Quantitative in vivo measurement of central benzodiazepine receptors in the brain of cats by use of positron-emission tomography and [11C]flumazenil

OBJECTIVE: To map central benzodiazepine receptors (BZRs) in the brain of cats by use of positron-emission tomography (PET) and [11C]flumazenil. ANIMALS: 6 male cats that weighed between 2.0 and 3.6 kg. PROCEDURE: Brain images obtained by PET evaluation of [11C]flumazenil were superimposed on T2-weighted magnetic-resonance imaging (MRI) scans of the same cats. Detailed anatomic regions, such as the cerebral cortex, striatum, thalamus, midbrain, and cerebellum, on the PET images were evident by PET-MRI registration. Regional binding of [11C]flumazenil to BZRs was quantitatively measured by use of a model with 2 tissue compartments and 4 variables. RESULTS: The highest value for distribution volume was observed in the cerebral cortex, and the lowest value was found in the midbrain of cats. CONCLUSIONS AND CLINICAL RELEVANCE: Binding of [11C]flumazenil to BZRs in the brain of cats can be quantitatively measured by use of PET with the aid of PET-MRI registration. It is difficult to diagnose changes in these neuroreceptors within the field of current veterinary science. In the future, PET should prove useful for investigating and diagnosing brain disorders in animals in clinical settings.     

Quantitative electroencephalography of medetomidine,medetomidine-midazolam and medetomidine-midazolam-butorphanol in dogs

The purpose of this study was to evaluate the effects of the administration of an alpha2-adrenoceptor agonist alone and in combination with other derivatives on brain wave activity. In addition, the diagnostic values of the electroencephalogram (EEG) for judging the depth of the balanced anaesthesia with an alpha2-adrenoceptor agonist was evaluated. The treatments comprised 20 microg/kg medetomidine (Me-20), 80 microg/kg medetomidine (Me-80), 20 microg/kg medetomidine and 0.5 mg/kg midazolam (Me-Mi) administered intramuscularly, and 20 microg/kg medetomidine with 0.5 mg/kg midazolam and 0.1 mg/kg butorphanol (Me-Mi-Bu). The EEG was recorded continuously at pre-administration, and at 7, 10, 20, 30, 45 and 60 min after administration. The recorded data were analysed by separating the power spectrum into 1-3, 4-7, 8-13 and 14-30 Hz bands. Spectral-edge analysis was used to calculate the spectral edge frequency 90 (SEF90) and the median edge frequency (MEF). Time-related changes in power spectrum analysis showed a significant increase in the Me-80 group in the 1-3 Hz band. The power for 1-3 Hz in the Me-80 group was significantly higher than in all the other groups. In the 14-30 Hz band, there was a significant reduction of power in all groups following administration of the agents. The SEF90 frequencies were significantly reduced in all groups except for the Me-20 group after administration of the agents. The SEF90 frequencies in the Me-20, Me-Mi and Me-Mi-Bu were all significantly higher than those in the Me-80 group. However, there was no significant difference between the Me-20, Me-Mi and Me-Mi-Bu groups in any analyses. Our results demonstrated that the changes in quantitative EEG made by the Me-Mi-Bu and Me-Mi groups were similar to those made by Me-20 groups. Present results suggest that the EEG should be interpreted with caution in assessing the anaesthetic level in balanced anaesthesia in dogs.     

Comparison of plasma benzodiazepine concentrations following intranasal and intravenous administration of diazepam to dogs

OBJECTIVE: To determine whether plasma concentrations of benzodiazepines (BDZ) in dogs following intranasal (IN) administration of diazepam are comparable to concentrations following IV administration. ANIMALS: 6 (4 male, 2 female) healthy adult Greyhounds. PROCEDURE: Dogs were randomly assigned to 2 groups of 3 dogs in a crossover design. Diazepam (0.5 mg/kg of body weight) was administered intravenously to dogs in group 1 and intranasally to dogs in group 2. Blood was collected from the jugular vein of each dog into tubes containing lithium heparin before and 3, 6, 9, 12, 15, 20, 30, 60, 120, 240, and 480 minutes following diazepam administration. After a 4-day washout period, dogs in group 1 received diazepam intranasally, dogs in group 2 received diazepam intravenously, and blood was again collected. Plasma concentration of BDZ was determined by use of a fluorescence polarization immunoassay. RESULTS: Mean (+/- SD) peak plasma concentration of BDZ following IV administration (1,316 +/- 216 microg/L) was greater than that following IN administration (448 +/- 41 microg/L). Time to peak concentration was < or = 3 minutes following IV administration and 4.5 +/- 1.5 minutes following IN administration. Mean bioavailability of BDZ following IN administration was 80 +/- 9%. CONCLUSIONS AND CLINICAL RELEVANCE: Diazepam is rapidly and efficiently absorbed following IN administration of the parenteral formulation. Plasma concentrations match or exceed the suggested therapeutic concentration (300 microg/L). Intranasal administration of diazepam may be useful for treatment of seizures in dogs by owners or when intravenous access is not readily available.     

Autoantibodies against structures of the central nervous system in steroid responsive meningitis-arteriitis in dogs

Steroid-responsive meningitis-arteriitis (SRMA) is a disease of dogs familiar in small animal practice for decades. A combined evaluation of IgA in serum and cerebrospinal fluid (CSF) is an important diagnostic tool. It is suspected that immunpathological mechanisms are involved in the pathogenesis of SRMA because of the marked response to steroids. Excessive production of IgA seems to play a central role and might be caused by an immune reaction to self-antigens of the central nervous system (CNS). To test this hypothesis, we analyzed CSF samples from 55 dogs with SRMA using the western blot method. After blotting canine brain tissue, IgA, IgM and IgG of the CSF samples were tested for their binding to CNS antigens. We also evaluated CSF samples from 45 dogs with other brain diseases, including different encephalitides and intracranial tumors, and from healthy dogs as controls. Positive reactions (mostly IgA) were observed in the CSF samples from dogs with SRMA, different encephalitides and brain tumors (a total of 8% positive samples). The occurrence of autoantibodies against CNS structures was significantly higher in the control group "other brain diseases" than in the SRMA group (p = 0.0135). There was no significant difference in the number of positive samples between dogs with SRMA and the negative control group (healthy dogs, p = 0.1535). Despite the small number of positive samples, only dogs with abnormal findings in the CSF analysis also had autoantibodies in the CSF. There was no significant correlation between the occurrence of autoantibodies and levels of IgA, protein content and cell counts in the cerebrospinal fluid. However, there was a certain trend toward positive reactions in CSF samples with high protein content. The occurrence of autoantibodies in dogs with SRMA thus seems to be an epiphenomenona rather than the cause of the disease.     

Acute injury to the central nervous system

Central nervous system (CNS) trauma is divided into brain and spinal cord injury. A basic understanding of the pathophysiology of CNS trauma helps the practitioner more accurately evaluate, treat, and prognose cases of CNS trauma. The progressive nature of CNS injuries and the contribution of microvascular ischemic are explored.     

Total protein, albumin quota, and electrophoretic patterns in cerebrospinal fluid of dogs with central nervous system disorders

Cerebrospinal fluid was analyzed for total protein, albumin quota, and electrophoretic patterns of albumin and alpha-, beta-, and gamma-globulins in 10 healthy dogs and 35 dogs with CNS disorders. Values obtained in healthy dogs were used to establish control data. Samples also were collected from dogs with neurologic diseases that were classified according to clinical and pathologic diagnosis as inflammation, neoplasm, and spinal cord compression. The albumin quota and total CSF albumin values were used as indicators of blood-brain barrier disturbance. Four patterns were observed on agarose electrophoresis that included intrathecal immunoglobulin production, intrathecal immunoglobulin production combined with blood-brain barrier disturbance, blood-brain barrier disturbance, and unaltered CSF. These patterns correlated with the observed clinical and pathologic conditions. Seemingly, agarose electrophoresis of CSF is a simple and reliable technique that aids in the diagnosis of CNS disorders of dogs.     

Experimentally induced thiamine deficiency in beagle dogs: pathologic changes of the central nervous system

Brain and spinal cord were examined in twenty-two 2- to 5-month-old Beagle dogs fed a purified thiamine-deficient ration for 84 +/- 42 (range, 32 to 134) days. Eleven dogs were used as principals, 6 were pair-fed controls, and 5 were controls fed ad libitum. Thiamine at 300 micrograms/kg of body weight was administered IM to control groups once a week. Lesions occurred in 2 topographic patterns in the brain of 8 of the principals. In pattern I, only the caudal colliculi were involved. In pattern II, the suprasplenial gyri of the cerebral cortex and the claustra, caudal colliculi, cerebellar nodulus, and medial vestibular nuclei were commonly involved. In both patterns I and II, gray matter was primarily involved, and in bilateral structures, the 2 sides were affected. Lesions were not limited to a given cerebral lamina or layer of the cerebellum, whereas sulcal areas were relatively spared, and the cingulate gyri were completely spared. Microscopic appearance of the lesions varied greatly among locations and individual principals. Collectively, regressive and reparative changes indicated that there was a progressive process which began with spongiosis and ended with tissue necrosis. These included hydropic vacuolation of the neuropil and myelin sheaths followed by demyelination, neuronal cell body necrosis, hypertrophy and hyperplasia of endothelial cells, necrosis of glia, neutrophil infiltration, disintegration of neuropil, and, finally, accumulation of lipid-containing phagocytes. Axonal degeneration was variable. Neuronal necrosis in the brain stem was characterized by acute swelling and lysis and by shrinkage of the cell body in cerebral and cerebellar cortex and basal ganglia.     

Effects of diazepam and flumazenil on minimum alveolar concentrations for dogs anesthetized with isoflurane or a combination of isoflurane and fentanyl

OBJECTIVE: To determine the effect of a constant-rate infusion of fentanyl on minimum alveolar concentration (MAC) of isoflurane and to determine the interaction between fentanyl and a benzodiazepine agonist (diazepam) and antagonist (flumazenil) in isoflurane-anesthetized dogs. ANIMALS: 8 mixed-breed adult dogs. PROCEDURE: Dogs were anesthetized with isoflurane 3 times during a 6-week period. After a 30-minute equilibration period, each MAC determination was performed in triplicate, using standard techniques. Fentanyl was administered as a bolus (10 microg/kg of body weight, IV) that was followed by a constant infusion (0.3 microg/kg per min, IV) throughout the remainder of the experiment. After determining isoflurane-fentanyl MAC in triplicate, each dog received saline (0.9% NaCl) solution, diazepam, or flumazenil. After 30 minutes, MAC was determined again. RESULTS: Fentanyl significantly decreased isoflurane MAC (corrected to a barometric pressure of 760 mm Hg) from 1.80+/-0.21 to 0.85+/-0.14%, a reduction of 53%. Isoflurane-fentanyl-diazepam MAC (0.48+/-0.29%) was significantly less than isoflurane-fentanyl-saline MAC (0.79+/-0.21%). Percentage reduction in isoflurane MAC was significantly greater for fentanyl-diazepam (74%), compared with fentanyl-saline (54%) or fentanyl-flumazenil (61%). Mean fentanyl concentrations for the entire experiment were increased over time and were higher in the diazepam group than the saline or flumazenil groups. CONCLUSIONS AND CLINICAL RELEVANCE: Fentanyl markedly decreased isoflurane MAC in dogs. Diazepam, but not flumazenil, further decreased isoflurane-fentanyl MAC. Our results indicate that diazepam enhances, whereas flumazenil does not affect, opioid-induced CNS depression and, possibly, analgesia in dogs.     

Clinical use of yohimbine as an antagonist of xylazine depression of the central nervous system in cats

Antagonizing effects of various doses of yohimbine on a xylazine depression of the cerebroneural system (CNS) were studied in cats. Administration of various doses of yohimbine was investigated with respect to its antagonizing effects on various doses of xylazine. The time of CNS depression induced by commonly recommended doses of xylazine (2-4 mg/kg live weight) was shortened statistically significantly by intramuscular injections of yohimbine at a dose of 3 mg per kg live weight. After this yohimbine dose, the animals recovered consciousness already 10-15 minutes from application, with the complete resumption of reflexes. Preventive administration of the same dose of yohimbine hindered reliably the full development of CNS depression after the two xylazine doses (2 and 4 mg/kg live weight).     

An immunohistochemical and ultrastructural study on age-related astrocytic gliosis in the central nervous system of dogs.

The pattern of astrocytic gliosis (AG) was examined in 2-month-old to 18-year-old dogs using glial fibrillary acidic protein (GFAP) immunohistochemistry and electron microscopy. Coronal sections from various levels of the central nervous system (CNS) were stained with hematoxylin & eosin, Luxol Fast Blue, Nissl, and Bodian in addition to GFAP. A consistent pattern of age-related AG was observed in the dogs. The white matter, cortico-medullary junction, and subcortical nuclei in the cerebrum, central nuclei in the cerebellum, various nuclei in the brain stem, and grey matter of the spinal cord showed even and intense GFAP staining. AG was also prominent in the cerebral and cerebellar cortices and thalamus. Moderate AG was observed in the hippocampus and white matter of the cerebellum and spinal cord. Electron microscopy demonstrated increased number of profiles of degenerative neural components in the vicinity of hypertrophic astrocytes in the cerebral cortex of the aged dogs. Moderate to severe AG was consistently shown in the CNS of the aged dogs. In contrast, young normal dogs showed minimum amounts of GFAP-positive astrocytes in the CNS. These findings suggest that the observed AG in the CNS of the dogs is a morphological expression of aging.     

Clinical signs, imaging features, neuropathology, and outcome in cats and dogs with central nervous system cryptococcosis from California

Background: Cryptococcus spp. is a fungal pathogen with a predilection for the central nervous system (CNS). Objectives: To compare the clinical, advanced imaging, and neuropathologic findings in dogs and cats with CNS cryptococcosis, and to evaluate outcome of treatment in these animals. Animals: Twenty‐six cats and 21 dogs with CNS cryptococcosis. Methods: Medical records were reviewed for clinical findings and results of CNS imaging. Archived cerebrospinal fluid and CNS tissue specimens were reviewed for pathology. Findings in cats were compared with those in dogs and the effects of variables on survival were determined by survival curve analysis. Results: When present, pain was localized to the cervical region in dogs and was generalized or localized to the thoracolumbar spine or pelvic limbs in cats. Magnetic resonance imaging (MRI) findings were variable but correlated with CNS histopathological findings of meningitis, meningitis with gelatinous pseudocyst formation, and granulomatous mass lesions. Peripherally enhancing brain lesions were seen only in cats. Histopathologically, the inflammatory response was milder in cats compared with dogs. Remissions of ≥1 year occurred in 32% of treated animals. Altered mentation was associated with negative outcome. Glucocorticoid use after diagnosis was associated with improved survival in the first 10 days. Conclusions and Clinical Importance: Lesions seen on MRI reflected neuropathological findings and were similar to those reported in human patients. The immune response to infection may differ between cats and dogs, or relate to the infecting cryptococcal species. Long‐term (>6 month median survival time) survival may be possible in animals surviving ≥4 days after diagnosis.     

Effects of averaging data series on the electroencephalographic response to noxious visceral stimulation in isoflurane-anaesthetized dogs

The effects of averaging epochs on electroencephalographic (EEG) responses to visceral stimulation has been determined in seven isoflurane-anaesthetized dogs. Quantitative EEG variables including 80% spectral edge frequency (SEF80), median frequency (MF), relative power in the δ, θ, α, β band and power band ratios (θ/δ, α/δ, β/δ) were recorded over 1 min before stimulation and during a 1-minute stimulation period. During off-line analysis EEG variables were derived from either single 2-second EEG epochs or as an average from 5, 10, 15 and 30 consecutive 2-second epochs. Noxious stimulation resulted in significant increases in SEF80, MF, α power, β power, α/δ ratio and β/δ ratio. The number of variables that were significantly affected as well as the strength of changes as indicated by p-values, however, varied with the number of epochs subjected to averaging. The data suggest that stimulation-induced EEG changes may be more pronounced at lower rather than at higher averaging rates.     

Effects of averaging data series on the electroencephalographic response to noxious visceral stimulation in isoflurane-anaesthetized dogs

The effects of averaging epochs on electroencephalographic (EEG) responses to visceral stimulation has been determined in seven isoflurane-anaesthetized dogs. Quantitative EEG variables including 80% spectral edge frequency (SEF80), median frequency (MF), relative power in the delta, theta, alpha, beta band and power band ratios (theta/delta, alpha/delta, beta/delta) were recorded over 1min before stimulation and during a 1-minute stimulation period. During off-line analysis EEG variables were derived from either single 2-second EEG epochs or as an average from 5, 10, 15 and 30 consecutive 2-second epochs. Noxious stimulation resulted in significant increases in SEF80, MF, alpha power, beta power, alpha/delta ratio and beta/delta ratio. The number of variables that were significantly affected as well as the strength of changes as indicated by p-values, however, varied with the number of epochs subjected to averaging. The data suggest that stimulation-induced EEG changes may be more pronounced at lower rather than at higher averaging rates.     

Inflammatory disease of the central nervous system

Inflammatory diseases involving the central nervous system can be difficult to diagnose and frustrating to treat. The clinician can maximize successful treatment of these patients by recognizing the clinical signs in the early stages of disease, following a logical diagnostic plan to identify the specific etiologic agent involved, and formulating an appropriate and aggressive therapeutic plan. Treatment will not always be successful owing to lack of effective treatments and irreversible neurologic damage.