@article{schachar_bocage_nelson_early_mariani_olby_munana_2024, title={Clinical and imaging findings in dogs with nerve root signature associated with cervical intervertebral disc herniation}, volume={1}, ISSN={["1939-1676"]}, url={https://doi.org/10.1111/jvim.16982}, DOI={10.1111/jvim.16982}, abstractNote={AbstractBackgroundIntervertebral disc herniation (IVDH) is the most common spinal cord disease in dogs. Little information is available regarding the clinical presentation of nerve root signature (NRS) associated with cervical IVDH.Hypothesis/ObjectiveTo detail the clinical and magnetic resonance imaging (MRI) findings in dogs with NRS associated with cervical IVDH.AnimalsForty‐seven client‐owned dogs presenting with thoracic limb NRS and MRI confirmed IVDH.MethodsMedical records from 2010 to 2020 were retrospectively reviewed for dogs that met inclusion criteria. Imaging studies were evaluated by 2 individuals to characterize location and severity of neural tissue compression.ResultsChondrodystrophoid dogs comprised the majority of the study cohort, with dachshund the most common breed (n = 10). Three‐quarters of dogs were ≥7 years of age. Interobserver agreement was moderate or good for all of the imaging variables evaluated. The C6‐C7 intervertebral disc space was significantly overrepresented (P = .01), comprising 32% (15/47) of the affected discs. However, 42% (20/47) of cases involved C2‐C3 though C4‐C5 disc sites. Disc material was more frequently located laterally compared to medially within the vertebral canal (P = .0005), and to be associated with compression of the nerve root at the level of the intervertebral foramen (P = .012).Conclusion/Clinical ImportanceNRS is most commonly associated with lateralized or foraminal cervical disc herniations. It is most prevalent with C6‐C7 intervertebral disc involvement, suggesting that there might be unique anatomic factors that contribute to development of NRS at this site, but can be a clinical manifestation of IVDH occurring anywhere along the cervical spine.}, journal={JOURNAL OF VETERINARY INTERNAL MEDICINE}, author={Schachar, Jordan and Bocage, Alan and Nelson, Nathan C. and Early, Peter J. and Mariani, Christopher L. and Olby, Natasha J. and Munana, Karen R.}, year={2024}, month={Jan} } @article{colon_early_munana_olby_mariani_mancini_fefer_li_briley_bailey_et al._2024, title={Pharmacokinetics of subcutaneous ketamine administration via the Omnipod® system in dogs}, volume={3}, ISSN={["1365-2885"]}, DOI={10.1111/jvp.13440}, abstractNote={AbstractKetamine is an injectable anesthetic agent with analgesic and antidepressant effects that can prevent maladaptive pain. Ketamine is metabolized by the liver into norketamine, an active metabolite. Prior rodent studies have suggested that norketamine is thought to contribute up to 30% of ketamine's analgesic effect. Ketamine is usually administered as an intravenous (IV) bolus injection or continuous rate infusion (CRI) but can be administered subcutaneously (SC) and intramuscularly (IM). The Omnipod® is a wireless, subcutaneous insulin delivery device that adheres to the skin and delivers insulin as an SC CRI. The Omnipod® was used in dogs for postoperative administration of ketamine as a 1 mg/kg infusion bolus (IB) over 1 hour (h). Pharmacokinetics (PK) showed plasma ketamine concentrations between 42 and 326.1 ng/mL. The median peak plasma concentration was 79.5 (41.9–326.1) ng/mL with a Tmax of 60 (30–75) min. After the same infusion bolus, the corresponding norketamine PK showed plasma drug concentrations between 22.0 and 64.8 ng/mL. The median peak plasma concentration was 43.0 (26.1–71.8) ng/mL with a median Tmax of 75 min. The median peak ketamine plasma concentration exceeded 100 ng/mL in dogs for less than 1 h post infusion. The Omnipod® system successfully delivered subcutaneous ketamine to dogs in the postoperatively.}, journal={JOURNAL OF VETERINARY PHARMACOLOGY AND THERAPEUTICS}, author={Colon, Claudia and Early, Peter and Munana, Karen and Olby, Natasha and Mariani, Christopher and Mancini, Shelby and Fefer, Gilad and Li, Zhong and Briley, Jessica and Bailey, Kate and et al.}, year={2024}, month={Mar} } @article{lewis_early_bergman_love_nelson_2024, title={Quantification of metallic artifact on CT associated with titanium pedicle screws}, volume={11}, ISSN={2297-1769}, url={http://dx.doi.org/10.3389/fvets.2024.1448188}, DOI={10.3389/fvets.2024.1448188}, abstractNote={In dogs undergoing vertebral column stabilization, post-operative computed tomography (CT) evaluates implant placement. The impact on the interpretation of metallic artifact associated with titanium implants in dogs remains to be established. Our objective was to quantify metallic artifact on CT associated with titanium pedicle screws.}, journal={Frontiers in Veterinary Science}, publisher={Frontiers Media SA}, author={Lewis, M. J. and Early, P. J. and Bergman, R. and Love, K. and Nelson, N.}, year={2024}, month={Jul} } @article{fefer_bynum_early_2024, title={Surgical management of a lumbar far lateral intervertebral disc extrusion in a cat}, volume={10}, ISSN={["2055-1169"]}, DOI={10.1177/20551169241261577}, abstractNote={Case summary A 9-year-old male castrated domestic shorthair cat was presented with a 2-week history of acute, progressive left pelvic limb lameness. Gait evaluation revealed a grade 3/5 left pelvic limb lameness with no apparent orthopedic cause for the lameness based on orthopedic examination or radiographs. The neurological examination was otherwise normal. MRI revealed a left-sided L6–7 far lateral intervertebral disc extrusion with possible secondary neuritis of the L6 spinal nerve. A left-sided L6–7 foraminotomy was performed to remove the extruded disc material and provide additional space for the significantly enlarged nerve root. An L6–7 fenestration was also performed. The patient made an excellent recovery with near-complete resolution of lameness at 26 days postoperatively. Relevance and novel information This case report contributes to the growing body of literature on lateral intervertebral disc extrusion as an etiological factor in pelvic limb lameness in cats, particularly when neurological deficits are absent. Furthermore, the case report highlights the diagnostic utility of cross-sectional advanced imaging for cats with lameness for which an orthopedic or radiographic cause cannot be identified. Finally, this case underscores the efficacy of surgical intervention as a treatment option for cats with lumbar far lateral intervertebral disc extrusions that do not improve with medical management alone. This finding could have implications for future surgical approaches in cats with similar findings.}, number={2}, journal={JOURNAL OF FELINE MEDICINE AND SURGERY OPEN REPORTS}, author={Fefer, Gilad and Bynum, Lauren and Early, Peter}, year={2024}, month={Jul} } @article{kei_korff_porter_early_2023, title={Chronic, progressive paraparesis and acute paraplegia in an 8-year-old Australian Shepherd mixed-breed dog}, volume={261}, ISSN={["1943-569X"]}, DOI={10.2460/javma.22.11.0529}, number={6}, journal={JAVMA-JOURNAL OF THE AMERICAN VETERINARY MEDICAL ASSOCIATION}, author={Kei, Tiffany G. and Korff, Courtney P. and Porter, Ian R. and Early, Peter J.}, year={2023}, month={Jun} } @article{piazza_mcanulty_early_guevar_2023, title={Craniectomies for Dogs With Skull Multilobular Osteochondrosarcoma Using the Misonix Bone Scalpel: Cadaveric Evaluation and Retrospective Case Series}, volume={53}, ISSN={["1946-9837"]}, DOI={10.1016/j.tcam.2023.100772}, abstractNote={To evaluate the Misonix bone scalpel (MBS) for craniotomies in dogs and describe clinical findings and surgical experience in 3 dogs with large multilobular osteochondrosarcoma (MLO) of the skull. Cadaver evaluation and retrospective case series. One canine cadaver; 3 client-owned dogs. Craniotomies of different sizes and at different locations were performed with MBS. Dural tear and bone discoloration were recorded. Clinical, imaging, and surgical findings of dogs diagnosed with MLO and where MBS was used for craniectomies were retrospectively included. Cadaveric evaluation identified MBS as an efficient tool for rapid craniectomies (>5minutes) albeit dural tears and some small foci of bone discoloration were observed. Craniectomies could be performed without complications in 3 dogs with MLO without dural tear or bone discoloration. .Excision was in complete in all cases. The short-term outcome was good, and the long-term outcome was fair to good. Piezoelectric bone surgery with the Misonix bone scalpel is an alternative technology to perform craniectomies in dogs. It was not associated with complications in 3 dogs diagnosed and surgically treated for MLO. Dural tears and suspected bone necrosis can occur. Great care should be taken when using CT to establish disease free surgical osteotomy.}, journal={TOPICS IN COMPANION ANIMAL MEDICINE}, author={Piazza, Alexander M. and McAnulty, Jonathan F. and Early, Peter and Guevar, Julien}, year={2023} } @article{bray_platt_kent_olby_early_mariani_munana_holmes_2023, title={Magnetic resonance imaging characteristics of atlanto-axial subluxation in 42 dogs: Analysis of joint cavity size, subluxation distance, and craniocervical junction anomalies}, volume={13}, ISSN={["2218-6050"]}, DOI={10.5455/OVJ.2023.v13.i9.4}, abstractNote={Background: Atlanto-axial (AA) subluxation can be a complex syndrome in dogs. Accurate identification and assessment of this condition is key to providing treatment and resolution. Aim: The purpose of this retrospective study was to describe the magnetic resonance imaging (MRI) characteristics of AA subluxation and associated neurologic deficits. Methods: A multicenter review of dogs with a diagnosis of AA subluxation was conducted, evaluating signalment, neurologic grade, duration of signs, and MRI characteristics. MRI characteristics included degree of spinal cord compression and joint subluxation, integrity of odontoid ligaments, presence of a dens, spinal cord signal intensity, and presence of syringohydromyelia, hydrocephalus, and Chiari-like malformation. A control population with normal AA joints was also evaluated. MR images of 42 dogs with AA subluxation were compared to 26 age and breed-matched control dogs. Results: Affected dogs had a median age of 27 months and median weight of 2.7 kg, and the most commonly affected breed was Yorkshire terrier (47.5%). Spinal cord signal hyperintensity, increased AA joint size, and cross-sectional cord compression at the level of the dens and mid-body C2 were associated with AA subluxation. No associations were found between cord compression, appearance of the dens, or cord signal intensity and neurologic grade. Affected dogs did not have a higher incidence of Chiari-like malformation, syringohydromyelia, or hydrocephalus than control dogs, and their neurologic grade was not associated with MRI findings. Lack of a dens and/or odontoid ligaments was associated with larger subluxations. Conclusion: Dogs with clinical signs of AA subluxation were significantly more likely to have intramedullary hyperintensity at the level of compression (p=0.0004), an increased AA joint cavity size (p=0.0005), and increased spinal cord compression at the level of dens and mid-body C2 (p=<0.05). The authors suggest an AA joint cavity size >1.4mm and a subluxation distance >2.5mm as cutoffs for MRI diagnosis of AA subluxation in dogs. No differences were noted between dogs with AA subluxation and control dogs regarding syringohydromyelia, hydrocephalus, and Chiari-like malformation.}, number={9}, journal={OPEN VETERINARY JOURNAL}, author={Bray, Kathryn Y. and Platt, Simon R. and Kent, Marc and Olby, Natasha J. and Early, Peter J. and Mariani, Christopher L. and Munana, Karen R. and Holmes, Shannon P.}, year={2023}, pages={1091–1098} } @article{woelfel_mariani_nolan_keenihan_topulos_early_muñana_musulin_olby_2023, title={Presumed pituitary apoplexy in 26 dogs: Clinical findings, treatments, and outcomes}, volume={37}, ISSN={0891-6640 1939-1676}, url={http://dx.doi.org/10.1111/jvim.16703}, DOI={10.1111/jvim.16703}, abstractNote={AbstractBackgroundPituitary apoplexy refers to hemorrhage or infarction within the pituitary gland resulting in acute neurological abnormalities. This condition is poorly described in dogs.ObjectivesTo document presenting complaints, examination findings, endocrinopathies, magnetic resonance imaging (MRI), treatments, and outcomes of dogs with pituitary apoplexy.AnimalsTwenty‐six client‐owned dogs with acute onset of neurological dysfunction.MethodsRetrospective case series. Dogs were diagnosed with pituitary apoplexy if MRI or histopathology documented an intrasellar or suprasellar mass with evidence of hemorrhage or infarction in conjunction with acute neurological dysfunction. Clinical information was obtained from medical records and imaging reports.ResultsCommon presenting complaints included altered mentation (16/26, 62%) and gastrointestinal dysfunction (14/26, 54%). Gait or posture changes (22/26, 85%), mentation changes (18/26, 69%), cranial neuropathies (17/26, 65%), cervical or head hyperpathia (12/26, 46%), and hyperthermia (8/26, 31%) were the most frequent exam findings. Ten dogs (38%) lacked evidence of an endocrinopathy before presentation. Common MRI findings included T1‐weighted hypo‐ to isointensity of the hemorrhagic lesion (21/25, 84%), peripheral enhancement of the pituitary mass lesion (15/25, 60%), brain herniation (14/25, 56%), and obstructive hydrocephalus (13/25, 52%). Fifteen dogs (58%) survived to hospital discharge. Seven of these dogs received medical management alone (median survival 143 days; range, 7‐641 days) and 8 received medications and radiation therapy (median survival 973 days; range, 41‐1719 days).Conclusions and Clinical ImportanceDogs with pituitary apoplexy present with a variety of acute signs of neurological disease and inconsistent endocrine dysfunction. Dogs that survive to discharge can have a favorable outcome.}, number={3}, journal={Journal of Veterinary Internal Medicine}, publisher={Wiley}, author={Woelfel, Christian W. and Mariani, Christopher L. and Nolan, Michael W. and Keenihan, Erin K. and Topulos, Sophia P. and Early, Peter J. and Muñana, Karen R. and Musulin, Sarah E. and Olby, Natasha J.}, year={2023}, month={Apr}, pages={1119–1128} } @article{tammaro_early_bergman_petrovsky_kraus_2022, title={Diagnostic traction and dorsal locking plate stabilization of a fifth and sixth thoracic vertebral fracture/luxation in a golden retriever: Case report}, volume={9}, ISSN={["2297-1769"]}, DOI={10.3389/fvets.2022.1011983}, abstractNote={Traction was used to diagnose instability of a T5-T6 traumatic luxation that was stabilized with locking plates in the laminae and dorsal pedicles. A two-year-old, 27 kg, female spayed golden retriever was presented to a veterinary teaching hospital after being referred for possible mandibular and spinal fractures after being hit by a car. The dog presented non-ambulatory paraparetic with intact pain perception. Computed tomographic (CT) imaging showed a fifth and sixth thoracic vertebral fracture/luxation, with and without manual traction. Surgical stabilization of the spine was performed with bilateral dorsally placed locking plates (String-of-Pearls, Orthomed, UK) in the laminae and dorsal aspects of the vertebral pedicles. The dog recovered well, and neurologic status improved significantly overnight and continued to improve up until discharge, which was 6 days postoperatively. Upon recheck exam at 8 weeks postoperatively, the dog appeared neurologically normal with no obvious surgical complications. This case demonstrates that diagnostic traction—the process of pulling, during imaging, on the dog's pelvis while the forelimbs are secured in extension—demonstrated instability of the spine which was not readily apparent on initial CT imaging. Additionally, the dorsal locking plate stabilization is a viable fixation option that provided acceptable stabilization of the mid-thoracic vertebrae.}, journal={FRONTIERS IN VETERINARY SCIENCE}, author={Tammaro, William J. and Early, Peter J. and Bergman, Robert and Petrovsky, Brian L. and Kraus, Karl H.}, year={2022}, month={Dec} } @article{mancini_early_slater_olby_mariani_munana_woelfel_schacher_zhong_messenger_2022, title={Novel subcutaneous cytarabine infusion with the Omnipod system in dogs with meningoencephalomyelitis of unknown etiology}, volume={83}, ISSN={["1943-5681"]}, DOI={10.2460/ajvr.22.03.0046}, abstractNote={Abstract OBJECTIVE To investigate the feasibility and pharmacokinetics of cytarabine delivery as a subcutaneous continuous-rate infusion with the Omnipod system. ANIMALS 6 client-owned dogs diagnosed with meningoencephalomyelitis of unknown etiology were enrolled through the North Carolina State University Veterinary Hospital. PROCEDURES Cytarabine was delivered at a rate of 50 mg/m2/hour as an SC continuous-rate infusion over 8 hours using the Omnipod system. Plasma samples were collected at 0, 4, 6, 8, 10, 12, and 14 hours after initiation of the infusion. Plasma cytarabine concentrations were measured by high-pressure liquid chromatography. A nonlinear mixed-effects approach generated population pharmacokinetic parameter estimates. RESULTS The mean peak plasma concentration (Cmax) was 7,510 ng/mL (range, 5,040 to 9,690 ng/mL; SD, 1,912.41 ng/mL), average time to Cmax was 7 hours (range, 4 to 8 hours; SD, 1.67 hours), terminal half-life was 1.13 hours (SD, 0.29 hour), and the mean area under the curve was 52,996.82 hours X μg/mL (range, 35,963.67 to 71,848.37 hours X μg/mL; SD, 12,960.90 hours X μg/mL). Cmax concentrations for all dogs were more than 1,000 ng/mL (1.0 μg/mL) at the 4-, 6-, 8-, and 10-hour time points. CLINICAL RELEVANCE An SC continuous-rate infusion of cytarabine via the Omnipod system is feasible in dogs and was able to achieve a steady-state concentration of more than 1 μg/mL 4 to 10 hours postinitiation of cytarabine and a Cmax of 7,510 ng/mL (range, 5,040 to 9,690 ng/mL; SD, 1,912.41 ng/mL). These are comparable to values reported previously with IV continuous-rate infusion administration in healthy research Beagles and dogs with meningoencephalomyelitis of unknown etiology. }, number={9}, journal={AMERICAN JOURNAL OF VETERINARY RESEARCH}, author={Mancini, Shelby L. and Early, Peter J. and Slater, Bailey M. and Olby, Natasha J. and Mariani, Christopher L. and Munana, Karen R. and Woelfel, Christian W. and Schacher, Jordan A. and Zhong, Li and Messenger, Kristen M.}, year={2022}, month={Sep} } @article{schmitt_early_bergman_riedesel_yuan_mochel_kraus_2021, title={Computed tomography evaluation of proposed implant corridors in canine thoracic vertebrae}, ISSN={["1532-950X"]}, DOI={10.1111/vsu.13680}, abstractNote={AbstractObjectiveIdentify acceptable implant corridors in the normal canine thoracic vertebrae (T) from T1 to T9.Study DesignRetrospective study.Sample PopulationComputed tomographic (CT) studies of normal canine thoracic spines (n = 39).MethodsCT imaging studies of normal T1‐T9 canine spines were evaluated by five independent observers. Each identified a proposed corridor, measured the width, length, and angle off mid‐sagittal that the corridor occupied.ResultsCT studies were from 39 dogs weighing 3.19–60 kg (mean 10.72, SD 9.9 kg). Vertebral corridors ranged in average width from 3.8 to 5.2 mm, the widest being located at T1. They ranged in average length from 13.3 to 17.5 mm, shortest being T1 and longest being T6. The angle of corridors varied the most between individual vertebrae at T1‐T3. The average corridor angles were: T1 = 38°, T2 = 32°, T3 = 27°, T4 = 26°. T5‐T9 angle ranged from 23° to 24°.ConclusionThe average dimensions of corridors measured in dogs weighing 3.1–60 kg were consistent with those of commercially available cortical screws and pins.Clinical SignificanceCorridor trajectories identified in this population can be achieved from a dorsal approach between T5 and T9. A dorsal approach for implant placement would be challenging for T1‐T4 due to the variability found in these vertebrae as well as regional anatomical constraints.}, journal={VETERINARY SURGERY}, author={Schmitt, Elizabeth M. and Early, Peter and Bergman, Robert and Riedesel, Elizabeth A. and Yuan, Lingnan and Mochel, Jonathan P. and Kraus, Karl H.}, year={2021}, month={Jul} } @article{woelfel_robertson_mariani_munana_early_olby_2021, title={Outcomes and prognostic indicators in 59 paraplegic medium to large breed dogs with extensive epidural hemorrhage secondary to thoracolumbar disc extrusion}, volume={50}, ISSN={["1532-950X"]}, DOI={10.1111/vsu.13592}, abstractNote={AbstractObjectiveTo evaluate outcomes and prognostic factors after decompressive hemilaminectomy in paraplegic medium to large breed dogs with extensive epidural hemorrhage (DEEH) and thoracolumbar intervertebral disc extrusion (TL‐IVDE).Study designRetrospective, cohort, descriptive study.AnimalsFifty‐nine client‐owned dogs.MethodsMedical records and advanced imaging were reviewed for paraplegic dogs with DEEH. Ambulatory status 6 months after surgery and postoperative complications were recorded. Multiple logistic regression models were constructed to explore prognostic factors.ResultsRecords of 22 dogs with and 37 dogs without pelvic limb pain perception at presentation were included. Median age of dogs was 5 years (interquartile range, 4‐7), and mean weight was 26.9 kg (SD, ±9.71). Labradors and Labrador mixes were most common (17/59 [28.8%]). Recovery of ambulation occurred in 17 of 22 (77.3%) dogs with and in 14 of 37 (37.8%) dogs without pain perception prior to surgery. Progressive myelomalacia was recorded in three of 59 (5.1%) dogs, one with pain perception and two without pain perception at presentation. Postoperative complications (14/59 [23.7%]) were common. Factors independently associated with outcome included clinical severity (odds ratio [OR] 0.179, P = .005), number of vertebrae with signal interruption in half Fourier single‐shot turbo spin‐echo sequences (HASTEi; OR, 0.738; P = .035), and ratio of vertebral sites decompressed to HASTEi (OR, 53.79; P = .03).ConclusionParaplegic medium to large breed dogs with DEEH have a less favorable outcome after surgical decompression than paraplegic dogs with TL‐IVDE.Clinical significanceDogs with DEEH can have severe postoperative complications. Loss of pain perception and increased HASTEi are associated with a poor outcome, while more extensive decompression improves outcome.}, number={3}, journal={VETERINARY SURGERY}, author={Woelfel, Christian W. and Robertson, James B. and Mariani, Chris L. and Munana, Karen R. and Early, Peter J. and Olby, Natasha J.}, year={2021}, month={Apr}, pages={527–536} } @article{woelfel_bray_early_mariani_olby_2021, title={Subaxial cervical articular process subluxation and dislocation: Cervical locked facet injuries in dogs}, volume={11}, ISSN={["1532-950X"]}, DOI={10.1111/vsu.13746}, abstractNote={AbstractObjectiveTo describe neurologic signs, diagnostic imaging findings, potential treatments, and outcomes in dogs with subaxial cervical articular process subluxation and dislocation, or a “locked facet.”Study designRetrospective case series.AnimalsTen client‐owned dogs.MethodsDogs with a diagnosis of cervical locked facets were identified through medical records and imaging reports searches. Data on presenting signs, diagnostic findings, treatment, and outcome were recorded.ResultsAll cases were small or toy‐breed dogs with preceding trauma. Four dogs were tetraplegic with intact pain perception, five were nonambulatory tetraparetic, and one was ambulatory tetraparetic, with half of the tetraparetic dogs having worse motor function in the thoracic limbs. The only sites affected were C5/6 (n = 6) and C6/7 (n = 4). All dogs had unilateral dorsal displacement of the cranial articular process of the caudal vertebra relative to the caudal articular process of the cranial vertebra at the luxation site. Five dogs were treated surgically, three by external coaptation, one by restriction, and one was euthanized the day after diagnosis. All dogs with outcome data (n = 8) became ambulatory. Nonambulatory dogs returned to ambulation in a median of 4 weeks (IQR 1‐12; range 1‐28).ConclusionIn these dogs, locked facet injuries affected the caudal cervical vertebrae in small breeds and could be identified on imaging through the presence of dorsal displacement of a cranial articular process. Our small cohort had a functional recovery regardless of treatment.Clinical signiicanceLocked facet injuries should be a differential for small or toy‐breed dogs with a cervical myelopathy secondary to trauma.}, journal={VETERINARY SURGERY}, author={Woelfel, Christian W. and Bray, Katherine Y. and Early, Peter J. and Mariani, Christopher L. and Olby, Natasha J.}, year={2021}, month={Nov} } @article{paushter_early_perkins_applegate_2021, title={Surgical Resection of a Parietal Osteoma in a Domestic Ferret Using Advanced Neurosurgical Techniques}, volume={57}, ISBN={1547-3317}, DOI={10.5326/JAAHA-MS-7053}, abstractNote={ABSTRACT A 3.5 yr old male neutered ferret presented with progressive enlargement of a right dorsocaudal skull mass that had occurred over 18 mo. Computed tomography imaging revealed a large (2.4 × 2.7 cm), well-defined, pedunculated osseous mass arising from the right parietal bone. Cytology was inconclusive, and surgical biopsy was consistent with an osteoma. Further enlargement of the mass occurred over the next 3 mo, at which time surgical intervention was pursued. The patient recovered well, despite the persistence of a bony defect at the former mass site, and no mass regrowth occurred in the 14 mo following the surgical resection. This is one of only two reports in the literature to document the surgical removal of an osteoma in a ferret, and this is the sole case in which a custom apparatus was fabricated for head stabilization, a multiaxis adjustable surgical table was used to improve access to the surgical site, and an ultrasonic scalpel was used for the mass resection.}, number={2}, journal={JOURNAL OF THE AMERICAN ANIMAL HOSPITAL ASSOCIATION}, author={Paushter, Aaron and Early, Peter and Perkins, Tyler and Applegate, Jeffrey}, year={2021}, pages={91–95} } @article{wolf_early_pozzi_vigani_2021, title={Ultrasound-guided paravertebral perineural glucocorticoid injection for signs of refractory cervical pain associated with foraminal intervertebral disk protrusion in four dogs}, volume={258}, ISSN={["1943-569X"]}, DOI={10.2460/javma.258.9.999}, abstractNote={Abstract CASE DESCRIPTION 4 dogs, 7.5 to 10 years of age, were presented for evaluation of signs of chronic cervical pain and forelimb lameness secondary to cervical foraminal intervertebral disk protrusion (IVDP). All dogs were refractory to ≥ 2 weeks of conservative management including strict rest and pain management with anti-inflammatory drugs, methocarbamol, and gabapentin. CLINICAL FINDINGS The MRI findings included left foraminal IVDP at C2-3 causing mild C3 nerve root compression (dog 1), multifocal degenerative disk disease with mild focal left-sided disk protrusion at C6-7 without associated spinal cord or nerve root compression (dog 2), left foraminal C6-7 IVDP with suspected focal spinal cord atrophy or mild compression (dog 3), and right foraminal C6-7 IVDP and multifocal cervical intervertebral disk degeneration with annulus fibrosus protrusion (dog 4). TREATMENT AND OUTCOME Ultrasound-guided paravertebral perineural injections with methylprednisolone acetate (1 mg/kg [0.45 mg/lb]) at the C3 nerve root in dog 1 and at the C7 nerve root in the other 3 dogs were performed. Injections were repeated at intervals of 4 weeks to 3 months on the basis of clinical response. None of the dogs had any complications from the procedures. For dogs 1 and 4, there was complete resolution of lameness and signs of cervical pain following perineural injections, and for dog 3, there was complete resolution of lameness and only minimal residual cervical pain. Dog 2 did not have long-lasting improvement. CLINICAL RELEVANCE Findings indicated that ultrasound-guided paravertebral perineural injection can be an effective treatment of cervical foraminal IVDP for some dogs. Additional studies to determine appropriate case selection and better assess the overall success rate and risks associated with this technique are warranted. }, number={9}, journal={JAVMA-JOURNAL OF THE AMERICAN VETERINARY MEDICAL ASSOCIATION}, author={Wolf, Johanna K. and Early, Peter J. and Pozzi, Antonio and Vigani, Alessio}, year={2021}, month={May}, pages={999–1006} } @misc{chiavaccini_schachar_early_bailey_2021, title={Ultrasound-guided perineural injections for the medical management of thoracic limb root signature in a dog}, volume={48}, ISSN={["1467-2995"]}, DOI={10.1016/j.vaa.2021.03.003}, abstractNote={Perineural injection of corticosteroids using fluoroscopy guidance has been proposed as part of the multimodal medical management of root-signature signs associated with cervical lateralized disc material in dogs ( Giambuzzi et al., 2016 Giambuzzi S. Pancotto T. Ruth J. Perineural injection for treatment of root-signature signs associated with lateralized disk material in five dogs (2009–2013). Front Vet Sci. 2016; 3: 1 Crossref PubMed Scopus (5) Google Scholar ). However, the technique requires specialized equipment, is time-consuming and carries the risk of radiation exposure.}, number={3}, journal={VETERINARY ANAESTHESIA AND ANALGESIA}, author={Chiavaccini, Ludovica and Schachar, Jordan and Early, Peter J. and Bailey, Kate M.}, year={2021}, month={May}, pages={480–482} } @article{mariani_niman_boozer_ruterbories_early_munana_olby_2021, title={Vascular endothelial growth factor concentrations in the cerebrospinal fluid of dogs with neoplastic or inflammatory central nervous system disorders}, volume={6}, ISSN={["1939-1676"]}, url={https://doi.org/10.1111/jvim.16181}, DOI={10.1111/jvim.16181}, abstractNote={AbstractBackgroundVascular endothelial growth factor (VEGF) is a key molecular driver of angiogenesis and vascular permeability and is expressed by a wide variety of neoplasms. Although blood VEGF concentrations have been quantified in intracranial tumors of dogs, cerebrospinal fluid (CSF) VEGF concentration might be a more sensitive biomarker of disease.ObjectiveConcentrations of VEGF in CSF are higher in dogs with central nervous system (CNS) neoplasia compared to those with meningoencephalomyelitis and other neurologic disorders.AnimalsOne hundred and twenty‐six client‐owned dogs presented to a veterinary teaching hospital.MethodsCase‐control study. Cerebrospinal fluid was archived from dogs diagnosed with CNS neoplasia and meningoencephalomyelitis. Control dogs had other neurological disorders or diseases outside of the CNS. A commercially available kit was used to determine VEGF concentrations.ResultsDetectable CSF VEGF concentrations were present in 49/63 (77.8%) neoplastic samples, 22/24 (91.7%) inflammatory samples, and 8/39 (20.5%) control samples. The VEGF concentrations were significantly different between groups (P < .0001), and multiple comparison testing showed that both neoplastic and inflammatory groups had significantly higher concentrations than did controls (P < .05), but did not differ from each other. Gliomas and choroid plexus tumors had significantly higher VEGF concentrations than did the control group (P < .05).Conclusions and Clinical ImportanceCerebrospinal fluid VEGF concentrations may serve as a marker of neoplastic and inflammatory CNS disorders relative to other conditions.}, journal={JOURNAL OF VETERINARY INTERNAL MEDICINE}, publisher={Wiley}, author={Mariani, Christopher L. and Niman, Zachary E. and Boozer, Lindsay B. and Ruterbories, Laura K. and Early, Peter J. and Munana, Karen R. and Olby, Natasha J.}, year={2021}, month={Jun} } @article{lewis_early_mariani_munana_olby_2020, title={Influence of Duration of Injury on Diffusion Tensor Imaging in Acute Canine Spinal Cord Injury}, volume={37}, ISSN={["1557-9042"]}, DOI={10.1089/neu.2019.6786}, abstractNote={Diffusion tensor imaging (DTI) quantifies microstructural lesion characteristics but impact of the interval between spinal cord injury (SCI) and examination on imaging characteristics is unclear. Our objective was to investigate the impact of duration of injury on DTI indices in dogs with acute, spontaneous SCI due to thoracolumbar intervertebral disc herniation (IVDH) and explore associations with clinical severity. Twenty-six dogs with acute thoracolumbar IVDH of variable severity who underwent DTI were included. Neurologic severity was graded using the Modified Frankel Score (0-V). Fractional anisotropy (FA) and mean diffusivity (MD) were calculated on regions of interest within and adjacent to the lesion epicenter. Relationships between FA or MD and duration (injury to imaging interval) or neurologic severity were determined using regression analysis and Wilcoxon rank sum. Median age was 6.8 years (1-13), median duration was 1.5 days (1-9) and neurologic signs ranged from ambulatory paraparesis (MFS II) to paraplegia with absent pain perception (MFS V). Mean FA was 0.61+/-0.09 cranial to the lesion, 0.57+/-0.12 at the epicenter and 0.55+/-0.10 caudally. Mean MD was 1.18x10-3+/-0.0002 cranially, 1.09x10-3+/-0.0002 at the epicenter and 1.14x10-3+/-0.0002 caudally. Accounting for neurologic severity and age, FA caudal to the epicenter decreased with increasing duration of injury (p = 0.02). Lower MD within the lesion epicenter was associated with worse neurologic severity (p = 0.01). Duration of injury should be considered when interpreting DTI results in dogs with acute thoracolumbar IVDH. MD might differentiate injury severity in the acute setting and be worthy of development as an imaging biomarker.}, number={21}, journal={JOURNAL OF NEUROTRAUMA}, author={Lewis, Melissa J. and Early, Peter J. and Mariani, Christopher L. and Munana, Karen R. and Olby, Natasha J.}, year={2020}, month={Nov}, pages={2261–2267} } @article{amengual-batle_jose-lopez_durand_czopowicz_beltran_guevar_lazzerini_de decker_munana_early_et al._2020, title={Traumatic skull fractures in dogs and cats: A comparative analysis of neurological and computed tomographic features}, volume={34}, ISSN={["1939-1676"]}, DOI={10.1111/jvim.15838}, abstractNote={AbstractBackgroundTraumatic skull fractures (TSF) are relatively frequent in dogs and cats, but little information is available regarding their clinical and imaging features.Hypothesis/ObjectivesTo describe the neurological and computed tomographic (CT) features of a large cohort of dogs and cats with TSF.AnimalsNinety‐one dogs and 95 cats with TSF identified on CT.MethodsMulticenter retrospective comparative study. Signalment, cause of trauma, fracture locations and characteristics, presence of neurological deficits, and 1‐week survival were recorded. Fractures were classified according to the extent of fragmentation and displacement.ResultsThe cranial vault was affected more frequently in dogs (P = .003), whereas the face and base of the cranium more often was affected in cats (P < .001). Cats presented with multiple fractures more frequently (P < .001). All animals with TSF in the cranial vault were more likely to develop neurological signs (P = .02), especially when depressed fractures were present (95% confidence interval [CI], 1.7‐8.2; P = .001). Animals with TSF located only in the facial region were less likely to have neurological signs (odds ratio with Mantel‐Haenszel's method [ORMH], 0.2; 95% CI, 0.1‐0.6; P = .004). Most affected animals (84.9%) survived the first week post‐trauma. Death was more likely with fractures of the cranial vault (P = .003), especially when fragmented (P = .007) and displaced (P = .004).Conclusions and Clinical ImportanceTraumatic skull fracture distribution and patterns are different between dogs and cats. Cranial vault fractures were associated with neurological deficits and worse survival. The presence of TSF alone should not be considered a negative prognostic factor because most affected animals survived the first week.}, number={5}, journal={JOURNAL OF VETERINARY INTERNAL MEDICINE}, author={Amengual-Batle, Pablo and Jose-Lopez, Roberto and Durand, Alexane and Czopowicz, Michal and Beltran, Elsa and Guevar, Julien and Lazzerini, Kali and De Decker, Steven and Munana, Karen and Early, Peter and et al.}, year={2020}, month={Sep}, pages={1975–1985} } @article{castel_olby_ru_mariani_muñana_early_2019, title={Risk factors associated with progressive myelomalacia in dogs with complete sensorimotor loss following intervertebral disc extrusion: a retrospective case-control study}, volume={15}, ISSN={1746-6148}, url={http://dx.doi.org/10.1186/s12917-019-2186-0}, DOI={10.1186/s12917-019-2186-0}, abstractNote={AbstractBackgroundProgressive myelomalacia (PMM) is a usually fatal complication of acute intervertebral disc extrusion (IVDE) in dogs but its risk factors are poorly understood. The objective of this retrospective case-control study was to identify risk factors for PMM by comparing dogs with complete sensorimotor loss following IVDE that did and did not develop the disease after surgery. We also investigated whether any risk factors for PMM influenced return of ambulation. Medical records of client-owned dogs with paraplegia and loss of pain perception that underwent surgery for IVDE from 1998 to 2016, were reviewed. Dogs were categorized as PMM yes or no based on clinical progression or histopathology. Walking outcome at 6 months was established. Signalment, onset and duration of signs (categorized), steroids, non-steroidal anti-inflammatory drugs (yes or no), site of IVDE (lumbar intumescence or thoracolumbar) and longitudinal extent of IVDE were retrieved and their associations with PMM and walking outcome were examined using logistic regression.ResultsOne hundred and ninety seven dogs were included, 45 with and 152 without PMM. A 6-month-outcome was available in 178 dogs (all 45 PMM dogs and 133 control dogs); 86 recovered walking (all in the control group). Disc extrusions at the lumbar intumescence were associated with PMM (p = 0.01, OR: 3.02, CI: 1.3–7.2). Surgery performed more than 12 h after loss of ambulation was associated with PMM (OR = 3.4; CI = 1.1–10.5,p = 0.03 for 12-24 h and OR = 4.6; CI = 1.3–16.6,p = 0.02 for the > 24 h categories when compared with the ≤12 h category). Treatment with corticosteroids was negatively associated with PMM (OR: 3.1; CI: 1.3–7.6,p = 0.01). The only variable to affect walking outcome was longitudinal extent of IVDE (OR = 2.6; CI = 1.3–5.3,p = 0.006).ConclusionDogs with lumbar intumescence IVDE are at increased risk of PMM. Timing of surgery and corticosteroid use warrant further investigations. PMM and recovery of walking are influenced by different factors.}, number={1}, journal={BMC Veterinary Research}, publisher={Springer Science and Business Media LLC}, author={Castel, Aude and Olby, Natasha J. and Ru, Hongyu and Mariani, Christopher L. and Muñana, Karen R. and Early, Peter J.}, year={2019}, month={Dec} } @article{dixon_chen_rossmeisl_sturges_vernau_levine_otamendi_early_partnow_curtis_et al._2019, title={Surgical decompression, with or without adjunctive therapy, for palliative treatment of primary vertebral osteosarcoma in dogs}, volume={17}, ISSN={["1476-5829"]}, DOI={10.1111/vco.12508}, abstractNote={AbstractVertebral osteosarcoma (OSA) is the most common primary vertebral tumor in dogs, however studies examining the survival time after surgical decompression of these tumors are limited. There is also limited information regarding the benefit of adjunctive treatments such as radiation therapy or chemotherapy in these patients. The goal of this study was to determine survival time of dogs with primary vertebral OSA after palliative decompressive surgery alone and combined with radiation therapy and/or chemotherapy. Records from 22 client‐owned dogs diagnosed with primary vertebral OSA and treated with decompressive surgery were collected retrospectively from eight referral institutions. Survival time was assessed for dogs treated with surgery alone as well as dogs who received adjunctive radiation therapy and/or chemotherapy. Median survival time in the 12 dogs treated with surgery alone was 42 days (range: 3‐1333 days). The three dogs treated with surgery and chemotherapy had a median survival time of 82 days (range: 56‐305 days). Only one dog was treated with surgery and radiation therapy; this dog survived 101 days. Six dogs were treated with surgery, radiation therapy and chemotherapy; these dogs had a median survival time of 261 days (range: 223‐653 days). Cause of death in all cases that survived the initial postoperative period was euthanasia secondary to confirmed or suspected tumor regrowth. The results of this study suggest that definitive radiation therapy, possibly combined with concurrent chemotherapy, significantly improves survival in dogs treated with palliative decompressive surgery for vertebral OSA and should be the treatment of choice in selected cases.}, number={4}, journal={VETERINARY AND COMPARATIVE ONCOLOGY}, author={Dixon, Alexandra and Chen, Annie and Rossmeisl, John H., Jr. and Sturges, Beverly and Vernau, Karen and Levine, Jonathan M. and Otamendi, Arturo and Early, Peter and Partnow, Alix and Curtis, Lara and et al.}, year={2019}, month={Dec}, pages={472–478} } @article{zidan_sims_fenn_williams_griffith_early_mariani_munana_guevar_olby_et al._2018, title={A randomized, blinded, prospective clinical trial of postoperative rehabilitation in dogs after surgical decompression of acute thoracolumbar intervertebral disc herniation}, volume={32}, ISSN={0891-6640}, url={http://dx.doi.org/10.1111/jvim.15086}, DOI={10.1111/jvim.15086}, abstractNote={BackgroundExperimental evidence shows benefit of rehabilitation after spinal cord injury (SCI) but there are limited objective data on the effect of rehabilitation on recovery of dogs after surgery for acute thoracolumbar intervertebral disc herniations (TL‐IVDH).ObjectiveCompare the effect of basic and intensive post‐operative rehabilitation programs on recovery of locomotion in dogs with acute TL‐IVDH in a randomized, blinded, prospective clinical trial.AnimalsThirty non‐ambulatory paraparetic or paraplegic (with pain perception) dogs after decompressive surgery for TL‐IVDH.MethodsBlinded, prospective clinical trial. Dogs were randomized (1:1) to a basic or intensive 14‐day in‐house rehabilitation protocol. Fourteen‐day open field gait score (OFS) and coordination (regulatory index, RI) were primary outcomes. Secondary measures of gait, post‐operative pain, and weight were compared at 14 and 42 days.ResultsOf 50 dogs assessed, 32 met inclusion criteria and 30 completed the protocol. There were no adverse events associated with rehabilitation. Median time to walking was 7.5 (2 – 37) days. Mean change in OFS by day 14 was 6.13 (confidence intervals: 4.88, 7.39, basic) versus 5.73 (4.94, 6.53, intensive) representing a treatment effect of −0.4 (−1.82, 1.02) which was not significant, P=.57. RI on day 14 was 55.13 (36.88, 73.38, basic) versus 51.65 (30.98, 72.33, intensive), a non‐significant treatment effect of −3.47 (−29.81, 22.87), P = .79. There were no differences in secondary outcomes between groups.ConclusionsEarly postoperative rehabilitation after surgery for TL‐IVDH is safe but doesn't improve rate or level of recovery in dogs with incomplete SCI.}, number={3}, journal={Journal of Veterinary Internal Medicine}, publisher={Wiley}, author={Zidan, Natalia and Sims, Cory and Fenn, Joe and Williams, Kim and Griffith, Emily and Early, Peter J. and Mariani, Chris L. and Munana, Karen and Guevar, Julien and Olby, Natasha J. and et al.}, year={2018}, month={Apr}, pages={1133–1144} } @article{zidan_fenn_griffith_early_mariani_muñana_guevar_olby_2018, title={The Effect of Electromagnetic Fields on Post-Operative Pain and Locomotor Recovery in Dogs with Acute, Severe Thoracolumbar Intervertebral Disc Extrusion: A Randomized Placebo-Controlled, Prospective Clinical Trial}, volume={35}, ISSN={0897-7151 1557-9042}, url={http://dx.doi.org/10.1089/neu.2017.5485}, DOI={10.1089/neu.2017.5485}, abstractNote={Spinal cord injury (SCI) attributed to acute intervertebral disc extrusions (IVDEs) is common in dogs and is treated by surgical decompression. Dogs with sensorimotor complete injuries have an incomplete recovery. Pulsed electromagnetic fields (PEMFs) reduce post-operative pain through anti-inflammatory effects and there is growing evidence for neuroprotective effects. This randomized, controlled clinical trial evaluated the effect of PEMF on post-operative pain and neurological recovery in dogs with surgically treated sensorimotor complete SCI attributed to acute IVDE. Sixteen dogs with surgically treated complete thoracolumbar SCI were randomized to receive PEMF (15 min every 2 h for 2 weeks then twice-daily for 4 weeks) or placebo starting immediately after diagnosis. The primary outcome was gait score at 2 weeks. Secondary measures of gait, pain perception, and proprioceptive function were evaluated at 2 and 6 weeks. Plasma glial fibrillary acidic protein (GFAP) concentration was measured as an SCI biomarker. Post-operative pain was quantified by measuring mechanical sensory thresholds (MSTs) at control and surgical sites. There was no significant difference in demographics or GFAP concentration between the two groups at trial entry. There was no difference in primary outcome or in secondary measures of gait, but proprioceptive placing was significantly better at 6 weeks and GFAP concentrations were significantly lower at 2 weeks in the PEMF group. MSTs were significantly higher in the PEMF-treated group. We conclude that PEMF reduced incision-associated pain in dogs post-surgery for IVDE and may reduce extent of SCI and enhance proprioceptive placing. Larger clinical trials are warranted.}, number={15}, journal={Journal of Neurotrauma}, publisher={Mary Ann Liebert Inc}, author={Zidan, Natalia and Fenn, Joe and Griffith, Emily and Early, Peter J. and Mariani, Chris L. and Muñana, Karen R. and Guevar, Julien and Olby, Natasha J.}, year={2018}, month={Aug}, pages={1726–1736} } @article{pastina_early_bergman_nettifee_maller_bray_waldron_castel_munana_papich_et al._2018, title={The pharmacokinetics of cytarabine administered subcutaneously, combined with prednisone, in dogs with meningoencephalomyelitis of unknown etiology}, volume={41}, ISSN={["1365-2885"]}, url={https://doi.org/10.1111/jvp.12667}, DOI={10.1111/jvp.12667}, abstractNote={AbstractThe objective of this study was to describe the pharmacokinetics (PK) of cytarabine (CA) after subcutaneous (SC) administration to dogs with meningoencephalomyelitis of unknown etiology (MUE). Twelve dogs received a single SC dose of CA at 50 mg/m2 as part of treatment of MUE. A sparse sampling technique was used to collect four blood samples from each dog from 0 to 360 min after administration. All dogs were concurrently receiving prednisone (0.5–2 mg kg−1day−1). Plasma CA concentrations were measured by HPLC, and pharmacokinetic parameters were estimated using nonlinear mixed‐effects modeling (NLME). Plasma drug concentrations ranged from 0.05 to 2.8 μg/ml. The population estimate (CV%) for elimination half‐life and Tmax of cytarabine in dogs was 1.09 (21.93) hr and 0.55 (51.03) hr, respectively. The volume of distribution per fraction absorbed was 976.31 (10.85%) ml/kg. Mean plasma concentration of CA for all dogs was above 1.0 μg/ml at the 30‐, 60‐, 90‐, and 120‐min time points. In this study, the pharmacokinetics of CA in dogs with MUE after a single 50 mg/m2 SC injection in dogs was similar to what has been previously reported in healthy beagles; there was moderate variability in the population estimates in this clinical population of dogs.}, number={5}, journal={Journal of Veterinary Pharmacology & Therapeutics}, publisher={Wiley}, author={Pastina, B. and Early, P.J. and Bergman, R.L. and Nettifee, J. and Maller, A. and Bray, K.Y. and Waldron, R.J. and Castel, A.M. and Munana, K.R. and Papich, M.G. and et al.}, year={2018}, month={Oct}, pages={638–643} } @article{fenn_laber_williams_rousse_early_mariani_munana_decker_volk_olby_et al._2017, title={Associations Between Anesthetic Variables and Functional Outcome in Dogs With Thoracolumbar Intervertebral Disk Extrusion Undergoing Decompressive Hemilaminectomy}, volume={31}, ISSN={0891-6640}, url={http://dx.doi.org/10.1111/jvim.14677}, DOI={10.1111/jvim.14677}, abstractNote={BackgroundOutcome of acute experimental spinal cord injury is strongly associated with tissue perfusion and oxygenation. Cardiopulmonary depression could affect outcome in dogs undergoing general anesthesia for surgical treatment of thoracolumbar intervertebral disk extrusion (IVDE).Hypothesis/ObjectivesTo evaluate the effects of general anesthesia on functional outcome in dogs undergoing surgery to treat thoracolumbar IVDE.AnimalsEighty‐four client‐owned dogs with acute thoracolumbar IVDE treated by decompressive hemilaminectomy.MethodsExploratory, retrospective observational study. Medical records were reviewed for clinical presentation and anesthetic monitoring variables, including duration of anesthesia and surgery, hypotension, bradycardia, temperature, and respiratory parameters. Multivariable regression tree analysis was performed to explore associations between anesthetic variables and functional outcome scores after 6 weeks, as well as return to ambulatory status.ResultsEpisodes of bradycardia (69%) and hypotension (57%) were frequent. Across all outcome measures, regression tree analysis highlighted functional grade at presentation as the primary determining factor, and among pain perception negative dogs, there was a possible association between increased duration of surgery and poorer outcome. In dogs with intact pain perception, duration of bradycardia, mean body temperature, and mean end‐tidal carbon dioxide were highlighted.Conclusions and Clinical ImportanceExploratory statistical methods can facilitate hypothesis‐generating studies to inform prospective investigations in veterinary medicine. Although the mechanism is uncertain, increased duration of surgery might be associated with poorer outcome in pain perception negative dogs with thoracolumbar IVDE.}, number={3}, journal={Journal of Veterinary Internal Medicine}, publisher={Wiley}, author={Fenn, J. and Laber, E. and Williams, K. and Rousse, C. A. and Early, P. J. and Mariani, C. L. and Munana, Karen and Decker, S. De and Volk, H. A. and Olby, N. J. and et al.}, year={2017}, month={Mar}, pages={814–824} } @article{castel_olby_mariani_muñana_early_2017, title={Clinical Characteristics of Dogs with Progressive Myelomalacia Following Acute Intervertebral Disc Extrusion}, volume={31}, ISSN={0891-6640}, url={http://dx.doi.org/10.1111/jvim.14829}, DOI={10.1111/jvim.14829}, abstractNote={BackgroundProgressive myelomalacia (PMM) is a catastrophic disease associated with acute intervertebral disc extrusion (IVDE). Published data on the clinical characteristics of this disease are limited.ObjectiveTo describe the onset and progression of clinical signs of PMM in a large case cohort.AnimalsFifty‐one dogs, 18 with histopathologically confirmed PMM, 33 presumptively diagnosed based on clinical signs and diagnostic imaging.MethodsRetrospective study. Dogs with confirmed IVDE and either a histopathologic diagnosis of PMM or a high clinical suspicion were identified by medical record search. Data on nature and progression of signs were extracted.ResultsTwenty‐four of 51 dogs were Dachshunds. T12–T13 was the most common site of disc extrusion (12 of 56), and 18 of 55 of mid‐to‐caudal lumbar discs (between L3 and L6) were affected. Onset of PMM signs ranged from present at first evaluation (17/51) to 5 days after presentation, with 25 of 51 cases developing signs within 48 hours. Progression of signs from onset of PMM to euthanasia or death, excluding 7 cases euthanized at presentation, ranged from 1 to 13 days with 23 being euthanized within 3 days. Nonspecific systemic signs were documented in 30 of 51 dogs.Conclusion and Clinical ImportanceThe majority of dogs developed PMM within 2 days of presentation and was euthanized within another 3 days. However, onset can be delayed up to 5 days after presentation with progression to euthanasia taking as long as 2 weeks. Mid‐to‐caudal lumbar discs might be associated with an increased risk of PMM.}, number={6}, journal={Journal of Veterinary Internal Medicine}, publisher={Wiley}, author={Castel, A. and Olby, N.J. and Mariani, C.L. and Muñana, K.R. and Early, P.J.}, year={2017}, month={Sep}, pages={1782–1789} } @article{lewis_olby_early_mariani_muñana_seiler_griffith_2016, title={Clinical and Diagnostic Imaging Features of Brain Herniation in Dogs and Cats}, volume={30}, ISSN={0891-6640}, url={http://dx.doi.org/10.1111/jvim.14526}, DOI={10.1111/jvim.14526}, abstractNote={BackgroundQuantification of brain herniation on MRI and its immediate clinical implications are poorly described.ObjectivesDefine the normal position of caudal fossa structures on brain MRIs in dogs and cats utilizing morphometry, compare this to dogs and cats with caudal transtentorial herniation (CTH), foramen magnum herniation (FMH) or both identified on MRI, and investigate associations between herniation severity, clinical signs, and 24‐hour outcome.AnimalsNinety‐two controls (66 dogs, 26 cats), 119 cases with herniation (88 dogs, 31 cats).MethodsRetrospective case series. The MRI database was searched for controls with normal brain anatomy and cases with brain herniation. Morphometry in controls established TTX (transtentorial to rostroventral cerebellum) to quantify CTH and FMX (caudoventral cerebellum to foramen magnum) to quantify FMH. Measurements were compared between cases and controls. Correlations with specific clinical variables and outcome were investigated.ResultsMeasurements in medium/large control dogs versus small dog and cat controls were significantly different (P < .001, TTX: −0.46, −0.305, −0.3, FMX: 0.695, 0.27, 0.25, respectively). 119/1564 (7.6%) cases that underwent brain imaging had brain herniation. TTX and FMX were significantly different between controls and cases with CTH or FMH (P < .001). 67/89 (75%) cases with supratentorial lesions had no signs directly attributable to herniation. 71/119 (60%) had a normal anesthetic recovery. TTX was significantly associated with 24‐hour survival (P < .001).Conclusions and clinical importanceBrain herniation can be quantified on MRI. Clinical signs directly attributable to brain herniation commonly are absent, and more severe CTH based on TTX is associated with a worse short‐term outcome.}, number={5}, journal={Journal of Veterinary Internal Medicine}, publisher={Wiley}, author={Lewis, M.J. and Olby, N.J. and Early, P.J. and Mariani, C.L. and Muñana, K.R. and Seiler, G.S. and Griffith, E.H.}, year={2016}, month={Sep}, pages={1672–1680} } @article{olby_vaden_williams_griffith_harris_mariani_muñana_early_platt_boozer_et al._2016, title={Effect of Cranberry Extract on the Frequency of Bacteriuria in Dogs with Acute Thoracolumbar Disk Herniation: A Randomized Controlled Clinical Trial}, volume={31}, ISSN={0891-6640}, url={http://dx.doi.org/10.1111/jvim.14613}, DOI={10.1111/jvim.14613}, abstractNote={BackgroundDogs with spinal cord injury are at increased risk of developing bacteriuria due to increased residual urine volume. Cranberry extract inhibits binding of E. coli to uroepithelial cells, potentially reducing risk of bacteriuria.HypothesisCranberry extract reduces risk of bacteriuria in dogs after acute TL‐IVDH.AnimalsClient‐owned dogs with acute onset TL‐IVDH causing nonambulatory status.MethodsRandomized, placebo‐controlled, blinded, prospective clinical trial. Dogs with acute TL‐IVDH were recruited 48 hours postoperatively and randomized to receive cranberry extract or placebo in a masked fashion. Urine cultures and neurological examinations were performed 2, 4, and 6 weeks postoperatively. The number of dogs with bacteriuria (all bacterial species) and bacteriuria (E. coli) were primary and secondary outcome measures and were evaluated using chi‐squared test. Urine antiadhesion activity (AAA) was measured in a subset (N = 47) and examined in a secondary analysis evaluating additional risk factors for bacteriuria.ResultsBacteriuria was detected 17 times in 94 dogs (6 placebo, 11 cranberry, P = .12). There were 7 E. coli. positive cultures (1 placebo, 6 cranberry, P = .09). Dogs in both groups had positive urine AAA (14/21: placebo, 16/26: cranberry), and dogs with urine AAA had significantly fewer E. coli positive cultures (n = 1) than dogs without it (n = 4) (P = .047).Conclusions and Clinical ImportanceThis clinical trial did not show a benefit of oral cranberry extract but had low power. Cranberry extract supplementation did not impact urine AAA, but a possible association between urine AAA and lower risk of E. coli bacteriuria was identified. Other doses could be investigated.}, number={1}, journal={Journal of Veterinary Internal Medicine}, publisher={Wiley}, author={Olby, N.J. and Vaden, S.L. and Williams, K. and Griffith, E.H. and Harris, T. and Mariani, C.L. and Muñana, K.R. and Early, P.J. and Platt, S.R. and Boozer, L. and et al.}, year={2016}, month={Dec}, pages={60–68} } @article{early_crook_williams_davis_munana_papich_messenger_2017, title={Plasma and serum concentrations of cytarabine administered via continuous intravenous infusion to dogs with meningoencephalomyelitis of unknown etiology}, volume={40}, ISSN={["1365-2885"]}, url={http://www.scopus.com/inward/record.url?eid=2-s2.0-84988369300&partnerID=MN8TOARS}, DOI={10.1111/jvp.12360}, abstractNote={The objective of this study was to evaluate the plasma and serum concentrations of cytarabine (CA) administered via constant rate infusion (CRI) in dogs with meningoencephalomyelitis of unknown etiology (MUE). Nineteen client‐owned dogs received a CRI of CA at a dose of 25 mg/m2/h for 8 h as treatment for MUE. Dogs were divided into four groups, those receiving CA alone and those receiving CA in conjunction with other drugs. Blood samples were collected at 0, 1, 8, and 12 h after initiating the CRI. Plasma (n = 13) and serum (n = 11) cytarabine concentrations were measured by high‐pressure liquid chromatography. The mean peak concentration (CMAX) and area under the curve (AUC) after CRI administration were 1.70 ± 0.66 μg/mL and 11.39 ± 3.37 h·μg/mL, respectively, for dogs receiving cytarabine alone, 2.36 ± 0.35 μg/mL and 16.91 + 3.60 h·μg/mL for dogs administered cytarabine and concurrently on other drugs. Mean concentrations for all dogs were above 1.0 μg/mL at both the 1‐ and 8‐h time points. The steady‐state achieved with cytarabine CRI produces a consistent and prolonged exposure in plasma and serum, which is likely to produce equilibrium between blood and the central nervous system in dogs with a clinical diagnosis of MUE. Other medications commonly used to treat MUE do not appear to alter CA concentrations in serum and plasma.}, number={4}, journal={JOURNAL OF VETERINARY PHARMACOLOGY AND THERAPEUTICS}, author={Early, P. J. and Crook, K. I. and Williams, L. M. and Davis, E. G. and Munana, K. R. and Papich, M. G. and Messenger, K. M.}, year={2017}, month={Aug}, pages={411–414} } @article{moore_early_hettlich_2016, title={Practice patterns in the management of acute intervertebral disc herniation in dogs}, volume={57}, ISSN={["1748-5827"]}, DOI={10.1111/jsap.12496}, abstractNote={Objectives Acute intervertebral disc herniation is commonly managed by veterinary neurologists and surgeons. Anecdote suggests that patterns of management vary considerably and there is controversy surrounding many aspects of treatment. The goal of this study was to document patterns in management of acute spinal cord injury caused by acute intervertebral disc herniation among these two groups to aid in future discussions on best practices.Methods A survey querying diagnostic, medical and surgical practices for dogs with acute intervertebral disc herniation was distributed to diplomates on the databases of the American College of Veterinary Surgeons and the American College of Veterinary Internal Medicine (Neurology).Results Responses were received from 314 board‐certified veterinary surgeons and neurologists. Both groups handled timing of decompression, surgical approach, and most postoperative recommendations in a similar fashion. Case volume differed between groups, with 77% of neurologists and 18% of surgeons managing ≥50 cases of acute intervertebral disc herniation per year. MRI was used most frequently as a diagnostic tool by neurologists (75%), while CT was used most commonly by surgeons (58%). Corticosteroids were routinely administered as a neuroprotective strategy by 34% of surgeons and 11% of neurologists. Disc fenestration was performed “always” or “most of the time” by 69% of neurologists and 36% of surgeons.Clinical Importance Understanding the common practices in the management of canine acute intervertebral disc herniation can provide a springboard for future discussions regarding the best practices in diagnosing and treating this disease.}, number={8}, journal={JOURNAL OF SMALL ANIMAL PRACTICE}, author={Moore, S. A. and Early, P. J. and Hettlich, B. F.}, year={2016}, month={Aug}, pages={409–415} } @article{rousse_olby_williams_harris_griffith_mariani_muñana_early_2016, title={Recovery of stepping and coordination in dogs following acute thoracolumbar intervertebral disc herniations}, volume={213}, ISSN={1090-0233}, url={http://dx.doi.org/10.1016/j.tvjl.2016.04.002}, DOI={10.1016/j.tvjl.2016.04.002}, abstractNote={Prospective data on the recovery of coordination in dogs suffering acute thoracolumbar intervertebral disc herniations (TL-IVDH) are limited. The purpose of this study was to use treadmill based and open field scores (OFS) to quantify recovery of stepping ability and forelimb, hindlimb coordination in the 6 weeks following surgical decompression of dogs with TL-IVDH. Sixty-three dogs were grouped at presentation as grades 3 (non-ambulatory paraparetic), 4 (paraplegic) or 5 (paraplegic without pain sensation) and were evaluated 2, 4, and 6 weeks post-operatively. Stepping scores and Regularity Index (RI), a measure of coordination, were calculated from treadmill walking, and an OFS incorporating supported and unsupported walking was assigned. Outcomes for the three measures were compared between groups and correlation between scoring methods was assessed. Grade 3 and 4 dogs recovered ambulation by 2 weeks, reaching median stepping scores of 96 and 90% by 6 weeks, respectively. Recovery of coordination differed between groups 3 and 4 with median RI scores of 93.9% and 63%, respectively, by 6 weeks. Eight grade 5 dogs failed to recover independent ambulation by 6 weeks. Nine dogs recovered with scores that were significantly worse than the grade 3 and 4 dogs at 6 weeks for stepping score (P < 0.001) and RI (P < 0.001). OFS correlated closely with stepping and RI scores and each group was significantly different using this ordinal scale. In conclusion, recovery of coordination was incomplete in dogs that showed good recovery of stepping. The data generated could be used for clinical trial design.}, journal={The Veterinary Journal}, publisher={Elsevier BV}, author={Rousse, C.A. and Olby, N.J. and Williams, K. and Harris, T.L. and Griffith, E.H. and Mariani, C.L. and Muñana, K.R. and Early, P.J.}, year={2016}, month={Jul}, pages={59–63} } @article{olby_muguet-chanoit_lim_davidian_mariani_freeman_platt_humphrey_kent_giovanella_et al._2016, title={A Placebo-Controlled, Prospective, Randomized Clinical Trial of Polyethylene Glycol and Methylprednisolone Sodium Succinate in Dogs with Intervertebral Disk Herniation}, volume={30}, ISSN={["1939-1676"]}, url={http://www.scopus.com/inward/record.url?eid=2-s2.0-84956678975&partnerID=MN8TOARS}, DOI={10.1111/jvim.13657}, abstractNote={BackgroundAcute intervertebral disk herniation (IVDH) is a common cause of spinal cord injury in dogs and currently there is no proven medical treatment to counter secondary injury effects. Use of methylprednisolone sodium succinate (MPSS) or polyethylene glycol (PEG) as neuroprotectants is advocated but controversial because neither treatment has been tested in placebo‐controlled, randomized, blinded trials in dogs.HypothesisPolyethylene glycol will improve the outcome of severe spinal cord injury caused by IVDH compared to MPSS or placebo.AnimalsClient‐owned dogs with acute onset of thoracolumbar IVDH causing paralysis and loss of nociception for <24 hours.MethodsDogs were randomized to receive MPSS, PEG, or placebo; drugs appeared identical and group allocation was masked. Drug administration was initiated once the diagnosis of IVDH was confirmed and all dogs underwent hemilaminectomy. Neurologic function was assessed 2, 4, 8, and 12 weeks postoperatively using an open field gait score (OFS) as the primary outcome measure. Outcomes were compared by the Wilcoxon rank sum test.ResultsSixty‐three dogs were recruited and 47.6% recovered ambulation. 17.5% developed progressive myelomalacia but there was no association with group. There was no difference in OFS among groups. Although full study power was not reached, conditional power analyses indicated the futility of continued case recruitment.ConclusionsThis clinical trial did not show a benefit of either MPSS or PEG in the treatment of acute, severe thoracolumbar IVDH when used as adjunctive medical treatment administered to dogs presenting within 24 hours of onset of paralysis.}, number={1}, journal={JOURNAL OF VETERINARY INTERNAL MEDICINE}, author={Olby, N. J. and Muguet-Chanoit, A. C. and Lim, J. -H. and Davidian, M. and Mariani, C. L. and Freeman, A. C. and Platt, S. R. and Humphrey, J. and Kent, M. and Giovanella, C. and et al.}, year={2016}, pages={206–214} } @article{early_mente_dillard_roe_2015, title={In vitro biomechanical evaluation of internal fixation techniques on the canine lumbosacral junction}, volume={3}, journal={PeerJ}, author={Early, P. and Mente, P. and Dillard, S. and Roe, S.}, year={2015} } @article{lewis_olby_sharp_early_2013, title={Long-Term Effect of Cervical Distraction and Stabilization on Neurological Status and Imaging Findings in Giant Breed Dogs With Cervical Stenotic Myelopathy}, volume={42}, ISSN={0161-3499}, url={http://dx.doi.org/10.1111/j.1532-950X.2013.12034.x}, DOI={10.1111/j.1532-950x.2013.12034.x}, abstractNote={AbstractObjectivesTo assess long‐term clinical and imaging outcomes in giant breed dogs with cervical stenotic myelopathy treated surgically.Study DesignRetrospective case series.AnimalsDogs (n = 7).MethodsAll dogs had lateral or dorsolateral cord compression at 1 or more sites and were treated with cervical distraction and stabilization using PMMA plugs. Four dogs had follow‐up CT or CT/myelography performed at least 6 months postoperatively. Spinal canal stenosis measurements were compared between pre‐ and postoperative CT images. Long‐term clinical neurologic re‐evaluation ranged from 4 to 7 years. Outcome was considered positive, satisfactory, or negative. Recurrence was defined as signs of a cervical myelopathy in dogs that initially improved or had stable disease postoperatively.ResultsAll dogs had immediate postoperative improvement. Recurrence (4 months to 4 years postoperatively) occurred in 3 dogs that had multiple sites of compression. Long‐term outcome was positive in 4 of 7 dogs. Postoperative imaging revealed subjective regression of bony proliferation at surgical sites in 2 of 4 dogs that improved clinically but morphometric data showed no change in canal measurements. An adjacent site lesion was confirmed in 1 dog.ConclusionsDistraction and stabilization with PMMA plugs and bone grafts is a safe surgical option for giant breed dogs with CSM with a single site of lateral or dorsolateral compression. Long‐term recurrence was common among dogs with multiple sites of compression. Follow‐up of 4 years or more among a larger population is indicated to fully assess implications of surgical intervention and determine recurrence rates.}, number={6}, journal={Veterinary Surgery}, publisher={Wiley}, author={Lewis, Melissa and Olby, Natasha J and Sharp, Nick JH. and Early, Peter}, year={2013}, month={Jul}, pages={701–709} } @article{munana_thomas_inzana_nettifee-osborne_mclucas_olby_mariani_early_2012, title={Evaluation of Levetiracetam as Adjunctive Treatment for Refractory Canine Epilepsy: A Randomized, Placebo-Controlled, Crossover Trial}, volume={26}, ISSN={["1939-1676"]}, url={http://www.scopus.com/inward/record.url?eid=2-s2.0-84858746170&partnerID=MN8TOARS}, DOI={10.1111/j.1939-1676.2011.00866.x}, abstractNote={BackgroundThere is little evidence‐based information available to guide treatment of refractory epilepsy in dogs. The antiepileptic drug levetiracetam (LEV) is administered to dogs, although its safety and efficacy are unknown.ObjectiveTo evaluate the safety and efficacy of LEV as adjunctive therapy for refractory epilepsy in dogs.AnimalsThirty‐four client‐owned dogs with idiopathic epilepsy.MethodsRandomized, blinded trial involving dogs resistant to phenobarbital and bromide. Dogs received LEV (20 mg/kg PO q8h) or placebo for 16 weeks, and after a 4‐week washout were crossed over to the alternate treatment for 16 weeks. Owners kept records on seizure frequency and adverse events. Hemogram, chemistry profile, urinalysis, and serum antiepileptic drug concentrations were evaluated at established intervals.ResultsTwenty‐two (65%) dogs completed the study. Weekly seizure frequency during the 1st treatment period decreased significantly during LEV administration relative to baseline (1.9 ± 1.9 to 1.1 ± 1.3, P = .015). The reduction in seizures with LEV was not significant when compared to placebo (1.1 ± 1.3 versus 1.5 ± 1.7, P = .310). The most common adverse event was ataxia, with no difference in incidence between LEV and placebo (45 versus 18%, P = .090). No changes in laboratory parameters were identified and owners reported an improved quality of life (QOL) with LEV compared to placebo (QOL score 32.7 ± 4.3 versus 29.4 ± 4.5, P = .028).Conclusions and Clinical ImportanceAdjunctive treatment with LEV appears safe in epileptic dogs. Efficacy of LEV over placebo was not demonstrated, although the power of the study was limited. Further evaluation of LEV as treatment for epilepsy in dogs is warranted.}, number={2}, journal={JOURNAL OF VETERINARY INTERNAL MEDICINE}, author={Munana, K. R. and Thomas, W. B. and Inzana, K. D. and Nettifee-Osborne, J. A. and McLucas, K. J. and Olby, N. J. and Mariani, C. J. and Early, P. J.}, year={2012}, pages={341–348} } @article{early_mente_dillard_roe_2013, title={In vitro biomechanical comparison of the flexion/extension mobility of the canine lumbosacral junction before and after dorsal laminectomy and partial discectomy}, volume={196}, ISSN={["1090-0233"]}, DOI={10.1016/j.tvjl.2012.11.006}, abstractNote={The purpose of this canine cadaver study was to evaluate the range of flexion and extension of the canine lumbosacral spine before and after dorsal laminectomy and partial discectomy. Using a cantilever biomechanical system, a 3Nm bending moment was applied to flex and extend the lumbosacral segment. Motion in L7 (total range of motion [ROM] and neutral zone motion [NZ]) was recorded via a rotational potentiometer. There was a significant increase in NZ and ROM after the decompressive procedures (NZ before decompression 6.0±1.2°; NZ after decompression 7.6±2.1°; ROM before decompression 32.8±6.4°; ROM after decompression 40.2±5.6°). It is unknown whether dorsal laminectomy and partial discectomy will induce the same increased motion in clinical cases. Dogs with lumbosacral subluxation, active dogs with little radiographic degenerative changes and working dogs could benefit from lumbosacral stabilization. This cadaver study demonstrated that dorsal laminectomy and partial discectomy at the lumbosacral junction does lead to significant spinal instability.}, number={3}, journal={VETERINARY JOURNAL}, author={Early, P. and Mente, P. and Dillard, S. and Roe, S.}, year={2013}, month={Jun}, pages={533–535} } @article{crook_early_messenger_munana_gallagher_papich_2013, title={The pharmacokinetics of cytarabine in dogs when administered via subcutaneous and continuous intravenous infusion routes}, volume={36}, ISSN={["1365-2885"]}, url={http://www.scopus.com/inward/record.url?eid=2-s2.0-84880035701&partnerID=MN8TOARS}, DOI={10.1111/jvp.12008}, abstractNote={This crossover study compared the pharmacokinetics of cytarabine in six healthy dogs following intravenous constant rate infusion (CRI) and subcutaneous (SC) administrations, as these are two routes of administration commonly employed in the treatment of meningoencephalitis of unknown etiology. Each dog received a SC cytarabine injection of 50 mg/m2 or an 8 h CRI of 25 mg/m2 per hour, with a 7‐day washout before receiving the alternative treatment. Blood samples were collected for 16 h after CRI initiation and for 8 h after SC injection. Plasma concentrations were measured by high‐pressure liquid chromatography (HPLC). Pharmacokinetic parameters were estimated using the best‐fit compartmental analysis for both CRI and SC routes. Terminal half‐life (T½) of cytarabine was 1.35 ± 0.3 and 1.15 ± 0.13 h after SC administration and CRI, respectively. Mean peak concentration (Cmax) was 2.88 and 2.80 μg/mL for SC and CRI administration, respectively. Volume of distribution was 0.66 ± 0.07 l/kg. The 8‐h CRI produced steady‐state plasma concentrations as determined by consecutive measurement that did not decline until the end of the infusion. The SC administration did not achieve steady‐state concentrations because cytarabine administered by this route was rapidly absorbed and eliminated quickly. The steady state achieved with the cytarabine CRI may produce a more prolonged exposure of cytarabine at cytotoxic levels in plasma compared to the concentrations after SC administration.}, number={4}, journal={JOURNAL OF VETERINARY PHARMACOLOGY AND THERAPEUTICS}, author={Crook, K. I. and Early, P. J. and Messenger, K. M. and Munana, K. R. and Gallagher, R. and Papich, M. G.}, year={2013}, month={Aug}, pages={408–411} } @article{muguet-chanoit_olby_lim_gallagher_niman_dillard_campbell_early_mariani_muñana_et al._2011, title={The Cutaneous Trunci Muscle Reflex: A Predictor of Recovery in Dogs with Acute Thoracolumbar Myelopathies Caused by Intervertebral Disc Extrusions}, volume={41}, ISSN={0161-3499}, url={http://dx.doi.org/10.1111/j.1532-950X.2011.00921.x}, DOI={10.1111/j.1532-950x.2011.00921.x}, abstractNote={ObjectiveTo determine whether changes in the cutaneous trunci muscle (CTM) reflex are an early predictor of outcome in dogs with severe acute thoracolumbar intervertebral disc extrusion (IVDE).Study DesignMulticenter prospective cohort study.AnimalsDogs (n= 36) with acuteIVDEcausing paraplegia, loss of nociception in pelvic limbs and tail, and an abnormalCTMreflex postoperatively.MethodsThe caudal border of theCTMreflex was established 24 hours after surgery and at discharge, and was reported as moving cranially, caudally, or staying static. Dogs were re‐evaluated at 12–20 weeks and at 7–36 months postoperatively. Outcome was classified as improved or unimproved, successful or unsuccessful, and ascending myelomalacia or not, and compared with early movement of theCTMreflex by construction of contingency tables and performing aFisher's exact test.ResultsBy discharge (mean, 4.7 days;SD= 2.10),CTMreflex progression was caudal in 19 dogs, static in 11, and cranial in 6. Five of 6 dogs with cranial movement developed ascending myelomalacia (P< .0001). Seventeen of 19 dogs with caudal movement showed an improvement by 12–20 weeks (P= .0046) and none developed ascending myelomalacia (P= .0013).ConclusionsPostoperative changes of the caudal border of theCTMreflex are an early indicator of outcome in dogs with severe acuteIVDE. Cranial movement of theCTMreflex is significantly associated with the development of ascending myelomalacia. Caudal movement is significantly associated with improvement, but not associated with a long‐term successful outcome.}, number={2}, journal={Veterinary Surgery}, publisher={Wiley}, author={Muguet-Chanoit, Audrey C. and Olby, Natasha J. and Lim, Ji-Hey and Gallagher, Ryan and Niman, Zachary and Dillard, Stacy and Campbell, James and Early, Peter and Mariani, Christopher L. and Muñana, Karen R. and et al.}, year={2011}, month={Dec}, pages={200–206} } @article{jaeger_early_munana_hardie_2004, title={Lumbosacral disc disease in a cat}, volume={17}, DOI={10.1055/s-0038-1636482}, abstractNote={SummaryAn eight-year-old male castrated domestic shorthair admitted with a two-day history of acute back pain, flaccid tail, and urinary and faecal incontinence. Diagnostic tests, including myelogram, epidurogram, and CT scan revealed an extradural lesion at the L7-S1 disc space. Exploratory surgery and histopathology confirmed a Type II lumbosacral intervertebral disc protrusion. The cat regained neurological function by six weeks after surgery. This is the first case report of a cat with documented lumbosacral disc disease. Lumbosacral disease should be considered as a differential diagnosis in cats with caudal lumbar pain or neurological signs localizable to the S1-S3 spinal cord segments or peripheral nerves.}, number={2}, journal={Veterinary and Comparative Orthopaedics and Traumatology}, author={Jaeger, G. H. and Early, P. J. and Munana, K. R. and Hardie, E. M.}, year={2004}, pages={104–106} }