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Evaluation of concurrent analysis of cerebrospinal fluid samples collected from the cerebellomedullary cistern and lumbar subarachnoid space for the diagnosis of steroid-responsive meningitis arteritis in dogs

Beatrice E. Carletti1Department of Small Animal Clinical Science, Institute of Veterinary Science, University of Liverpool, Neston CH64 7TE, England

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Steven De Decker2Department of Clinical Science and Services, Royal Veterinary College, University of London, Hatfield AL9 7TA, England

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Jeremy Rose4Fitzpatrick Referrals, Halfway Ln, Godalming GU7 2QQ, England

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Daniel Sanchez-Masian1Department of Small Animal Clinical Science, Institute of Veterinary Science, University of Liverpool, Neston CH64 7TE, England

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Erika Bersan1Department of Small Animal Clinical Science, Institute of Veterinary Science, University of Liverpool, Neston CH64 7TE, England

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Camilla Cooper1Department of Small Animal Clinical Science, Institute of Veterinary Science, University of Liverpool, Neston CH64 7TE, England

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Balazs Szladovits3Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, Hatfield AL9 7TA, England

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Gemma Walmsley1Department of Small Animal Clinical Science, Institute of Veterinary Science, University of Liverpool, Neston CH64 7TE, England

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Rita Gonçalves1Department of Small Animal Clinical Science, Institute of Veterinary Science, University of Liverpool, Neston CH64 7TE, England

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Abstract

OBJECTIVE

To evaluate whether concurrent analysis of CSF samples from 2 collection sites (cerebellomedullary cistern [CMC] and lumbar subarachnoid space [LSS]) versus only 1 site could improve the diagnostic sensitivity of CSF analysis for dogs with suspected steroid-responsive meningitis arteritis (SRMA).

ANIMALS

111 client-owned dogs with SRMA diagnosed at 3 veterinary referral hospitals between 2011 and 2017.

PROCEDURES

Only dogs with CSF collected from both sites (CMC and LSS) and with no previous history of corticosteroid administration were included. Medical record data and logistic regression were used to identify factors associated with having a total nucleated cell concentration (TNCC) within the reference interval in a CSF sample from 1 collection site.

RESULTS

The TNCC was within the reference interval (TNCC < 5 cells/μL) in the CSF sample from 1 collection site for 8 of 111 (7%) dogs and was only slightly high (TNCC, 5 to 9 cells/μL) in the sample from 1 or both sites for 10 (11%) other dogs. For each of these 18 dogs, results for samples from 1 site were consistent with SRMA. The proportion of CSF samples that had a TNCC within the reference interval was comparable between sites. As age increased, so did the risk of having an unremarkable TNCC in the CSF sample from 1 site, albeit only slightly (OR, 1.08; 95% confidence interval, 1.01 to 1.16).

CONCLUSIONS AND CLINICAL RELEVANCE

CSF samples from both the CMC and LSS should be analyzed when evaluating dogs with suspected SRMA to improve the chance of detecting a high TNCC.

Abstract

OBJECTIVE

To evaluate whether concurrent analysis of CSF samples from 2 collection sites (cerebellomedullary cistern [CMC] and lumbar subarachnoid space [LSS]) versus only 1 site could improve the diagnostic sensitivity of CSF analysis for dogs with suspected steroid-responsive meningitis arteritis (SRMA).

ANIMALS

111 client-owned dogs with SRMA diagnosed at 3 veterinary referral hospitals between 2011 and 2017.

PROCEDURES

Only dogs with CSF collected from both sites (CMC and LSS) and with no previous history of corticosteroid administration were included. Medical record data and logistic regression were used to identify factors associated with having a total nucleated cell concentration (TNCC) within the reference interval in a CSF sample from 1 collection site.

RESULTS

The TNCC was within the reference interval (TNCC < 5 cells/μL) in the CSF sample from 1 collection site for 8 of 111 (7%) dogs and was only slightly high (TNCC, 5 to 9 cells/μL) in the sample from 1 or both sites for 10 (11%) other dogs. For each of these 18 dogs, results for samples from 1 site were consistent with SRMA. The proportion of CSF samples that had a TNCC within the reference interval was comparable between sites. As age increased, so did the risk of having an unremarkable TNCC in the CSF sample from 1 site, albeit only slightly (OR, 1.08; 95% confidence interval, 1.01 to 1.16).

CONCLUSIONS AND CLINICAL RELEVANCE

CSF samples from both the CMC and LSS should be analyzed when evaluating dogs with suspected SRMA to improve the chance of detecting a high TNCC.

Supplementary Materials

    • Supplementary Table S1 (PDF 70 kb)
    • Supplementary Table S2 (PDF 24 kb)

Contributor Notes

Address correspondence to Dr. Carletti (beatrice.carletti@gmail.com).