BackgroundAcquired myasthenia gravis (MG) in cats most commonly causes generalized weakness without megaesophagus and is more often associated with a cranial mediastinal mass, compared to dogs.Hypothesis/ObjectivesTo extend the clinical findings described in the report of 2000 on MG in cats (J Am Vet Med Assoc 215:55–57).AnimalsTwo hundred and thirty‐five cats with MG.MethodsRetrospective case study to evaluate the long‐term outcome and incidence of spontaneous remission in myasthenic cats. Information including signalment, clinical presentation, presence of and type of cranial mediastinal mass, treatment including surgical versus medical, survival time, and outcome including spontaneous remissions was collected and analyzed in cats diagnosed at the Comparative Neuromuscular Laboratory, University of California San Diego by detection of acetylcholine receptor antibody titers >0.3 nmol/L by immunoprecipitation radioimmunosassay.ResultsAcquired MG in cats is associated with a euthanasia rate of 58%. Abyssinian and Somali cats had an increased incidence of MG compared to mixed breed cats or cats of other breeds. A cranial mediastinal mass, most commonly thymoma, was observed in 52% of the cats, which is higher than in the previous report. Spontaneous remission is not a characteristic of MG in cats.Conclusions and clinical importanceMyasthenia gravis in cats is a chronic disease associated with a high incidence of a cranial mediastinal mass. Spontaneous remission is not common and clinicians should warn owners of the necessity for long‐term treatment. The clinical outcome with a cranial mediastinal mass did not differ between surgical or medical treatment.

BackgroundExtraparenchymal spinal cord hematoma has been described in veterinary medicine in association with neoplasia, intervertebral disk disease, and snake envenomation. There are rare reports of spontaneous extraparenchymal spinal cord hematoma formation with no known cause in human medicine. Multiple cases of spontaneous extraparenchymal spinal cord hematoma have not been described previously in veterinary medicine.ObjectivesTo describe the signalment, clinical findings, magnetic resonance imaging (MRI) features, and surgical outcomes in histopathologically confirmed extraparenchymal spinal cord hematomas in dogs with no identified underlying etiology.AnimalsSix dogs had MRI of the spinal cord, decompressive spinal surgery, and histopathologic confirmation of extraparenchymal spinal cord hematoma not associated with an underlying cause.MethodsMulti‐institutional retrospective study.ResultsSix patients had spontaneous extraparenchymal spinal cord hematoma formation. MRI showed normal signal within the spinal cord parenchyma in all patients. All hematomas had T2‐weighted hyperintensity and the majority (5/6) had no contrast enhancement. All dogs underwent surgical decompression and most patients (5/6) returned to normal or near normal neurologic function postoperatively. Follow‐up of the patients (ranging between 921 and 1,446 days) showed no progression of neurologic clinical signs or any conditions associated with increased bleeding tendency.Conclusions and Clinical ImportanceBefore surgery and histopathology confirming extraparenchymal hematoma, the primary differential in most cases was neoplasia, based on the MRI findings. This retrospective study reminds clinicians of the importance of the combination of advanced imaging combined with histopathologic diagnosis. The prognosis for spontaneous spinal cord extraparenchymal hematoma with surgical decompression appears to be favorable in most cases.

Granulomas can “mimic” gliomas on magnetic resonance imaging (MRI) in human patients. The goal of this retrospective study was to report canine brain granulomas that were consistent with glioma based upon MRI, report their histologic diagnosis, and identify MRI criteria that might be useful to distinguish granuloma from glioma. Ten granulomas, initially suspected to be glioma based on MRI, were ultimately diagnosed as granulomatous meningoencephalomyelitis ( n = 5), infectious granulomas ( n = 3) or other meningoencephalitis ( n = 2). Age was 1.6–15.0 years and two dogs were brachycephalic breeds. MRI characteristics overlapping with glioma included intra-axial, heterogeneous, T2-weighted hyperintense, T1-weighted hypointense to isointense mass lesions with contrast-enhancement. Signals on fluid attenuation inversion recovery, gradient echo and diffusion weighted imaging also matched glioma. Peri-lesional edema and mass effect were toward the high end of findings reported for glioma. MRI characteristics that would be considered unusual for glioma included dural contact ( n = 4), T2-hypointensity ( n = 2), concomitant meningeal-enhancement ( n = 9), and minor changes in the contralateral brain ( n = 2). Cerebrospinal fluid analysis revealed albuminocytological dissociation or mild pleocytosis. These cases show that granulomas can “mimic” glioma on canine brain MRI. In individual cases, certain MRI findings may help increase the index of suspicion for granuloma. Lack of pronounced cerebrospinal fluid pleocytosis does not exclude granuloma. Signalment is very useful in the suspicion of glioma, and many of these dogs with granuloma were of ages and breeds in which glioma is less commonly seen.

Objective To evaluate the efficacy of a surgical safety checklist (SSC) in reducing perioperative and postoperative complications. Study design Before‐and‐after intervention study. Animals Client‐owned dogs (n = 633) and cats (n = 44). Methods Consecutive surgeries were enrolled in the study. The “before” phase consisted of 267 surgeries performed without an SSC (SSC−) followed by 75 SSC− surgeries in which a trained observer was in the operating room to detect possible complications. An SSC was then implemented in the operating rooms during 1 week. The “after” phase consisted of 58 surgeries in which a safety checklist (SSC+) and an observer were used and 277 SSC+ surgeries without an observer. Complications were prospectively recorded when witnessed by the observer, and all other perioperative complications were retrospectively recorded from veterinary records and client telephone communication. Results There were more perioperative and postoperative complications when surgeries were performed without an SSC (140/342 [40.9%; 95% CI, 35.7%‐46.4%]) than there were when surgeries were performed with an SSC (98/335 [29.3%; 95% CI, 24.4%‐34.4%]; P = .002). Surgical checklist use, presence of an observer, American Society of Anesthesiologists score, and anesthesia time were all independently associated with the odds of complications. Conclusion Implementation of an SSC in an academic teaching hospital decreased the odds of perioperative and postoperative surgical complications. Clinical significance This study supports the use of an SSC to prevent surgical complications in veterinary teaching hospitals.

Background Cerebrospinal fluid (CSF) analysis aids in categorizing underlying disease processes in patients with neurologic disease. Convention suggests that CSF should be collected caudal to the lesion. However, little evidence exists to justify this assertion. Hypothesis/Objectives Evaluate the clinicopathologic differences between CSF collected from the cerebellomedullary (CM) and lumbar cisterns in dogs presented for evaluation of neurologic disease. Animals Fifty‐one client‐owned dogs undergoing magnetic resonance imaging (MRI) and CSF collection for investigation of neurologic disease. Methods Cerebrospinal fluid was prospectively collected from the CM and lumbar cisterns in all patients. The total protein (TP) concentration, red blood cell (RBC) count, and total nucleated cell count (TNCC) were analyzed within 30 minutes of collection. Results and cytology findings were interpreted by a single pathologist. Results Fifty‐one paired samples were collected. The TNCC (P < .001), RBC (P < .001), and TP (P < .001) were different between collection sites. When grouped by neurolocalization, TP (intracranial, P < .001; cervical, P < .001; thoracolumbar, P < .001) and RBC (intracranial, P < .001; cervical, P ≤ .002; thoracolumbar, P = .006) counts were significantly different. The TNCC was significantly different in the cervical (P = .04) and thoracolumbar localizations (P = .004) but not for intracranial (P = .30) localizations. The pathologist's interpretation differed between sites in 66.7% of the cases (34/51). Conclusions In dogs with lesions that neurolocalized to the brain or cervical spinal cord, there may be clinical benefit in collecting fluid from both the CM and lumbar cisterns. In dogs with thoracolumbar myelopathy, CSF collected from the CM cistern may not be representative of the underlying disease process.