Slowly progressive lymphohistiocytic meningoencephalomyelitis in 21 adult cats presenting with peculiar neurological signs

Risio, Luisa De; Brown, Richard; Tennant, Bryn; Sparkes, Andy; Matiasek, Lara; Stefani, Alberta De; Weissenböck, Herbert; Matiasek, Kaspar

doi:10.1177/1098612x11435460

Cited by 5 publications

(7 citation statements)

References 22 publications

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“…All brains were fixed through immersion in 10% neutral-buffered formalin for at least 3 days before external inspection and trimming as described earlier (19). For the standardized hippocampal examination, the brains were cut transversely at the level of the temporo-ventral body of the hippocampus.…”

Section: Tissue Sampling and Processingmentioning

confidence: 99%

Hippocampal Sclerosis in Feline Epilepsy

et al. 2014

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Hippocampal sclerosis (HS) refers to loss of hippocampal neurons and astrogliosis. In temporal lobe epilepsy (TLE), HS is a key factor for pharmacoresistance, even though the mechanisms are not quite understood. While experimental TLE models are available, there is lack of models reflecting the natural HS development. Among domestic animals, cats may present with TLE-like seizures in natural and experimental settings. With this study on the prevalence, segmental pattern and clinicopathological correlates of feline HS, we evaluated the translational value for human research. Evaluation schemes for human brains were applied to epileptic cats. The loss of neurons was morphometrically assessed and the degree of gliosis was recorded. Hippocampal changes resembling human HS were seen in about one third of epileptic cats. Most of these were associated with infiltrative diseases such as limbic encephalitis. Irrespective of the etiology and semiology of seizures, total hippocampal sclerosis was the most prevalent form seen in epileptic animals. Other HS types also occur at varying frequencies. Segmental differences to human HS can be explained by species-specific synaptic connectivities and a different spectrum of etiologies. All these variables require consideration when translating results from feline studies regarding seizure-associated changes of the temporal lobe and especially HS.

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Section: Tissue Sampling and Processingmentioning

confidence: 99%

Hippocampal Sclerosis in Feline Epilepsy

et al. 2014

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“…Inflammatory diseases have been reported to ac-count for 32-44% of histologically confirmed central nervous system diseases in cats (Bradshaw et al, 2004;Rand et al, 1994). The most common cause of meningoencephalitis in cats is feline coronavirus, the etiological agent of feline infectious peritonitis (De Risio et al, 2012). Other known etiologies of feline meningoencephalitis are uncommon and include viruses such as feline immunodeficiency virus (FIV), feline leukemia virus (FeLV), feline parvovirus, pseudorabies virus/ porcine herpesvirus 1, rabies virus, Borna disease virus, West Nile virus, encephalomyocarditis virus, and protozoal, bacterial, rickettsial, fungal and parasitic agents (Gunn Moore, 2005;Schwab et al, 2007).…”

Section: Etiology Of Seizures In Catsmentioning

confidence: 99%

“…In a large number of feline cases with central nervous disease, histopathological changes consistent with lymphohistiocytic (non-suppurative) meningoencephalitis are found (Schwab et al, 2007). Although, lymphohistiocytic meningoencephalitis is usually suggestive of viral infection, the causative agent is often not identified (De Risio et al, 2012). In lymphohistiocytic meningoencephalitis of unknown origin the clinical signs appear at a young age (2 years or less), and the progression is no longer than a couple of weeks (Gunn Moore, 2005;Rand et al, 1994).…”

Section: Etiology Of Seizures In Catsmentioning

confidence: 99%

“…A causative agent could not be identified. Thus, the cats in this study had been affected by a unique, previously unreported condition (De Risio et al, 2012). MRI images of the brain must be evaluated carefully as many mass lesions regarded as tumors can be fungal or protozoal granulomas (Foster et al, 2001;Pfohl and Dewey, 2005).…”

Section: Etiology Of Seizures In Catsmentioning

confidence: 99%

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Feline Epilepsy: An update

Baka

Polizopoulou

2020

J Hellenic Vet Med Soc

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Epileptic seizures are the most common neurological disorder in the clinical setting. Their etiology is multifactorial and is mainly divided into structural, reactive and idiopathic epilepsy. Structural epilepsy can be caused by vascular events, inflammatory conditions (encephalitis), traumatic injuries, neoplasia, congenital and inherited (degenerative) disorders. Reactive epilepsy is caused by exposure in toxins or metabolic derangements. Although idiopathic epilepsy was thought to be rare in cats, it is now established as a common cause. Epileptic seizures in cats appear with various clinical presentations including generalized, focal with or without secondary generalization epileptic seizures. Diagnostic investigation is crucial in order to establish final diagnosis and to determine the therapeutic plan. Diagnostics include physical and neurological examination with detailed history (drug or toxin exposure), routine hematology (CBC, biochemistry, urinalysis), specific laboratory tests if concurrent or metabolic disease are suspected, advanced diagnostic imaging (CT/MRI) whether intracranial disease is suspected and cerebrospinal fluid (CSF) analysis. Most commonly used antiepileptic drugs (AED) in cats are phenobarbital and levetiracetam. Bromide is contraindicated in cats due to severe respiratory disease caused as an adverse life-threatening reaction. Diazepam is an emergency AED used to eliminate cluster seizures or status epilepticus but it should be avoided as a long-term medication because it has been associated with fatal hepatotoxicity. Gabapentin in another potential antiepileptic drug however its longterm efficacy has to be evaluated. Prognosis depends on the underlying etiology and treatment response. In most cats quality of life is improved and (>50% reduction of epileptic seizures) regardless of etiology. The complete remission of epileptic seizures in cats is rare and most cats should be maintained on anti-epileptic therapy.

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“…As causas não infecciosas mais comuns são inflamação, neoplasia, doença vascular e encefalopatia metabólica ou tóxica [1,15]. Já a meningoencefalite está geralmente associada a infecções, como toxoplasmose [12], peritonite infecciosa felina (PIF) [5,12] ou coronavírus felino [5], mas podem ser causadas por infecção bacteriana em orelha média ou interna [12].…”

Section: Introductionunclassified

Bacterial Otitis by Klebsiella sp. as a Cause of Encephalitis in a Cat

Silveira

Vidor

Dhein

et al. 2018

Acta Scientiae. Vet.

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Background: Meningoencephalitis in cats is usually related to infectious diseases but may also be caused by the extension of bacterial infections originated in the middle or inner ear. This paper seeks to report on a case of encephalitis due to an infection in the middle/inner ear in a 15-year-old cat. The diagnosis was made through brain CT scan and culture and antibiogram of material collected during a ventral osteotomy of the tympanic bulla and reported grave intravascular haemolysis associated to the treatment with antimicrobial imipenem with cilastatin sodium that has already been described in humans but not in small animals in the researched literature.Case: A 15-year-old, male, castrated, Siamese cat was brought to the Veterinary Clinical Hospital of the UFRGS. The animal presented pyrexia and hyporexia, tested negative in the immunoenzymatic test to detect antigens of the FeLV and antibodies of the FIV. The animal had a history of three episodes of tonic convulsion within two days and otitis that hadgone untreated for 10 months prior to the consultation, with apparent spontaneous remission. After blood tests, serum biochemistry profile, abdominal ultrasound scan, chest x-rays and CT scan was requested. It revealed middle and inner otitis in the right ear. It was performed a ventral osteotomy of the right tympanic bulla. Material was collected for culture and antibiogram. It was confirmed that the animal had an inner otitis of bacterial origin by multi-resistant Klebsiella spp. that was sensitive only to antimicrobial imipenem with cilastatin sodium. Fifteen days into the treatment with this antibacterial combination, grave haemolysis was observed, probably associated to the use of the medicine. The patient died on the 17th day of the treatment which was not interrupted as per its owner’s decision. At necropsy, both in the tympanic bulla and liver were found mucous content and whitish lumps. The material collected from the tympanic bulla and cerebrospinal liquid were cultured post-mortem when the bacteria Klebsiella sp. was isolated in the CNS and no bacterial growth was observed in the right tympanic bulla.Discussion: This makes it possible to deduce that there was an intracranial expansion of the otitis which would explain the convulsions and, that due to the use of the antimicrobial agent, the growth of Klebsiella sp. in the tympanic bulla was inhibited. The final diagnosis was bacterial otitis with probable bacterial migration to the brain and liver. Suppurativemeningoencephalitis caused by the expansion of the inflammation deriving from middle/inner otitis has been reported as being the cause of convulsions in cats with bacterial isolation. The bacteria that was isolated from the tympanic bulla is in agreement with the microbiota present in middle/inner otitis in cats. Regarding haemolysis, there are no reports thatlink the use of carbapenems in small animals to it or that mention what the safe therapeutic dosage should be if they were administered. Regarding humans, there have been various reports of haemolytic anaemia caused by this type of medicine including carbapenems. It is also known that, in in vitro tests, imipenem may cause inhibition due to competition from human erythrocyte-glutathione reductase, in charge of defending the erythrocyte against haemolysis. It has been concludedthat meningoencephalitis caused by middle/inner otitis must be included as a differential diagnosis in case of convulsions in cats. Additionally, further studies must be carried out in order to determine both the efficacy and the toxicity of carbapenems in veterinary patients, including studies of the occurrence of grave haemolysis after they are administered.Keywords: meningoencephalitis, computed tomography, convulsions, imipinem, carbapenems.

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Slowly progressive lymphohistiocytic meningoencephalomyelitis in 21 adult cats presenting with peculiar neurological signs

Cited by 5 publications

References 22 publications

Hippocampal Sclerosis in Feline Epilepsy

Hippocampal Sclerosis in Feline Epilepsy

Feline Epilepsy: An update

Bacterial Otitis by Klebsiella sp. as a Cause of Encephalitis in a Cat

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