clinical and imaging findings can help. FCEM can occur in both adult and immature animals, whereas ANNPE or IIVDE have been reported only in animals older than 1 year. In dogs, ANNPE and IIVDE most commonly occur in the intervertebral disc spaces between T12 and L2, whereas FCEM has not such site predilection. In cats, FCEM occurs more frequently in the cervical spinal cord than in other locations. Data on cats with ANNPE and IIVDE is limited. Optimal magnetic resonance imaging (MRI) definition and experience in neuroimaging can help identify the findings that allow differentiation between FCEM, ANNPE, and IIVDE. In animals with ANNPE and IIVDE the affected intervertebral disc space is often narrowed and the focal area of intramedullary hyperintensity on T2-weighted images is located above the affected intervertebral dis

Comparison of medical and surgical treatment for acute cervical compressive hydrated nucleus pulposus extrusion in dogs

Although successful outcomes have been reported after medical and surgical treatment for dogs with cervical hydrated nucleus pulposus extrusion (HNPE), it is unknown which treatment option is preferred. Thirty-four dogs treated medically (n=18) or surgically (n=16) for cervical HNPE were retrospectively identified. Signalment, clinical presentation and imaging findings were compared between medically and surgically treated dogs. Medical management consisted of restricted exercise in combination with physiotherapy. Surgical treatment consisted of a ventral slot procedure. Short-term follow-up information was retrieved from re-examination visits. Long-term outcome was obtained via telephone interviews. More dogs in the surgical group demonstrated cervical hyperaesthesia on initial clinical presentation (P=0.045), otherwise there was no significant difference in signalment, clinical presentation or imaging findings between both groups. Two dogs in the medically managed group underwent surgical decompression due to an unsatisfactory response to medical management. All cases for which long-term information was available (n=30) were neurologically normal at the time of data collection. There were no significant differences for any of the short-term or long-term outcome variables between both treatment groups. This study demonstrated successful outcomes after medical or surgical treatment and suggests that both treatment modalities can be considered for dogs with cervical HNPE

Clinical reasoning in canine spinal disease: what combination of clinical information is useful?

Spinal disease in dogs is commonly encountered in veterinary practice. Numerous diseases may cause similar clinical signs and presenting histories. The study objective was to use statistical models to identify combinations of discrete parameters from the patient signalment, history and neurological examination that could suggest the most likely diagnoses with statistical significance. A retrospective study of 500 dogs referred to the Queen Mother Hospital for Animals before June 2012 for the investigation of spinal disease was performed. Details regarding signalment, history, physical and neurological examinations, neuroanatomical localisation and imaging data were obtained. Univariate analyses of variables (breed, age, weight, onset, deterioration, pain, asymmetry, neuroanatomical localisation) were performed, and variables were retained in a multivariate logistic regression model if P<0.05. Leading diagnoses were intervertebral disc extrusion (IVDE, n=149), intervertebral disc protrusion (n=149), ischaemic myelopathy (IM, n=48) and neoplasms (n=44). Multivariate logistic regression characterised IM and acute non-compressive nucleus pulposus extrusions as the only peracute onset, non-progressive, non-painful and asymmetrical T3-L3 myelopathies. IVDE was most commonly characterised as acute onset, often deteriorating, painful and largely symmetrical T3-L3 myelopathy. This study suggests that most spinal diseases cause distinctive combinations of presenting clinical parameters (signalment, onset, deterioration, pain, asymmetry, neuroanatomical localisation). Taking particular account of these parameters may aid decision making in a clinical setting

Clinical presentation, diagnostic findings and outcome of dogs with presumptive spinal-only meningoencephalomyelitis of unknown origin

Objectives: To summarise clinical presentation, diagnostic findings and long-term outcome for dogs clinically diagnosed with meningoencephalomyelitis of unknown origin affecting the spinal cord alone. Methods: Medical records were reviewed for dogs diagnosed with presumptive spinal-only meningoencephalomyelitis of unknown origin between 2006 and 2015. Results: 21 dogs were included; the majority presented with an acute (43%) or chronic (52%) onset of neurological signs. Ambulatory paresis was the most common neurological presentation (67%). Neurological examination most commonly revealed a T3-L3 myelopathy, and spinal hyperaesthesia was a common finding (71%). A spinal cord lesion was visible in 90% of cases on magnetic resonance imaging. Eighteen lesions (86%) showed parenchymal contrast enhancement and 17 lesions (81%) showed contrast enhancement of overlying meninges. All dogs were treated with immunosuppressive doses of glucocorticosteroids, sometimes combined with cytosine arabinoside. At time of data capture, 10/21 dogs (48%) had died or been euthanased because of the condition. Overall median survival time was 669 days. Clinical Significance: Meningoencephalomyelitis of unknown origin should be considered in the differential diagnosis of dogs presenting with a progressive myelopathy. Magnetic resonance imaging features can possibly help to distinguish presumptive meningoencephalomyelitis of unknown origin from other more common spinal diseases. Overall, long-term survival is guarded, approximately 50% of dogs will die or be euthanased despite appropriate therapy

Algorithms for Automatic, Real-Time Tsunami Detection in Sea Level Measurements

Automatic, real-time tsunami detection in sea-level measurements is a main component of a tsunami early warning system (TEWS). Although a great effort has been recently undertaken by the scientific and engineering community in developing new technologies (e.g. satellite altimetry, detectors of low-frequency elastic oscillations associated to a tsunami) capable of increasing the awareness of potential tsunamis in the minimum amount of time, at present direct detection in sea level measurements is still the main mean to confirm their actual generation and propagation, i.e. to upgrade or cancel the rapid initial warning usually given on the sole basis of seismic data. The paper describes the best available algorithms and numerical techniques which can be used for automatic real-time tsunami detection by using sea level measurements. The paper takes into consideration all possible device and locations for the sea level detection

Investigating the potential of the anti-epileptic drug imepitoin as a treatment for co-morbid anxiety in dogs with idiopathic epilepsy

Abstract Background Behavioural changes associated with idiopathic epilepsy (IE) have been identified in dogs, with fear and anxiety-related problems seen in both drug-naïve dogs and dogs treated with anti-epileptic drugs (AEDs). Treating anxiety-related behaviour in dogs with IE may be challenging, as seizures are a contraindication for many conventional anxiolytic drugs. In addition, many dogs with IE are already treated with AEDs to reduce their seizure frequency, which may have negative effects if used in polytherapy. Imepitoin is low-affinity partial agonist at the benzodiazepine (BDZ) site of the GABAA receptor, and has been demonstrated to have both anticonvulsant and anxiolytic effects in laboratory rodents. Imepitoin has been developed for the treatment of IE in dogs, with demonstrated anticonvulsant effects and high tolerability and safety. To date, imepitoin’s potential to reduce anxiety in dogs with IE has not been investigated. An online survey was conducted to investigate the effect of imepitoin on fear and anxiety-related behaviours in dogs with IE. Eighty-five valid responses were received from owners of dogs with IE currently treated with imepitoin. Anxiety-related behaviour was quantified before and during imepitoin treatment using a validated questionnaire tool (C-BARQ). Results No differences were observed in the five fear/anxiety-related measures between the two time periods (before vs. during treatment) for dog directed fear, stranger directed fear, non-social fear, pain sensitivity and separation related behaviour. A median 45% reduction in seizure frequency/month was observed following imepitoin treatment; however, imepitoin did not appear effective in reducing seizure frequency in a minority of cases. Polyphagia was the most common chronic side effect, and more side effects were reported in polytherapy cases. Conclusions Imepitoin does not appear to improve anxiety-related behaviour in dogs with IE treated with this medication for its anti-epileptic effects. Investigating the effects of imepitoin upon the behaviour of dogs with recognised behavioural anxiety-related problems (e.g. specific fears and phobias, separation related behaviours), in both healthy dogs and dogs with epilepsy is required to further explore any potential anxiolytic effects of this medication