Explore all the previous studies we have interpreted and highlighted over the years.
| February 2025 Clinical characterization of a novel episodic ataxia in young working Cocker Spaniels. JVIM. Open access. https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvim.17268 In people, episodic ataxias are rare disorders characterized by recurrent attacks of cerebellar dysfunction. This retrospective case series documents suspected episodic ataxia in seven working Cocker spaniels. The dogs were young at clinical onset (mean age of 4 months) and episodes were characterised by episodic body swaying, titubation, cerebellar ataxia, wide-base stance and/or hypermetria. The episodes were variable in duration (30 mins to 24 hours) and frequency (weekly to once every 5 months). Follow-up information was available for 5 dogs, all of which showed a decrease in frequency or resolution of the episodes. Four dogs were transitioned to a gluten free diet and a subsequent decrease in seizure frequency and/or duration was reported in all 4 (although it is possible that this was unrelated to the diet change). Video examples of each dog’s episodes are included in the supporting information. Comorbidities, long-term outcome and poststroke epilepsy associated with ischemic stroke – A multicenter observational study of 125 dogs. JVIM. Open access https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvim.17291 In this retrospective study of 125 dogs with ischaemic stroke, a comorbidity such as such as hypertension, proteinuria or cardiac disease was identified in 52 dogs (41.6%). Greyhounds were the most represented breed. Eleven dogs (9%) were reported to have epileptic seizures as a primary presenting sign, but interestingly the infarct was located in a cerebral hemisphere in only 4 of these. The cerebellum was the most common site of the ischaemic infarct (67 dogs, 54%). Median survival time for dogs with a comorbidity was 482 days (range, 1-3013), compared to 907 days (range, 1-3027) in dogs without comorbidities (P = .602). Twenty-four dogs (19.2%) had a suspected stroke recurrence and 8 of 109 dogs (7.3%) with follow up information developed suspected post-stroke epilepsy (this included one of the 11 dogs that had seizures as a presenting sign). Masticatory muscle changes on magnetic resonance imaging of dogs with Neospora caninum compared to meningoencephalitis of unknown origin. Frontiers in Veterinary Science. Open access. https://www.frontiersin.org/journals/veterinary-science/articles/10.3389/fvets.2024.1517256/full This study investigated whether the presence of masticatory muscle changes on MRI can be used to distinguish dogs with neosporosis from those with MUO. Of 22 dogs with neosporosis, six (27%) had bilateral, multifocal, T2W and FLAIR hyperintense, contrast enhancing masticatory muscle lesions; three also had masticatory muscle atrophy. One of 23 dogs (4%) with MUO had muscle changes, characterised as a mild, focal, unilateral temporal muscle lesion visible only in the T1W post-contrast images. Thus, detailed interrogation of the muscles of mastication could be useful in cases where neosporosis is a clinical concern, and can be combined with assessment of AST and CK (previously demonstrated to increase suspicion for neosporosis when elevated https://onlinelibrary.wiley.com/doi/10.1111/jvim.16334) while awaiting serology and/or PCR results. Spinal arachnoid diverticula in cats: Clinical presentation, diagnostic imaging findings, treatment, and outcome. JVIM. Open access. https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvim.17294 Spinal arachnoid diverticulum (SAD) is characterized by a focal dilatation of the subarachnoid space that causes progressive spinal cord compression. In this retrospective description of 18 cats with SAD diagnosed by MRI, most presented with a chronic, progressive, non-painful T3-L3 myelopathy. An underlying previous or concurrent spinal condition was found in ~ half of the cats. Twelve cats were treated medically, 8 surgically, and 1 was medically treated before opting for surgery. Eight of the eleven (73%) cats for which long term follow up was available ultimately deteriorated, regardless of treatment. Characterization of post-ictal clinical signs in dogs with idiopathic epilepsy: A questionnaire-based study. JVIM. Open access. https://onlinelibrary.wiley.com/doi/10.1111/jvim.17302 In this study 79 of the included 87 dogs (90%) were reported to show post ictal signs, with the most common being disorientation and wobbliness. I was interested to see deafness documented as a postictal deficit by owners; perhaps something we could be more proactive in considering (and even documenting/quantifying with BAER testing). Cerebrospinal fluid-specific oligoclonal bands in dogs with idiopathic epilepsy. JVIM. Open access. https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvim.17265 Immunoglobulin G oligoclonal bands (OCBs) are found in the cerebrospinal fluid (CSF) in various diseases and can indicate intrathecal synthesis of IgG (secondary to autoimmune encephalitis, generalized immunological reaction, or seizure-induced CSF changes). In this study of 84 dogs with idiopathic epilepsy, OCBs were identified in the CSF in 13 (15.5%). In dogs with antiseizure medication-resistant idiopathic epilepsy, 21.4% (6/28) had CSF-specific OCBs compared with 12.5% (7/56) in those responsive to antiseizure medications. This raises interesting questions about the potential for neuroinflammation to contribute to disease progression and pharmacoresistance, as has been documented in some human patients with epilepsy. High-field MRI findings in epileptic dogs with a normal inter-ictal neurological examination. Frontiers in Veterinary Science. Open access. https://www.frontiersin.org/journals/veterinary-science/articles/10.3389/fvets.2024.1507861/full This study supports our clinical suspicions that structural pathology is an uncommon cause of epilepsy in dogs with a normal inter-ictal examination. Of 412 epileptic dogs with a normal inter-ictal neurological examination, 76 (18.5%) had abnormalities detected on MRI, 60 of which were considered to be incidental (such as Chiari-like malformation, otitis or ventricular dilation). Of the remaining 16 dogs with a structural cause of their epileptic seizures (3.9% of the total study population), 9 were over the age of 8 years. Holocord syringomyelia in 18 dogs. Frontiers in Veterinary Science. Open access. https://www.frontiersin.org/journals/veterinary-science/articles/10.3389/fvets.2024.1514441/full Holocord syringomyelia (HSM) is characterized by a continuous spinal cord cavitation extending through the cervical, thoracic and lumbar spinal cord segments which is isointense to normal CSF on MRI. Interestingly, despite its very extensive and dramatic appearance on MRI, 4 of the 18 dogs in this study had no associated clinical signs, 2 had spinal pain spinal pain/paresthesia/allodynia, and 12 were myelopathic (+/- pain/paresthesia/allodynia) at the time of diagnosis. The French bulldog was the most represented breed (9/18). Surgical management of single-level thoracolumbar vertebral body segmentation and formation failure causing progressive thoracolumbar myelopathy in three adult large-breed dogs. Frontiers in Veterinary Science. Open access. https://www.frontiersin.org/journals/veterinary-science/articles/10.3389/fvets.2024.1504477/full Although rarely reported in large breed dogs, congenital thoracic vertebral malformations can result in progressive kyphotic deformation of the vertebral column, with vertebral canal stenosis and spinal cord compression. In this retrospective case series, a complex combined failure of vertebral formation and segmentation between T8 and L1 was associated with focal but marked kyphosis of the vertebral column in 3 adult large-breed dogs. Successful medium-term outcome was documented following surgical management consisting of bilateral mini-hemilaminectomy, partial lateral corpectomy and vertebral fixation. Some interesting MRI and CT images of this unusual presentation are included in the manuscript. Cerebellar Bergmann glia integrate noxious information and modulate nocifensive behaviors. Nature Neuroscience. https://www.nature.com/articles/s41593-024-01807-z And something a little different to end on. It seems that the cerebellum has ever more diverse roles than previously understood… December 2024 Characteristics and clinical course of myoclonus in Cavalier King Charles Spaniels. JVIM. Open access. https://onlinelibrary.wiley.com/doi/10.1111/jvim.17227 Myoclonus is an involuntary, shock-like movement of a muscle or group of muscles. A spontaneous myoclonus has been described in older CKCS typically characterised by rapid eye blinking and head nodding. In this questionnaire-based study of 27 CKCS with myoclonus, the majority had myoclonic episodes that increased in frequency (20/27) and severity (17/27) over time. Behavioural changes since the onset of myoclonus were reported in 18 dogs. Eight dogs were prescribed levetiracetam; all had an initial decrease in episode frequency following initiation of treatment, but a subsequent increase in both frequency and severity of episodes was common thereafter. Neosporosis in 21 adult dogs, 2010-2023 JVIM. Open access. https://onlinelibrary.wiley.com/doi/10.1111/jvim.17219 This retrospective study of 21 dogs with a clinical diagnosis of neosporosis documented varied clinical presentations, including generalized myopathy (6 dogs), multifocal intracranial disease (7), myelopathy (4 ) and polyneuropathy (2). Serum CK activity was increased in all dogs tested. Eight dogs made a complete recovery following treatment, 6 had persistent neurological deficits and 7 showed minimal treatment response (and these 7 died or were euthanized a median of 15 days after onset of clinical signs). Four dogs experienced at least one relapse event during the follow-up period; 2 of which had shown a complete resolution of clinical signs with treatment. I often wonder about the sensitivity of PCR on CSF for detecting Neospora; 4 dogs had PCR performed on CSF in this study and only one was positive. Characterization of annulus fibrosus lesions on magnetic resonance imaging in dogs affected by intervertebral disc disease, a descriptive case series. Frontiers in Veterinary Science – Veterinary Neurology and Neurosurgery. Open access. https://www.frontiersin.org/journals/veterinary-science/articles/10.3389/fvets.2024.1434447/full The clinical relevance of lesions of the anulus fibrosus remain incompletely understood. In people they have been associated with chronic lumbar pain but can also represent subclinical degenerative changes. In this retrospective study the authors describe 39 dogs (41 affected IVDs) with annular fissures on MRI. These fissures appear as a focal T2W hyperintense signal in the annulus fibrosus, referred to as “high-intensity zone” (HIZ) lesions. The HIZ lesions were associated with an ANNPE in 9 discs, a HNPE in 9 discs, and were detected without associated extruded disc material in 23 discs. In the dogs in which the HIZ lesion(s) was the only significant MRI finding, pain or chronic paresis were present. Perhaps this is something we can begin to evaluate more actively in our cases, and using the authors descriptors of HIZ lesion location, shape, orientation, extent etc could facilitate more detailed assessment and recording. Electroencephalography: electrode arrays in dogs. Frontiers in Veterinary Science – Veterinary Neurology and Neurosurgery. Open access. https://www.frontiersin.org/journals/veterinary-science/articles/10.3389/fvets.2024.1402546/full In people, electroencephalography (EEG) is a major component of defining epilepsy syndromes and in guiding treatment, namely pharmacological, dietary, and/or surgical. EEG remains underutilised in veterinary medicine, with marked variations in the precise technique (including electrode number and positioning) between studies. This review article discusses current understanding of EEG electrode arrays in veterinary patients, their utilization in the profession, and limitations in our knowledge. Neurotoxic phospholipase A2: A proposed cause of equine grass sickness and other animal dysautonomias (multiple system neuropathies). Equine Veterinary Journal. Free to read https://beva.onlinelibrary.wiley.com/doi/epdf/10.1111/evj.14442 In this Editorial the authors summarise the current understanding of the aetiopathogenesis of equine grass sickness. Recent studies have indicated that a neurotoxic phospholipase is a likely cause of equine grass sickness as well as the dysautonomias that occur in cats, dogs, rabbits, llamas etc. The phospholipase A2 protein superfamily is a diverse group of enzymes, ubiquitous in mammalian cells, with multiple roles including in lipid homeostasis and digestion. The unidentified neurotoxic PLA2 could be an ingested microbial or plant enzyme (grazing animals ingest a wide range of microbial PLA2s), or produced in vivo by gastrointestinal microbes. Following absorption from the GI tract the neurotoxic PLA2 is proposed to decrease cholinergic activity and increase sympathetic activity. The authors briefly discuss the potential role of neurotoxic microbial PLA2s in the pathogenesis of human neurodegenerative diseases such as Parkinson’s and Alzheimer’s disease. Evaluation of gabapentin administration on neurologic examination in 2 different age groups of healthy cats. JVIM. Open access. https://onlinelibrary.wiley.com/doi/10.1111/jvim.17206 This prospective crossover study investigated the effect of a gabapentin (100mg single dose PO) on anxiety and neurologic examination findings in both young and geriatric cats. Approximately 40% of the cats showed new postural reaction deficits, in addition to new paresis and ataxia after receiving gabapentin. Sedation was seen in both the young and geriatric groups, while anxiety was improved only in the geriatric group. Clinical, magnetic resonance imaging, histopathological features, treatment options and outcome of spinal ependymoma in dogs: 8 cases (2011-2022). JSAP. https://onlinelibrary.wiley.com/doi/10.1111/jsap.13792 Ependymomas are rare neoplasms arising from the ependyma of the ventricles or central canal. In this description of 8 dogs with spinal ependymoma, the authors document an intramedullary T2-weighted hyperintense, T1-weighted isointense oval-shaped mass lesion with marked homogeneous or ring contrast enhancement. Three dogs also had a T2- and T1w hypointense rim to the mass, potentially consistent with a hemosiderin cap sign (as has been documented in people with ependymomas, as well as paragangliomas and hemangioblastomas). Perspective: Raman spectroscopy for detection and management of diseases affecting the nervous system. Frontiers in Veterinary Science – Veterinary Neurology and Neurosurgery. Open access. https://www.frontiersin.org/journals/veterinary-science/articles/10.3389/fvets.2024.1468326/full Perhaps something we might start to see more studies on…The authors of this Perspective discuss the basics of Raman Spectroscopy, a technique in which the chemical composition of a wide variety of solids and liquids can be determined. Irradiation of molecular mixtures (e.g., biological fluids like urine) with wavelength-specific laser energy produces weak polarization shifts from deformation/relaxation of chemical bonds in hundreds of distinct molecules in the specimen. This information is collated and displaying as a spectra. Analysis of these spectra can provide insights into the underlying disease. There has been significant interest and research in applying Raman Spectroscopy to human neurodegenerative diseases and to detection and management of gliomas. The authors discuss that raman spectrometers are readily available, durable, small (mobile phone size), relatively inexpensive ($5 K–25 K), and operate in ambient conditions. And if you would like a little more reading over the festive holiday 😉 there is a new issue from Veterinary Clinics Small Animal Practice entitled: Update on Diagnosis and Treatment of Brain Tumors in Dogs and Cats https://www.vetsmall.theclinics.com/issue/S0195-5616(24)X0006-6 This has multiple review articles covering topics including MRI features of brain tumours, biopsy, radiation therapy and surgery. October 2024 Seropositivity to louping ill virus in dogs in the UK. Veterinary Record. https://bvajournals.onlinelibrary.wiley.com/doi/10.1002/vetr.4702 Louping ill virus (LIV) is a tick-borne flavivirus that can cause fatal meningoencephalomyelitis in dogs. In this study residual serum or plasma from dogs was used to determine the seroprevalence of LIV by haemagglutination inhibition test. Of 202 dogs included in the study, 9 (4.5%) were seropositive for LIV, six of which were presented for neurological disease. The authors conclude that the seroprevalence of LIV in the UK dog population appears to be low. However, LIV should be considered in dogs presenting with unexplained acute or subacute progressive neurological clinical signs. Effect of repetitive transcranial magnetic stimulation on trigeminal-mediated headshaking in 17 horses. JVIM. Open access. https://onlinelibrary.wiley.com/doi/10.1111/jvim.17194 Seventeen horses with nonseasonal signs of trigeminal mediated head shaking (a neuropathic pain condition, with no obvious underlying cause) underwent repetitive transcranial magnetic stimulation under standing sedation on 5 consecutive days. The protocol was reported to be well tolerated and headshaking signs during exercise were decreased by 70%, with persistent decreases after four weeks. Clinical outcome of cats with suppurative otitis media and intact tympanum submitted to myringotomy: retrospective findings from 26 cases. JFMS.Open access https://journals.sagepub.com/doi/full/10.1177/1098612X241275286 Otitis-media/interna is a relatively common cause of vestibular dysfunction in cats. This study reports the use of a single myringotomy (using a 2mm diameter catheter) procedure with saline ear flushing in 26 cats with suppurative otitis media, followed by oral corticosteroids and a 1-month course of systemic antibiotics according to sensitivity testing. Nineteen (73%) cats showed resolution of clinical signs 60–240 days after treatment. Two cats died or were euthanised and five went on to have a ventral bulla osteotomy. The report includes some very nice otoendoscopic images and a clear description of the procedure. Canine idiopathic generalized tremor syndrome, immune-mediated? Frontiers in Veterinary Science.Open access. https://www.frontiersin.org/journals/veterinary-science/articles/10.3389/fvets.2024.1453698/full The aetiology of idiopathic generalized tremor syndrome (IGTS) is unknown, but the positive response to immunomodulatory drugs supports an immune-mediated process. This study investigated 30 affected dogs for the presence of autoantibodies to neural surface proteins in serum and/or CSF using human cell-based assays as well as mouse brain tissue assays. The authors report mGluR1 antibodies in two dogs, GFAP and mGLuR1 antibodies in one dog and unspecific autoantibodies which could not be further classified in two dogs. Dynamic contrast enhanced high field magnetic resonance imaging for canine primary intracranial neoplasia. Frontiers in Veterinary Science. Open access. https://www.frontiersin.org/journals/veterinary-science/articles/10.3389/fvets.2024.1468831/full Dynamic contrast enhanced MRI (DCI-MRI) involves the acquisition of repeated fast images before, during and after the rapid administration of intravenous contrast agent. It can be used to provide quantitative assessment of tissue perfusion and blood–brain barrier dysfunction. This article evaluates DCE-MRI in a small cohort of dogs and provides support for its potential utility in distinguishing intracranial mass lesions. Resolution of Canine Acute Bilirubin Encephalopathy and Immune-Mediated Hemolytic Anemia Following Four Plasmapheresis Treatments. JAAHA. https://meridian.allenpress.com/jaaha/article/60/5/207/502892/Resolution-of-Canine-Acute-Bilirubin This case report describes an 8mo mixed breed dog with IMHA, marked hyperbilirubinemia and suspected bilirubin encephalopathy (stuporous to comatose, intermittent opisthotonus, absent menace response). After four total plasma exchange treatments (alongside immunosuppressive therapy) the dog became autoagglutination negative and showed progressive neurological improvement, with full resolution of neurological deficits ultimately documented. Applying the Techniques of Materials Science towards an Understanding of the Process of Canine Intervertebral Disc Degeneration. Animals. Open access. https://www.mdpi.com/2076-2615/14/18/2665 In this paper the authors discuss that intervertebral disc degeneration is a complex and multi-faceted process, which is still poorly understood. A better characterisation of this process could offer means to more effective prophylaxis and treatment protocols. Extruded intervertebral disc samples were collected during decompressive surgery, as well as non-extruded disc material collected from fenestration, and examined using a range of techniques (including Infra-red Spectroscopy, Electron Microscopy (EM) and Atomic Force Microscopy). The authors show that calcium phosphate exists in an amorphous state within the disc and that the formation of crystalline particles of hydroxyapatite occurs prior to disc extrusion. They report the first use of Scanning EM for analysis of the canine nucleus pulposus, specifically using the technique to identify regions rich in calcium phosphate. Compression testing generated stress/strain curves which will facilitate investigation into disc stiffness. Relationship between radiation dose and cerebral microbleed formation in dogs with intracranial tumors. JVIM.Open access. https://onlinelibrary.wiley.com/doi/10.1111/jvim.17213 This retrospective study investigated whether dogs irradiated for intracranial tumours develop cerebral microbleeds. Most dogs (21/34, 62%) developed cerebral microbleeds after radiotherapy; these microbleeds appeared predominantly within the area of brain receiving the highest radiation dose, typically within the first year after radiotherapy and they increased in number over time. The clinical significance of these cerebral microbleeds remains to be determined. And something a little different: Patient-derived glioblastoma organoids as real-time avatars for assessing responses to clinical CAR-T cell therapy. bioRxiv preprint. https://www.biorxiv.org/content/10.1101/2024.10.03.616503v1 Patient tumour-derived organoids (where a sample of the patient’s tumour is cultured and studied ex vivo) provide a more accurate and physiological representation of patient tumours compared to other techniques such as cell line or xenograft models. In this study, Glioblastoma organoids (GBOs) were derived from surgically excised tissue from patients undergoing a phase 1 study with CAR-T cell treatment. The GBOs were then treated with the same CAR-T therapy being trialed in the patients, and their response monitored. The authors found similar responses to the treatment in the GBO and the patient from which it was derived. Specifically, they found target antigen reduction and cytolysis of tumour cells in the GBOs, the degree of which correlated with CAR-T cell engraftment detected in patients’ cerebrospinal fluid. Furthermore, cytokine release patterns in GBOs mirrored patient CSF samples over time. These results support GBOs as a valuable platform for real-time assessment of immunotherapy efficacy. And if you would like to learn a bit more about CAR-T therapy this is a useful link: https://www.cancer.gov/about-cancer/treatment/research/car-t-cells September 2024 A multimodal approach to diagnosis of neuromuscular neosporosis in dogs. JVIM. Open access. https://onlinelibrary.wiley.com/doi/10.1111/jvim.17145 This study acts as a useful reminder of the range of diagnostic tests available for Neospora caninum infection and emphasises the importance of a multimodal diagnostic approach. Of 16 dogs with Neospora infection, 87% were positive on serology, 69% on PCR, and 56% on IHC, ISH, or parasite identification using a standard histopathology stain (H&E). A negative result in one single assay should not exclude the diagnosis and combining serology with direct parasite identification (e.g. by PCR on CSF samples, or IHC of muscle biopsies) might offer a more reliable means to achieve a diagnosis. Recovery of ambulation in small, nonbrachycephalic dogs after conservative management of acute thoracolumbar disk extrusion. JVIM. Open access. https://onlinelibrary.wiley.com/doi/10.1111/jvim.17149 This prospective study aimed to describe the natural history of thoracolumbar intervertebral disc extrusion in conservatively managed non-ambulatory dogs <15kg. Brachycephalic dogs were specifically excluded due to their increased risk of regurgitation and aspiration pneumonia. Within the 12-week study period, 49/51 nociception positive dogs recovered ambulation, with a median time to ambulation of 11 days. Of 21 dogs that were nociception negative on presentation, 10 recovered ambulation with a median time to ambulation of 25 days, 4 remained nociception negative and 7 developed progressive myelomalacia. Reduction in spinal cord compression over the 12-week study period varied from minimal to complete. Resolution of compression and persistent compression was evident in both dogs that recovered and those that did not. Clinical findings and outcome in feline tetanus: a multicentric retrospective study of 27 cases and review of the literature. Frontiers in Veterinary Science. Open access. https://www.frontiersin.org/journals/veterinary-science/articles/10.3389/fvets.2024.1425917/full Tetanus is rarely reported in cats, seemingly due to their innate resistance to the tetanospasmin toxin. This retrospective study from 11 referral centres in Europe documents the clinical presentation of 27 cats with tetanus. The presenting clinical sign was typically lameness/a stiff limb, with a wound often identified on or close to the affected limb. In 18 cats the clinical signs progressively worsened, with 16 displaying evidence of extension of clinical signs to other parts of the body. In 11/12 cats, electromyography revealed continuous motor unit action potentials. One cat was euthanised due to financial concerns, while 23 returned to independent ambulation on all limbs within a median of 25 days. Median to long term sequelae were reported in 6 (23%) cats and were mostly persistent gait deficits such as lameness, muscular rigidity and mild paraparesis. Magnetic resonance imaging pattern recognition of metabolic and neurodegenerative encephalopathies in dogs and cats. Frontiers in Veterinary Science. Open access. https://www.frontiersin.org/journals/veterinary-science/articles/10.3389/fvets.2024.1390971/full This retrospective study reports the MRI features of 100 dogs and cats with a range of metabolic and neurodegenerative disorders. The authors use changes in brain volume (increased, decreased and normal) and distribution of the lesions (grey and/or white matter) to facilitate classification of these disorders. Figure 14 provides a useful flow chart to guide MRI evaluation of these cases. Mydriasis associated with ischemic cerebrovascular infarct affecting the ipsilateral cerebellar interposital nucleus in 2 dogs. JVIM. Open access. https://onlinelibrary.wiley.com/doi/10.1111/jvim.17176 A nice differential for anisocoria…previously only documented experimentally after ablation of the fastigial or interposital nucleus of the cerebellum in cats. Canine paroxysmal dyskinesia—a review. Frontiers in Veterinary Science. Open access. https://www.frontiersin.org/journals/veterinary-science/articles/10.3389/fvets.2024.1441332/full This review article summarises the canine paroxysmal dyskinesias reported to date, including (where known) information on their phenotype, genotype, pathophysiology and treatment, supported by video examples. Bromide: the good, the bad, and the ugly of the oldest antiseizure medication. Frontiers in Veterinary Science. Open access. https://www.frontiersin.org/journals/veterinary-science/articles/10.3389/fvets.2024.1433191/full Perhaps not everyone’s favourite AED, this review provides a summary of the advantages and disadvantages of potassium bromide and emphasises the sparsity of information available despite its common use in clinical practice. Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. The Lancet. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01296-0/abstract The 2024 report of the Lancet Commission on dementia prevention, intervention, and care adds untreated vision loss and high LDL cholesterol to the list of risk factors for dementia in people. Overall, around 45% of cases of dementia are potentially preventable by addressing 14 modifiable risk factors (which, in addition to vision loss and high LDL cholesterol, include less education, hearing loss, hypertension, smoking, obesity, depression, physical inactivity, traumatic brain injury, air pollution and social isolation). The report also provides updates on advances in fluid biomarkers for detection of Alzheimer’s disease, new definitions for diagnosis of Alzheimer’s and an update on progress in disease-modifying treatments. July 2024 Factors influencing serum concentrations of levetiracetam in dogs with epilepsy. JVIM. Open access. https://onlinelibrary.wiley.com/doi/10.1111/jvim.17128 A typical treatment regime when using oral levetiracetam would be 20mg/kg PO q8hrs, potentially increasing to 25-30mg/kg q8hrs in dogs also receiving phenobarbital. To date, there is no definitively accepted target therapeutic range for serum levetiracetam concentration in dogs, but to achieve a serum concentration of at least 20ug/ml (as recommended in people with epilepsy) a dose of 99 mg/kg/day (33 mg/kg q8hrs) was documented necessary in this study population, increasing to 216 mg/kg/day (72mg/kg q8hrs) in dogs receiving 7mg/kg/day of phenobarbital. Prospective randomized trial comparing relapse rates in dogs with steroid-responsive meningitis-arteritis treated with a 6-week or 6-month prednisolone protocol. JVIM. Open access. https://onlinelibrary.wiley.com/doi/10.1111/jvim.17130 In this prospective randomised trial 20 dogs with SRMA were treated with a 6-month course of tapering oral prednisolone, and 24 dogs with a 6-week tapering course. Relapses were recorded over a 12 month follow up period and occurred in 6 (30%) dogs in the 6-month protocol, and 9 (38%) in the 6-week protocol. There was no statistical difference in the incidence risk of at least 1 relapse between the treatment groups. Thus, shorter prednisolone courses can be considered in SRMA with the expectation that dogs experience fewer prednisolone-related side effects and improved quality of life during treatment (although this wasn’t specifically evaluated in the study). Allele frequency of a genetic risk variant for necrotizing meningoencephalitis in pug dogs from Europe and association with the clinical phenotype. Frontiers in Veterinary Science. Open access https://www.frontiersin.org/journals/veterinary-science/articles/10.3389/fvets.2024.1407288/full This study found the allele frequency of the CFA12 necrotising meningoencephalitis (NME) risk variant (CFA12:2605517delC ) in the European pug population to be 25.7%, and that pugs with an NME phenotype were frequently homozygous for the NME risk variant (compared to pugs ≥6 years without neurological signs or seizures (p = 0.008)). Comparison of stereotactic brain biopsy techniques in dogs: neuronavigation, 3D-printed guides, and neuronavigation with 3D-printed guides. Frontiers in Veterinary Science. Open access. https://www.frontiersin.org/journals/veterinary-science/articles/10.3389/fvets.2024.1406928/full This study used 5 canine cadavers to compare two previously described stereotactic brain biopsy techniques (3D skull contoured guides and neuronavigation with Brainsight) to a novel technique using Brainsight combined with a 3D-printed headframe. The results suggest that both 3D skull contoured guides and Brainsight neuronavigation were accurate for stereotactic biopsy (with median deviation from the target of ~3mm), however the Brainsight with 3D-printed headframe was not (with a median deviation of ~15mm) and so requires optimisation. The effect of oral zonisamide treatment on serum phenobarbital concentrations in epileptic dogs. Frontiers in Veterinary Science. Open access. https://www.frontiersin.org/journals/veterinary-science/articles/10.3389/fvets.2024.1389615/full Both phenobarbital and zonisamide are predominantly metabolised by cytochrome p450 hepatic enzymes. The elimination half-life and maximum serum concentrations of zonisamide are decreased when given concurrently with phenobarbital, necessitating an increase in the recommended starting dose of zonisamide from 3–7 mg/k BID to 7–10 mg/kg BID when given alongside phenobarbital in epileptic dogs. This case series suggests that zonisamide can affect phenobarbital metabolism. Following addition of zonisamide and despite no increase in phenobarbital dosage, an increase in serum phenobarbital concentration was observed in 9 out of 10 dogs. In five dogs, the serum phenobarbital concentration exceeded the therapeutic range, accompanied by generalised ataxia and sedation, and necessitated a reduction in the phenobarbital dose. Clinical, imaging and histopathological characterization of a series of three cats with cerebellar cortical degeneration. BMC Veterinary Research. Open access. https://0-bmcvetres-biomedcentral-com.brum.beds.ac.uk/articles/10.1186/s12917-024-04127-3 Some nice histopathology images in this case series documenting 3 cats with cerebellar cortical degeneration. The authors also perform MRI morphometric analysis to help support the diagnosis, and in so doing recognise a need to identify feline specific reference intervals/cuts off. Case report: Radiofrequency-induced thermal burn injury in a dog after magnetic resonance imaging. Frontiers in Veterinary Science. Open access. https://www.frontiersin.org/journals/veterinary-science/articles/10.3389/fvets.2024.1364635/full Radiofrequency-induced thermal burn injuries are a well-documented complication in people undergoing MRI, and can occur secondary to contact with conductive objects, skin-on-skin contact (e.g. skin folds or extremities in contact with the body) etc. This case reports documents suspected radiofrequency burns in the axillae of a Sharpei after undergoing MRI (1.5T) of the brain and cervical region. The partial thickness burns became evident four days after the MRI and ultimately healed by secondary intention. Skin to skin contact in the axillae was thought to be the cause. This reiterates the importance of screening the patient prior to the MRI to identify conductive objects and of careful patient positioning for MRI. Magnetic resonance imaging in canine idiopathic epilepsy: a mini-review. Frontiers in Veterinary Science. Open access. https://www.frontiersin.org/journals/veterinary-science/articles/10.3389/fvets.2024.1427403/full This mini-review article considers novel MRI techniques that could improve understanding of canine epilepsy and enhance epileptogenic zone detection via the evaluation of metabolic, cellular, architectural and functional alterations in the brain. Clinical and pathological aspects of toxic myopathies. Journal of Neuroscience. https://link.springer.com/article/10.1007/s00415-024-12522-x And just in case of interest…… having recently been a bit baffled by a dog with generalised myonecrosis I found this review useful to consider some differentials. With an estimated prevalence of > 2000/100,000 people, toxic myopathies are the most common cause of acquired myopathy in people. A large number of substances can induce myotoxicity, including statins, alcohol and corticosteroids. June 2024 Clinical efficacy and tolerability of zonisamide monotherapy in dogs with newly diagnosed idiopathic epilepsy: Prospective open-label uncontrolled multicenter trial. JVIM.Open access. https://onlinelibrary.wiley.com/doi/10.1111/jvim.17108 Fifty-six dogs with newly diagnosed idiopathic epilepsy were included in this prospective study. All were naïve to antiseizure drugs and received zonisamide as their sole treatment. Efficacy data was available for 53 dogs: 40 had a 50% or greater reduction in seizure frequency, and 29 achieved seizure freedom in the 12+ week follow up. A decrease in seizure duration was also noted and zonisamide appeared effective at reducing cluster seizures and status epilepticus. Seven dogs showed mild and transient adverse effects such as reduced activity, vomiting or hindlimb weakness. The authors propose a starting dose of 2.5-5mg/kg PO BID when using zonisamide as a monotherapy in dogs with idiopathic epilepsy. Corticosteroid monotherapy versus combined cytarabine continuous rate infusion and corticosteroid therapy in dogs with meningoencephalitis of unknown origin: A blinded, randomized, controlled trial. JVIM.Open access. https://onlinelibrary.wiley.com/doi/10.1111/jvim.17088 In this blinded randomised study, 35 dogs with MUO (MUA) received corticosteroids while 34 received corticosteroids plus a cytarabine CRI. The proportion of dogs that deteriorated neurologically or died within the first 7, 30 and 100 days of treatment was not significantly different between groups, however few dogs received ongoing cytarabine treatment. Client’s understanding of instructions for small animals in a veterinary neurological referral center. JVIM.Open access. https://onlinelibrary.wiley.com/doi/10.1111/jvim.17085 The authors of this study discuss the relative paucity of scientific literature investigating clinician and pet owner interaction (in contrast to numerous publications in human medicine) and recognise the often-overlooked potential for educating and empowering pet owners to improve therapeutic success. In this study, questionnaires were completed by owners and discharging veterinary surgeons to evaluate owner’s understanding and retention of discharge instructions. The authors found that clients were able to correctly recall ~ two thirds of the information provided on discharge. Questions regarding adverse effects of medication, residual clinical signs and confinement instructions had the lowest agreement between owners and vets. Traumatic and iatrogenic sciatic nerve injury in 38 dogs and 10 cats: Clinical and electrodiagnostic findings. JVIM.Open access. https://onlinelibrary.wiley.com/doi/10.1111/jvim.17076 This retrospective study reports 38 dogs and 10 cats with sciatic nerve injury and electrodiagnostic evaluation including electromyography and motor nerve conduction studies of sciatic-tibial and sciatic-peroneal nerves. The most common causes of sciatic nerve injury included pelvic trauma, bite wounds and perioperative complications. A poor outcome was documented in eight dogs and one cat that underwent limb amputation, and one dog was euthanised. Ability to flex and extend the hock was significantly associated with a positive outcome, and the amplitude of the compound muscle action potential (CMAP) during proximal sciatic-tibial nerve stimulation was higher in dogs with a positive outcome. A cut-off for CMAP amplitude of 1.45mV might help to identify those dogs more likely to have a good prognosis. Use of levetiracetam for the successful treatment of suspected myoclonic seizures: five dogs (2016-2022). JSAP.Open access. https://onlinelibrary.wiley.com/doi/10.1111/jsap.13719 Levetiracetam has been reported to be a safe and effective treatment for myoclonic seizures secondary to a range of conditions such as Lafora disease and audiogenic reflex seizures in cats. This case series reports 5 dogs with suspected myoclonic seizures for which no underlying cause was identified that were managed with levetiracetam (starting dose of 15 mg/ kg PO q8hr to 32.5 mg/kg PO q12hr (extended release)). All 5 dogs showed a positive response with complete cessation or marked reduction in the frequency of the myoclonic episodes. Assessment of glial fibrillary acidic protein and anti-glial fibrillary acidic protein autoantibody concentrations and necrotising meningoencephalitis risk genotype in dogs with pug dog myelopathy. Veterinary Record.Open access. https://bvajournals.onlinelibrary.wiley.com/doi/10.1002/vetr.3895 CNS lymphohistiocytic infiltrates have been reported in a number of pugs with pug dog myelopathy (PDM) raising the possibility of immune-mediated inflammation as a trigger or contributor in the pathogenesis of this condition. This study identified anti-GFAP autoantibodies in CSF from 15/19 pugs with PDM (compared with 6/16 dogs with other neurological disorders) tested. Neuropathic pain in cats: Mechanisms and multimodal management. JFMS.Open access. https://journals.sagepub.com/doi/10.1177/1098612X241246518 This review article discusses the anatomy of nociception and pain perception, summarises important terminology regarding neuropathic pain and provides extensive descriptions of multimodal pharmacotherapy supported by case examples. It is a very useful resource. Novel MRI and histopathological findings in a young Bullmastiff cross dog with mitochondrial fission encephalopathy. Veterinary Radiology and Ultrasound. Open access. https://onlinelibrary.wiley.com/doi/epdf/10.1111/vru.13342 The clinical presentation, MRI findings and histopathology in a dog with mitochondrial fission encephalopathy are described. In contrast to previously reported cases where the most severe lesions have tended to be in the cerebellar nuclei, the olivary nuclei appeared to be most severely affected in this dog (bilateral symmetrical T2W hyperintense, T1W iso- to hypointense and non-contrast-enhancing foci on MRI, corresponding to severe vacuolation, gliosis and some neuronal loss on histopathology). And an interesting preprint to end with: The gut microbiome associated with LGI1- and CASPR2-antibody encephalitis https://www.medrxiv.org/content/10.1101/2024.04.25.24305899v1 The exact causes of autoantibodies in LGI1- and CASPR2-antibody encephalitis in people remain unknown but established predispositions include overrepresented human leukocyte antigen alleles. However, these alleles are common in the healthy ancestry-matched population and so it is hypothesised that environmental trigger(s), such as the gut microbiome, could interact with a genetically predisposed individual. In this study the gut microbiome was compared between 47 patients with LGI1 or CASPR2-antibody encephalitis and 37 matched controls. The results suggest that a shift in the gut microbiome associates with a neuroinflammatory state, possibly via reduction of short chain fatty acids. April 2024 Randomized Controlled Trial of Durotomy as an Adjunct to Routine Decompressive Surgery for Dogs With Severe Acute Spinal Cord Injury. Neurotrauma Reports. Open access. https://www.liebertpub.com/doi/10.1089/neur.2023.0129 Durotomy has been investigated as a means of reducing pressure within the injured spinal cord, so improving perfusion and potentially enhancing functional recovery. In this multi-centre, randomised controlled trial the proportion of dogs demonstrating a functional recovery after traditional decompressive surgery for severe acute thoracolumbar intervertebral disc extrusion (with loss of nociception in the pelvic limbs & tail) with that recovering after the addition of durotomy (over 4 vertebral lengths) to the traditional approach were compared. Durotomy was found to be ineffective in improving functional outcome (ability to take 10 consecutive steps in the pelvic limbs without falling): 35/62 (56%) dogs in the traditional decompression group recovered ambulation, compared with 30/66 (45%) in the durotomy group. Prognosis in meningoencephalitis of unknown origin in dogs: Risk factors associated with survival, clinical relapse, and long-term disability. JVIM. Open access. https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvim.17037 This large retrospective study evaluated 447 dogs diagnosed with MUO with the goal of identifying prognostic indicators from clinical variables. The presence of epileptic seizures, paresis, pug breed and a higher score on the neurodisability scale (NDS) at presentation were found to be negatively associated with survival to 6 months. Persistent neurological deficits 6 months after diagnosis, higher NDS score at presentation and >7 days duration of clinical signs before diagnosis were associated with relapse (suspected or confirmed with repeat MRI & CSF analysis). The authors discuss that identification of a higher NDS score at diagnosis should raise concerns for early death and relapse, and thus more frequent examinations ± repeat MRI and alterations in treatment protocols could be considered in these dogs. Magnetic resonance imaging prognostic factors for survival and relapse in dogs with meningoencephalitis of unknown origin. Frontiers in Veterinary Science. Open access. https://www.frontiersin.org/articles/10.3389/fvets.2024.1370882/full Continuing their work, Goncalves and colleagues undertook a retrospective cohort study to evaluate the prognostic value of different MRI variables in 138 dogs with MUO. Lower T2 lesion load was associated with longer survival, while a higher T1 post-contrast lesion load was associated with relapse in this study population. A higher NDS score at presentation was associated with higher lesion load on T2, FLAIR and T1 weighted images. Rapid hearing threshold assessment with modified auditory brainstem response protocols in dogs. Frontiers in Veterinary Science. Open access. https://www.frontiersin.org/articles/10.3389/fvets.2024.1358410/full The auditory brainstem response (ABR) (or perhaps more commonly referred to as the brainstem auditory evoked response [BAER]) is the gold standard for objective and quantitative hearing screening in newborn babies and dogs. Assessment of hearing threshold requires repeated testing at decreasing stimulus intensities (hearing threshold was defined as the lowest stimulation intensity with an identifiable peak V). However, long test times limit their use in clinical practice. In this study the authors aimed to develop a rapid hearing screening protocol in dogs. Ninety dogs were recruited; 87 had ABR testing under sedation or general anaesthesia. Extrapolating from techniques used to reduce testing time in newborn babies, the authors found that binaural test mode, higher stimulus rates, a broadband chirp stimulus and an algorithm for automatic peak V detection in a stepwise fashion enabled a mean of 1.11 minutes test time for hearing threshold assessment in both ears. Computed tomographic features of canine intracranial and jugular foraminal masses involving the combined glossopharyngeal, vagus, and accessory nerve roots. Vet Radiol Ultrasound. https://onlinelibrary.wiley.com/doi/10.1111/vru.13359 This case series describes 5 dogs with coughing, gagging and/or dysphagia due to suspected jugular foramen syndrome (neurological deficits associated with CN IX, X and XI dysfunction) and CT identification of a soft tissue attenuating extra-axial mass at the cerebellomedullary angle. Smooth widening of the bony jugular foramen (5/5), mild hyperostosis of the petrous temporal bone (3/5), isolated severe atrophy of the ipsilateral sternocephalic, cleidocephalic, and trapezius muscles (5/5), and atrophy of the ipsilateral thyroarytenoideus and cricoarytenoideus muscles (5/5) were also documented. Neurological examination findings in the included dogs are not reported but the figures nicely demonstrate the jugular foramen widening, intrinsic laryngeal and shoulder muscle atrophy. Prevalence, clinical presentation, and etiology of myelopathies in 224 juvenile dogs. JVIM. Open access. https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvim.17045 This retrospective study evaluated 224 dogs aged 18 months or less presenting with a myelopathy. The three most common causes were vertebral malformation, spinal arachnoid diverticulum and traumatic fracture of the vertebral column. Intervertebral disc disease was the cause in 4.5% of dogs. Clinical findings and outcome in goats with discospondylitis and vertebral osteomyelitis. JVIM. Open access. https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvim.17035 This case series reports 5 goats (median age 6wks) with discospondylitis confirmed by CT. Despite the dramatic, multifocal CT findings (it is worth having a look at the figures) 4 goats regained ambulation (after presenting with non-ambulatory para- or tetraparesis). The 5th was euthanised at the time of diagnosis. Updated ACVIM consensus statement on equine herpesvirus-1. JVIM. Open Access. https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvim.17047 Key questions concerning vaccination, pharmaceutical treatment, pathogenesis, and diagnostic testing are discussed. A few useful reminders: Primary infection (or reactivation of latent infection during periods of stress) causes clinical disease including rhinopneumonitis, epidemic abortion in late gestation, neonatal death and equine herpes virus myeloencephalopathy (EHM). Increasing age, fever, and female sex have been identified as risk factors for EHM. EHV-1 vaccination might limit some signs of disease and the spread of infection, but it must be part of a comprehensive biosecurity program if EHV-1 infection is to be prevented or limited. There is moderate evidence that valacyclovir given to horses in advance of EHV-1 exposure can limit the development of EHM. This strategy could be considered in an outbreak situation pre-exposure when early intervention is possible. It is advisable to test both nasal secretions and blood for the presence of EHV-1. qPCR has surpassed conventional PCR and virus culture for the detection of EHV-1 as a diagnostic tool because of its high sensitivity and specificity. And something from medical neurology to end on…. Sublingual Edaravone Dexborneol for the Treatment of Acute Ischemic Stroke The TASTE-SL Randomized Clinical Trial. JAMA Neurology. Open access. https://jamanetwork.com/journals/jamaneurology/fullarticle/2815107?widget=personalizedcontent&previousarticle=2815832 The major goal of intervention in acute ischemic stroke (AIS) is to salvage the ischemic penumbra. Despite compelling evidence for the potential benefit of brain cytoprotection observed in preclinical animal models, most of the previously published clinical trials evaluating brain cytoprotection have failed to show significant clinical efficacy for patients with AIS. Edaravone dexborneol is a multitarget brain cytoprotective agent with synergistic antioxidant and anti-inflammatory effects. In this randomized clinical trial 914 patients with AIS received sublingual edaravone dexborneol or placebo. The proportion of patients achieving a favourable outcome (defined as a 90-day modified Rankin Scale score of 1 or less) was significantly higher (64.4%) in the sublingual edaravone dexborneol group, compared with the placebo group (54.7%). The rate of adverse events was similar between the 2 groups. This is the first sublingual brain cytoprotective agent to be administered to patients with AIS and the authors report several potential advantages compared with intravenous administration, including faster onset of action, lower dose requirement, improved patient compliance and convenience, and increased bioavailability. February 2024 Use of video-electroencephalography as a first-line examination in veterinary neurology: development and standardization of electroencephalography in unsedated dogs and cats. Frontiers in Veterinary Science – Veterinary Neurology and Neurosurgery.Open access https://www.frontiersin.org/articles/10.3389/fvets.2024.1326165/full This article reports the author’s experience with 150 EEGs (101 dogs and 49 cats), 141 of which were performed without sedation or anaesthesia. Owners were typically present and a median of 40 minutes recording time was achieved using surface electrodes (rather than the more typical needle electrodes). It was often possible to record periods of wakefulness, drowsiness and sleep (with the figures providing nice reminders of the EEG features of these, also of some of the more common artefacts), with additional efforts to trigger epileptic events using photic and/or noise stimulation. Precision medicine using whole genome sequencing identifies a novel dystrophin (DMD) variant for X-linked muscular dystrophy in a cat. JVIM. Open access https://onlinelibrary.wiley.com/doi/10.1111/jvim.16971 This case report documents a 1yo male DSH cat that presented with a 6-month history of progressive difficulty walking with a stiff, stilted gait, macroglossia and dysphagia. Creatine kinase activity was markedly elevated (24 830 IU/L; reference interval 50-200) and immunohistochemistry confirmed absence of dystrophin protein expression in a skeletal muscle biopsy, confirming dystrophin-deficient muscular dystrophy. The authors report their methodology in identifying the causative mutation and demonstrate how improved access to genome sequencing can enable accurate patient diagnosis and support animal model discovery, while also potentially facilitating development of targeted treatments for companion animals (e.g. gene therapies amenable to the patient’s mutation). A retrospective study of the efficacy of zonisamide in controlling seizures in 57 cats. JVIM.Open access https://onlinelibrary.wiley.com/doi/10.1111/jvim.16984 In this study, zonisamide use was retrospectively evaluated in a cohort of 57 cats. A small, but statistically significant, decrease in monthly seizures events and in monthly seizure days was detected following initiation of zonisamide (as either a sole therapy or add on treatment). One or more adverse effects were documented in 26% of the cats, including inappetence, transient sedation, ataxia and/or vomiting. These adverse effects were more common in cats receiving BID treatment compared with SID. ACVIM consensus statement on diagnosis and management of urinary incontinence in dogs. JVIM.Open access https://onlinelibrary.wiley.com/doi/10.1111/jvim.16975 A wealth of information in this consensus statement. For those with an interest in neurology the summaries of the anatomy of the lower urinary tract are very useful, also table 1 (lists important neurogenic causes of storage and voiding disorders), section 5.2.1 (discusses management of functional outflow disorders, with a useful summary in table 3) and Supplemental table 2 (summarises the clinical signs of urinary incontinence that would be expected with various neuroanatomical localisations/disorders). Insights into the clinical presentation, diagnostics and outcome in dogs presenting with neurological signs secondary to infection with Neospora caninum: 41 cases (2014-2023) JSAP https://onlinelibrary.wiley.com/doi/10.1111/jsap.13702 Forty-one dogs diagnosed with Neospora caninum (by serology and/or CSF PCR) affecting the central and/or peripheral nervous system are retrospectively reported. Presenting clinical signs included gait changes, weight loss, lethargy and stiffness. Nineteen dogs (46%) had a multifocal neuro-anatomical localisation and MRI typically documented multifocal, poorly defined areas of T2W hyperintensity with or without heterogeneous contrast enhancement in the neuroparenchyma and/or muscles. Of the 36 dogs for which follow up data was available, two (6%) were reported to make a full recovery, while 10 had a relapse of neurological deficits (28%) and 11 (31%) were euthanised. Cytologic features of canine melanotroph and corticotroph pituitary adenomas. Veterinary Clinical Pathology.Open access https://onlinelibrary.wiley.com/doi/10.1111/vcp.13311 Intraoperative cytology has been documented to improve patient outcome in human neurosurgery but is much less commonly used in veterinary patients. This study reports the cytological features of imprint smears from 12 dogs with a pituitary adenoma obtained during transsphenoidal hypophysectomy. All samples showed classic neuroendocrine features: round to polygonal cells, individually or in small tight clusters, with round to oval, eccentric nuclei and finely stippled chromatin. They had moderate to abundant amounts of grainy cytoplasm with distinct borders and variable numbers of discrete vacuoles. Bare nuclei were also abundant. Cytology did not distinguish between types of pituitary adenoma but appears valuable in differentiating adenomas from other sellar masses such as lymphoma, meningiomas and germ cell tumours. The value of a head turn in neurolocalization. JVIM. Open access https://onlinelibrary.wiley.com/doi/10.1111/jvim.16957 This study prospectively evaluated 49 dogs with a head turn documented at the time of presentation. While a head turn is typically associated with a unilateral forebrain lesion, the authors also documented a head turn in dogs presenting with brainstem, cerebellar and cervical spinal cord disease. Sacral fracture stabilisation using dorsal transiliac locking plates: 12 cases (2017-2023) JSAP https://onlinelibrary.wiley.com/doi/10.1111/jsap.13711 This article reports 12 cases in which paired dorsal transiliac string of pearl plates were placed for sacral fracture stabilisation. The plate fixation was augmented with additional surgical stabilisation in 11 cases (such as transiliac pins or PMMA and screws). No major peri- or postoperative complications were encountered, with successful fracture healing in all 12. Sacral fractures are often concurrent with pelvic fractures and hence these cases might be managed by orthopaedic surgeons primarily, but certainly useful to be aware of the various surgical options available. And a bit of neuroscience for those that might enjoy…. Nucleus pulposus cells regulate macrophages in degenerated intervertebral discs via the integrated stress response-mediated CCL2/7-CCR2 signaling pathway. Nature – Experimental and Molecular Medicine.Open access. https://www.nature.com/articles/s12276-024-01168-4 The critical role of inflammation in progression of intervertebral disc degeneration has recently drawn attention in the medical literature. Anulus fibrosus fissures allow macrophage infiltration into the immune-privileged nucleus pulposus, where they become polarised into a proinflammatory phenotype and amplify an inflammatory cascade. This study specifically investigated how macrophages are recruited and become polarised within the degenerative IVD. The authors found that nucleus pulposus cells recruit macrophages to the IVD region through the chemokine receptor type 2 pathway and promote M1 polarization (“proinflammatory” macrophage phenotype). Blocking the CCR2 pathway (and other upstream signalling pathways) was found to be an effective strategy to alleviate inflammation and the progression of IVD degeneration in an in vivo model. Thus, characterisation of the precise molecular environment of the degenerate IVD could offer novel therapeutic strategies with translational potential. |