Case report: Necrotizing leukomyelitis and meningitis in a Pomeranian
A 2.5-year-old female entire Pomeranian dog was presented for acute paraparesis progressing within 2 days to paraplegia. General physical examination was unremarkable. Neurological examination showed paraplegia without nociception, a mass reflex upon testing perineal reflexes and withdrawal reflexes...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-03-01
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| Series: | Frontiers in Veterinary Science |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fvets.2024.1303084/full |
| _version_ | 1797263220320239616 |
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| author | Koen M. Santifort Koen M. Santifort Laurent Garosi Erik A. W. S. Weerts |
| author_facet | Koen M. Santifort Koen M. Santifort Laurent Garosi Erik A. W. S. Weerts |
| author_sort | Koen M. Santifort |
| collection | DOAJ |
| description | A 2.5-year-old female entire Pomeranian dog was presented for acute paraparesis progressing within 2 days to paraplegia. General physical examination was unremarkable. Neurological examination showed paraplegia without nociception, a mass reflex upon testing perineal reflexes and withdrawal reflexes in the pelvic limbs and patellar hyperreflexia. Cutaneous trunci reflexes were absent caudal to the level of the 6th thoracic vertebra. Spinal hyperesthesia was present. Neuroanatomical localization was consistent with a T3-L3 myelopathy. Hematological and biochemical blood tests [including C-reactive protein (CRP)] were within reference ranges. MRI of the spinal cord from the level of the 1st thoracic vertebra to the sacrum revealed a patchy, ill-defined, moderate to marked T2W hyperintense, contrast enhancing intramedullary lesion extending from T1 to L4. Medical treatment based on a working diagnosis of meningomyelitis of unknown cause was initiated with corticosteroids and methadone based on pain scores. Prognosis was grave and after 3 days without return of nociception, the dog was euthanized according to the owners’ wishes. Post-mortem histopathological examination of the brain and spinal cord yielded a morphological diagnosis of severe, segmental, bilateral and fairly symmetrical, necrotizing lymphohistiocytic leukomyelitis, with a non-suppurative angiocentric leptomeningitis. Some minor, focal, lymphocytic perivascular cuffing was found in the medulla oblongata as well, but otherwise there were no signs of brain involvement. No infectious causes were identified with ancillary tests. This case report underlines the importance of including meningomyelitis in the differential diagnosis list of dogs presented for acute progressive neurological signs referable to a myelopathy. |
| first_indexed | 2024-04-25T00:09:33Z |
| format | Article |
| id | doaj.art-d923fb9648bb461e955f88164876453f |
| institution | Directory Open Access Journal |
| issn | 2297-1769 |
| language | English |
| last_indexed | 2024-04-25T00:09:33Z |
| publishDate | 2024-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Veterinary Science |
| spelling | doaj.art-d923fb9648bb461e955f88164876453f2024-03-13T15:32:03ZengFrontiers Media S.A.Frontiers in Veterinary Science2297-17692024-03-011110.3389/fvets.2024.13030841303084Case report: Necrotizing leukomyelitis and meningitis in a PomeranianKoen M. Santifort0Koen M. Santifort1Laurent Garosi2Erik A. W. S. Weerts3IVC Evidensia Small Animal Referral Hospital Arnhem, Neurology, Arnhem, NetherlandsIVC Evidensia Small Animal Referral Hospital Hart van Brabant, Neurology, Waalwijk, NetherlandsVet Oracle Teleradiology, Norfolk, United KingdomDivision of Pathology, Department of Biomedical Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, NetherlandsA 2.5-year-old female entire Pomeranian dog was presented for acute paraparesis progressing within 2 days to paraplegia. General physical examination was unremarkable. Neurological examination showed paraplegia without nociception, a mass reflex upon testing perineal reflexes and withdrawal reflexes in the pelvic limbs and patellar hyperreflexia. Cutaneous trunci reflexes were absent caudal to the level of the 6th thoracic vertebra. Spinal hyperesthesia was present. Neuroanatomical localization was consistent with a T3-L3 myelopathy. Hematological and biochemical blood tests [including C-reactive protein (CRP)] were within reference ranges. MRI of the spinal cord from the level of the 1st thoracic vertebra to the sacrum revealed a patchy, ill-defined, moderate to marked T2W hyperintense, contrast enhancing intramedullary lesion extending from T1 to L4. Medical treatment based on a working diagnosis of meningomyelitis of unknown cause was initiated with corticosteroids and methadone based on pain scores. Prognosis was grave and after 3 days without return of nociception, the dog was euthanized according to the owners’ wishes. Post-mortem histopathological examination of the brain and spinal cord yielded a morphological diagnosis of severe, segmental, bilateral and fairly symmetrical, necrotizing lymphohistiocytic leukomyelitis, with a non-suppurative angiocentric leptomeningitis. Some minor, focal, lymphocytic perivascular cuffing was found in the medulla oblongata as well, but otherwise there were no signs of brain involvement. No infectious causes were identified with ancillary tests. This case report underlines the importance of including meningomyelitis in the differential diagnosis list of dogs presented for acute progressive neurological signs referable to a myelopathy.https://www.frontiersin.org/articles/10.3389/fvets.2024.1303084/fullmeningomyelitisMUOimmune-mediatedsmall breeddoglymphohistiocytic |
| spellingShingle | Koen M. Santifort Koen M. Santifort Laurent Garosi Erik A. W. S. Weerts Case report: Necrotizing leukomyelitis and meningitis in a Pomeranian Frontiers in Veterinary Science meningomyelitis MUO immune-mediated small breed dog lymphohistiocytic |
| title | Case report: Necrotizing leukomyelitis and meningitis in a Pomeranian |
| title_full | Case report: Necrotizing leukomyelitis and meningitis in a Pomeranian |
| title_fullStr | Case report: Necrotizing leukomyelitis and meningitis in a Pomeranian |
| title_full_unstemmed | Case report: Necrotizing leukomyelitis and meningitis in a Pomeranian |
| title_short | Case report: Necrotizing leukomyelitis and meningitis in a Pomeranian |
| title_sort | case report necrotizing leukomyelitis and meningitis in a pomeranian |
| topic | meningomyelitis MUO immune-mediated small breed dog lymphohistiocytic |
| url | https://www.frontiersin.org/articles/10.3389/fvets.2024.1303084/full |
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