VNIOC Blog

Read Veterinary Neurology and Imaging of the Chesapeake's ALL NEURONS FIRING for in-depth case studies, success stories and features about all things neurology, neurosurgery and advanced imaging!

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Brain tumors are unfortunately as common in dogs and cats as they are in people. They’re relatively common in older dogs, but as we’ve seen with many of our patients including Remi and Danny, there are multiple treatment options that can be used successfully.

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Reprinted with permission from www.petfoodology.org

As our pets live longer lives, we face new medical challenges in maintaining them with a high quality of life. One condition that can have an adverse effect on senior pets is Cognitive Dysfunction Syndrome. Cognitive Dysfunction Syndrome (CDS) in pets is similar to dementia in people. Affected pets may have altered sleep-wake cycles, “lose” their housetraining or litterbox training, seem disoriented, and have altered social relationships with people and other pets in the home. All of these changes can reduce the pet’s quality of life and potentially strain the human-animal bond.

CDS is likely under-diagnosed, with many pet owners just assuming that these changes are “normal” aspects of aging. It is estimated to affect up to a third of dogs over age 8 and may affect as many as 50% of cats in their mid to late teens. There are many other health concerns that can potentially result in similar clinical signs and there is no...

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Brain tumors are unfortunately as common in dogs and cats as they are in people. They’re relatively common in older dogs, but as we’ve seen with many of our patients including Remi and Danny, there are multiple treatment options that can be used successfully.

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On October 31, 2019, Rusty Kaehn, a nine-and-a-half year-old Weimaraner, had MRI on that showed he was suffering from caudal cervical spondylomyelopathy (CSM), or Wobbler syndrome. CSM, a disease of the cervical spine (base of the neck) that is commonly seen in large and giant-breed dogs, is characterized by compression of the spinal cord and/or nerve roots, which leads to neurological signs and/or neck pain. The term “Wobbler syndrome” is used to describe the characteristic wobbly gait that affected dogs have.”

Dr. McDonnell performed C4-5 artificial disk replacement surgery on November 19 and, as you can see from the video, Rusty has gone from paralyzed to walking in a month!

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Six-year-old Max is “a big, beautiful, goofy black Lab,” who’s clearly adored by his two humans, Ingrid Bergstrom. and her neurologist husband, Dr. Craig Bogen. Athletic like most Labs, Max is also injury-prone. A year ago he suffered a neck injury so when Max fell down the steps recently, the local ER veterinarian near their home in Delaware recommended going to VNIoC for a full work-up, which would include an MRI.

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On this lovely fall Friday, we received a “thank you” note that warmed our hearts.

Evey Troisi-Hollock is a 12-year-old female spayed mixed breed who presented to Dr. McDonnell in June 2019 for unexplained episodes. Initially, Evey eating and suddenly jumped back from the food bowl and would not return to it, which her owners found very strange. She did not have another episode for 5 months, until she was in the back yard when Evey suddenly came running to her owner with her hair standing up and shaking. She continued to shake for several minutes then was fine for another 2 weeks. However, over the following weekend, Evey had 2 – 3 episodes where she would suddenly jump into her owners’ laps, hair standing up, and shake for 5 – 10 minutes. Other times, she would hide under the dining room table for long periods of time.

Evey’s owner Sommer is a veterinary technician with one of our partner practices, Atlantic Veterinary Internal Medicine and Oncology. She knew these episodes were strange and...

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HELPING PETS IN NEED THROUGH THE AVMF CHARITABLE FUND

VNIoC is proud to be participating in the AVMA’s Veterinary Care Charitable Fund, an umbrella 501c3 administered by the American Veterinary Medical Association that allows us to accept donations for care of neurology patients in need of financial assistance.

Funds are used to provide neurology and imaging care for (but not necessarily limited to):

  • Support for local rescue organizations
  • Support for local service animals, such as police, fire and rescue, or service animals for armed services veterans
  • Local disaster relief where animals are at risk
  • Assistance for low-income senior citizens
  • Assistance to local shelters/law enforcement agencies for care of animals in cruelty cases
  • Assistance for persons affected by unforeseen financial...
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REFERRING BACK EMERGENCIES: THINGS TO KNOW

The referral process for a back fracture, paraplegic dog +/- negative deep pain perception:

  • During the day (8am-6 pm), call 410-828- 0911 ext 5 to set up a transfer.
  • Outside of normal hours, please refer the patient directly to Pet+E.R. (Towson), where we can facilitate a direct transfer first thing in the morning.
  • The neurologist will examine the patient and review any previous work-up prior to meeting with owner, and will be able to expand on the prognosis and process from that point on.

How urgent is urgent? Surgical priorities and prognostications:

  • Paraplegia with absent sensation should be worked-up within 12-24 hours.
  • Paraplegia with intact sensation should be given the option to treat medically or proceed with work-up and surgery within 24-48 hours.
  • Ambulatory paraparesis or tetraparesis with normal sensation needs to be seen by a neurologist as soon as scheduling allows.
  • Dogs with signs consistent with FCEs, dogs with hemivertebrae...
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When a patient with suspected neurological disease presents to Veterinary Neurology & Imaging of the Chesapeake, there are a number of steps in the process of identifying, diagnosing and treating their condition. The first step includes a thorough physical and neurologic exam to evaluate the patient’s symptoms and neurologic capabilities. From the examination, we assess the location of the problem and create a rule-out list. From this, we will perform confirmatory advanced neurodiagnostics such as magnetic resonance imaging (MRI) or computed tomography (CT). Both CT and MRI use powerful computers to reconstruct the anatomy in three dimensions.

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When your cat is acting strangely, you notice. Vestibular Disease in cats is characterized by head tilting, vomiting, and droopy face along with unnatural eye movements. As pet owners, none of us like it when our pets are sick. We want to get them help right away. Veterinary Neurology and Imaging of the Chesapeake located in Annapolis, Maryland, has your pets’ best interests at heart. We strive to provide all animals with the best quality of life possible. Specializing in nervous system disorders, we offer MRIs, CSF (Spinal Taps), and Baer testing on animals, which allows us to diagnose and treat nervous system disorders.

WHAT IS VESTIBULAR DISEASE IN CATS?

Vestibular disease or feline vestibular syndrome affects the cat’s inner ear, which controls balance and coordination. Known as the vestibular system, the inner ear’s working also control vertigo and...

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Watching your dog have a seizure can be quite scary. You usually have no idea what to do if this is your first experience with seizures in dogs. After the episode is over, you schedule an appointment with your veterinarian who suggests you see a vet specialist, particularly a veterinary neurologist who specializes in the neurological systems of animals. Your primary vet emphasizes the importance of the proper diagnosis for overall treatment and health of your pet as there are different types of seizures dogs can have.

Veterinary Neurology and Imaging of the Chesapeake in Towson have some of the most experienced veterinary neurologists in the country. Our compassionate and caring veterinary neurologists will diagnose and treat disorders of the neurological system in your pet. We treat dogs, cats, and other animals. Contact us today for more information.

WHAT IS A SEIZURE IN DOGS?

If you’re like most people, you didn’t even realize there were different types of seizures in dogs. It’s important to...

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When most of us hear the word “meningitis”, we get a sinking feeling in our guts. Meningitis, although rare, affects the membranes of the brain and spinal cord (known as meninges). When these meninges become infected by viruses or bacteria, the infection can cause death.

Meningitis in dogs is very similar and can result in death as well. This neurological disease inflames these protective membranes, which can cause seizures and paralysis as well. What makes meningitis so dangerous as it is often misdiagnosed as the flu, resulting in a delay in treatment. Early diagnosis is key to a successful recovery.

Veterinary Neurologist & Imaging of the Chesapeake located in Annapolis, MD, specializes in the diagnosis and treatment of meningitis in dogs. If you suspect your dog has meningitis, call your vet immediately or visit an emergency pet hospital in order to give your dog the best chance of successful treatment.

SIGNS OF MENINGITIS IN DOGS

These symptoms of meningitis vary among dogs....

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As pet owners, our main job is to take care of our pets. This includes feeding them adequate meals and portions, filling their water bowls, taking them for walks or playing indoors for exercise, and, of course, giving them lots of love. Another one of our jobs as a pet owner is to take our pets to the pet doctor or veterinarian for regular check-ups and when we suspect something is wrong.

Thus, when we see our dogs’ heads trembling or shaking for no reason, we get worried. Of course, our dogs can’t tell us what’s wrong with them or why they’re doing it. First stop is a call to your local veterinarian. Head tremors can be a symptom of many issues or illnesses in dogs. Often, when a neurological issue is found, your local veterinarian will refer you to a specialist — in this case, a neurological veterinarian such as Veterinary Neurology & Imaging of the Chesapeake in Annapolis, Maryland. Like other neurological veterinarians, we specialize in the diagnoses and treatment of neurological disorders in pets. Usually, we rule...

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A 10-year-old female spayed German Shepherd dog presented to the neurology service for new onset of seizure activity. Her previous medical history included hypothyroidism (well-controlled on medication), anal sac adenocarcinoma (surgically removed 2 years prior), and lumbosacral disc disease (surgically treated approximately 4 months prior). Her medications at that time included soloxine, carprofen, gabapentin, and amitriptyline. Levetiracetam was added to her regimen the night prior by the emergency service. Neurologic exam that morning revealed mild paraparesis and proprioceptive ataxia. Differential diagnoses included neoplasia, inflammatory disease, and less likely idiopathic epilepsy given the patient’s age at time of onset.

An MRI of the brain and skull was recommended under general anesthesia. The dog was classified as an ASA III patient due to the concern for brain disease, but with mild clinical signs. She was pre-medicated with butorphanol (0.3mg/kg IV) approximately 30 min prior to onset of the procedure. She was induced with midazolam (0.2mg/kg IV) and propofol...

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We are so happy to be part of healing these wonderful companions. Check out these short videos of a terrific pooch making his way back home! Thanks to all of our vet partners and pet-parents who trust us to get their loved-ones up and atom once again.

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If you’ve ever been to Healing Hands Animal Hospital on the Eastern Shore, you’ve likely met Simba the cat, who’s been the “practice pet” for the past 11 years. His family signed him over to Dr. Carol Ross Lewis after Simba was hit by dump truck and sustained serious injuries. While Simba healed well, he was left with a crooked jaw and a tongue that often stuck out.

As Stephanie Bystrak, the practice’s Reception Manager explains, Simba soon found his “job” at the practice. “Simba became our mascot. He’d hang out at the front desk and greet people and their pets. At Christmas, we’d put him in a Santa suit. He has quite the personality and doesn’t mind being dressed up in the least!”

In 2015, the staff noticed that Simba seemed wobbly. His tongue was protruding more, and he couldn’t jump up to his usual perches in the lab. “Dr. Lewis examined him and became very concerned that something neurological was going on, so we took him to Dr. McDonnell.”

An MRI revealed a meningioma, so Dr. McDonnell performed a craniectomy on the then 11-year-old cat.

That was 28...

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This is a picture of a cat’s food dishes after it had eaten.

Why do you think they look like this?

We suspect this is an example of “hemi-neglect” in a cat.

Hemi-neglect, hemi-inattention or hemi-spatial neglect is a neuropsychological condition in people where they do not have awareness to the opposite visual field after damage to one hemisphere of the brain. For instance, if a person sustains damage to the left cerebral hemisphere, they are unable to process and perceive stimuli on one side of the body or environment.

Sydney, a 13-year-old FS DMH cat, had brain surgery the day before the photo of her food was shot. She had a large meningioma involving her right cerebral hemisphere removed (see below).

Hemi-inattention is not well defined in veterinary patients but in this situation, we assume the phenomenon resulted in Sydney failing to identify the food in her left visual field.

We solved this problem for Sydney by spinning her food bowl 180 degrees—and she happily ate the food right up. At her two-week recheck, Sydney did not show any...

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WHAT HAPPENS WHEN A PET IS ANESTHETIZED?

Q: While the majority of veterinary anesthesiologists are employed by veterinary teaching hospitals., you’ve opted to work in private practice, Veterinary Imaging of the Chesapeake (VIoC). Why is having a veterinary anesthesiologist so important in this type of practice?

A: When a patient —whether a human or animal—is undergoing an MRI, the patient must remain absolutely motionless throughout the procedure. The only way to ensure this with an animal is to anesthetize it. My job is to develop, implement and oversee an individualized anesthesia protocol that brings the animal safely through the procedure and recovery. So many different diseases that are treatable and even curable can only be definitively diagnosed using MRI; it’s gratifying being part of that process.

I also develop anesthetic protocols for referring veterinarians who have questions on how best to manage their patients that have complex or unusual issues.

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Free CVRC Spring CE Conference: Two Tracks, One Day-Sunday, March 11

For the second year, CVRC is hosting two conferences on the same day at the elegant Chesapeake Bay Beach Club, Stevensville, Maryland.

Veterinarians and Registered Veterinary Technicians from the mid-Atlantic are invited to take in lectures by CVRC’s board-certified veterinary specialists, with opportunities to mingle during breakfast and lunch. Join us for the Continuing Education, terrific food, the opportunity to catch up with colleagues–and the chance to take home attendance prizes.

We anticipate 6 hours of Maryland-approved CE for each track.

REGISTRATION OPENS JANUARY 11. To register, visit https://cvrcspringconference18.eventbrite.com

Last year both tracks sold out. If you find your track is sold out, please add your name to the wait list!

NOTE: Out of respect for our venue, please note that no denim or ball caps will be permitted.

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We hope everyone had a fabulous and fun New Year’s Day, and that your 2017 closed out well with the holidays. Family, friends, food and festivities are a great way to celebrate.

Ready or not, 2018 is here! We’ve got lots of things going on at Veterinary Neurology and Imaging of the Chesapeake. In the coming months, we’ll be bringing you news, information and some entertaining stories on these pages.

Update on our new facility and new technology

The new CVRC-Annapolis building is well underway. The exterior is nearly completed and our team is finalizing the interior plans. The building will be 28,000 square feet, with VNIoC occupying over 2,800 square feet of dedicated space.

We will be bringing in a 16-slice Toshiba CT to complement our 1.5 T Phillips MRI. Pet Cure Oncology will be adjacent to our “wing,” providing stereotactic radiosurgery as well as conventional radiation treatment.

The likely date for occupying our new space is currently September. More information will follow!...

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There are thousands of cases of Canine Cushing’s Disease in the U.S. each year, but the current medical treatment is medication given daily or several times per week that treats the symptoms.

Surgery for pituitary macroadenomas in dogs and cats has been pioneered by Björn P. Meij, DVM, PhD, Dipl ECVS of the University of Utrecht in the Netherlands. His transphenoidal hypophysectomy was first refined in the early 1990s and has proven to be an excellent treatment for the tumors that cause hyperadrenocorticism (Canine Cushing’s disease). In human medicine, pituitary surgery (hypophysectomy) is the treatment of choice for functional pituitary tumors.

Despite Meij’s pioneering work and the proven success of the technique over other treatments such as radiation and chemotherapy, the surgery has failed to be widely adopted as a viable treatment option. The technique is technically challenging and has a very steep learning curve so Dr. McDonnell went to the Netherlands in the spring of 2010 to study with Dr. Meij; and he also arranged a special seminar with Dr. Meij at the...

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PART 1: OVERVIEW & DIAGNOSIS

The diagnosis of brain tumor in a much-loved dog or cat can be overwhelming for an owner—and it can be a great concern for the family’s veterinarian who typically doesn’t see this type of condition frequently.

The one thing we try to stress to both is: The diagnosis of brain tumor does not mean that the situation is hopeless. In fact, it is curable in many cases. Some of the most rewarding cases we’ve seen are dogs and cats that are 5 years post-surgery with no disease recurrence.

In this article, we’ll look at which animals are more prone to brain tumors, the common symptoms and types of tumors, and their diagnosis. Next month, we’ll review treatment options and outcomes.

ANIMALS AFFECTED & DISEASE ONSET

Brain tumors are a common cause of neurological dysfunction in older dogs and cats. The average age when the animal presents symptoms is 9-11 years in dogs and 10-12 in cats. Golden Retrievers, mixed breeds, Labrador Retrievers, Boxers, Boston Terriers and domestic short...

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Seizures are one of the most common complaints in veterinary neurology. While canine seizures may be caused by head trauma, brain tumors, toxins, infections, birth defects and many other identifiable causes, the vast majority of seizures in young dogs (one to three years old) are idiopathic or genetic epilepsy.

By definition, an idiopathic epileptic

  • has their first seizures between one and four years old.
  • has a normal metabolic workup, including a chemistry profile, pre- and postprandial bile acids, CBC and urinalysis.
  • has a normal interictal neurologic exam.
  • if performed, the brain MRI and CSF analysis are normal.

The type and frequency of seizures—partial/focal, generalized, cluster, etc.—does not necessarily reflect the underlying cause. For example, patients with idiopathic epilepsy can initially present with cluster seizures or even in status epilepticus. Alternatively, a patient with a brain tumor may present having had a single generalized seizure, after which their recovery is complete and their neurologic exam is...

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Our dog Tinker had to go out for his daily walk. His story will be posted here again shortly.

In the meantime, please review our other blog posts or contact us directly for any information.

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Metronidazole is a synthetic nitroimidazole compound used in small animal practice for the treatment of inflammatory bowel disease, gastritis associated with helicobacter, giardiasis and empirical treatment of diarrhea. Metronidazole is also used to alter intestinal flora in dogs with hepatic encephalopathy and exocrine pancreatic insufficiency.

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Discospondylitis is an infection of the intervertebral disk and adjacent vertebra and may be associated with significant illness and neurologic impairment if definitive diagnosis and initiation of appropriate antimicrobial treatment are delayed.

The infection typically spreads to the intervertebral disk via the bloodstream from another source of infection such as the bladder, reproductive organs, abscesses, open wounds, respiratory tract and oral cavity. Migrating foreign bodies and penetrating wounds can also be a source of infection. Bacterial infections, especially staph infections, are more common and typically easier to treat than fungal infections.

Clinical signs in affected animals are often nonspecific and highly variable and can include lethargy, anorexia, weight loss, fever and spinal pain. Affected dogs may be neurologically normal or they may have varying degrees of neurologic impairment spanning from spinal pain only to paralysis. Neurologic deficits in this disease can be the result of extrusion of intervertebral disk material, scar...

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The most common neurosurgical cases for dogs are those of the thoracolumbar (T3-L3) spine, the cervical-cervicothoracic (C1-T2) spine and intracranial surgery. Knowing when to refer your neurosurgical cases can be the most artful of the art and science of veterinary medicine.

We wish to provide our patients with the best options for a successful outcome, while not needlessly running unwarranted and potentially dangerous tests.

The most common questions I receive about these types of cases from veterinarians in general practice are:

  1. When should I refer?
  2. What should I do prior to referral?
  3. If the owner declines a referral, what recommendations should I provide for the pet and the owner?

Please keep in mind that, as I attempt to answer these questions, it is with the understanding that all cases are not the same and I can only provide general guidelines for the “typical case.”

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1. What is a spinal arachnoid cyst?

A spinal subarachnoid cyst is not actually a cyst; instead it is a fluid-filled dilation within the subarachnoid space. It’s best referred to as an Arachnoid Diverticulum (plural=Diverticula). The term “pseudocyst” has been used to describe this abnormality as well.

2. What are the clinical signs and history of a Spinal Arachnoid Diverticulum?

It depends on the location. If found in the thoracolumbar spine, spastic long-strided pelvic limb weakness with spinal ataxia that is slowly progressive over several months is one clinical sign. Fecal incontinence is another common sign with thoracolumbar arachnoid diverticulae. Anal tone is normal; however dogs will drop stool in the house or outside while walking (without posturing and without apparent awareness).

3. Who is affected by an Arachnoid Diverticulum?

Any dog can be affected; however middle-aged Pugs and juvenile to young adult Rottweilers are over-represented. Arachnoid diverticula have also been reported in...

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For more than 15 years, I’ve had a special interest in the definitive treatment of cervical spondylomyelopathy (CSM or Wobbler Syndrome). The two most commonly recognized forms of the disease include the static form (young Great Danes and Mastiffs) and dynamic CSM (middle-aged Dobermans, Rottweilers and retrievers).

Over the past several years, I have been involved in development of a new surgical treatment that treats dynamic CSM in a much more physiological manner: cervical arthroplasty using an artificial disc developed by Dr. Filippo Adamo in California (see video below). I am the first veterinary neurosurgeon in the mid-Atlantic area to perform the procedure.

Not only do we feel this surgery provides a better outcome for dynamic CSM; it is less invasive, requires minimal post-op care and hospitalization, reduces post-op pain and discomfort, has a lower mortality rate and a lower cost to the owners. Some dogs that are ambulatory when they come in can be operated on as outpatients.

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In July, Shannon G. and her family brought home two Yorkie puppies, Benny and his sister, Pippa. After having Benny groomed, they noticed Benny started to wobble. His condition worsened over the next few days to the point where Benny fell and couldn’t get up.

“We took him to our regular veterinarian who put Benny on steroids and antibiotics, but when we tried to wean him off the steroids, he got worse,” Shannon related recently. “On our third visit to the vet, he took an x-ray and saw a problem with the axial cervical spine. He then referred us toVNoC. After examining Benny, the neurologist explained that Benny was missing a bone that connects the cervical and axial spine. We could have gone with a neck brace since the neurologist said Benny could still be growing, but we realized that that was only a stopgap measure. After having lost two Yorkies last April, we wanted to do whatever we could to make Benny better. So we decided to do the surgery right away.”

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1. Why is my dog trembling or shaking? Could it be a seizure?

There are many reasons your dog may be shaking or trembling including stress or anxiety, cold, pain, muscular weakness, a neurological problems, chronic kidney disease and Generalized Tremor Syndrome (GTS). GTS is a condition that was first seen in small, white dogs such as Maltese and West Highland white terriers, but it can occur in dogs of any size, breed or color. The cause of GTS isn’t known, but it is treatable with corticosteroids like prednisone.

It is unlikely that your dog’s trembling or shaking is a seizure, but if you are unsure of the cause, it’s best to have your dog checked by your veterinarian.

2. What are the symptoms of a seizure in dogs?

A seizure can have several manifestations, from a far-away look or twitching in one part of the face to a dog falling on its side barking, clenching and unclenching its teeth, urinating, defecating and paddling all four limbs. Seizures can vary in time between seconds to hours.

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1. My dachshund is having trouble walking. My vet suspects that it’s a problem with his spine. Is there anything that can be done—or will my dog end up in a doggie wheelchair?

Dogs that can barely walk and those that can’t walk at all due to disk disease have an 80% to 95% chance to return to normal function with surgery.

First however, tumors, infections, strokes in the spine, and other conditions must be ruled out before a diagnosis of disk disease must be made. The gold standard for diagnosis of intervertebral disk disease (IVDD) is veterinary MRI.

After surgery, most dogs have a rapid recovery and can return to normal function in days to weeks. Medical treatment alone can provide improvement in 50-60% of cases, but 50% of those relapse within 6 to 10 months, typically with the problem in the same site. Those who have had surgery have little likelihood of relapse since surgery eliminates the problem.

Dogs that end up in carts either didn’t have the surgery, received medical treatment alone but are in the 40-50% that don’t respond to...

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1. What is Feline idiopathic vestibular disease?

Feline idiopathic vestibular disease (IVD) is a disease of uncertain cause that affects the peripheral (outside the brain) vestibular system.

Although the origin of the disease has yet to be determined, it is speculated that it occurs due to an inflammatory process that affects the peripheral vestibular apparatus of the labyrinth – a sensory system located deep within your cat’s ear that is responsible for maintaining balance and movement.

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There’s exciting, ground-breaking research on brain tumors in dogs being done by G. Elizabeth Pluhar, DVM, PhD and John Ohlfest, PhD and their colleagues at the University of Minnesota.

The Canine Brain Tumor Clinical Trial Program they direct seeks to further cutting edge brain tumor treatment using dogs with naturally-occurring brain tumors — the same tumors that humans get. Their goal is to offer therapy intended to preserve quality of life for the dogs and improve long-term survival rates. Additionally, they use the information gained from treating dogs to design similar treatments for people with brain tumors.

Brain tumors occur in dogs more frequently than they do in humans: 20 per year per 100,000 canine populations at risk compared with 18.1 per 100,000 humans. Canine glioma, an aggressive type of brain tumor, occurs most frequently in brachycephalic breeds (those with a broad, short skulls) such as Boxers and Boston terriers, although the tumors occur in other breeds, as well. Researchers have found that there are a number of similarities between canine...

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Veterinary neurologists often evaluate, diagnose, and treat patients that are referred to us for back pain and/or weakness. Polyarthritis is often considered the Great Imitator as patients suffering from this problem can appear very similar to patients with intervertebral disc disease, myopathies, meningitis, and even myasthenia gravis.

The most critical step required to diagnose polyarthritis is to consider it on your differential diagnosis list. As neurologists, we harp on localizing the lesion (i.e. C1-C5, T3-L3, left prosencephalon, etc.) and if you can’t localize the lesion because you’re only finding poorly localized back pain, think, “What about the joints?” In patients with polyarthritis, the facet joints of the vertebral column may be affected and/or the pressure placed on the back may cause discomfort in the hock or stifle joints. In patients without an obvious neuroanatomic localization, remember to pay special attention to the joints.

Initial clinical signs may include lethargy, inappetance, pyrexia, reluctance to walk, shifting-leg lameness, and poorly...

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When older pets (age 10 year or older) have a seizure, the owner’s first thought typically is, “This has to be a tumor or something else bad. This must be a death knell for my pet.” I’d like to assure you: This isn’t necessarily true.

Every week in my practice I see geriatric pets that have had seizures. When we do a work-up with MRI and spinal tap, often there are NO terminal conditions present.

Frequently in dogs, the cause of the seizure(s) is a stroke. It’s valuable to utilize a CSF tap and MRI to make a diagnosis of stroke as we know that many pets will not get worse. Instead, with treatment using standard anti-convulsants, they recover with minimal deficits. Another advantage to diagnosis is that we are able to anticipate future stroke episodes and prevent them.

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Degenerative myelopathy (DM) is a poorly understood, progressive neurodegenerative disease seen in many dog breeds. Onset of the disease is typically is seen in dogs age 8 to 14.

Degenerative myelopathy begins with the spinal cord in the chest. The degeneration is two-fold: demyelination, i.e. the stripping away of the protective covering (myelin sheath) that surrounds nerve fibers in the spinal cord, and interference in the communication between the brain and the limbs.

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A much anticipated study describing the distribution of Canine Degenerative Myelopathy (DM) across a huge spectrum of canine DNA covering 222 breeds has been released. The genetic marker SOD1 alleles has previously been associated with the progressive neurological disease of Canine Degenerative Myelopathy. DNA samples from over 35,000 individual dogs representing 222 breeds and and cross-bred dogs were reviewed.

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1. What are idiopathic head tremors?

Idiopathic head tremors are a series of repetitive, horizontally (“no” gesture) or vertically-directed (“yes”), involuntary muscle contractions involving the head and neck. A typical episode lasts about three minutes (yet may seem to last much longer as you are watching it!).

Dogs remain fully conscious and aware during the episode, and when the episode ends, your dog should be completely unaffected. The tremors are benign – meaning the dog is not caused any pain or distress, and there are no short or long-term effects.

2. Who gets them?

Young to middle-aged male and female dogs are most commonly affected. All dogs including mixed breed dogs have been seen with these tremors but Dobermans, Bulldogs, French Bulldogs, Boxers, and Labradors seem to be more commonly affected.

3. What causes them?

We don’t know, hence the term “idiopathic.” The exact cause of head tremors has yet to be determined. However, the most likely cause is dyskinesia (a movement disorder)...

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The Article: Clinical signs and outcome of dogs treated medically for degenerative lumbosacral stenosis: 98 cases (2004-2012) Steven de Decker, DVM, PhD; Lauren A. Wawrzenski, BVetMed; Holger A. Volk, DVM, PhD JAVMA, Vol 245, No4, August 15, 2014

Degenerative lumbosacral stenosis (DLSS) is a disorder that creates narrowing of the lumbosacral region and compression of the cauda equina. This is a multifactorial disease and is caused by a combination of many issues, such as Hansen type-II interverteblral disk protrusion, ligamentous and articular process hypertrophy, osteophyte formation, and vertebral misalignment. This is typically a disease of large breed dogs and can cause a clinical signs ranging from pain in the lumbosacral region to severe neurologic deficits in the hind end, and urinary and fecal incontinence.

As many surgical treatments for DLSS have been described, this paper was written to determine to outcomes of dogs treated medically for DLSS and to determine which dogs may be good candidates for medical treatment.

This was a retrospective study using...

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The Article: Magnetic resonance imaging features of Great Danes with and without clinical signs of cervical spondylomyelopathy Paula Martin-Vaquero, DMV, PhD, and Ronaldo C. da Costa, DMV, PhDJAVMA, Vol 245, No 4, August 15, 2014

Given the highly sensitive nature of MRI in evaluating the spinal cord and vertebral canal stenosis, potential for over-interpretation of the study can occur. For this reason, it is important to understand the frequency and variation of “normal” that can be seen on a clinically asymptomatic patient. Few veterinary studies have been conducted on MRI findings of clinically normal dogs.

Great Danes often have osseous-associated cervical spondylomyelopathy (CSM), which is different than the disc-associated CSM. This prospective cohort study of cervical spine MRI of 15 clinically normal and 15 CSM affected Great Danes was conducted to help characterize the morphological features between these groups.

Thirty client-owned Great Danes were enrolled in this study at The Ohio State University between April 4, 2011 and...

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vet examining a cat

Spinal cord diseases in cats can be incredibly frustrating. The adventure starts with the uncooperative patient, winds its way through the dreaded neurologic examination interpretation, and ends in the sea of diseases that could be causing the clinical signs. It’s not easier for a board certified neurologist, but there are some things that we can share that might be helpful.

Tips on neurologic examination in cats

Cats essentially say, “I don’t want to play your game and I am not going to participate.” However, there are ways to get them to participate without their knowledge or even with their cooperation. If you need some reminders on the neurological examination, please see, “The Neurological examination of the cat” by Laurent Garosi in the Journal of Feline Medicine and Surgery, 2009 Volume 11. We would like to emphasize a couple of key points:

  1. Gait Analysis – This is incredibly important in cats. Since time is always crucial, let the patient walk around the room while you are getting the history from the owner. Break the cat down into three...
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DEMENTIA IN DOGS: WHEN AN OLD DOG CAN’T REMEMBER OLD TRICKS

Dementia—a clinical state in which cognitive function declines—is well-known as a disease that afflicts aging humans. There’s less awareness that dementia is a disease seen in companion animals, especially dogs. In fact, dementia, also known as senility or cognitive dysfunction, may be a normal aging change in older pets. There does appear to be a substantially accelerated form of dementia seen in some dogs.

The diagnosis of cognitive dysfunction in companion animals generally requires the presence of two or more of the following behavioral changes in the absence of any physical causes:

  • Decreased interaction with the pet’s owners. The dog may appear confused or distant, or have increased irritability.
  • Slowness in obeying commands, even those learned at a young age and practiced frequently.
  • Alterations in sleep-wake cycle. The dog sleeps more during the day and less at night.
  • ...
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Epilepsy, convulsions, fits, and seizures are alarming and disturbing events to both dogs and their owners. A seizure can have several manifestations, from a far-away look or twitching in one part of the face to a dog falling on its side barking, clenching and unclenching its teeth, urinating, defecating and paddling all four limbs.

Seizures can vary in time between seconds to hours. They indicate a disturbance of the brain. There are many causes of seizures in dogs. A diagnosis of seizure disorder does not mean that nothing can be done for a dog. There are many treatment options, depending on the cause of the seizures.

Epilepsy is found in all dog breeds including mixed breeds. The breeds for which a genetic factor is either proved or highly suspected include the Beagle, Belgian Tervuren, Dachshund, German Shepherd Dog, Alsatian and Keeshond. A high incidence of seizure disorders is also found in Boxers, Cocker Spaniels, Collies, Golden Retrievers, Irish Setters, Labrador Retrievers, Miniature Schnauzers, Poodles, Saint Bernards, Siberian Huskies, and Wire‑Haired...

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The Article: Clinical Characterization of Epilepsy of Unknown Cause in Cats. A.M.Wahle, et al. J Vet Intern Medicine 2104; 28: 182-188

This study tries to determine the prevalence of Epilepsy of Unknown Cause (EUC) in cats. Idiopathic epilepsy in dogs and humans is presumed to be genetic. [See Dr. McDonnell’s previous articles, Canine Epilepsy: An Information Guide and Geriatric Onset Ideopathic Epilepsy, for more on this subject.] However, causes for feline seizures haven’t been systematically reviewed.

Many times we falsely assume that a cat has “epilepsy of unknown cause” without a complete work-up and start anticonvulsants that simply treat the symptoms. The authors postulate that EUC is being overestimated in cats because a rigorous work-up is not followed. A typical recommended work-up needed for the diagnosis of EUC includes either a high field strength MRI scan or a post-mortem exam (PME). All of this is important because if we can diagnose a cause for the...

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