Dysautonomia in dogs: 65 cases (1993-2000)

OBJECTIVE: To determine signalment, history, clinical findings, results of autonomic function testing and other antemortem diagnostic tests, and pathologic findings in dogs with dysautonomia. DESIGN: Retrospective study. ANIMALS: 65 dogs with dysautonomia. PROCEDURE: Case records of 68 dogs with a diagnosis of dysautonomia were reviewed; inclusion criteria included histologic confirmation of dysautonomia or clinical signs and results of pharmacologic testing consistent with dysautonomia. RESULTS: 65 dogs fulfilled all criteria for dysautonomia. Dogs from rural environments were overrepresented, and cases of dysautonomia were reported for every month, although the highest number of cases was reported in February and March. Vomiting was the most common clinical sign, followed by diarrhea, signs of anorexia and depression, weight loss, and dysuria. The most common physical examination finding was decreased or absent anal tone, followed by absent pupillary light reflexes and elevated nictitating membrane. Results of pharmacologic testing were consistent with dysautonomia, although no single test was 100% sensitive. Histologic lesions consistent with dysautonomia were found in the autonomic ganglia, brainstem nuclei, and ventral horns of the spinal cord. CONCLUSIONS AND CLINICAL RELEVANCE: Dysautonomia is an endemic disease in Kansas, and a high index of suspicion of the disease can be made by combining clinical signs, physical examination findings, and results of pharmacologic testing.     

Clinical equine dysautonomia and autonomic neuron damage.

Damage to the neurons of selected autonomic ganglia was quantified in relation to the severity of the clinical signs shown in acute, subacute and chronic cases of dysautonomia (grass sickness). No connection between the clinical severity of acute or subacute dysautonomia and the amount of neuronal damage in the superior cervical, stellate and coeliaco-mesenteric ganglia could be demonstrated. However, a higher proportion of normal neurons were found in chronic cases. Jejunal submucosal neuronal damage was correlated with clinical severity but further work is required to confirm this finding and to establish how widespread the alimentary neuronal lesions are in dysautonomia of different severities.     

Feline dysautonomia (the Key-Gaskell or dilated pupil syndrome): a preliminary review

Features of 46 cases of feline dysautonomia are described and the current state of knowledge of this syndrome reviewed with emphasis on practical aspects of diagnosis and management of such cases.     

Autonomic dysfunction in a Jack Russell terrier

A 4-year-old Jack Russell terrier was presented with an array of clinical signs suggestive of autonomic dysfunction. Many of the clinical signs were consistent with a diagnosis of dysautonomia; however, both chronicity and resolution of signs contradicted a diagnosis of this disease.     

Small intestine and small colon neuropathy in equine dysautonomia (grass sickness)

The number of neurons in the coeliacomesenteric ganglia and the myenteric and submucosal plexuses of the jejunum, ileum and small colon, and the pathological changes induced in them, were studied in various types of equine dysautonomia. In all forms of dysautonomia, severe and extensive neuron loss and damage occurred in the ileum. In acute and subacute dysautonomia, jejunal neuron loss and damage were severe, but in chronic cases significantly less loss or damage occurred. The damage followed the same pattern in the small colon but it was always less obvious than in the jejunum. The distribution of the damage was uniform within a segment of the intestine. In fatal cases of dysautonomia, the clinical severity and duration of illness seems, in most instances, to be related to the amount of neuronal disruption occurring in the jejunum. Severe disruption results in acute/subacute dysautonomia, while milder damage leads to the chronic form.No case of dysautonomia was encountered in which enteric neuron loss and damage occurred without significant neuronal disruption also occurring in the coeliacomesenteric ganglia.Ileal neuronal damage and loss are not invariably worse than that in the jejunum, and the possible reasons for this, together with the relationship between neuronal damage and possible causes of dysautonomia, are discussed.Abbreviations H&E haematoxylin and eosin Deceased. Formerly of the Moredun Research Institute, 408 Gilmerton Road, Edinburgh, EH17 7JH, UK     

Feline dysautonomia (the Key-Gaskell syndrome): a clinical and pathological study of forty cases

Feline dysautonomia is a dysfunction of the autonomic nervous system, the main features of which are dilated pupils, dry mucous membranes, mega-oesophagus and constipation. The clinical and pathological features, treatment and follow-up details of 40 cases seen at the University of Glasgow Veterinary School are described. The pathology was demonstrated to be mainly restricted to the autonomic ganglia and neurons in selected cranial nerve nuclei. Less marked changes were also found in neurons of the spinal cord and dorsal root ganglia. Nine cases recovered but this required up to one year and, in some, mild clinical signs persisted. Viral, toxicological and epidemiological studies were unrewarding and the aetiology is presently unknown. The similarities between this condition, grass sickness of horses and dysautonomia in the dog and man are discussed.     

Development of a clinical prediction score for detection of suspected cases of equine grass sickness (dysautonomia) in France

Equine grass sickness (EGS) (equine dysautonomia) is a neurodegenerative condition of grazing equines. Pre-mortem diagnosis of EGS is a challenge for practitioners as definitive diagnosis requires ileal/myenteric lymph node biopsies. This study aimed to develop a clinical score that could be used by practitioners to improve the detection of acute or subacute EGS cases in the field. Suspected EGS cases were declared by veterinary practitioners. A case was classified as confirmed positive if ileal or rectal biopsy samples showed neuronal degeneration typical of EGS. A semi-quantitative scoring system, including epidemiological and clinical data, was created to attempt to classify suspected EGS horses into confirmed positive or negative cases. Each variable was weighted based on a boosted regression trees model, while taking into account its clinical relevance. Twenty-eight EGS cases were confirmed by biopsy during the entire study period. The best cut-off value for the score to have a high sensitivity while maximizing specificity was 8, with a sensitivity of 100% and a specificity of 53%. In our dataset, 77% of animals would be correctly classified with this cut-off value of 8. Highest sensitivity was chosen in order to detect the highest number of potential cases. Our score represents an inexpensive and useful tool to aid in the identification of suspected EGS cases in the field and selection for further diagnostics procedures to confirm or rule out the disease. Application of the score to larger populations of animals would be required to further adapt and refine the score.     

RADIOGRAPHIC FINDINGS OF CANINE DYSAUTONOMIA IN TWENTY-FOUR DOGS

Canine dysautonomia is an idiopathic condition resulting in loss of autonomic nervous system function. Recently, the prevalence of dogs diagnosed with dysautonomia in the mid-western United States has increased. In this study the medical records and radiographic findings in 24 dogs with dysautonomia were reviewed. A diagnosis of dysautonomia was made in 17 (71%) of the dogs in this study by postmortem examination, the remaining 7 (29%) dogs were diagnosed pharmacologically. The radiographic findings supportive of dysautonomia include aspiration pneumonia, megaesophagus, or a distended stomach, small bowel, or urinary bladder. In some instances, the disease radiographically mimicked other disorders of the gastrointestinal tract, including mechanical obstruction.     

Feline dysautonomia in the Midwestern United States: a retrospective study of nine cases

Dysautonomia of domestic animals is pathologically characterized by chromatolytic degeneration of the neurons in the autonomic nervous ganglia that results in clinical signs related to dysfunction or failure of the sympathetic and parasympathetic nervous systems. The exact cause is unknown. It has a poor prognosis among all species reported and no definitive treatment is available currently. To date, most reported feline cases have occurred in the United Kingdom and Scandinavia. The cases reported here highlight the clinical signs, physical examination findings, and results of autonomic nervous system function testing in nine cats with dysautonomia in the US. Feline dysautonomia is uncommon in the US, but may have a regional prevalence, as is seen in dogs with most cases reported in Missouri and Kansas.     

Incidence of canine dysautonomia in Missouri,USA, between January 1996 and December 2000

A cross-sectional survey of 217 veterinary facilities in Missouri, USA, was conducted to gather information about the occurrence of canine dysautonomia between January 1996 and December 2000. The state was divided into seven geographic regions for sampling, and 40 veterinary facilities from each region were selected randomly by computer-generated numbers to receive the questionnaire. Veterinarians from 74% (95% CI: 69, 79) of clinics in the state that saw canine patients were aware of dysautonomia prior to receiving the survey, and 43 respondents from five of the seven sampled regions stated that dysautonomia had been diagnosed in their practices during the study period. Respondents had diagnosed 182 cases of dysautonomia, leading to an estimated statewide total of 609 (95% CI: 272, 946) cases over the 5 years. Regional incidence estimates ranged from 0 to 1.91 cases per 10,000 dog years at risk. Case-fatality risk was 92%.     

Dysautonomia in a family of German shorthaired pointers.

Four, 5-week-old German shorthaired pointers from a litter of five puppies were presented for evaluation of vomiting and diarrhea. The dam was euthanized for suspected dysautonomia, and the fifth puppy died 1 day prior to presentation. On presentation, two puppies had vomiting and diarrhea, and the other two appeared healthy. The results of testing supported the diagnosis of dysautonomia in the two affected puppies but not in the healthy puppies. On day 5 of hospitalization, one apparently healthy puppy developed vomiting and diarrhea and had supportive testing for dysautonomia. Dysautonomia was confirmed at necropsy in affected dogs.     

Changes in nasal mucosal innervation in horses with grass sickness

REASONS FOR PERFORMING STUDY: Equine grass sickness is a dysautonomia characterised by widespread destruction of autonomic ganglia, resulting in the clinical signs of dysphagia, constipation, profuse sweating, tachycardia, rhinitis sicca and high mortality rate. Rhinitis sicca is a common finding in horses with the chronic form and we have postulated that alterations in autonomic innervation of the nasal mucosa might underlie this clinical presentation. OBJECTIVES: In this study, the expression and distribution of nerve fibres immunoreactive for calcitonin gene-related peptide (CGRP), substance P (SP), the general neuronal marker protein gene-product 9.5 (PGP 9.5; ubiquitin) and the intermediate neurofilaments (PAN-N; neurorfilaments L, M and H) in the nasal mucosa of normal horses (n = 10) and horses with EGS (n = 18; acute n = 8, subacute n = 3, chronic n = 7) was assessed. METHODS: Innervation density and distribution was investigated in the different groups using standard immunohistochemical techniques. RESULTS: Significant differences were noted when comparing the density and distribution of nerve fibres immunoreactive for PGP 95 and PAN-N, with PGP 95 consistently giving better staining in all groups and at all sites in the nasal mucosa. An apparent increase in the density of innervation was noted for acute vs. normal cases. A significant reduction in the density of innervation was noted only with PAN-N when comparing normal horses and acute cases with the chronic group (P < 0.05). CGRP and SP immunoreactive nerve fibres were typically most abundant in the epithelial and subepithelial layers, but the quality of staining and nerve fibre density was greater for SP, achieving significant difference in several comparisons. The density of innervation for SP was significantly reduced in the chronic group compared to the normal and acute groups (P < 0.01). A significant decrease was noted for CGRP only for the acute and chronic groups (P<0.05). CONCLUSIONS: These results demonstrate a reduction in the expression of the sensory neuropeptides in nasal mucosal innervation as a consequence of equine dysautonomia, and may underlie the clinical presentation of rhinitis sicca noted with this disease. POTENTIAL RELEVANCE: Nasal biopsy may be of use in antemortem diagnosis of grass sickness and identification of mucosal denervation; and might also be useful in the treatment of rhinitis in EGS cases.     

Dysautonomia in a six‐year‐old mule in the United States

Equine dysautonomia, also known as equine grass sickness (EGS), is a well documented disease in several countries. To the authors’ knowledge, EGS has not been reported previously in North America. This report describes EGS in a 6‐year‐old female mule in the USA. Failure initially to consider EGS resulted in a delayed diagnosis. EGS should be considered as a differential diagnosis and appropriate diagnostic tests performed in similar cases in North America.     

犬临床常见皮肤病的诊断与治疗

引起犬皮肤病的因素很多,论文通过查阅文献结合宠物临床诊疗病例,对犬皮肤病类型进行综合梳理,并对各类型皮肤病诊断和治疗进行阐述。     

Crusted scabies (sarcoptic mange) in four cats due to Sarcoptes scabiei infestation

Four new cases of sarcoptic mange in cats are described. Two cats resided in areas known to be frequented by foxes, another cohabited with a dog recently diagnosed with sarcoptic mange, while the final cat lived with a mixed breed dog that had been treated for sarcoptic mange 7 months previously. Three cases were diagnosed on the basis of characteristic mite size and morphology in skin scraping from representative lesions, situated on the head (two cases) or head and distal hind limbs (one case). Mites were highly mobile and abundant in all instances, and easily detected also in skin biopsy specimens procured from two cases. Eosinophilic inflammation, hyperkeratosis and parakeratosis were prominent in the tissue sections. In the remaining case, the diagnosis was presumptive, based on characteristic lesions, cohabitation with a canine scabies patient and positive response to scabicide therapy. Pruritus was not a prominent clinical feature in any patient and was considered to be absent in three of the four cases. Lesions in three cats with long-standing disease were reminiscent of crusted scabies (synonym: Norwegian scabies, parakeratotic scabies) as seen in human patients. In three cases, in-contact human carriers developed itchy cutaneous papular lesions. Two cases responded promptly to therapy with systemic avermectin drugs, while one responded to topical treatment with lime sulphur and the remaining cat received both a lime sulphur rinse and ivermectin. Sarcoptic mange should be considered in the differential diagnosis of cats with non-pruritic crusting skin diseases, especially when there is contact with foxes or dogs, and when owners have itchy papular lesions.     

Progressive ethmoidal haematoma in horses

Progressive ethmoidal haematoma was diagnosed in 12 Thoroughbreds, 1 part- Arab and 1 stock horse. Ages ranged from 3 to 18 years and both males and females were affected. Diagnosis was based on history, clinical signs, endoscopic and radiographic findings, and was confirmed histologically in 10 cases. Eleven (78%) of the lesions were unilateral and 3 (22%) were bilateral. Two horses were euthanased on diagnosis, 4 were treated conservatively. Of the latter, 3 were euthanased 6 to 24 months after diagnosis, due to progression of the lesions, while 1 case resolved completely within 13 months. Eight horses were treated by surgical excision of the lesion. Three died in the post-operative period, 3 were euthanased within 48 months after recurrence of the condition, and 2 had no recurrence within 60 and 72 months, respectively.     

微量元素缺乏导致绵羊脱毛症的诊断和治疗

绵羊脱毛症通常具有一种或多种病因。通过对某羊场羊群进行流行病学调查以及临床症状初步诊断,发现有22只羊疑似发生脱毛症,再随机选择患有脱毛症的羊只共计10只,对血清中19种元素进行测定,被检血清中Zn、I含量均低于参考值,3只羊血清中Cu含量略低于参考值。根据初步诊断、寄生虫检测、血清常量及微量元素检测结果,确定该养殖场羊只脱毛症的发病原因主要为Zn、I、Cu缺乏,补充相应元素治疗2周后,22只脱毛症病羊全部治愈,治愈率100%。     

Thoracic actinomycosis (arcanobacteriosis) or nocardiosis causing thoracic pyogranuloma formation in three dogs

OBJECTIVE: To describe three cases of canine thoracic actinomycosis (arcanobacteriosis) or nocardiosis in which the primary pathological lesion was a pyogranulomatous abscess in the mediastinum. Clinical signs, difficulties in diagnosis, treatment and prognosis are examined. Comparisons are made between human and veterinary literature to assist in formulating a rational treatment plan. DESIGN: Retrospective clinical study. PROCEDURE: Review of case records from 1984 to 1998. RESULTS: Three dogs presented with large intrathoracic pyogranulomas producing variable clinical signs, not necessarily associated with the respiratory tract. Ages ranged from 2 to 5 years old. Two dogs responded to surgical opening and passive drainage of the abscess, or surgical excision of the granuloma with associated structures, and medical therapy. One dog died intra-operatively. CONCLUSION: A combination of surgical and antimicrobial therapy may carry a fair-to-good prognosis for thoracic granuloma caused by actinomycosis (arcanobacteriosis) or nocardiosis. The extent of surgery should be based on assessment of individual cases and must include surgical biopsy for histology and culture to enable a specific diagnosis to be made. Complete surgical excision is not necessarily required. Prolonged antimicrobial therapy is indicated.     

P-83 Intradermal testing in cattle: evaluation of sensitization to Dermatophagoides extracts in healthy cattle and cattle infected with Psoroptes or Chorioptes

The purpose of this retrospective study was to evaluate six cases of equine sarcoidosis for initial presenting symptoms, response to therapy and actual outcome. Dermatologists and dermatopathologists from Europe, the United States, Australia and Canada were contacted to obtain these six cases, as this is a rare disease. Signalment, clinical signs, histological findings, clinical management and outcome were determined via a questionnaire and compared to former reports. There was no age or breed predilection, and four of six horses were geldings. Age of onset ranged from 3 months to 17 years. Onset of the disease was insidious or rapid. Interestingly, in five of six cases, scaling began on the trunk (girth and shoulder). Scaling, crusting and alopecia were seen in all six horses. In one horse, clinical signs of systemic disease were reported and included intermittent fever, prescapular lymphadenopathy, depression, poor body condition and nasal discharge. Treatment included phenylbutazone, deworming agents, antibiotics, short-term low-dose corticosteroids, and 1–1.5 mg/kg of prednisolone. One horse showed a partial response to trimethoprim and sulfonamide, and five of six went into clinical remission with corticosteroid treatment. Five of six horses were still alive 1 year after diagnosis; one horse was diagnosed <12 months ago. Two horses are in complete remission 4 and 8 years after diagnosis. In both horses, clinical signs recurred after cessation of therapy and went into remission again with reintroduction of treatment. Both of these horses have been in remission for several years without therapy.
Funding: Self-funded.     

P‐81 A retrospective study of equine sarcoidosis

The purpose of this retrospective study was to evaluate six cases of equine sarcoidosis for initial presenting symptoms, response to therapy and actual outcome. Dermatologists and dermatopathologists from Europe, the United States, Australia and Canada were contacted to obtain these six cases, as this is a rare disease. Signalment, clinical signs, histological findings, clinical management and outcome were determined via a questionnaire and compared to former reports. There was no age or breed predilection, and four of six horses were geldings. Age of onset ranged from 3 months to 17 years. Onset of the disease was insidious or rapid. Interestingly, in five of six cases, scaling began on the trunk (girth and shoulder). Scaling, crusting and alopecia were seen in all six horses. In one horse, clinical signs of systemic disease were reported and included intermittent fever, prescapular lymphadenopathy, depression, poor body condition and nasal discharge. Treatment included phenylbutazone, deworming agents, antibiotics, short‐term low‐dose corticosteroids, and 1–1.5 mg/kg of prednisolone. One horse showed a partial response to trimethoprim and sulfonamide, and five of six went into clinical remission with corticosteroid treatment. Five of six horses were still alive 1 year after diagnosis; one horse was diagnosed <12 months ago. Two horses are in complete remission 4 and 8 years after diagnosis. In both horses, clinical signs recurred after cessation of therapy and went into remission again with reintroduction of treatment. Both of these horses have been in remission for several years without therapy. Funding: Self‐funded.