Publications by authors named "Peter J Early"

19 Publications

  • Page 1 of 1

The bioavailability of cytarabine in dogs with meningoencephalitis of unknown etiology through iontophoresis and rectal delivery.

Open Vet J 2021 Jan-Mar;11(1):36-38. Epub 2021 Jan 17.

NC State University Veterinary Hospital, 1052 William Moore Drive, Raleigh, NC, 27607, USA.

Background: Cytarabine (CA) is used to treat dogs with meningoencephalitis of unknown etiology (MUE) by subcutaneous or intravenous administration.

Aim: The objective was to investigate transdermal iontophoresis and rectal administration as alternative routes of CA delivery.

Methods: Two client-owned dogs with MUE were studied. The ActivaPatch® IONTOGO™ 12.0 iontophoresis drug delivery system delivered 200 mg/m2 CA transdermally. Blood samples were collected by sparse sampling technique after initiation of the device. At another visit, 100 mg/m2 CA was administered rectally. Blood samples were collected by sparse sampling technique after administration. Plasma CA concentrations were measured by high-pressure liquid chromatography.

Results: The concentration of plasma CA after transdermal and rectal administration was below the limits of quantification (0.1 μg/ml) in all samples suggesting inadequate bioavailability with transdermal and rectal administration.

Conclusion: Transdermal and rectal CA administration are not reasonable alternative routes of delivery.
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http://dx.doi.org/10.4314/ovj.v11i1.6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8057209PMC
January 2021

Ultrasound-guided perineural injections for the medical management of thoracic limb root signature in a dog.

Vet Anaesth Analg 2021 May 19;48(3):480-482. Epub 2021 Mar 19.

Department of Medical Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA.

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http://dx.doi.org/10.1016/j.vaa.2021.03.003DOI Listing
May 2021

Ultrasound-guided paravertebral perineural glucocorticoid injection for signs of refractory cervical pain associated with foraminal intervertebral disk protrusion in four dogs.

J Am Vet Med Assoc 2021 May;258(9):999-1006

Case Description: 4 dogs, 7.5 to 10 years of age, were presented for evaluation of signs of chronic cervical pain and forelimb lameness secondary to cervical foraminal intervertebral disk protrusion (IVDP). All dogs were refractory to ≥ 2 weeks of conservative management including strict rest and pain management with anti-inflammatory drugs, methocarbamol, and gabapentin.

Clinical Findings: The MRI findings included left foraminal IVDP at C2-3 causing mild C3 nerve root compression (dog 1), multifocal degenerative disk disease with mild focal left-sided disk protrusion at C6-7 without associated spinal cord or nerve root compression (dog 2), left foraminal C6-7 IVDP with suspected focal spinal cord atrophy or mild compression (dog 3), and right foraminal C6-7 IVDP and multifocal cervical intervertebral disk degeneration with annulus fibrosus protrusion (dog 4).

Treatment And Outcome: Ultrasound-guided paravertebral perineural injections with methylprednisolone acetate (1 mg/kg [0.45 mg/lb]) at the C3 nerve root in dog 1 and at the C7 nerve root in the other 3 dogs were performed. Injections were repeated at intervals of 4 weeks to 3 months on the basis of clinical response. None of the dogs had any complications from the procedures. For dogs 1 and 4, there was complete resolution of lameness and signs of cervical pain following perineural injections, and for dog 3, there was complete resolution of lameness and only minimal residual cervical pain. Dog 2 did not have long-lasting improvement.

Clinical Relevance: Findings indicated that ultrasound-guided paravertebral perineural injection can be an effective treatment of cervical foraminal IVDP for some dogs. Additional studies to determine appropriate case selection and better assess the overall success rate and risks associated with this technique are warranted.
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http://dx.doi.org/10.2460/javma.258.9.999DOI Listing
May 2021

Outcomes and prognostic indicators in 59 paraplegic medium to large breed dogs with extensive epidural hemorrhage secondary to thoracolumbar disc extrusion.

Vet Surg 2021 Apr 19;50(3):527-536. Epub 2021 Feb 19.

North Carolina State University College of Veterinary Medicine, Raleigh, North Carolina.

Objective: To evaluate outcomes and prognostic factors after decompressive hemilaminectomy in paraplegic medium to large breed dogs with extensive epidural hemorrhage (DEEH) and thoracolumbar intervertebral disc extrusion (TL-IVDE).

Study Design: Retrospective, cohort, descriptive study.

Animals: Fifty-nine client-owned dogs.

Methods: Medical records and advanced imaging were reviewed for paraplegic dogs with DEEH. Ambulatory status 6 months after surgery and postoperative complications were recorded. Multiple logistic regression models were constructed to explore prognostic factors.

Results: Records of 22 dogs with and 37 dogs without pelvic limb pain perception at presentation were included. Median age of dogs was 5 years (interquartile range, 4-7), and mean weight was 26.9 kg (SD, ±9.71). Labradors and Labrador mixes were most common (17/59 [28.8%]). Recovery of ambulation occurred in 17 of 22 (77.3%) dogs with and in 14 of 37 (37.8%) dogs without pain perception prior to surgery. Progressive myelomalacia was recorded in three of 59 (5.1%) dogs, one with pain perception and two without pain perception at presentation. Postoperative complications (14/59 [23.7%]) were common. Factors independently associated with outcome included clinical severity (odds ratio [OR] 0.179, P = .005), number of vertebrae with signal interruption in half Fourier single-shot turbo spin-echo sequences (HASTEi; OR, 0.738; P = .035), and ratio of vertebral sites decompressed to HASTEi (OR, 53.79; P = .03).

Conclusion: Paraplegic medium to large breed dogs with DEEH have a less favorable outcome after surgical decompression than paraplegic dogs with TL-IVDE.

Clinical Significance: Dogs with DEEH can have severe postoperative complications. Loss of pain perception and increased HASTEi are associated with a poor outcome, while more extensive decompression improves outcome.
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http://dx.doi.org/10.1111/vsu.13592DOI Listing
April 2021

Continuous rate infusion of midazolam as emergent treatment for seizures in dogs.

J Vet Intern Med 2021 Jan 16;35(1):388-396. Epub 2020 Dec 16.

Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA.

Background: Midazolam delivered by continuous rate infusion (CRI) might be effective in dogs with cluster seizures (CS) or status epilepticus (SE).

Objective: To describe the use and safety of midazolam CRI in dogs with CS or SE.

Animals: One-hundred six client-owned dogs presenting to a veterinary teaching hospital with CS or SE.

Methods: Retrospective review of medical records for dogs with CS or SE treated with a midazolam CRI.

Results: Seventy-nine dogs presented with CS and 27 dogs had SE. Seizure control was achieved in 82/106 dogs (77.4%) receiving a midazolam CRI. The median dose associated with seizure control was 0.3 mg/kg/h (range, 0.1-2.5 mg/kg/h). The median duration of CRI was 25 hours (range, 2-96 hours). Seizures were controlled in 34/40 dogs (85%) with idiopathic epilepsy, 32/43 dogs (74%) with structural epilepsy, 12/16 dogs (75%) with unknown epilepsy, and 4/7 dogs (57%) with reactive seizures (P = .20). Seizure control was achieved in 81% of dogs with CS and 67% in dogs with SE (P = .18). Dogs with idiopathic/unknown epilepsy were more likely to survive than those with structural epilepsy (87% vs 63%, P = .009). Adverse effects were reported in 24 dogs (22.6%) and were mild in all cases.

Conclusions And Clinical Importance: Midazolam CRI is apparently safe and might be an effective treatment in dogs with CS or SE.
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http://dx.doi.org/10.1111/jvim.15993DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7848341PMC
January 2021

Cerebrospinal fluid lactate concentrations in dogs with seizure disorders.

J Vet Intern Med 2020 Nov 2;34(6):2562-2570. Epub 2020 Nov 2.

Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA.

Background: Cerebrospinal fluid (CSF) lactate concentrations increase after seizure activity in many human patients independent of the underlying disease process. The effect of seizure activity on CSF lactate concentration in dogs is unknown.

Hypothesis/objectives: Cerebrospinal fluid lactate concentration is unaffected by seizure activity in dogs and is more dependent on the underlying disease process causing the seizures.

Animals: One-hundred eighteen client-owned dogs with seizure disorders.

Methods: Case series. Cerebrospinal fluid lactate concentration was determined using a commercially available lactate monitor. Seizure semiology, time from last seizure to CSF collection, number of seizures within the 72 hours preceding CSF collection, and clinical diagnosis were recorded.

Results: Dogs with focal seizures had higher CSF lactate concentrations than did those with generalized seizures (P = .03). No differences in lactate concentrations were found among dogs with single seizures, cluster seizures or status epilepticus (P = .12), among dogs with CSF collection at different time points after the last seizure activity (P = .39) or among dogs having different numbers of seizures within the 72 hours preceding CSF collection (P = .42). A significant difference (P = .001) was found in CSF lactate concentrations among diagnostic groups, and dogs with inflammatory and neoplastic disease had higher concentrations than did dogs with idiopathic or unknown epilepsy.

Conclusions And Clinical Importance: Cerebrospinal fluid lactate concentration is minimally affected by seizure activity in dogs and increased concentrations are more likely associated with the underlying disease process.
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http://dx.doi.org/10.1111/jvim.15953DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7694838PMC
November 2020

Influence of Duration of Injury on Diffusion Tensor Imaging in Acute Canine Spinal Cord Injury.

J Neurotrauma 2020 11 10;37(21):2261-2267. Epub 2020 Aug 10.

Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA.

Diffusion tensor imaging (DTI) quantifies microstructural lesion characteristics, but impact of the interval between spinal cord injury (SCI) and examination on imaging characteristics is unclear. Our objective was to investigate the impact of duration of injury on DTI indices in dogs with acute, spontaneous SCI from thoracolumbar intervertebral disc herniation (IVDH) and explore associations with clinical severity. Twenty-six dogs with acute thoracolumbar IVDH of variable severity who underwent DTI were included. Neurological severity was graded using the modified Frankel Score (0-V). Fractional anisotropy (FA) and mean diffusivity (MD) were calculated on regions of interest within and adjacent to the lesion epicenter. Relationships between FA or MD and duration (injury to imaging interval) or neurological severity were determined using regression analysis and Wilcoxon rank sum. Median age was 6.8 years (1-13), median duration was 1.5 days (1-9), and neurological signs ranged from ambulatory paraparesis (MFS II) to paraplegia with absent pain perception (MFS V). Mean FA was 0.61 ± 0.09 cranial to the lesion, 0.57 ± 0.12 at the epicenter and 0.55 ± 0.10 caudally. Mean MD was 1.18 10 ± 0.0002 cranially, 1.09 10 ± 0.0002 at the epicenter, and 1.14 10 ± 0.0002 caudally. Accounting for neurological severity and age, FA caudal to the epicenter decreased with increasing duration of injury ( = 0.02). Lower MD within the lesion epicenter was associated with worse neurological severity ( = 0.01). Duration of injury should be considered when interpreting DTI results in dogs with acute thoracolumbar IVDH. The MD might differentiate injury severity in the acute setting and be worthy of development as an imaging biomarker.
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http://dx.doi.org/10.1089/neu.2019.6786DOI Listing
November 2020

An update on hemilaminectomy of the cranial thoracic spine: Review of six cases.

Open Vet J 2020 04 29;10(1):16-21. Epub 2020 Jan 29.

Purdue University College of Veterinary Medicine, West Lafayette IN 47907, USA.

Background: The optimal surgical approach to relieve spinal cord compression in the cranial thoracic spine is not well described, and the anatomy of the cranial thoracic vertebrae creates added surgical difficulty.

Aim: This study describes the surgical approach, treatment, and outcome of three dogs and three cats that underwent a cranial thoracic hemilaminectomy for the treatment of extradural spinal cord compression. Surgical positioning was tailored to avoid extensive dissection and provide for a restricted, careful approach.

Methods: Three dogs and three cats presenting for cranial thoracic spinal cord compression requiring surgical intervention were included.

Results: All patients were discharged within 5 days. No patients experienced postoperative deterioration in neurologic status, and four animals had improved neurologic status at discharge.

Conclusion: In cases with cranial thoracic spinal cord compression, the spinous processes can be spared, extensive muscle dissection minimized, and successful outcomes achieved with the appropriate positioning and limited approach.
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http://dx.doi.org/10.4314/ovj.v10i1.4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7193876PMC
April 2020

Association between anesthesia duration and outcome in dogs with surgically treated acute severe spinal cord injury caused by thoracolumbar intervertebral disk herniation.

J Vet Intern Med 2020 Jul 17;34(4):1507-1513. Epub 2020 May 17.

The Canine Spinal Cord Injury Consortium (CANSORT-SCI).

Background: Retrospective research recently identified a possible relationship between duration of surgery and outcome in severely affected dogs treated surgically for acute thoracolumbar intervertebral disk herniation (TL-IVDH).

Hypothesis: That increased duration of surgery is associated with poorer outcome in dogs with absent pain perception treated surgically for TL-IVDH.

Animals: Two hundred ninety-seven paraplegic dogs with absent pain perception surgically treated for acute TL-IVDH.

Methods: Retrospective cohort study. Medical records of 5 institutions were reviewed. Inclusion criteria were paraplegia with absence of pain perception, surgical treatment of TL-IVDH, and 1-year postoperative outcome (ambulatory: yes or no). Canine data, outcome, and surgery and total anesthesia duration were retrieved.

Results: In this study, 183/297 (61.6%) dogs were ambulatory within 1 year, 114 (38.4%) dogs failed to recover, including 74 dogs (24.9%) euthanized because of progressive myelomalacia. Median anesthesia duration in dogs that regained ambulation within 1 year of surgery (4.0 hours, interquartile range [IQR] 3.2-5.1) was significantly shorter than those that did not (4.5 hours, IQR 3.7-5.6, P = .01). Multivariable logistic regression demonstrated a significant negative association between both duration of surgery and total anesthesia time and ambulation at 1 year when controlling for body weight and number of disk spaces operated on.

Conclusions And Clinical Importance: Findings support a negative association between increased duration of anesthesia and outcome in this group of dogs. However, the retrospective nature of the data does not imply a causal relationship.
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http://dx.doi.org/10.1111/jvim.15796DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7379036PMC
July 2020

Evaluation of a collar-mounted accelerometer for detecting seizure activity in dogs.

J Vet Intern Med 2020 May 15;34(3):1239-1247. Epub 2020 Apr 15.

Whistle Laboratories, San Francisco, California, United States.

Background: The majority of dogs with idiopathic epilepsy continue to have seizures despite appropriate treatment.

Objectives: To assess the use of a commercially available, collar-mounted accelerometer to detect generalized seizures in dogs.

Animals: Twenty two client-owned dogs with idiopathic epilepsy.

Methods: Six-month prospective clinical study during which dogs wore a collar-mounted accelerometer. Seizure documentation was based on owner observations and video recordings. The accelerometer used a predefined algorithm to detect seizures in the first study phase, and an individualized algorithm in the second study phase. Caregivers completed a quality of life (QoL) questionnaire at the initial and final study visit.

Results: Using the predefined algorithm, the accelerometer detected seizures with a sensitivity of 18.6% (95% CI [13.4%, 23.8%]) and mean false detection rate of 0.096/day. Values did not change significantly with use of an individualized algorithm (sensitivity 22.1%, 95% CI [15.1%, 29.0%]; false detection rate 0.054/day). Mean composite QoL score was significantly improved at study completion (50.42) compared to study initiation (39.53; P = .005), and this change was moderately correlated with a change in weekly exercise (r = 0.46, P = .05).

Conclusions And Clinical Importance: Generalized seizures in dogs can be detected with a collar-mounted accelerometer, but the overall sensitivity is low.
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http://dx.doi.org/10.1111/jvim.15760DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7255659PMC
May 2020

Risk factors associated with progressive myelomalacia in dogs with complete sensorimotor loss following intervertebral disc extrusion: a retrospective case-control study.

BMC Vet Res 2019 Dec 3;15(1):433. Epub 2019 Dec 3.

Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA.

Background: Progressive myelomalacia (PMM) is a usually fatal complication of acute intervertebral disc extrusion (IVDE) in dogs but its risk factors are poorly understood. The objective of this retrospective case-control study was to identify risk factors for PMM by comparing dogs with complete sensorimotor loss following IVDE that did and did not develop the disease after surgery. We also investigated whether any risk factors for PMM influenced return of ambulation. Medical records of client-owned dogs with paraplegia and loss of pain perception that underwent surgery for IVDE from 1998 to 2016, were reviewed. Dogs were categorized as PMM yes or no based on clinical progression or histopathology. Walking outcome at 6 months was established. Signalment, onset and duration of signs (categorized), steroids, non-steroidal anti-inflammatory drugs (yes or no), site of IVDE (lumbar intumescence or thoracolumbar) and longitudinal extent of IVDE were retrieved and their associations with PMM and walking outcome were examined using logistic regression.

Results: One hundred and ninety seven dogs were included, 45 with and 152 without PMM. A 6-month-outcome was available in 178 dogs (all 45 PMM dogs and 133 control dogs); 86 recovered walking (all in the control group). Disc extrusions at the lumbar intumescence were associated with PMM (p = 0.01, OR: 3.02, CI: 1.3-7.2). Surgery performed more than 12 h after loss of ambulation was associated with PMM (OR = 3.4; CI = 1.1-10.5, p = 0.03 for 12-24 h and OR = 4.6; CI = 1.3-16.6, p = 0.02 for the > 24 h categories when compared with the ≤12 h category). Treatment with corticosteroids was negatively associated with PMM (OR: 3.1; CI: 1.3-7.6, p = 0.01). The only variable to affect walking outcome was longitudinal extent of IVDE (OR = 2.6; CI = 1.3-5.3, p = 0.006).

Conclusion: Dogs with lumbar intumescence IVDE are at increased risk of PMM. Timing of surgery and corticosteroid use warrant further investigations. PMM and recovery of walking are influenced by different factors.
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http://dx.doi.org/10.1186/s12917-019-2186-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6892155PMC
December 2019

Cerebrospinal fluid lactate in dogs with inflammatory central nervous system disorders.

J Vet Intern Med 2019 Nov 24;33(6):2701-2708. Epub 2019 Sep 24.

Veterinary Specialty Hospital of the Carolinas, Cary, North Carolina.

Background: Cerebrospinal fluid (CSF) lactate is frequently used as a biomarker in humans with inflammatory central nervous system (CNS) disorders including bacterial meningitis and autoimmune disorders such as multiple sclerosis.

Hypothesis: Cerebrospinal fluid lactate concentrations are increased in a subset of dogs with inflammatory CNS disorders.

Animals: One hundred two client-owned dogs diagnosed with inflammatory CNS disease.

Methods: Case series. Cases were identified both prospectively at the time of diagnosis and retrospectively by review of a CSF biorepository. Cerebrospinal fluid lactate was analyzed with a commercially available, handheld lactate monitor. Subcategories of inflammatory disease were created for comparison (eg, steroid-responsive meningitis arteritis, meningoencephalitis of unknown etiology).

Results: Cerebrospinal fluid lactate concentrations were above reference range in 47% of dogs (median, 2.5 mmol/L; range, 1.0-11.7 mmol/L). There was no significant difference in lactate concentrations between disease subcategories (P = .48). Significant but weak correlations were noted between CSF lactate concentration and nucleated cell count (r = .33, P < .001), absolute large mononuclear cell count (r = .44, P < .001), absolute small mononuclear cell count (r = .39, P < .001), absolute neutrophil cell count (r = .24, P = .01), and protein (r = .44, P < .001). No correlation was found between CSF lactate concentration and CSF red blood cell count (P = .58). There was no significant association of CSF lactate concentration with survival (P = .27).

Conclusions And Clinical Importance: Cerebrospinal fluid lactate concentrations could serve as a rapid biomarker of inflammatory CNS disease in dogs.
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http://dx.doi.org/10.1111/jvim.15606DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6872616PMC
November 2019

Presence of cerebrospinal fluid antibodies associated with autoimmune encephalitis of humans in dogs with neurologic disease.

J Vet Intern Med 2019 Sep 8;33(5):2175-2182. Epub 2019 Sep 8.

Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina.

Background: Presumed autoimmune diseases affecting the central nervous system (CNS) of dogs are common. In people, antibodies against neuronal cell surface antigens that are associated with a wide variety of neurological syndromes have been identified. The presence of cerebrospinal fluid (CSF) autoantibodies that target neuronal cell surface proteins has not been reported in dogs with neurologic disorders.

Objectives: Autoantibodies to neuronal cell surface antigens can be found in the CSF of dogs with inflammatory CNS disease. Our aim was to determine whether 6 neuronal cell surface autoantibodies were present in the CSF of dogs diagnosed with inflammatory and noninflammatory CNS disease.

Animals: Client-owned dogs with CNS disease and complete diagnostic evaluation including magnetic resonance imaging and CSF analysis were included. One healthy dog was included as a negative control.

Methods: Cerebrospinal fluid was tested for 6 antigenic targets with a commercially available indirect immunofluorescence assay test kit.

Results: There were 32 dogs with neurological disease, 19 diagnosed with inflammatory disease (encephalitis and meningitis), 10 with noninflammatory disease (neoplasia, intervertebral disk disease, degenerative myelopathy, and epilepsy), 2 with no diagnosis, and 1 with neoplasia and meningoencephalitis. Anti-N-methyl-d-aspartate receptor 1 (NMDAR1) antibodies were detected in 3 dogs (3/32; 9.38%). All 3 dogs responded to treatment of meningoencephalomyelitis of unknown etiology (MUE).

Conclusions And Clinical Importance: Further evaluation of the prevalence and clinical relevance of CSF and serum antibodies to neuronal cell surface antigens is warranted. Defining antigenic targets associated with encephalitis in dogs might allow diagnostic categorization of MUE antemortem.
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http://dx.doi.org/10.1111/jvim.15616DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6766506PMC
September 2019

Comparison of cerebrospinal fluid parameters from the cerebellomedullary and lumbar cisterns in 54 dogs.

Can Vet J 2019 Aug;60(8):885-888

Department of Clinical Sciences, North Carolina State University, 1052 William Moore Drive, Raleigh, North Carolina 27607, USA.

The purpose of this retrospective study was to compare findings from analyses of paired samples of cerebrospinal fluid (CSF) from cerebellomedullary cistern and lumbar cistern in dogs. Tests of fluid collected from the lumbar cistern were more sensitive for identifying pleocytosis and elevated protein concentrations compared to the fluid from the cerebellomedullary cistern in dogs with spinal cord disease.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6625374PMC
August 2019

Clinical characteristics, breed differences, and quality of life in North American dogs with acute steroid-responsive meningitis-arteritis.

J Vet Intern Med 2019 Jul 7;33(4):1719-1727. Epub 2019 Jun 7.

Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina.

Background: Steroid-responsive meningitis-arteritis (SRMA) is a common inflammatory neurologic disorder of dogs for which certain breeds are predisposed.

Objectives: To determine whether breed differences exist in clinical features, treatment response, and relapse in a population of North American dogs with SRMA, and to evaluate the effect of disease on dogs' quality of life (QoL).

Animals: Sixty-one client-owned dogs with SRMA: 29 dogs identified through an American Kennel Club-Canine Health Foundation survey and 32 dogs from North Carolina (NC) State Veterinary Hospital.

Methods: Retrospective case series. Caregivers completed an online survey to assess QoL.

Results: Breeds represented most often included the Golden Retriever (n = 12), Bernese Mountain Dog (10), Wirehaired Pointing Griffon (9), Boxer (9), and Beagle (6). No breed differences were identified with respect to clinical severity, diagnostic findings, or outcome. Twenty-nine dogs (48%) had ≥1 disease relapse. There was a significant effect of cerebrospinal fluid nucleated cell count on the frequency of disease relapse (P = .003), but no relationship was identified between treatment protocol and relapse. Dogs' QoL was associated with the severity of corticosteroid-related adverse effects (P = .03), which were dose-related (r = .24, P = .02) and more prevalent in Wirehaired Pointing Griffons than in other breeds (P = .04).

Conclusion And Clinical Importance: Golden Retrievers and Wirehaired Pointing Griffons should be considered among the breeds recognized to develop SRMA. Treatment with higher corticosteroid dosages is correlated with more severe adverse effects and worse QoL, but it may not improve clinical outcome.
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http://dx.doi.org/10.1111/jvim.15543DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6639478PMC
July 2019

Time course and prognostic value of serum GFAP, pNFH, and S100β concentrations in dogs with complete spinal cord injury because of intervertebral disc extrusion.

J Vet Intern Med 2019 Mar 13;33(2):726-734. Epub 2019 Feb 13.

Department of Statistics, North Carolina State University, Raleigh, North Carolina.

Background: A noninvasive biomarker is needed to predict recovery from severe spinal cord injury (SCI) because of thoracolumbar intervertebral disc extrusion (TL-IVDE). Proteins released from neural and glial cells can be detected in the blood and show promise as prognostic tools, but their concentration is influenced by time after injury.

Hypothesis/objectives: Serum concentrations of glial fibrillary acidic protein (GFAP), phosphorylated neurofilament heavy chain (pNFH), and S100β will follow different time courses; measurement of combinations of these proteins will predict outcome.

Animals: Thirty-one dogs with TL-IVDE causing paralysis with no pain perception.

Methods: Prospective study. Serum samples were taken at presentation and intervals over 56 days and banked at -80°C. Glial fibrillary acidic protein, pNFH, and S100β concentrations were measured using ELISA tests and plotted against time from onset of nonambulatory status. Outcome was established at 6 months. The association between biomarker concentration and outcome was examined using logistic regression, receiver operator characteristics curve analysis, and model development.

Results: Thirty-one dogs participated, 3/31 (10%) developed progressive myelomalacia and 19/31 (62%) recovered ambulation. Glial fibrillary acidic protein and S100β concentrations rose for the first 1 to 3 days, and were undetectable by 14 and 28 days, respectively. Phosphorylated neurofilament heavy chain concentrations peaked at 14 days and were detectable at 56 days. Glial fibrillary acidic protein concentrations in the first 72 hours after onset of nonambulatory status predicted recovery with an accuracy of 76.7%-89% depending on sample timing.

Conclusions And Clinical Importance: Serum GFAP concentrations can be used to predict outcome in clinically complete SCI. A rapid inexpensive bedside test is needed.
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http://dx.doi.org/10.1111/jvim.15439DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6430936PMC
March 2019

A randomized, blinded, prospective clinical trial of postoperative rehabilitation in dogs after surgical decompression of acute thoracolumbar intervertebral disc herniation.

J Vet Intern Med 2018 May 10;32(3):1133-1144. Epub 2018 Apr 10.

Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, North Carolina.

Background: Experimental evidence shows benefit of rehabilitation after spinal cord injury (SCI) but there are limited objective data on the effect of rehabilitation on recovery of dogs after surgery for acute thoracolumbar intervertebral disc herniations (TL-IVDH).

Objective: Compare the effect of basic and intensive post-operative rehabilitation programs on recovery of locomotion in dogs with acute TL-IVDH in a randomized, blinded, prospective clinical trial.

Animals: Thirty non-ambulatory paraparetic or paraplegic (with pain perception) dogs after decompressive surgery for TL-IVDH.

Methods: Blinded, prospective clinical trial. Dogs were randomized (1:1) to a basic or intensive 14-day in-house rehabilitation protocol. Fourteen-day open field gait score (OFS) and coordination (regulatory index, RI) were primary outcomes. Secondary measures of gait, post-operative pain, and weight were compared at 14 and 42 days.

Results: Of 50 dogs assessed, 32 met inclusion criteria and 30 completed the protocol. There were no adverse events associated with rehabilitation. Median time to walking was 7.5 (2 - 37) days. Mean change in OFS by day 14 was 6.13 (confidence intervals: 4.88, 7.39, basic) versus 5.73 (4.94, 6.53, intensive) representing a treatment effect of -0.4 (-1.82, 1.02) which was not significant, P=.57. RI on day 14 was 55.13 (36.88, 73.38, basic) versus 51.65 (30.98, 72.33, intensive), a non-significant treatment effect of -3.47 (-29.81, 22.87), P = .79. There were no differences in secondary outcomes between groups.

Conclusions: Early postoperative rehabilitation after surgery for TL-IVDH is safe but doesn't improve rate or level of recovery in dogs with incomplete SCI.
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http://dx.doi.org/10.1111/jvim.15086DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5980307PMC
May 2018

The Effect of Electromagnetic Fields on Post-Operative Pain and Locomotor Recovery in Dogs with Acute, Severe Thoracolumbar Intervertebral Disc Extrusion: A Randomized Placebo-Controlled, Prospective Clinical Trial.

J Neurotrauma 2018 08 2;35(15):1726-1736. Epub 2018 Apr 2.

1 Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University , Raleigh, North Carolina.

Spinal cord injury (SCI) attributed to acute intervertebral disc extrusions (IVDEs) is common in dogs and is treated by surgical decompression. Dogs with sensorimotor complete injuries have an incomplete recovery. Pulsed electromagnetic fields (PEMFs) reduce post-operative pain through anti-inflammatory effects and there is growing evidence for neuroprotective effects. This randomized, controlled clinical trial evaluated the effect of PEMF on post-operative pain and neurological recovery in dogs with surgically treated sensorimotor complete SCI attributed to acute IVDE. Sixteen dogs with surgically treated complete thoracolumbar SCI were randomized to receive PEMF (15 min every 2 h for 2 weeks then twice-daily for 4 weeks) or placebo starting immediately after diagnosis. The primary outcome was gait score at 2 weeks. Secondary measures of gait, pain perception, and proprioceptive function were evaluated at 2 and 6 weeks. Plasma glial fibrillary acidic protein (GFAP) concentration was measured as an SCI biomarker. Post-operative pain was quantified by measuring mechanical sensory thresholds (MSTs) at control and surgical sites. There was no significant difference in demographics or GFAP concentration between the two groups at trial entry. There was no difference in primary outcome or in secondary measures of gait, but proprioceptive placing was significantly better at 6 weeks and GFAP concentrations were significantly lower at 2 weeks in the PEMF group. MSTs were significantly higher in the PEMF-treated group. We conclude that PEMF reduced incision-associated pain in dogs post-surgery for IVDE and may reduce extent of SCI and enhance proprioceptive placing. Larger clinical trials are warranted.
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http://dx.doi.org/10.1089/neu.2017.5485DOI Listing
August 2018