View all veterinary jobs
The researchers say that although increased appetite has been reported as a side effect of many AEDs in veterinary literature, the effect had not been quantified or studied in detail.
To assess the phenomenon in greater detail, the research team analysed food motivation through a validated Dog Obesity Risk Assessment questionnaire created by University of Cambridge1.
The study compared 222 dogs diagnosed with idiopathic epilepsy with a control population of 7,086 healthy dogs.
The survey was designed to determine if epilepsy and AEDs were associated with increased food motivation, weight gain and decreased activity, and to assess if and how caregivers managed weight gain in this population.
The data revealed that dogs with idiopathic epilepsy receiving AEDs had significantly higher food motivation in comparison to healthy dogs – they had increased interest in food, were less selective about food, were more interested in food between meals, and wanted more food than usually offered.
In response, carers of dogs on medication put greater effort into restricting how much their dogs ate, particularly of human food.
Despite this, these dogs had significantly greater fat mass.
More than half of owners of dogs with epilepsy always used treats to administer their dog’s ASD medication (53%) and did not compensate for it by reducing the dog’s main food ration (34%).
Given the epilepsy treatment often involves medication two or three times a day, this has the potential to increase calorie intake substantially, an issue compounded by epileptic dogs also being less active.
The researchers say it's important that vets and nurses advise owners to monitor their dog's weight and help them manage it.
Dr Anna Morros-Nuevo of the University of Cambridge, and primary author of this study, said: "Idiopathic epilepsy, and in particular seizure episodes, have such an overwhelming impact on these dogs' families that side effects such as weight gain often get overlooked, both by vets and the pet's families.
"But unfortunately, obesity has lifelong negative impact on health and quality of life, since it predisposes dogs to suffer from joint problems and respiratory diseases, as well as metabolic disorders and urinary incontinence.
"Obese dogs have also been shown to have a shorter lifespan than dogs with a normal weight.
"While ASD are non-negotiable for many of these dogs, their caregivers and veterinarians should be aware of the lifelong impact of their side effects and manage them carefully.
"We hope these findings will help to increase awareness for both veterinary professionals and dog carers of the side effects of ASD and their impact for the patient."
Reference
The researchers, from the Dick Vet Equine Hospital, University of Edinburgh, Newcastle University, Istituto Zooprofilattico Sperimentale delle Venezie, and the University of Padova found that affected horses have major abnormalities in the structure of their neuromuscular junctions, microscopic sites of communication between nerves and muscles that are crucial for normal muscle function.
These abnormalities are believed to represent a toxin specific signature, effectively a ‘smoking gun’, for a neurotoxic enzyme termed a phospholipase A2.
Work is now underway to definitively identify the source of the toxin, in the hope that it will lead to novel treatments and improved diagnostics for this devastating disease.
The researchers think the toxin is likely to be produced by a microbe such as a bacterium or fungus growing on the horse’s pasture during the cold and dry weather which commonly precedes the disease.
Neurotoxic phospholipase A2 toxins are also present in the venom of many poisonous snakes, and there are many similarities between the signs of grass sickness and those of snake envenomation.
While there is no suggestion that venomous snakes cause grass sickness, it is hoped that some of the drugs that are currently being developed to treat and promote nerve regeneration in people paralysed by snake venoms can aid recovery of horses from grass sickness.
The researchers say that the neurotoxin most likely also causes the apparently identical diseases (termed animal dysautonomias) which affect cats, dogs, hares, rabbits, llamas, alpacas and sheep, and that their finding contradicts the previous leading hypothesis that grass sickness is a form of botulism.
This breakthrough is summarised in an editorial in the January 2025 issue of the Equine Veterinary Journal (EVJ).
The editorial, by Bruce McGorum and colleagues, looks at the implications of their article 'Equine grass sickness is associated with major abnormalities in the ultrastructure of skeletal neuromuscular junctions2".
Bruce said: “Identifying a probable cause of Equine Grass Sickness represents a significant breakthrough.
"We hope that this discovery will lead to novel treatments and improved diagnostics for this devastating condition.
"We are very grateful for the generous support we have received from horse owners, veterinary surgeons, scientists, charities and funding bodies.”
Bruce's editorial is currently available on Early View, free for 12 weeks, and will also be published in the January 2025 print issue of the EVJ.
Rodolfo said: “We are the only independent specialist veterinary hospital in the area with the equipment and experience to diagnose and manage neurological issues in pets.
"With a custom-built veterinary hospital and the expertise to help vets get the best results for their patients, we will provide the next level of affordable, specialist care for owners and their pets with the transparency that our independent status enables.
“We will work hand in hand with referring vets, consulting with them on the best approach for their clients and always keep them fully updated on progress as each case unfolds.
"Initially, we are offering neurology services, but we plan to quickly upscale our operations and offer other services like orthopaedics soon.”
Pets suffering from symptoms including seizures, pain, difficulty walking and problems with balance and orientation can be referred.
"Any peripheral nervous system problems and neuromuscular diseases outside the spinal cord area can also be identified and treated.
Rodolfo added: “My focus is on pure collaboration with the vets that refer to us and their owners.
"I’m wholeheartedly motivated by providing the very best service at accessible prices.
"With a focus on communication and compassion – we will always work with the first opinion vet to put the best interests of their clients’ pets first.
www.southeastvetreferrals.com
The new directive, set out in a consensus statement led by neurologist Dr Marios Charalambous, Neurology Consultant at Blaise Veterinary Referral Hospital, champions a stage-based and prompt approach which targets the abnormal impediments responsible for sustaining seizure activity and establishing refractory stages.
Marios said: "This consensus statement is the culmination of extensive research and experience in managing complex neurological emergencies.
"By formulating clear and universally applicable guidelines for all vets, it presents both a novel perspective in terms of how seizures should be treated, and a huge step forward in this specific field."
Marios was joined by a panel of clinicians including Karen Muñana, Ned E. Patterson, Simon R. Platt, and Holger A. Volk, who have jointly made these recommendations based on prevailing evidence in peer-reviewed literature, as well as their own extensive clinical experience.
It was then validated by the ACVIM Board-Certified Specialists before being distributed globally by ACVIM to form official guidelines for vets across the world.
Marios will be presenting and discussing his findings at the BSAVA Congress 2024 in Manchester this weekend as part of the neurology agenda on Saturday 23 March 2024.
Dan Lewis, National ECC Lead at IVC Evidensia, said: “Being presented with an actively seizing animal can be incredibly stressful for owners and clinicians and has potentially dire consequences.
"Decision-making under such circumstances is often very difficult, even for the most knowledgeable teams, and access to these straightforward treatment guidelines will make a massive difference to how these cases progress.”
https://onlinelibrary.wiley.com/doi/10.1111/jvim.16928.
For the research, the medical histories of 188 Basset Hounds and 270 Dachshunds presenting to CVS’ Dovecote Veterinary Hospital and Chestergates Veterinary Specialists, and the University of Ghent were retrospectively assessed.
Information included signalment, whether the dog had received a diagnosis of TL-IVDE, the duration of clinical signs, affected discs and anatomical region and the neurological grading at presentation and discharge.
Basset Hounds and Dachshunds are both chondrodystrophic breeds which are predisposed to IVDE.
However, the study found 77.4% of Dachshunds had presented with IVDE, compared to only 36.2% of Basset Hounds.
Dachshunds also presented earlier (66.5 months) compared to Basset Hounds (median 87.5 months).
Dachshunds had a lower proportion of midlumbar IVDE and were more frequently non-ambulatory at discharge than Basset Hounds.
In addition, Dachshunds were more likely to be paraplegic without sensation at presentation than Basset Hounds (16/154 Dachshunds compared to just one Basset).
The Basset Hound is the largest chondrodystrophic breed and the physical characteristics of this larger body conformation may have benefits, with previous studies suggesting the protective effects of being a larger dog2.
One hypothesis is whether breed conformation and anatomy – the relative height/weight ratio - influences the severity and occurrence of IVD and points to a link between the size of the patient and the space in the vertebral canal.
A smaller spinal cord versus vertebral canal ratio in the Basset Hound may indicate a less compressive lesion.
Sergio Gomes, Head of Neurology and specialist in veterinary neurology at Dovecote Veterinary Hospital, who led the study, said: “This is the first time that IVDE data for Basset Hounds has been directly compared with that for Dachshunds.
“We now need to look closely at the conformation and anatomy of the Basset Hound to see what learnings we can take.
"This could have positive future implications for Dachshund breeding programmes, so that longer term we can try to minimise this painful and common canine condition.”
References
Matthew’s award is in recognition of his paper Approach to initial management of canine generalised epileptic seizures in primary-care veterinary practices in the United Kingdom, co-authored with Laurent Garosi, which was selected by the BSAVA Committee as being the most valuable to veterinary practice.
James’ study explored data collected as part of the Small Animal Veterinary Surveillance Network (SAVSNET) at the University of Liverpool.
In total, clinical records concerning 3,150,713 consultations (917,373 dogs) were collected and analysed from 224 UK veterinary practices.
This included the management of canine generalised epileptic seizures in 517 dogs up to 6 years of age.
The study concluded that 98% of dogs presenting for a single epileptic seizure were not started on long-term therapy, in accordance with the approach recommended by the International Veterinary Epilepsy Task Force (IVETF).
Other findings from the study included:
The paper also reported on factors potentially associated with prescription of ASDs.
It stated that dogs who presented for cluster seizures (more than one epileptic seizure in a 24-hour period) were more likely to be prescribed ASDs, or to be referred to a specialist, than dogs without cluster seizures.
Dogs that were neutered or microchipped were more likely to be started on ASDs following the initial presentation, perhaps suggesting that owners who take part in regular preventative healthcare prior to the onset of their dog’s seizures could be more willing to start therapy in the earlier stages of the disease.
In addition, more than half of dogs with cluster seizures were not prescribed any ASDs.
Given that the presence of cluster seizures is typically considered an indication to start long-term therapy by the IVETF, Matthew says this may be one aspect of seizure management that could be improved in primary care practice.
Regarding the choice of anti-seizure drugs (ASDs), imepitoin was more frequently prescribed than phenobarbital in response to cluster seizures.
But unlike phenobarbital, the paper highlighted that the market authorisation for imepitoin does not include the treatment of cluster seizures.
Therefore vets should be aware that the use of imepitoin for cluster seizures should be considered as “off-licence” - and has additional implications for obtaining informed consent.
Matthew said: “We believe this research contributes to an improved understanding of the current management strategies for canine epilepsy in general practice and how this compares to the current guidelines advised by the IVETF.
"Given the prevalence of epileptic seizures within the UK canine population, as well as the large proportion of dogs that will be managed entirely within general practice without referral to a neurologist, it is vital to ensure that the level of care being provided is optimal.
"We therefore hope that this research ultimately supports and guides general practitioners in their approach to canine epilepsy, thereby improving the quality of life of affected dogs and their owners.”
https://onlinelibrary.wiley.com/doi/epdf/10.1111/jsap.13543
They say that dogs which lose sensation following damage to the spinal cord from a slipped disc have a prognosis for recovery of about 50%.
However, there is no reliable way of determining which dog will recover and failing that, owners must wait weeks to months to see if there are any signs of recovery, during which time dogs may need anaesthesia, surgery, and intensive nursing care.
The researchers say that the stiffness of an organ can be a marker of how damaged it is.
So, for the research, a new ultrasound machine equipped with an advanced piece of software (known as ‘shear wave elastography’) – will be used to measure the stiffness of a dog’s spinal cord during surgery.
The dog’s recovery to walking after surgery will then be monitored routinely.
The results will allow researchers to see if a relationship between spinal cord stiffness at time of surgery and recovery exists.
If successful, this would help them provide a more accurate prognosis for dogs with spinal cord injury in the future.
If you have a case suitable for this study, CVS says they will receive a gold standard treatment for spinal cord injury, which will include spinal surgery.
They will also have an ultrasound of the spinal cord performed during surgery, a procedure taking approximately 15 minutes.
Contact referrals@highcroftvet.co.uk or nicolas.granger@bristolvetspecialists.co.uk.
BVS Neurology study from CVS (UK) Ltd on Vimeo.
To apply for the VTS, you have to have to have been working in your speciality for a minimum of three years, and demonstrate 40-plus hours of RACE-approved CPD.
Before you can sit the exam, you also need to show that you already meet the required standards.
Emily said: “For the application itself, I had to demonstrate mastery of more than 40 advanced nursing skills, signed off by a neurology specialist, and submit three exam questions.
“I submitted more than 60 case logs demonstrating my nursing care in a variety of different patients and disease processes, and four of these logs I further expanded into 10-page case reports where I discussed the nursing care and disease process in more detail.
“Then, after submitting my application, there was a nerve-wracking wait for the results, but last December I received the news I had been accepted and I was invited to sit the examination in Philadelphia, USA, in June.
“The examination was four hours long and consisted of 200 questions in my specialty, and I’m really delighted I passed.
“Neurology is an area that can be quite niche and daunting to those unfamiliar with it, and I hope to use my new qualification to share my knowledge and enthusiasm with other professionals to help them feel more confident and comfortable with these patients.
“Personally, I find nursing neurologic patients extremely rewarding, as there is so much we can do as RVNs which has a direct impact on patient comfort, client understanding and, ultimately, on the clinical outcome.”
Dr Guillaume Leblond, an American specialist in veterinary neurology at NDSR said: “Traditionally, bone cement has been used to provide support and stabilisation when treating veterinary spinal instability cases.
“Polyaxial pedicle screws have proven a very reliable and efficient way of treating such spinal problems in human medicine.
“These special screws can be inserted in the vertebrae and connected to strong metal rods instead of bone cement and we’re now very excited to be offering this new service to our patients.
“The main advantage to this cutting-edge procedure is its flexibility.
"Once cement is set in place it is obviously very hard to move, manipulate or remove should you need to adjust or correct.
“With the metal rod and screw system, it is more adaptable and you can adjust it far more easily and quickly.
“It may also be less prone to infection compared to cement, which has been known to harbour bacteria sometimes causing infections several years after the surgery.
"Another hope we have for this system is that it will be less prone to failure compared to cement, especially on extended stabilisation constructs.
Guillaume added: “The neurology team at NDSR has been training in applying this new system as soon as it became available and we have already used it to treat two dogs, both of them having surgery on the same day.
“One was a golden retriever treated by my colleagues Rodolfo Cappello (head of neurology) and Natalie West (neurology resident), and the other was a whippet under my care.
"They were two very different sizes of dog but both operations went well.
“We are grateful to OrthomedTM, the company manufacturing the stabilization system, provided all necessary details to plan the surgeries as precisely as possible.
“We also collaborated with Vet3DTM to create patient specific 3D printed guides to ensure the precise placement of screws and it proved a great solution in both cases.”
“Admittedly, it is still early days for the introduction of this new spinal stabilisation system but we are optimistic it will prove a significant advancement in treating many spinal problems.”
www.ndsr.co.uk
For the study, 21 owners were interviewed and transcripts thematically analysed.
Owners who reported positive experiences with their vets described the value of comprehensive initial explanations of their dog’s condition, seeing the same veterinary surgeon for each consult, and individual attributes of vets, including current knowledge on epilepsy management and good communication skills.
The authors say these factors are likely to contribute to improved two-way vet-owner communication, owner satisfaction and adherence to care instructions.
The implications of a negative relationship were also highlighted by the study.
Owners’ dissatisfaction with perceived insufficient expertise from their general practice vet (resulting in referrals to specialists), and when referred, poor communication between referral specialists and their primary care vet.
Owners’ pre-existing views and values were identified as drivers of negative experiences including strong dog-owner bonds leading to extremely high expectations for veterinary care.
Another factor was pre-existing distrust and perceived biases of the veterinary pharmaceutical industry.
Owners who had a more negative experience with veterinary surgeons were found to be more likely to perform their own personal research, putting them at higher risk of being influenced by the large amount of misinformation online.
The authors say that vets often report that they find epilepsy challenging to manage, particularly as a high proportion of dogs do not respond sufficiently to available medications.
This study aimed to help provide a better understanding of owners’ wants and needs.
Dr Rowena Packer, Primary supervisor on this study and Lecturer in Companion Animal Behaviour and Welfare Science at the Royal Veterinary College, said: “Epilepsy is a challenging condition to manage for dog owners and veterinary surgeons alike.
"Owners’ emotions often run high due to the trauma of witnessing their beloved dog’s seizure, and the ongoing stresses of caregiving for their dog.
"In tandem, vets can feel frustrated at not always being able to reduce seizures as much as they’d hope.
"Combined, the capacity for disappointment and conflict is high.
“Forging strong, trusting partnerships of care between owners and vets is key to maintaining wellbeing for all three members of the ‘treatment triangle’ – affected dogs, owners and vets."
Amy Pergande, Royal Veterinary College Veterinary graduate who conducted this research as part of her Master of Research degree, said: “Improving availability of reliable information sources for epilepsy management could help veterinary teams to confidently prescribe ’information prescriptions’ that boost owner confidence and help them to feel empowered to contribute more actively in decision-making for their dog, in partnership with their vet.”
Dr Zoe Belshaw, EBVS Recognised Specialist in Small Animal Medicine, of EviVet Evidence-based Medicine Research Consultancy and co-author of the study, said: “Our research suggests owners really value vets taking the time, once the initial shock has receded, to share information, answer questions and signpost to external resources, including peer-to-peer support forums.
"Ensuring that owners feel confident and competent about caring for their dog with epilepsy is likely to benefit the dog, its owners and the veterinary team providing their ongoing care”.
The new service is being headed by Dr Katia Marioni-Henry.
Katia graduated from the University of Parma in 1995 and went on to do a PhD in Clinical Electrodiagnostic at the University of Turin and Scott-Ritchey Research Center in Auburn, Alabama.
Her early career was spent at various American universities, where she became a Diplomate of the American College of Veterinary Internal Medicine, with a subspecialty in Neurology and finally an Assistant Professor of Neurology and Neurosurgery at the University of Tennessee.
Katia came to the UK to work as a consultant in neurology and neurosurgery for a number of large referral practices, before moving to the University of Edinburgh in 2013, where she started the neurology/neurosurgery service, building it from scratch to a nine-strong team.
Katia said: “This is absolutely the best place to be brought in an emergency, but previously we’d have to refer some cases elsewhere for conditions affecting the brain, peripheral nerves or the spine.
“Now some of these debilitating neurological conditions can be diagnosed and treated rapidly here without having to transport the animal.”
“With our CT scanner, for example, we can diagnose slipped discs quickly, especially in small breeds, and treat them surgically.
“And we can use it for brain scans if there is trauma or if we suspect a tumour or severe inflammation in the brain.
“We can do a lumbar tap to rule out inflammation of the central nervous system either on infectious or immune-mediated basis.”
The study “Approach to initial management of canine generalised epileptic seizures in primary-care veterinary practices in the United Kingdom” used the Small Animal Veterinary Surveillance Network to review electronic health records equating to 3,150,713 consultations (917,373 dogs) from 224 veterinary practices2.
Five hundred and seventeen cases were included. Dogs older than 6 years were excluded.
Of 321 dogs presented for a single seizure, seven (2.1%) were prescribed AEDs, which is in accordance with International Veterinary Epilepsy Task Force recommendations.
20% of the dogs in this group which had at least a 6-month follow-up, 20% did not have subsequent seizures recorded.
However, of 86 dogs which had suffered a seizure cluster at first presentation, only 38 (44%) were prescribe an AED, despite the task force recommendation that long term treatment in dogs with idiopathic epilepsy should be started immediately in the case of 2 or more seizures within 6 months, status epilepticus or a seizure cluster, severe post-ictal signs, or a deteriorating epileptic presentation.
Imepitoin was frequently selected in the treatment of cluster seizures despite no authorisation for this purpose.
Nicola Di Girolamo, Editor of JSAP said: “Studies like this one are instrumental to understand how primary care clinicians comply with current recommendations.
"Additional efforts may be required to fully adhere to the International Veterinary Epilepsy Task Force recommendations; being aware of these gaps is the first step towards improvement.”
Sabrina joins Fran Taylor-Brown, Simon Bertram and head of service Tom Cardy.
Tom, a European and RCVS specialist in neurology, said Cave is now the biggest specialist-led neurology service in the South West:
“We are very pleased to have Sabrina join the neurology service at Cave, expanding our team to four European and RCVS-recognised specialists in veterinary neurology. This really sets Cave apart from our competitors.
“Sabrina’s arrival, in conjunction with the installation of our new state-of-the-art MRI scanner, means we can see most urgent neurology referrals within 24-48 hours in nearly all cases and increase the number of neurology cases we treat each day.”
Cave’s new £1.2m Phillips Ingenia 1.5T Evolution offers 50% faster scans at a far higher resolution than its previous MRI and shorter general anaesthetics for patients.
It also allows a more detailed and accurate diagnosis of complex neurological conditions.
Tom added: “The MRI scanner is one of the most advanced imaging modalities for the nervous system, providing millimetre-thick cross-sectional images of the brain and spinal cord which is essential for both accurate diagnosis and treatment.
“Having such advanced equipment and facilities plus four recognised specialists means all our clients and their pets will see a vet with the highest level of training in veterinary neurology.
“All of our specialists are happy to discuss challenging cases on the phone with our referring vets and Sabrina's skills and enthusiasm will continue to improve and diversify the service we offer.
https://cave-vet-specialists.co.uk
Clare graduated from the University of Glasgow in 1991 and, following an internship at the University of Pennsylvania and general practice in Cambridgeshire, she completed a BSAVA/Petsavers Residency and was Staff Clinician in Neurology at the Royal Veterinary College.
Aged 26, she became the youngest ever Diplomate of the European College of Veterinary Neurology and three year later became a RCVS Specialist.
For 16 years, she operated a neurology and neurosurgery referral service at the Stone Lion Veterinary Hospital in Wimbledon and was awarded a PhD from Utrecht University in 2007.
Clare joined Fitzpatrick Referrals and the University of Surrey in 2013, was made a Fellow of the Royal College of Veterinary Surgeons in 2016 and awarded a Professorship of Veterinary Neurology in 2018.
Clare was made a Fellow of the Royal College of Veterinary Surgeons in 2016 in recognition of her meritorious contribution to the profession, including 25 years’ research into ‘Chiari-like malformation and syringomyelia’ in dogs.
Clare said: “I will be building and strengthening the neurology service at Wear to make it not just the leading centre in the North East, but in Europe.
“I love collaborating with others to find answers to the clinical problems we face and so, as well as potential partnership with my colleagues in the other disciplines at Wear, I hope to initiate or contribute to other multi-centre studies through the Linnaeus group.
“I am passionate about teaching and learning through collaboration, and I hope to bring multi-disciplinary rounds to the practice including neuro-radiology-neuropathology and neurology- behaviour.”
For the study, Luisa De Risio, clinical research and excellence director at Linnaeus and a co-investigator, is collaborating with neurology specialists and primary care vets at Linnaeus practices to recruit cases.
Luisa said: “Canine idiopathic epilepsy is a disease that is common in many breeds of dog and can significantly impact the quality of life of both affected dogs and their owners.
"However, there is limited knowledge concerning the role of genetic factors in susceptibility to the disease in most breeds.
“The overarching aim of this large-scale collaborative study is to identify the genetic factors contributing to the risk of developing idiopathic epilepsy as this could help develop tools to lower the incidence of the condition in future generations.
“The study will initially focus on the Border Collie and Italian Spinone, as they can suffer from a particularly severe and life-limiting form of epilepsy, before expanding the study to other breeds in the future.
Dr Sally Ricketts, the geneticist leading the study at the Kennel Club Genetics Centre in the Department of Veterinary Medicine at the University of Cambridge, said: “We are very excited about this collaboration, which will facilitate our sample collections to enable study of this debilitating disease.
For more information on the study, visit www.canine-genetics.org.uk/research/epilepsy.
Photo: Sally Ricketts, senior research associate at the Kennel Club Genetics Centre, Department of Veterinary Medicine, University of Cambridge; Luisa De Risio, clinical research and excellence director at Linnaeus and Christopher Jenkins, research assistant at the Kennel Club Genetics Centre, Department of Veterinary Medicine, University of Cambridge.
In the study titled “Safety of early postoperative hydrotherapy in dogs undergoing thoracolumbar hemilaminectomy”, the medical records of a single referral hospital in Sweden were retrospectively reviewed to identify dogs that had been treated with hemilaminectomy for acute or chronic thoracolumbar IVDE and had commenced hydrotherapy within five days after surgery.
Information collected from the medical records included signalment, presenting clinical signs, severity of neurological signs, initiation and duration of hydrotherapy, postoperative complications and follow-up.
Postoperative complications were considered major if there was a need for hospitalisation, surgery or if the dog died or was euthanised as a direct consequence of the complication.
A complication was deemed minor if outpatient medical treatment was sufficient to rectify it.
A total of 83 dogs were included in the study.
Hydrotherapy was started within a mean of 2.7 (one to five) days after surgery and consisted of swimming without underwater treadmill (UWTM) in dogs with severe paraparesis or paraplegia.
With neurological improvement, and when supported ambulation was possible, UWTM was initiated.
Ninety-six percent of the dogs used swimming as postoperative hydrotherapy, starting with a mean of 2.7 days after surgery, fifty-seven percent of the dogs used UWTM as the postoperative hydrotherapy, starting with a mean of 13 days after surgery.
Forty-five percent of dogs used both hydrotherapeutic modalities.
Dr Abtin Morjarradi, corresponding author for the paper, said: “A total of 10 minor complications were recorded during the study period, including surgical site infection (SSI) (n=5), diarrhoea (n=4) and urinary tract infection (n=1).
Major complications were recorded in 26 dogs during the study period and included euthanasia (n=13), acute dermatitis (n=1), spinal abscess (n=1) and disc extrusion (n=1).
Reasons for euthanasia were urinary incontinence (n=5), lack of neurological improvement (n=2), clinical suspicion of progressive myelomalacia (PMM) (n=2), persistent pain (n=1), aggression (n=1) and widespread cellulitis with an abscess caudal to the right stifle without known cause (n=1).”
Abtin added: “Follow-up visits for 71 dogs were performed at a mean of 15.3 (9 to 30) days, and 68 dogs at a mean of 45.9 (30 to 111) days, after surgery.
"At the first follow-up visit 68% of the dogs were ambulatory with Modified Frankel Score (MFS) 4 or higher.
"At the last follow-up visit 97% of the dogs were ambulatory with MFS 4 or higher, with 34% demonstrating normal neurological function. None of these dogs deteriorated after the initiation time of hydrotherapy.”
Nicola Di Girolamo, Editor of JSAP, said: “Whilst previous studies indicate that early rehabilitation may be beneficial after acute spinal cord injury, the optimal timing to start hydrotherapy is unclear.
“Despite a high number of complications being recorded in the present study, it is not clear how many of these complications were directly related to the initiation time of hydrotherapy and therefore further research is required.”
The full article can be found in the December issue of the Journal of Small Animal Practice: https://onlinelibrary.wiley.com/doi/full/10.1111/jsap.13412.
Vetbromide is presented as a 600mg double divisible tablet for both large and small dogs, and for greater flexibility with dose titration. Tablets are blister packed for ease of storage and dispensing, with a four-year unopened shelf life.
Alongside the launch, TVM has prepared a range of product support materials, including: product guidelines, treatment and monitoring guidelines, seizure management ‘lunch and learn’ sessions, and pet owner information.
TVM has also created a free e-learning tool which takes veterinary staff through the process of diagnosing, treating and monitoring dogs with suspected epilepsy.
Will Peel, product manager at TVM said: "The addition of Vetbromide to our epilepsy range allows vets more flexibility when treating epileptic patients. To further assist vets, we are also offering a wide range of free literature and in-practice support to ensure that veterinary staff are up to speed on such a common, yet at times complicated, topic.’
For more information, visit www.tvm-uk.com/epilepsy, or contact your TVM UK Territory Manager.
According to the College, other research suggests that comorbidities - such as anxiety and cognitive impairments - are common in dogs with epilepsy, meaning there is a need for new epilepsy management options which help to control seizures and improve behavioural and cognitive comorbidities.
Led by canine behaviour and welfare scientist Dr. Rowena Packer from the RVC and veterinary neurologist Professor Holger Volk from the University of Veterinary Medicine Hannover (TiHo), alongside RVC PhD student Dr. Benjamin Andreas Berk, the team of researchers tested the effects of an oil supplement on seizure frequency in dogs with drug-resistant epilepsy.
Multiple studies from the RVC have shown that medium chain triglyceride (MCT) oils-enriched diets can improve seizure control in difficult to treat, drug-resistant dogs with epilepsy. This controlled clinical study used non-invasive cognitive tests and a validated psychometric tool to show that dogs had improved spatial and working memory when treated with MCTs.
Dr Rowena Packer, Lecturer in Companion Animal Behaviour and Welfare at RVC, said: "Our ground-breaking research into the behavioural and cognitive comorbidities of canine epilepsy was the first to identify cognitive impairments in this population. We have now gone one step further and found a promising way to boost the impaired memories of these patients and reduce their seizure frequency, by a simple dietary change."
Professor Holger Volk, Department Chair for Small Animal Diseases at the University of Veterinary Medicine Hannover, said: "Our guts influence how well we think – this study highlights the importance of diets and the power of the gut-brain axis. We are just at the beginning of understanding how diets can influence complex diseases such as epilepsy and dementia. MCT oil could offer a promising addition to our management tool-kit."
The researchers say that research thus far has focused on developing treatments to manage idiopathic epilepsy and little attention has been given to the emotional and logistical challenges for owners managing their dog’s condition.
This study used semi-structured interviews to explore how owners’ lives were changed following their dogs’ diagnosis and glean in-depth insights into their lives.
The research discovered that following their dog’s initial seizure, all interviewees recalled feeling negative emotions such as being distraught, fearful or uncertain regarding their dog’s future and disease progression. Prior experience with canine epilepsy was rare, and owners were shocked and distressed by the appearance of their dog’s seizures.
Whilst many owners discussed a very emotionally close dog-owner bond, owning a dog with epilepsy had a significant impact on their lifestyle. Impacts affected many aspects of daily routines, and in some cases, owners’ jobs. The unpredictable and sometimes inconvenient timing of seizures negatively impacted owners’ sleep and wellbeing. This unpredictability also made some owners feel that they were living with “a ticking time bomb”.
Other limitations included strict daily medication schedules and difficulty finding assistance in caring for their dog. This, combined with a fear of leaving their dog unsupervised, had social implications in some instances and led to increased use of the Internet and online groups for peer support. Owners also reported that friends, family and colleagues did not always understand the magnitude of commitment required.
Amy Pergande, Small Animal Intern at the RVC and primary author of the study, said: "We are sincerely grateful to the owners who participated in this study for providing us with such detailed and often emotive accounts of their experiences. Many of the participants had willingly altered many aspects of their daily routine for their dogs, both socially and professionally, and sometimes at the expense of their own quality of life."
This research highlights that further consideration of these factors by veterinary professionals and the friends and families of owners of these dogs could improve owner quality of life and facilitate the provision of additional, much needed support.
Rowena Packer, Lecturer in Companion Animal Behaviour and Welfare Science and research lead in canine epilepsy at the RVC, said: "Epilepsy can be an extremely tough condition for owners to manage, where the love, time and money owners dedicate to their dogs is not necessarily matched by a significant improvement in their condition, with seizures often continuing unabated. Our study has revealed previously unrecognised or under-appreciated impacts that epilepsy introduced to these owners’ lives. Improved awareness and understanding of these challenges by veterinary professionals have the potential to improve communication with clients, to avoid owners feeling that social media is the only place they can go to feel supported and understood”.
These findings increase the understanding of the sometimes negative and often profound emotional effects and lifestyle changes experienced by owners managing a dog with idiopathic epilepsy. With better support and resources, the reported impacts could potentially be minimised to protect owner quality of life.
Zoe Belshaw, independent research collaborator, said: “The welfare of pets and their owners can be closely intertwined. This research exploring how owners’ lives change when their dogs develop epilepsy is another important piece in the jigsaw of understanding both what the veterinary profession can do to best support our clients, but also in starting to appreciate the substantial wider societal impacts of chronic ill health in our nations’ pets”.
The full paper is open access and available at: https://bmcvetres.biomedcentral.com/articles/10.1186/s12917-020-02669-w
Photo: The Melias Studio
For the study, 2,834 seizure incident cases were identified from a population of 455,553 dogs attending VetCompass participating practices in 2013.
The study found that that approximately 1 in 160 dogs under first opinion veterinary care are affected by seizures every year.
Many of those dogs will have underlying epilepsy, defined as dogs with two or more unprovoked seizures at least 24 hours apart. Seizures can be secondary to idiopathic epilepsy, structural epilepsy or epilepsy of unknown cause.
Until now, however, there has been little information on the classifications of seizures, diagnostic approaches, or clinical management of dogs with seizures in the veterinary first opinion population.
The main findings from the research were:
Dr Dan O’Neill, Senior Lecturer in Companion Animals Epidemiology at the RVC, and author of the paper, said: "Watching your dog undergo a seizure can be an incredibly scary moment for any dog owner. It is really important that dogs that seizure are rapidly diagnosed to decide whether they need no further treatment beyond careful monitoring or alternatively require a clinical work-up to define the cause of the seizures.
"There are now some excellent treatments for many seizure-related diseases. This study helps up to understand the current state of play for seizure management in dogs and identifies opportunities for improved care of these affected dogs."
The full paper is freely available from Journal of Veterinary Internal Medicine and can be accessed here:https://onlinelibrary.wiley.com/doi/full/10.1111/jvim.15911
The new service is led by Virginia Crespo DVM PGDip MSc MRCVS and Alex Hamilton BA VetMB MRCVS, pictured right.
Virginia qualified in 2012 from the Autonomous University of Barcelona, where she also served a rotating internship before completing an internship in neurology and neurosurgery at the Animal Health Trust in 2016. She finished a three-year residency in neurology and neurosurgery at Langford Veterinary Services in July, alongside attaining a Master’s of Science degree with Bristol University.
Alex graduated from Cambridge University in 2005 and after five years working in both mixed and emergency and critical care practice, he completed a surgical internship at the Animal Referral Hospital, Sydney, in 2012. He then completed a European accredited neurology residency at Melbourne University and Willows Veterinary Centre, in Solihull, and has since worked in Australia and the UK as a neurologist.
Clinical director Duncan Barnes said: “We’re delighted to welcome Virginia and Alex to Eastcott to lead this new service.
"They will provide in-depth consultations and neurological assessments alongside a variety of advanced diagnostic procedures to identify the problem and prepare an appropriate treatment plan.
"Virginia and Alex will have access to Eastcott’s new 1.5T MRI scanner and the clinic’s CT scanner, as well as electromyography, to assess the function of the nerves and muscles, and cerebrospinal fluid analysis.
"They will also work closely with another new recruit, Nicholas Taylor, who has joined us as referral radiographer, and other specialists across the hospital as part of a holistic approach to patient care."
For more information visit www.eastcottreferrals.co.uk.
The research, carried out by PhD student, Dr Sarah Finnegan and a multidisciplinary team of neurologists, behaviourists and biologists, found that 65% of owners reported pre-seizure changes in their dog, most commonly clinginess, excessive energy, and unsettled sleep. These signs varied between dogs, with other common changes including clumsiness, excessive panting, becoming withdrawn or quiet, and lacking energy.
43% of owners also reported seizure triggers, which commonly involved stress, food and excitement. A wide range of other triggers were reported by owners including loud noises, fireworks, storms, household products (cleaning products and air freshener), and preventative healthcare including flea and worming products and vaccinations.
60% of owners believed they were able to predict an upcoming seizure in their dog by using a combination of pre-seizure changes and recognising triggers. Nearly half of these owners were able to do so 30 minutes or more before the seizure commenced.
Dr Rowena Packer, BBSRC Research Fellow and research lead in canine epilepsy at the RVC, said: "It was fascinating to discover how in-tune many owners of dogs with epilepsy are with subtle changes in their dog’s behaviour before seizures. Many of our findings echo what is seen in human epilepsy patients and add evidence to support the presence of prodromal pre-seizure periods in dogs as well as people.
"Collecting further objective data to confirm these findings and explore ways to proactively utilise this period for seizure management are of priority for future research.
“This study also highlights how crucial it is that owners of dogs with epilepsy keep good records, not just of their dog’s seizures, but also of changes in behaviour and exposure to potential triggers, to gain a better picture of patterns in their dog’s seizure activity. The RVC Pet Epilepsy Tracker app allows owners to keep records, that can also be shared electronically with their vet and with RVC for further research.”
The research, which was conducted by a team at the Royal Veterinary College led by Professor Holger Volk and Dr Benjamin Andreas Berk alongside canine behaviour and welfare scientist Dr Rowena Packer, tested the effects of an MCT oil supplement on seizure frequency in dogs with drug-resistant epilepsy.
For the double-blinded study, 28 epileptic dogs received MCT oil for three months and a placebo oil for three months.
The researchers say that overall, dogs had significantly fewer seizures during the MCT phase compared the placebo phase, and an improved owner-reported quality of life. New therapies are urgently needed to improve the quality of life of affected dogs and their owners and the results of this study offer a promising addition to other methods commonly used to treat canine epilepsy.
Dr Rowena Packer, BBSRC Research Fellow at the Royal Veterinary College, said: “Epilepsy is often a challenging and distressing condition for dog owners to manage, particularly when dogs don’t respond to anti-seizure medications in the way their owner and vet might have expected or hoped. Historically, diet has not been considered a key part of epilepsy management, but along with other recent findings, these results indicate that nutrition likely plays an important role in seizure control.
"Our novel findings indicate that a relatively small change to the diet of dogs’ with hard-to-treat epilepsy can potentially reduce the number of seizures they have, while also improving their medication side effects and overall quality of life. MCT oil offers a promising addition to the wider epilepsy management tool-kit."
Titled ‘The Five Steps of Seizure Management’, the sessions will update veterinary surgeons and nurses on:
Will Peel, Product Manager at TVM UK said: "The Lunch and Learn sessions have proved very popular with veterinary practices. Our aim is to update vets and nurses on diagnosis and management of epilepsy in general practice whilst educating them about products and services which can help them better support their patients."
TVM says it will also provided supporting literature, including guidelines and owner educational tools, designed to help veterinary staff in diagnosing and treating pets with epilepsy.
To book a Lunch and Learn, contact your local TVM UK territory manager or email help@tvm-uk.com.
Lead author Professor Clare Rusbridge, Chief of Neurology at Fitzpartick Referrals, conducted the study because of a lack of clarity on the recognition and diagnosis of the clinical signs associated with CM as opposed to syringomyelia (SM).
CM is an abnormality in the skull, making it smaller, and impacting on the brain to alter the flow of cerebrospinal fluid; this results in pain and a collection of fluid pockets within the spinal cord. These fluid pockets are commonly known as SM and over time can cause irreversible damage to a dog’s spinal cord. However it is not clear whether signs of pain in affected dogs are due to CM or SM or both.
To try to rectify this, Clare studied the medical records of all the cavalier King Charles spaniels diagnosed with CM-associated clinical signs presenting to her at Fitzpatrick Referrals over a five year period. She documented the historical and examination findings and related them to the MRI findings, including presence and size of the SM.
She found common signs in all dogs were vocalisation, spinal pain (neck, middle or lower back), reduced activity, reduced stairs or jumping ability, aversion to being touched or groomed, altered emotional state (described as being more timid, anxious, withdrawn or aggressive) and sleep disturbance.
A tendency to rub or scratch at the head or ears was common but was more likely in dogs with small or no SM suggesting that this may be a sign of head discomfort associated with CM. Head and ear rubbing was not associated with the presence of material within the middle ear (a condition which is also common in this breed and often given the acronym PSOM).
The only signs that were specific to SM were phantom scratching, scoliosis (twisted spine) and weakness and these were only present when the SM was large (at least 4mm wide).
Clare says this study is important because it suggests that CM alone is a cause of pain in many dogs. The aim now is to use the information gained in this study to develop a questionnaire to determine risk of CM and monitor the response to clinical signs.
Photo: Charlie on a bad day