Research teams across the world publish hundreds of studies and articles each year. To help professionals keep up with the most important developments in veterinary neurology research, I’ve summarised five recent papers that could change the way you see neurological cases in veterinary practice.
In this study, researchers searched the databases of the Queen’s Veterinary School Hospital, looking for cases where conservative treatment for acute T3-L3 myelopathy was instigated without imaging work-up in order to determine how successful clinical reasoning is in choosing treatment. They focussed on Intervertebral Disc Extrusion (IVDE), Ischaemic Myelopathy (IM) or Acute Non-compressive Nucleus Pulposus Extrusion (ANNPE).
You can read the full study here.
Advanced imaging is not always possible, either due to financial or practical concerns. This study gives clinicians confidence in selecting a more conservative approach, and data on success rates so owners can make informed decisions.
The records of the Queen’s Veterinary School Hospital, Cambridge were searched for cases of paraparesis/paraplegia where IVDE, IM or ANNPE were suspected, but where no confirmatory advanced diagnostic imaging was carried out at presentation. A total of 123 and 16 dogs were included in the presumed IVDE and the presumed IM/ANNPE groups, respectively. It should be noted that 14 of the dogs had spinal radiographs before referral, but the dogs were still included in the study, because the diagnostic sensitivity of x-ray is low for IVDE.
The main limitations of the study are the retrospective design (which means that true clinician thoughts and reasoning could be lost from the notes), the small numbers (especially of subsets, like non-ambulatory dogs, meaning this may not be applicable to all dogs), and the fact that many of these dogs were referred to Queen’s after initial assessment in practice (which means the referring vet may have treated other dogs conservatively and the true proportion of successful treatments may be different). Paraplegic dogs with no deep pain went straight to surgery, so were excluded from this study, meaning the results are more applicable to mildly-affected dogs. In addition, the specialist vets available at Queen’s may be able to make more confident decisions to manage conservatively than the average GP vet, owing to their extensive experience with these conditions.
Researchers undertook a Faecal Microbiota Transplant (FMT) in dogs with drug-resistant epilepsy and related abnormal behaviours (like anxiety and ADHD-like behaviours), then measured the changes in their behaviour, quality of life, neurotransmitters, and microbiome composition.
You can read the full study here.
Epilepsy is the most common neurological condition we see in dogs. It can severely affect quality of life, especially when combined with behavioural comorbidities. Although this study had a small sample size, its results show early promise for novel therapies targeting the gut-brain axis.
Nine dogs with epilepsy resistant to drugs (eg still having seizures despite having trials of at least two antiepileptic drug regimens) and with at least one behavioural comorbidity (such as ADHD-like behaviours, or anxiety-like behaviours) were recruited. They had behavioural questionnaires, anxiety tests, cognition tests, a suite of blood tests, urine samples, and faecal samples taken at the beginning of the study.
A faecal donor (with well-controlled epilepsy, no dysbiosis, no enteropathogens and no behavioural comorbidities) provided faecal material, which was mixed with saline and frozen, then thawed before transplant. The transplant was given while the dogs were conscious, using a slurry injected into the colon through a catheter inserted rectally. This was repeated twice (three transplants in total) every two weeks. All tests were then repeated three months and six months after the faecal transplant and compared to baseline.
The study had a very small sample size, and no participants were blinded, which could have led to caregiver placebo effect. There’s a known high placebo effect in epilepsy studies, so the seizure-related findings are very likely to be biased.
Researchers examined the records of 447 dogs diagnosed with meningoencephalitis of unknown origin (MUO) in the UK between 2010 and 2022 to look at prognostic factors for survival, recovery, and relapse.
The full study can be found here.
Being able to properly advise owners of prognosis is important for clinicians dealing with cases of MUO. This study helped to identify risk factors, and revealed that the Neurodisability Scale may be a useful clinical metrology tool for general practitioners in the future.
The records of dogs diagnosed with MUO at either the Small Animal Teaching Hospital at the University of Liverpool or the Royal Veterinary College were reviewed retrospectively. The researchers removed records where the treatment was inappropriate, total nucleated cell count was low, or the follow up time was too short, leaving 447 records. They then extracted clinical and demographic information, neurological problems, and treatment regimens, and compared them.
The study was retrospective in nature, which meant that metrology instruments like the Neurodisability Scale (NDS) score had to be approximated from clinical signs. The sample size was large, but as the cases were all under referral care, they may not represent the clinical picture in practices with less resources to hand. The most important limitation of the study was that treatments differed, which likely had an effect on survival times, although there is not yet data demonstrating a superior treatment.
Between 2018 and 2024, 14 toy breed dogs with atlantoaxial subluxation were surgically treated at the Clinica Veterinaria San Giorgio in Italy using a cervical distraction-stabilisation technique with 1.5 to 2mm self-tapping screws and bone cement.
The full study can be read here.
Surgical treatment is widely recommended for atlantoaxial subluxation, but the most widely used techniques have a significant complication rate caused by migration or rupture of Kirschner wires, which can cause spinal canal injury and death. According to the authors, this technique offers a reduction in complications and operating time while demonstrating good clinical results.
Over the study period, 28 dogs were treated with the technique. Those who were lost to follow up or who had concomitant systemic disease were excluded, leaving 14 dogs described in the paper. The sample size was small, and the results may therefore not be representative of the whole population of these dogs. In addition, there’s no direct comparison with other types of ventral fixation surgeries, preventing statistical comparisons of complication rates or surgical time. However, the data from these cases is useful and could be followed up with prospective studies.
In this study, researchers examined a number of blood biomarkers for correlation with positive results from canine cognitive dysfunction syndrome (CCD) questionnaires.
The full study can be found here.
Canine cognitive dysfunction syndrome is underdiagnosed, with signs often being put down to normal aging. The development of a biomarker that can be part of a senior panel to flag early changes and prompt further discussion could be useful for vets in practice.
Sixty-three dogs over seven years of age were classified into groups depending on their cognitive dysfunction as measured by three questionnaires. Fourteen young, normal dogs were also recruited as a control group. Blood was taken from all dogs and tested with ELISA for a number of key blood biomarkers, namely Amyloid Beta 40 and 42 (Aβ40, Aβ42), Neurofilament Light chain (NfL), and Glial Fibrillary Acidic Protein (GFAP). The researchers examined differences between groups, correlation with disease severity, and correlation with the questionnaires.
There were limitations to the study. Firstly, the breeds are mostly small (as is normal for South Korea) meaning that the seven-year cut off as ‘senior’ may not be clinically relevant. In addition, the diagnosis of CCD was based on validated owner scoring systems, which can be subjective, and no further testing (such as MRI) was carried out, meaning that some of the cases may have been misdiagnosed as CCD, confusing results. Serum NfL could be raised in other diseases, missed due to the lack of advanced imaging.
I write these review articles relatively frequently on different subjects, and I was surprised by the sheer number of articles being published in veterinary neurology. It feels like an area that’s moving rapidly, with lots of innovative thinking and new developments – which means it’s an area to pay close attention to, and take CPD in regularly.
P.S don’t forget to log this article as CPD and reflect on it. Did you learn anything new? What surprised you? Do you agree with my conclusions?