Evaluation of concurrent analysis of cerebrospinal fluid samples collected from the cerebellomedullary cistern and lumbar subarachnoid space for the diagnosis of steroid-responsive meningitis arteritis in dogs

Abstract

Objective: To describe the clinical characteristics and outcomes in a population of dogs with negative-pressure pulmonary edema (NPPE) and to identify the main causes of the disease. To evaluate any associations with morbidity and mortality.Design: Retrospective study.Setting: Three university teaching hospitals and two private referral centers.Animals: Thirty-five client-owned dogs presented with NPPE. Interventions: NoneMeasurements and Main Results: Data collected included patient characteristics, clinical history, clinicopathological abnormalities, radiographic features, treatments and outcome. Median age was 4 months (range 2-90) and median weight was 7.1 kg (range 1.7-37.2). There were many causes of NPPE including leash tugs, near hanging, accidental choking, anatomical obstruction to airflow and purposeful airway obstruction by people. The most common cause of NPPE was accidental choking (40% of cases). Dogs with an anatomical obstruction were older than 24 months. Hypoxemia with an increased alveolar-arterial gradient was common on presentation. The majority of thoracic radiographs (65.7%) showed an alveolar or interstitial pattern in the caudodorsal area as previously described in the literature. Oxygen therapy was administered to 33 (94.3%) dogs. Furosemide was administered to 18 (51.4%) dogs. Median length of hospitalization was 2 days (range 0-14). Twenty-eight (80%) dogs survived to discharge. Seven dogs were mechanically ventilated and only 2 of them (28.6%) 2 survived to discharge. Requirement for mechanical ventilation (p<0.001) was the only parameter associated with mortality.Conclusions: Most cases of NPPE occur in juvenile dogs. Different incidents associated with upper airway obstruction can produce an episode of NPPE.Choking on food or toys and near hanging have not been previously described in the veterinary literature as inciting causes of NPPE. The overall prognosis is good.

Cerebrospinal fluid analysis in dogs: Main patterns and prevalence of albuminocytological dissociation

“…24 The differential cell count of the samples with low TNCC would still have been diagnostic of SRMA in six of eight cases, based on the presence of more than 40% of neutrophils. 19,24 Traditionally, when CMC and LSS puncture sites have been compared, a higher number of TNCC in samples from the CMC and higher level of TP concentration in samples from the LSS have been found. 25 The CSF sampling is usually performed caudally to the suspected site of the lesion in the CNS.…”

“…A discrepancy on the clinicopathological conclusion between the two samples was observed in one case, where only the CMC sample was diagnostic of SRMA. Recent studies have highlighted the potential clinical benefit of collecting both CMC and LSS CSF samples 24–26 . More specifically, Carletti et al 24 studied a population of 111 dogs diagnosed with SRMA with paired CSF samples (CMC and LSS).…”

“…Recent studies have highlighted the potential clinical benefit of collecting both CMC and LSS CSF samples 24–26 . More specifically, Carletti et al 24 studied a population of 111 dogs diagnosed with SRMA with paired CSF samples (CMC and LSS). In eight of 111 patients, only one of the two samples had an increased TNCC 24 .…”

“…More specifically, Carletti et al 24 studied a population of 111 dogs diagnosed with SRMA with paired CSF samples (CMC and LSS). In eight of 111 patients, only one of the two samples had an increased TNCC 24 . The differential cell count of the samples with low TNCC would still have been diagnostic of SRMA in six of eight cases, based on the presence of more than 40% of neutrophils 19,24 …”

Unilateral blindness associated with steroid‐responsive meningitis arteritis in a 9‐month‐old Beagle

“…This is not unusual. Carletti et al 12 reported that in 18% of dogs diagnosed with SRMA had a normal or only a mildly elevated total nucleated cell count (< 10), when sampling one location only. However, when sampling the second location, all dogs were showed a clear CSF inflammation compatible with SRMA, as it was the case in this Beagle.…”