Risk factors associated with short‐term mortality and recurrence of status epilepticus in dogs

BackgroundStatus epilepticus (SE) is an emergency associated with serious consequences for both patient and owner. Data regarding risk factors for short‐term mortality or recurrence in dogs with SE is limited.ObjectiveIdentify risk factors associated with short‐term mortality (euthanasia or spontaneous death) and recurrence of SE in dogs.AnimalsOne hundred twenty‐four client‐owned dogs that sustained an episode of SE.MethodsRetrospective multicenter study using data collected from medical records of dogs presented in SE to the contributing institutions. Multivariable logistic regression analysis was performed using a manual backwards stepwise approach to identify risk factors associated with short‐term mortality and recurrence of SE after discharge.ResultsShort‐term mortality for affected dogs was 29.8%. Factors significantly associated with short‐term mortality included increased patient age, shorter duration of hospitalization, development of SE before arrival, and SE caused by a potentially fatal etiology. Status epilepticus recurred in 27% of dogs that survived to discharge. Factors significantly associated with recurrence of SE included prior history of pharmacoresistant epilepsy and predominance of a focal seizure phenotype.Conclusions and Clinical ImportanceOur results may be used to inform clinicians and dog owners regarding risk factors for both short‐term mortality and recurrence in dogs with SE.     

Magnetic resonance imaging findings in Finnish Spitz dogs with focal epilepsy

Eleven Finnish Spitz dogs with focal seizures and 3 healthy controls were evaluated. General clinical and neurological examinations, blood examination, urinalysis, cerebrospinal fluid examination, electroencephalography (EEG), and magnetic resonance imaging (MRI) of the brain were performed on all dogs. On EEG examination, focal epileptic activity was found in 7 of 11 dogs (64%), and generalized epileptic activity was observed in 4 of 11 dogs (36%). MRI (performed with 1.5 T equipment) detected changes in 1 epileptic dog. Mild contrast enhancement after gadolinium injection was identified in this dog's right parietal cortex. However, no such changes were observed in repeated magnetic resonance images. Special emphasis was given to seizure history to determine any correlations between seizure intervals and MRI findings. Our results indicate that Finnish Spitz dogs with focal seizures suffer from focal idiopathic epilepsy and have nondetectable findings on MRI or pathology. MRI showed poor sensitivity in detecting epileptogenic areas in our patients with focal seizures. Reversible MRI changes in 1 dog could have been caused by seizures.     

Assessment of the use of plasma and serum chloride concentrations as indirect predictors of serum bromide concentrations in dogs with idiopathic epilepsy

BACKGROUND: Bromide (BR) administration causes pseudohyperchloremia when plasma or serum chloride (Cl-) concentrations are determined with commonly available automated analytical assays. In humans receiving BR, it has been previously demonstrated that the plasma Cl- concentration is a useful indirect estimator of the measured BR concentration. OBJECTIVE: The objective of this study was to determine if the magnitude of pseudohyperchloremia seen in epileptic dogs treated with BR could be used as a predictor of the measured serum BR concentration. METHODS: Plasma and serum Cl- concentrations, analyzed by ion-specific electrode (ISE) and colorimetric techniques, and serum BR concentrations, determined using the gold-trichloride assay, were simultaneously determined in 88 blood samples from dogs with idiopathic epilepsy that were treated with BR. RESULTS: For all methods used to quantify Cl- concentrations, there were significant (P < .0001) linear relationships between BR and Cl- concentrations. Linear relationships between BR and Cl- concentrations were significantly different (P < .0001) between blood samples from dogs obtained during routine therapeutic monitoring and those obtained during emergency hospital admissions. Calculated 95% prediction intervals for future values of BR using measured Cl- concentrations contained considerable error. Plasma Cl- values determined with ISE generally provided the best prediction of serum BR concentrations. Agreement between the measured BR and Cl- using all Cl- assay techniques was moderate, but was statistically significant only when Cl- was assayed in plasma using one ISE method. CONCLUSIONS: The pseudohyperchloremia observed in epileptic dogs receiving BR is an inadequate indirect estimator for the measured BR concentration, although in certain clinical situations identified through construction of a clinical decision tree, the measured Cl- value can be used to guide general therapeutic decisions regarding alterations in BR therapy. Optimal tailoring of BR therapy in dogs with idiopathic epilepsy should be based on results of therapeutic monitoring of BR concentrations.     

Benign familial juvenile epilepsy in Lagotto Romagnolo dogs

BACKGROUND: Idiopathic childhood epilepsies with benign outcomes are well recognized in human medicine, but are not reported in veterinary literature. We recognized such a neurologic syndrome in Lagotto Romagnolo dogs. ANIMALS: Twenty-five Lagotto Romagnolo puppies from 9 different litters examined because of simple or complex focal seizures and 3 adult Lagotto Romagnolo dogs exhibiting similar clinical signs were used. METHODS: Clinical and diagnostic evaluations of affected dogs were conducted, including electromyography, electroencephalography, and other testing. RESULTS: Seizures in puppies began at 5 to 9 weeks of age and usually resolved spontaneously by 8 to 13 weeks. Those with the most severe seizures also had signs of neurologic disease between these seizures, including generalized ataxia and hypermetria. There were no abnormalities in routine laboratory screenings of blood, urine, and cerebrospinal fluid. Electromyography, brainstem auditory-evoked potentials, and magnetic resonance imaging revealed no specific and consistent abnormalities. Fourteen of 16 (87.5%) affected puppies and 2 of 3 (67%) adult dogs revealed epileptiform activity in the electroencephalogram. Histopathologic examination in 1 puppy and 1 adult dog revealed lesions of Purkinje cell inclusions and vacuolation of their axons restricted to the cerebellum. Pedigree analysis suggests an autosomal recessive mode of inheritance. CONCLUSIONS AND CLINICAL IMPORTANCE: This disorder, with simple or complex focal seizures and cerebellar lesions, represents a newly recognized epileptic syndrome in dogs.     

Quantitative assessment of pupillary light reflex in normal and anesthetized dogs: a preliminary study

The purpose of this study was to quantitatively assess the pupillary light reflex (PLR) in normal and anesthetized dogs using a pupillometer. Eleven dogs (20 eyes) of various breeds were included. PLRs were measured with a handheld pupillometer in dim light before and during anesthesia. Anesthesia was conducted with atropine, xylazine and ketamine. Parameters of pupillometry included neurological pupil index (NPi), pupil size, percent of change (%CH), latency (LAT), constriction velocity (CV), maximum constriction velocity (MCV) and dilation velocity (DV). NPi,%CH, CV and MCV were significantly decreased during anesthesia compared with the pre-anesthesia data. The results suggest that atropine-xylazine-ketamine combination anesthesia depresses the PLR. Additionally, this study demonstrates the feasibility of the use of a pupillometer in dogs.     

Patient characteristics,prognostic factors and outcome of dogs with high‐grade primary mediastinal lymphoma

The goals of this retrospective study were to determine the patient characteristics of dogs with high‐grade primary mediastinal lymphoma and to determine outcome and associated prognostic factors. A total of 42 dogs were identified, in which 36 received treatment and had follow‐up information available. The most common clinical signs included lethargy, anorexia and polyuria/polydipsia. Hypercalcemia and pleural effusion were common findings at diagnosis. The phenotype was almost exclusively T‐cell, most often in association with lymphoblastic cytomorphology as defined by the World Health Organization (WHO) lymphoma classification scheme. The overall progression‐free survival (PFS) and overall survival (OS) were 133 and 183 days, respectively. Treatment with a CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) protocol was associated with an improved PFS (144 days) and OS (194 days) when compared with dogs that received other medical therapies (P = .005 and P = .002, respectively); the absence of pleural effusion at diagnosis was associated with an increased OS but not PFS. These results suggest that while the prognosis for dogs with mediastinal lymphoma is poor, survival may be improved with treatment using a CHOP‐based protocol.