Imaging: Ataxic Border Collie

1. 

   Angel says:

   October 24, 2023 at 4:33 am

   Difficult to see. Not used to MRI images, but I can see some cerebellar herniation with some degree of medullary compression. On T2*GRE left thalamus look abnormal, “diffuse” .
   Can’t tell any more, sorry

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   • 

     neuropetvet says:

     October 26, 2023 at 11:27 am

     Are you watching the video on a cell phone? If so, I recommend either a desktop/laptop computer or at least a large tablet (iPad, etc.).

     Reply
2. 

   neuropetvet says:

   October 31, 2023 at 2:27 pm

   Given the dog’s age, encephalitis (e.g., GME, infectious) was thought most likely but diffuse neoplasia (e.g., lymphoma) was also possible. A cisternal CSF tap was not attempted due to cerebellar herniation and we were unable to get a lumbar CSF sample. An infectious disease panel was submitted and it came back positive for Toxoplasma (IgM 1:50, IgG 1:100), Rocky Mountain Spotted Fever (RMSF, Rickettsia rickettsii; 1:50), and Cryptococcus (1:128). Many dogs in our area of the USA test low positive for RMSF so this was thought most likely to be a previous exposure. Cryptococcus is more common in cats than dogs and it’s rare in our area of the country. Additionally, while it’s carried in bird droppings, it’s most commonly found in pigeon droppings and this dog lived in a rural area. While I was a neurology resident in Philadelphia, I diagnosed 3-5 cases of Cryptococcus (primarily cats) each year. Since moving to New England in 2004, this is only my third positive case in almost 20 years. Of the 3 positive infectious agents, Toxoplasma is more common here. The dog already had been started on anti-inflammatory prednisone, oral cyclosporine, clindamycin, and doxycycline pending titer results. Fluconazole was added and the cyclosporine was discontinued. A marked increase in the Cryptococcus titer (1:32768) was found on repeat testing two weeks later while the RMSF titer was negative and the Toxoplasma titers unchanged. Unfortunately, the dog declined despite continued fluconazole and tapering to an even lower dose of prednisone and was subsequently humanely euthanized.

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