Posterior Paresis Research Articles

Arterial Thromboembolism in a Domestic Cat – A report

Arterial thromboembolism is more common in cats. Generally, it develops without premonitory signs. When the thrombus lodged in aortic trifurcation posterior paresis develops. This paper documents one such case and its successful management. A four-year-old male domestic short-haired cat was presented with a history of being unable to stand and walk for the past three hours. Clinical examination revealed that there was paraparesis on hind limbs, pulselessness in both the hind limbs, cold extremist and digital paws that looked cyanotic. Echocardiographic, radiographic and hemato-biochemical analyses were inconclusive. The absence of femoral pulse, pain and absence of blood flow in the Doppler blood pressure crystal and ultrasonographic exam confirmed the aortic thromboembolism. The animal was treated with buprenorphine @ 0.02 mg/kg every 6 hours, injection enoxaparin @ 1 mg/kg every 8 hours and tablet clopidogrel 75 mg total dose (1/4 -0 – 0). On the fourth day of therapy, the animal showed deep pain, improvement in the digital pad (Fig 3) and mild voluntary motor activity. On the seventh day of therapy, the animal showed significant improvement and after 10 days of therapy, the animal showed an uneventful recovery. The paper presents paraparesis due to aortic thromboembolism in a domestic cat and its management.

Thoracic and abdominal aortic dissection in a hypertensive hyperthyroid cat

Aortic dissection is an uncommon finding in both dogs and cats. The precise pathophysiological mechanisms responsible for the development of aortic dissection remain unclear. In humans, aortic dissection is usually secondary to another systemic disease, such as systemic arterial hypertension, an abnormality of connective tissues or a parietal trauma. This is a case of an aortic dissection in a hypertensive hyperthyroid cat, presenting with haemorrhagic pericardial effusion. The dissection affected both thoracic and abdominal aorta, with histopathological confirmation. This case is an example of the utility of both thoracic and abdominal ultrasound for the diagnosis of aortic dissection in cats and it highlights the importance of rigorous clinical examination. Aortic dissection should be considered in the differential diagnosis of pericardial effusion in cats. Further investigations are fundamental to understand how dissections develop and extend to achieve good clinical results.
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 Chetboul et al. (2006) Quantitative assessment of velocities of the annulus of the left atrioventricular valve and left ventricular free wall in healthy cats by use of two-dimensional colour tissue Doppler imaging. Am. J. Vet. Res. 2006, 67: 250-258.
 Cojocaru et al. (2013) Evaluation of oxidative stress in patients with acute ischemic stroke. Romanian Journal of Internal Medicine. 51(2):97-106.
 D’Ancona et al. (2014) Computational analysis to predict false-lumen perfusion and outcome of type B aortic dissection. The Journal of Thoracic and Cardiovascular Surgery. 148 (4):1756-1758.
 Gouni et al. (2018) Aortic dissecting aneurysm associated with systemic arterial hypertension in a cat. Schweiz Arch Tierheilkd. 160(5):320-324.
 Liao et al. (2008) A proteomic study of the aortic media in human thoracic aortic dissection: implication for oxidative stress. Journal of Thoracic and Cardiovascular Surgery. 136(1):65-72.
 Liu et al. (2016) Ursodeoxycholic acid attenuates acute aortic dissection formation in angiotensin II-infused apolipoprotein E-deficient mice associated with reduced ROS and increased Nrf2 levels. Cellular Physiology and Biochemistry. 38(4): 1391-1405.
 Phillippi et al. (2009) Basal and oxidative stress-induced expression of metallothionein is decreased in ascending aortic aneurysms of bicuspid aortic valve patients. Circulation. 119(18):2498-2506.
 Qin et al. (2016) Dynamic monitoring of platelet activation and its role in post-dissection inflammation in a canine model of acute type A aortic dissection. Journal of Cardiothoracic Surgery. 11(1):86.
 Qing et al. (2012) Ex-vivo haemodynamic models for the study of Stanford type B aortic dissection in isolated porcine aorta. European Journal of Vascular and Endovascular Surgery. 44(4):399-405.
 Waldrop et al. (2003) Aortic dissection associated with aortic aneurysms and posterior paresis in a dog. Journal of Veterinary Internal Medicine. 17(2):223-229.
 Wang et al. (2013) An experimental model of Stanford type B aortic dissection with intravenous epinephrine injection. Kaohsiung Journal of Medical Sciences. 29(4):194-199.
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Video Head Impulse Test Findings in Patients With Benign Paroxysmal Positional Vertigo Secondary to Idiopathic Sudden Sensorineural Hearing Loss

Benign paroxysmal positional vertigo (BPPV) is amongst the most common causes of episodic vestibular syndrome. It can be classified as idiopathic and secondary types according to the causative factors, and the underlying mechanism between idiopathic (i-BPPV) and secondary BPPV (s-BPPV) may differ. Idiopathic sudden sensorineural hearing loss (ISSNHL) has been considered as a common inner ear disease that precipitates s-BPPV. Yet, few studies have addressed the functional impairment of the semicircular canal (SCC) system in patients with s-BPPV associated with ISSNHL. Our purpose was to explore the pathophysiological mechanism and investigate the clinical implications of video head impulse test (vHIT) in these patients. Here, the clinical and laboratory data of patients with BPPV secondary to ISSNHL, including the results of vHIT, were retrospectively reviewed, and compared with those of patients with i-BPPV. Pathological vHIT findings (low vestibulo-ocular reflex gain and re-fixation saccade), which mainly affected the posterior SCC, were more common in the s-BPPV group than in the i-BPPV group (41.9 and 0%, respectively). The incidence of horizontal SCC involvement was also higher in the s-BPPV group (45.16 and 16.67%, respectively). Furthermore, patients with s-BPPV showed lower vHIT gains of the posterior and horizontal SCCs in affected ears than in unaffected ears. Compared to i-BPPV, posterior SCC paresis detected by vHIT is more prevalent in BPPV secondary to ISSNHL. This dysfunction may be associated mainly with vestibular impairments caused by ISSNHL, and not with BPPV per se.

Diagnosis of cervical chordoma in domestic ferrets (Mustela putorius furo): 3 cases

Chordomas on the tip of the tail are tumors commonly diagnosed in ferrets. Chordomas are known to originate from intraosseous remnants of the fetal notochord. Reportedly, they occur less frequently in the spinal column. Three cases of cervical chordoma were diagnosed using advanced diagnostic modalities including computed tomography (CT) and/or magnetic resonance imaging (MRI). Two cases were treated with radiotherapy. Two were diagnosed antemortem using cytology, while two were confirmed postmortemb by histopathology are described. In Case 1, a 4-year-old, castrated male ferret presented with ambulatory tetraparesis and tetra-ataxia with no obvious lateralization. In Case 2, a 4.5-year-old castrated male ferret presented with progressive ataxia, depression, and lethargy. A firm ovoid mass could be palpated extending from his left tympanic bulla to C2 vertebrae . Case 3, a 7-year- old, castrated male presented with a history of posterior paresis, ataxia, falling to the right side and central nervous system depression. On physical examination pronounced weakness and a firm non-displaceable mass on the cervical region surrounding the atlas dorsally and ventrally was noted. CT alone was utilized in one of the three cases while CT combined with MRI facilitated the diagnosis of one case, and MRI alone was also used in one case for diagnosis. Antemortem cytologic diagnosis was used in two ferrets prior to radiation therapy, as well as postmortem histologic in two of the three cases. CT and/or MRI were utilized for the diagnosis of cervical chordomas in three ferrets along with cytology and/or histopathology. Radiation therapy as used in two of these cases may be a viable option in some cases to palliate clinical signs related to chordomas in ferrets, albeit further research is needed.

Clinical and neurological evaluation following treatment with ultrasound and diathermy in dogs suffering from posterior paresis

Clinical and neurological evaluation following treatment with ultrasound and diathermy in dogs suffering from posterior paresis

MYCOTIC PNEUMONIA AND ENCEPHALITIS IN SOUTHERN PUDU (PUDU PUDA).

This case series describes six confirmed cases of mycotic encephalitis and/or mycotic pneumonia in southern pudu (Pudu puda). One case involved a 10.5-yr-old intact female that presented with an inability to stand, eventually progressing to grand mal seizures. Magnetic resonance imaging showed a lesion within the cerebellar vermis with edema causing cerebellar herniation. The animal was euthanized based on a grave prognosis. Gross and histologic examination revealed primary central nervous system phaeohyphomycosis. Curvularia spicifera was sequenced from the cerebellar tissue. This is the first time this fungus has been reported as a primary central nervous system infection in an artiodactyl species. The remaining five cases occurred in neonates between 17 and 67 days old. Clinical signs varied widely, including facial swelling, weakness, posterior paresis, and sudden death. Antifungal therapy was initiated in three neonatal animals but was unsuccessful in each case. All neonates had active mycotic pneumonia caused by Aspergillus fumigatus or Mucor spp. at time of death; four of these animals also had disseminated disease that caused mycotic encephalitis. This case series indicates that fungal disease should be included in the differential diagnosis list of any pudu presenting for neurologic or respiratory clinical signs.

Aortic thromboembolism with hind limb paralysis in a Japanese Black calf

A 7-day-old Japanese Black calf was presented to a local veterinarian with chief complaints of acute astasia, posterior paresis, and anorexia. Traumatic spinal injury was initially suspected. However, physical examination revealed hind leg coldness, absence of bilateral femoral artery pulse and deep pain sensation, diminished spinal reflexes, and dry gangrene of hind legs, suggesting thromboembolism of external iliac arteries. Increased activities of AST, LDH, and CPK were also suggestive of necrosis. On necropsy, a thrombus was found at the abdominal aortic bifurcation to bilateral external iliac arteries. Septic bacterial infection was suspected as the cause of aortic thromboembolism because Pseudomonas aeruginosa and Alcaligenes spp. were isolated from the thrombus. Aortic thromboembolism should be included in the differential diagnosis of posterior paresis.

Development of Polioencephalomyelitis in Cesarean-Derived Colostrum-Deprived Pigs Following Experimental Inoculation with Either Teschovirus A Serotype 2 or Serotype 11

Teschovirus encephalomyelitis is a sporadic disease associated with Teschovirus A (PTV) serotype 1 and, less frequently, other serotypes. In recent years, the number of cases submitted to the Iowa State University Veterinary Diagnostic Laboratory with a history of posterior paresis has increased. Submission histories from various regions of the United States suggest a trend for clinical disease to persist in herds and affect a wider age-range of pigs than historically reported. Polioencephalitis and/or myelitis was consistently present and PTV was detected in affected neural tissue by PCR in a portion of cases. Sequencing from two clinical cases identified PTV-2 and PTV-11. To assess neuropathogenicity of these isolates, 5-week-old cesarean derived and colostrum-deprived pigs were assigned to three groups: negative control (n = 4), PTV-2-inoculated (n = 7), and PTV-11-inoculated (n = 7). Three PTV-2-inoculated pigs developed mild incoordination of the hind limbs, one of which progressed to posterior ataxia. While all PTV-11-inoculated pigs showed severe neurological signs consistent with Teschovirus encephalomyelitis, no evidences of neurological signs were observed in sham-inoculated animals. All PTV-2- and PTV-11-inoculated pigs had microscopic lesions consistent with Teschovirus encephalomyelitis. To our knowledge, this is the first description of PTV-11 and experimental study demonstrating the neuropathogenicity of PTV-11 in the United States.

POISONING BY THE SWAINSONINE-CONTAINING PLANT SIDA CARPINIFOLIA IN CAPTIVE SAMBAR DEER (CERVUS UNICOLOR).

Plant intoxications in wildlife are difficult to diagnose, are overlooked, or are sometimes even neglected. Hence, factors that induce wild animals to ingest poisonous plants have not been sufficiently documented. An outbreak of glycoprotein storage disease in sambar deer ( Cervus unicolor ), induced by ingestion of the swainsonine-containing plant, common wireweed (Sida carpinifolia), is reported. Nine out of 55 deer held by a zoo in Brazil were affected. The poisoning was characterized by emaciation and neurologic signs followed by unexpected death in some of the animals. Animals presented abnormal consciousness, posterior paresis, and musculoskeletal weakness; less evident were vestibulo-cerebellar signs. Histologically, there was vacuolation of neurons and epithelial cells of the pancreatic acines, thyroid follicules, and renal tubules. Furthermore, in the central nervous system were axonal degeneration, necrosis, and loss of neurons. Three factors may lead to the ingestion of S. carpinifolia by sambar deer: 1) A grazing field with only S. carpinifolia as a source of forage; 2) a large number of animals kept in this field; and 3) a hierarchy within a cervid group in which dominant males isolated and displaced juvenile and weaker adult males, leaving them with access to only S. carpinifolia.

Clinical investigation into feed-related hypervitaminosis D in a captive flock of budgerigars (Melopsittacus undulatus): morbidity, mortalities, and pathologic lesions.

The Blank Park Zoo began suffering mortalities in the spring of 2012 within a flock of 229 captive budgerigars (Melopsittacus undulatus) housed in an interactive public-feeding aviary. Clinical signs in affected birds included weakness, posterior paresis, inability to fly, or acute death. Gross and microscopic lesions were not initially apparent in acutely affected deceased birds. Many birds had evidence of trauma, which is now hypothesized to have been related to the birds' weakness. Investigation into the cause(s) of morbidity and mortality were complicated by the opening of a new interactive enclosure. For this reason, environmental conditions and husbandry protocols were heavily scrutinized. Microscopic examination of dead budgies later in the course of the investigation revealed mineralization of soft tissues consistent with hypervitaminosis D. Pooled serum analysis of deceased birds identified elevated vitamin D3 levels. Vitamin D3 analysis was performed on the feed sticks offered by the public and the formulated maintenance diet fed to the flock. This analysis detected elevated levels of vitamin D3 that were 22.5-times the manufacturer's labeled content in the formulated diet. These findings contributed to a manufacturer recall of more than 100 formulated diets fed to a wide variety of domestic and captive wild animal species throughout the United States and internationally. This case report discusses the complexities of determining the etiology of a toxic event in a zoologic institution.

Unusual presentation of systemic coronavirosis in a ferret

A young ferret was presented for a posterior paresis, urinary and fecal incontinence, weight loss, anorexia and lethargy. Biochemichemistry and hematology revealed hyperproteinemia with hyperglobulinemia and anemia. Abdominal ultrasonography showed splenomegaly, adenomegaly and nephromegaly with abdnomal echogenicity of the abdominal organs, compatible with a diagnosis of systemic coronavirosis. The ferret was humanely euthanized. On histopathology, a severe pyogranulomatous inflammation with neutrophilic vasculitis was seen in several organs (kidney, liver, lung, spleen and lymph node). Immunochemistry with FIPV3-70 antibody revealed the presence of coronaviral antigen within the lesions, confirming the diagnosis of Feline Infectious Peritonitis-like disease. A slight mononuclear radiculoneuritis was also present in the sciatic nerve, possibly explaining the peripheral neuropathy observed in this ferret. Whereas posterior paresis is common and non-specific in ferrets, fecal and urinary incontinence are rarely described. Radiculoneuritis caused by systemic coronavirus should be considered in young patients presenting these symptoms.

Motor Neuron Disease and Acquired Axonal Neuropathy Association in HIV Infection: Case Report and Update

A possible viral etiology has been documented in the genesis of motor neuron disorders and acquired peripheral neuropathies, mainly due to the vulnerability of peripheral nerves and the anterior horn to certain viruses. In recent years, several reports show association of HIV infection with Amyotrophic Lateral Sclerosis - Syndrome, Motor Neuron Diseases and peripheral neuropathies. To report a case of an association between Motor Neuron Disease and Acquired Axonal neuropathy in HIV infection, and describe the findings of neurological examination, cerebrospinal fluid, neuroimaging and electrophysiology. The patient underwent neurological examination. General medical examinations were performed, including, specific neuromuscular tests, analysis of cerebrospinal fluid, muscle biopsy and imaging studies. The initial clinical presentation of our case was marked by cramps and fasciculations with posterior distal paresis and atrophy in the left arm. We found electromyography tracings with deficits in the anterior horn of the spinal cord and peripheral nerves. Dysphagia and release of primitive reflexes were also identified. At the same time, the patient was informed to be HIV positive with high viral load. He received antiretroviral therapy, with load control but with no clinical remission. Motor Neuron disorders and peripheral neuropathy may occur in association with HIV infection. However, a causal relationship remains uncertain. It is noteworthy that the antiretroviral regimen may be implicated in some cases.

Turning sickness in a cross bred cow naturally infected with Theileria annulata

Bovine tropical theileriosis (BTT) has been since long recognized as a persistent major constraint on genetic improvement programme of native cattle breeds under "Operation Flood". The disease accounts for high mortality in dairy cattle especially calves. A cross bred cow (Rathi×Holestein), aged 3years and weighing ~300kg, owned by a person from weaker sections of the society, initially suffered from ruminal hypotonocity, severe dyspnoea, frothy discharge, lacrymation, cessation of defaecation, anorexia besides, icterus, mild form of anaemia and moderately elevated temperature etc., for the past 48h. The cow suddenly developed pre mortal fall in temperature and neurological signs suggestive of posterior paresis. Ante mortem laboratory investigations revealed Koch Blue Bodies in the lymphocytes and Theileria annulata meronts in the erythrocytes. The cerebral form of BTT in the instant case was differentiated and discussed with other diseases causing analogous neurological signs.

Posterior paresis in pregnant gilts experimentally infected with Trypanosoma brucei

The effect of Trypanosoma brucei infection on reproductive efficiency in gilts (n=12) was conducted. The gilts were bought as piglets aged eight weeks from piggeries in Samaru village in Zaria, Nigeria. On attaining puberty, the gilts were divided into experimental and control groups, each group containing six animals. All the gilts were subsequently bred by fertile boars and they were confirmed pregnant. The pregnant gilts were then inoculated with about 1.8 × 106 trypanosomes via the anterior vena cava. The infected gilts developed clinical trypanosomosis after a pre-patent period of 2 to 3 days. The clinical signs observed were intermittent fever, short and moist cough, moist rales, mucopurulent ocular discharges, hyperaemia of the skin, reduced feed intake, loss of body condition, recumbency, uncoordinated movements, posterior paresis, loss of pregnancy and death. Severe degeneration of the fibers of the hamstring muscles was observed along with elevated levels of serum potassium, aspartate amino transferase and creatine kinase. Key words: Trypanosomosis, infection, pregnant gilts.

Nachhandparese infolge eines malignen Lymphoms bei einer Ziege

This report describes a 4-year-old goat with posterior paresis and subsequent paralysis caused by malignant lymphoma. The goat was referred to our clinic because of progressive posterior ataxia, which developed into posterior paresis and paralysis. The goat was presented in sternal recumbency but was able to assume a dog-sitting position. A neurological examination revealed reduced sensitivity to pricking of the skin with a needle, and a bilateral reduced panniculus reflex. The cerebrospinal fluid was slightly cloudy with increases in the protein concentration and leukocyte count, which consisted of 98 % lymphocytes, 1 % monocytes and 1 % neutrophils; three cells had mitotic figures. Based on the clinical findings, a tentative diagnosis of central nervous system disease of the thoracolumbar spinal cord was made, and euthanasia and postmortem examination were carried out. The lymph nodes in the ileosacral region appeared as a 15 × 12 × 5 cm confluent mass, which involved the ventral vertebral column and infiltrated the spinal canal. Histological examination of the tumour yielded a diagnosis of microcytic malignant lymphoma.

Evaluation of activated charcoal as treatment for Yellow tulp (Moraea pallida) poisoning in cattle : research note

The efficacy of activated charcoal as a treatment for cattle (n = 57) poisoned by Yellow tulp (Moraea pallida) was investigated. Treatment with activated charcoal resulted in full recovery, irrespective of the degree of posterior paresis, provided that this clinical sign did not develop within the first 12 hours after initial exposure to Yellow tulp-infested grazing. For instance, despite treatment, 1 of 7 cattle succumbed after manifesting mild posterior paresis 6 to 8 h after initial exposure and 3 of 3 treated cattle died after developing severe posterior paresis within 6 to 12 h.

Neurotoxicose em bovinos associada ao consumo de bagaço de malte contaminado por Aspergillus clavatus

Descrevem-se dois surtos de uma doença neurológica que afetou rebanhos bovinos leiteiros que consumiam bagaço de malte contaminado por Aspergillus clavatus no município de Viamão, estado do Rio Grande do Sul. A morbidade em ambos os surtos foi em torno de 30% e a letalidade, 50% e 100%. A evolução clínica da doença variou de 5 a 64 dias. Dentre os animais que se recuperaram apenas um permaneceu com seqüelas locomotoras leves. Os sinais clínicos eram predominantemente locomotores e incluíam tremores musculares de intensidade variável, hiperestesia e membros pélvicos com ataxia, paresia e paralisia progessivas, e apoio sobre os boletos. Os distúrbios locomotores eram intensificados pelo exercício que, em geral, desencadeava quedas. Havia também marcada queda na produção leiteira, no entanto o apetite e a dipsia eram mantidos até próximo da morte ou eutanásia. Cinco bovinos foram necropsiados e destes dois apresentaram lesões macroscópicas nos músculos esqueléticos, principalmente nos membros pélvicos e torácicos caracterizadas por alterações necróticas e mineralização. No sistema nervoso, os principais achados consistiam de degeneração e necrose neuronal cromatolítica em núcleos nervosos específicos no tronco encefálico, nos cornos ventrais da medula espinhal e nos gânglios trigeminal, estrelado, celíaco e espinhais. Em dois bovinos havia adicionalmente degeneração walleriana nos funículos dorsais da medula espinhal e nervos isquiádico e fibular. O diagnóstico foi baseado nos dados epidemiológicos, sinais clínicos, achados de necropsia, histopatológicos e micológicos. Os aspectos epidemiológicos, clínicos e patológicos da enfermidade, além de possíveis mecanismos patogenéticos e diagnósticos diferenciais são discutidos.

Rhabdomyosarcoma with Posterior Paresis and Megaesophagus in a Holstein Heifer

A 7-month-old Holstein heifer presented with posterior paresis and megaesophagus. At post mortem examination, a nodular tumor was found attached to the thoracic wall and the eighth to eleventh thoracic vertebrae, adjacent to the left posterior pulmonary lobe. The tumor was diagnosed as rhabdomyosarcoma by histology. This is a very rare case of spinal infiltration of rhabdomyosarcoma in cattle.

Posterior paresis resulting from a vertebral body fracture in a bull

A 2.5-year-old, mixed-breed rodeo bull was examined with a four-month history of ataxia and weakness in the pelvic limbs. The neurologic signs were noted while the bull was on pasture breeding cows. Spinal radiographs revealed a compression fracture of the 13th thoracic vertebrae, and myelography showed impingement of the spinal cord due to the fracture. Necropsy examination confirmed the diagnosis of a compression fracture of T13 with secondary damage to the spinal cord. Vertebral fractures are uncommon in adult cattle, yet this case appears to be unrelated to any previously published causes. Furthermore, myelography can be an effective diagnostic test in the evaluation of spinal cord disease in adult cattle.

Sarcocystis neurona Encephalitis in a Dog

A 1.5-year-old male Feist dog was presented to a veterinarian for reluctance to stand on the hind legs. Treatment included dexamethasone and resulted in a favorable initial response, but posterior paresis returned and progressed to recumbency, hyperesthesia, and attempts to bite the owner. The dog was euthanized. The brain was negative for rabies by fluorescent antibody analysis. Multiple foci of encephalitis were found in the cerebrum and particularly in the cerebellum. Protozoa morphologically consistent with Sarcocystis sp. were identified at sites of intense inflammation and malacia. Additionally, multiple schizonts were identified in areas without inflammation. Immunohistochemistry using both polyclonal and monoclonal antibodies specific for Sarcocystis neurona was strongly positive. No reaction to polyclonal antisera for Toxoplasma gondii or Neospora caninum was found. Polymerase chain reaction confirmed that the protozoa were S. neurona. Additional aberrant hosts for S. neurona other than horses have been identified, but S. neurona encephalitis has not been documented previously in the dog.