Category Archives: Interesting Clinical Cases

CNS MRI shows as DD: cyst / neoplasia / granuloma.

A dog came with rotated head and pain in the neck during the physical exam.

NMR under general anaesthesia was performed and the following image was seen:

2013-03-26 13.26.09

2013-03-26 13.25.222013-03-26 13.25.57

There’s a fluid like round mass localised in one of the brain hemispheres.

Possible conclusion:

The mass (cyst, neoplasia or inflammation) is causing a compression of the central spinal channel, which is supposed to be obstructing the cerebro-spinal fluid (CSF) flow causing a third ventricle enlargement in the brain.

Symptomatic therapy:

Omeprazole to decrease the CSF production and release the increased pressure and pain. For those who are thinking WTF has Omeprazole to do with CSF (although the action mechanism is still unknown!): http://www.ncbi.nlm.nih.gov/pubmed/?term=reduction+CSF+production+omeprazole

- Pain medication.

Possible further analysis: biopsy of the brain mass.

P.D. My understanding of Dutch is horrible, so there might be several mistakes in this informal short-mini case report.

Bibliography for the UGent Infectious Diseases Clinical Case resolution :D

Provided information: “A dog (Bouvier), almost 2 years old. Was anorectic, vomiting, lethargic, for 2 days. Conservative therapie was used. A couple of days later she could not stand up any more and she had ileus and palpation of belly was painfull. Ultrasound showed renomegalie and lymfadenopathie (mesenteriale lnn), bloodwork showed increased kidney and liver enzymes. They changed the treatment but she died the next day anyway. Autopsie reveals general lymfadenopathie, bilateral nefritis, mild hepatomegalie and macerated foeti, a mild enteritis and focal bleeding in the muscles.”

Macerated Foetus Syndrome

“A condition caused by the intrauterine death of a gestational product, with retention of a foetus for > 48 hours—missed labor—occurring after the 20thtian xiao cheng week of pregnancy.”

The differential diagnosis has to be set up for causes of abortion and maceration in dogs.

          The fact is that all the clinical signs and pathology related findings cannot be explained by Brucella ssp. Brucellosis causes abortion and maceration and generalized lymphadenitis but not kidney and liver failure so thatfree shipping might be due to Clostridium perfringens I think. I suspect from it because C. perfringens is a normal bacteria in the guts but immunosupression causes indirect overgrowth of it; overgrowth that can cause the enteritis; because they produce a toxin that goes through the blood you get liver and kidney failure and hemorraghes in muscles.
A Canine Herpesvirus plus E.coli overgrowth is possible too.
A pure Listeriosis might be possible.

 

More valuable info for the case resolution!!!

Overview of Canine Herpesviral Infection. Merck Manual.

Overview of Brucellosis in Dogs, Merck Manual.

2010 ACVIM Small Animal Consensus Statement on Leptospirosis: Diagnosis, Epidemiology, Treatment, and Prevention.

:)