A 1.5-year-old Chihuahua was presented with clinical signs consistent with multifocal localisation. MRI revealed hydrocephalus internus. Following placement of a ventriculoperitoneal (VP) shunt with a low-pressure valve, improvement was noted. Clinical signs returned one month later. A second MRI revealed subdural haematoma, meningeal reaction and slit-like ventricles, and was interpreted as overshunting. Saline solution was injected in the ventricles via the shunt, which was then ligated. Clinical improvement was noted, followed again by relapse three months later. A third MRI revealed recurrence of hydrocephalus internus. The VP shunt was reconnected and, additionally, the valve was positioned and fixed in a vertical position. A disconnection of the valve occurred two weeks later, and the owners elected euthanasia. Complications following VP shunting in this case reveal many similarities to those described in overshunting in people and should be considered as a possible complication.
The term “meningoencephalitis of unknown origin” (MUO) describes a group of different encephalitides in dogs in which no infectious agent can be identified and a multifactorial etiology is suspected. Among others, genetic factors and unknown triggers seem to be involved. Included are necrotizing leukoencephalitis (NLE), necrotizing meningoencephalitis (NME), and granulomatous meningoencephalitis (GME). In this case series, we describe the histopathological findings of four toy breed dogs with focal or multifocal necrotizing encephalitis and mainly lymphocytic perivascular infiltrates on histopathological examination. At the same time, however, in all dogs, focal or multifocal high-grade angiocentric granulomatous inflammatory lesions were evident with focal histiocytic perivascular infiltrates in the brain. The former changes are typical for NLE and NME. In contrast, the latter changes are indicative of GME. This case series shows that the boundaries between the necrotizing and granulomatous variants of MUO might be smooth and suggests that NLE, NME, and GME are not as distinct as previously described. This finding could be a crucial piece of the puzzle in the study of the pathogenesis of MUO as individual susceptibility and specific triggers could be responsible for the manifestation of the different MUO subtypes.
Background Hemorrhage in the spinal canal leads to further damage of the spinal cord influencing outcome in dogs with intervertebral disk (IVD) extrusion. The aim of the study was to evaluate blood degradation products and ferritin in the cerebrospinal fluid (CSF) of dogs with thoracolumbar IVD extrusion, and their association to clinical parameters and MRI findings. Results In the CSF of dogs with IVD extrusion, both net oxyhemoglobin absorption (NOA) and net bilirubin absorption (NBA) were significantly higher compared to the control groups of dogs with steroid responsive meningitis arteritis (SRMA) and idiopathic epilepsy (IE) ( P < 0.001), but NOA compared to the idiopathic epilepsy group contaminated artificially with blood (IEc) was not ( P = 0.890). Ferritin concentration was significantly higher in dogs with IVD extrusion compared to dogs with IE ( P = 0.034), but not to dogs with SRMA ( P = 0.526). There was no association between NOA, NBA or ferritin concentration and severity or duration of clinical signs. In dogs with a higher ferritin concentration the outcome was better ( P = 0.018). In dogs with evidence of hemorrhage on MRI, NOA and NBA were significantly higher ( P = 0.016, P = 0.009), but not ferritin ( P = 0.0628). Conclusion and clinical importance Quantification of blood degradation products and ferritin in the CSF of dogs to assess subarachnoidal hemorrhage is feasible; however, larger case numbers are needed to evaluate the relevance of NBA and ferritin as prognostic indicators.
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