Neurologic examination of healthy adult African pygmy hedgehogs (Atelerix albiventris)

Colin C. Berg Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI 53706.

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Grayson A. Doss Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI 53706.

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Julien Guevar Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI 53706.

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Abstract

OBJECTIVE

To describe a modified approach to neurologic examination of African pygmy hedgehogs (Atelerix albiventris).

ANIMALS

12 adult hedgehogs (7 males and 5 females).

PROCEDURES

Aspects of the standard neurologic examination of dogs and cats were evaluated for use with awake hedgehogs, and modified approaches to evaluating their normal behavior and mentation, select cranial nerves and refexes, and gait were then identified. Behavioral analysis and gait analysis were performed by using video recordings of hedgehogs in a novel environment. Performability and repeatability of all feasible aspects of the neurologic examination were assessed.

RESULTS

Most aspects of the standard neurologic examination could be successfully performed, with repeatable results. However, certain aspects, especially those evaluating the pelvic limbs, were more difficult to perform successfully or were less repeatable. All hedgehogs lacked a menace response but displayed a contraction of the frontodorsalis muscle. Facial sensation testing was unreliable.

CONCLUSIONS AND CLINICAL RELEVANCE

The entire standard neurologic examination could not be performed in hedgehogs. However, many aspects could be performed, and together they provided baseline data for neurologic examination of this species.

Abstract

OBJECTIVE

To describe a modified approach to neurologic examination of African pygmy hedgehogs (Atelerix albiventris).

ANIMALS

12 adult hedgehogs (7 males and 5 females).

PROCEDURES

Aspects of the standard neurologic examination of dogs and cats were evaluated for use with awake hedgehogs, and modified approaches to evaluating their normal behavior and mentation, select cranial nerves and refexes, and gait were then identified. Behavioral analysis and gait analysis were performed by using video recordings of hedgehogs in a novel environment. Performability and repeatability of all feasible aspects of the neurologic examination were assessed.

RESULTS

Most aspects of the standard neurologic examination could be successfully performed, with repeatable results. However, certain aspects, especially those evaluating the pelvic limbs, were more difficult to perform successfully or were less repeatable. All hedgehogs lacked a menace response but displayed a contraction of the frontodorsalis muscle. Facial sensation testing was unreliable.

CONCLUSIONS AND CLINICAL RELEVANCE

The entire standard neurologic examination could not be performed in hedgehogs. However, many aspects could be performed, and together they provided baseline data for neurologic examination of this species.

Introduction

Neurologic disease is common in pet African pygmy hedgehogs (Atelerix albiventris), but little information is available regarding the diagnosis and treatment of neurologic disease affecting these animals.1 Wobbly hedgehog syndrome is a progressive neurologic disease affecting young hedgehogs resulting from diffuse vacuolization of the CNS white matter,2 and its clinical presentation relates to the distribution and extent of the lesions. Affected animals may initially have mild clinical signs, such as gait abnormalities or proprioceptive deficits, that may progress to severe signs, such as ascending paralysis, self-mutilation, head tilt, circling, dysphagia, weight loss, and tremors.2,3 An effective treatment is not known, and hedgehogs are euthanized or die because of paralysis; the diagnosis is confirmed through postmortem examination. Intervertebral disk disease and primary CNS neoplasia have also been reported in pet hedgehogs, and clinical signs closely resemble wobbly hedgehog sydrome.4,5,6,7,8,9,10,11 Further confounding the diagnosis is that hedgehogs are frequently presented in torpor or with severe weakness secondary to other illness, both of which mimic neurologic disease.

Antemortem diagnosis of CNS disorders in hedgehogs is challenging because of their unique anatomy and defensive nature. When stimulated, they will usually assume a defensive posture in which they roll themselves into a ball shape, preventing access to their head and limbs and protecting themselves with a covering of sharp keratin spines (mantle; Supplementary Figure S1, available at: avmajournals.avma.org/doi/suppl/10.2460/javma.258.9.971). Subsequently, heavy sedation or general anesthesia is required for neurologic examination, which precludes the assessment of many reflexes typical for a neurologic examination of other species. A standardized neurologic examination for hedgehogs has not been reported. Therefore, the goal of the study reported here was to develop a standardized approach to the neurologic examination of hedgehogs.

Materials and Methods

Animals

Twelve 1-year-old sexually intact (male, n = 7; female, 5) African pygmy hedgehogs (Atelerix albiventris) with a median body weight of 535 g (18.9 oz; range, 310 to 698 g [10.9 to 24.6 oz]) were obtained from a private breeder. Animals were individually housed in ventilated plastic storage containers (84 × 51 × 36 cm) lined with paper liners, and containers were in a climate- and humidity-controlled room, with a temperature between 23.8°C (75°F) and 26.6°C (80°F) and relative humidity of < 40%. The photoperiod was set at 12 hours of light, and fresh water, food (commercial diet for hedgehogs and occasional insects), exercise wheels, hiding structures, and paper bedding for digging were provided at all times. Hedgehogs were acclimatized to their individual enclosures and the room for > 6 months prior to the start of the study. Hedgehogs were considered healthy on the basis of the results of serial physical examinations and CBC and serum biochemical analyses. This study was approved by the Institutional Animal Care and Use Committee of the University of Wisconsin-Madison School of Veterinary Medicine (protocol No. V006051).

Neurologic examination

The neurologic examination consisted of assessment of mentation, behavior, gait, proprioception, depth perception, response to visual and auditory stimuli, cranial nerves, spinal reflexes, and postural reactions; nociception was not evaluated. Assessment methods were extrapolated from those used for the neurologic examination of dogs and cats12 and were determined to be feasible for the neurologic examination of hedgehogs on the basis of the examination of 6 hedgehogs prior to initiating the present study. When necessary, however, assessment methods were altered. A complete neurologic examination was performed 2 times/animal to evaluate the repeatability of the findings from the first examination, with a minimum of a 1-week period between examinations. If an assessment could not be performed for both paired structures—left and right thoracic limb withdrawal reflexes, left and right pelvic limb withdrawal reflexes, left and right palpebral reflexes, and left and right menace responses—then the assessment was considered unsuccessful (eg, if elicitation of a palpebral reflex was only possible for the right eye, then elicitation of a palpebral reflex was considered unsuccessful). The examination was separated into observational and hands-on portions. The observational portion included assessment of mentation, behavior, gait, proprioception, and depth perception and was performed first. Materials used for the hands-on portion of the examination included latex-coated knit work gloves, a cotton-tipped applicator, and a 2-inch-wide roll of tape (Supplementary Figure S2, available at: avmajournals.avma.org/doi/suppl/10.2460/javma.258.9.971). Each animal was gently handled to minimize stress. For animals that appeared stressed (ie, did not unroll after several minutes or attempted to flee the examiner), examinations were aborted and attempted at a later date. All neurologic examinations were performed by a board-certified veterinary neurologist (JG).

Observation—For the observational portion of the neurologic examination (mentation, behavior, gait, proprioception, and depth perception), each hedgehog was transferred from its housing to a novel small animal kennel that was 60 cm3, lined with paper, and made of stainless steel. Each animal was observed and videos were recorded over a 5-minute period from a short distance (approx 1.5 m) with a smartphone.a Mentation, behavior, and gait were assessed by how quickly the hedgehog began investigating the novel enclosure and responding to the examiner's approach to the kennel. Proprioception and depth perception were assessed by placing each animal on a 10-cm-high platform that was 5 cm above a second platform, with that second platform 5 cm above the floor, and by allowing each animal to approach the edge of the kennel positioned 120 cm above the floor (Supplementary Figure S3; available at: avmajournals.avma.org/doi/suppl/10.2460/javma.258.9.971). An animal that descended the platforms to the floor without knuckling on its paws or stumbling and that did not attempt to step off the kennel edge was considered to have appropriate proprioception and depth perception, respectively.

Cranial nerves—Cranial nerves were assessed through facial symmetry, menace response, response to visual and auditory stimuli, palpebral reflex, facial and ear pinnal sensation, and tongue movement. Menace response, vision, and hearing were assessed without physical contact. The menace response, the first test of cranial nerve function performed after the observational examination, was elicited by repeatedly moving the smartphone toward each eye from a short distance (approx 25 cm) while attempting to avoid displacing a column of air toward the eye, looking for a subsequent blink. This method was chosen because hedgehogs are positioned low to the ground when at rest, such that using a hand with outstretched fingers for testing was impractical. Additionally, videos recorded during attempts to elicit a menace response were reviewed later to determine whether blinking occurred. The approach of the examiner's hand acted as a visual stimulus, and snapping of the examiner's fingers when outside a hedgehog's field of view (approx 5 feet away) acted as an auditory stimulus. A positive response to either stimulus was indicated by a hedgehog rapidly assuming a defensive posture (ie, starting to roll into a ball). Tongue movement was evaluated while a hedgehog explored the novel environment (a small animal kennel that was 60 cm3, lined with paper, and made of stainless steel). A hedgehog that displayed rapid extension of its tongue and licking of its nares during exploration was considered to have an intact hypoglossal nerve.

Reflex tests that required physical contact (eg, palpebral reflex and facial and ear pinnal sensation) were performed with the cotton-tipped applicator and a hedgehog positioned upright (sitting in a ball) on the roll of tape as a base for support (Supplementary Figure S4, available at: avmajournals.avma.org/doi/suppl/10.2460/javma.258.9.971). This simple setup was used because the supplies are often available in veterinary clinics and it was considered safe when working with the often rapidly moving hedgehogs. A palpebral reflex was elicited by touching the medial or lateral canthus of each eye with the soft end of the cotton-tipped applicator (Supplementary Video S1, available at: avmajournals.avma.org/doi/suppl/10.2460/javma.258.9.971). Maxillary, mandibular, and auricular sensations were assessed by touching the upper lip, lower lip, and concave surface of the ear pinna, respectively, with the wooden end of the cotton-tipped applicator and observing for local twitching, head shaking, or movement of the head away from the applicator.

Olfaction could not be reliably assessed because the eyes could not be covered, and taste could not be evaluated because of marked variation in preferred foods used for testing among animals. The pupillary light reflex could not reliably be performed because of poor compliance and an inability to determine iris constriction associated with the miniscule pupils. The oculocephalic, corneal, and gag reflexes could not be assessed because of the inability to grasp the skull and open the mouth of nonsedated hedgehogs.

Spinal reflexes—Spinal nerves were assessed through elicitation of thoracic and pelvic limb withdrawal reflexes. Each hedgehog in its defensive posture was placed on its back on a roll of tape that was used once again as support. As each hedgehog gradually unrolled and attempted to right itself on the support, extended limbs were grasped between 2 of the examiner's fingers and assessed for a withdrawal response (ie, pulling the limb away from the examiner's fingers in rapid succession until the limb was freed) after application of gentle pressure (Supplementary Figures S5, available at: avmajournals.avma.org/doi/suppl/10.2460/javma.258.9.971). If this approach was unsuccessful, then withdrawal reflexes were assessed while the hedgehog was standing and attempting to ambulate away from the examiner. A strong, repeatable flexion of the grasped limb was considered an intact reflex. Other spinal reflexes (patellar, biceps, gastrocnemius, triceps, and crossed extensor) were not assessed because each hedgehog did not permit handling and adopted a defensive posture during any attempt to assess these other spinal reflexes.

Postural reactions—Postural reactions tested included the righting reflex, hemiwalking, hopping, wheelbarrowing, and proprioception. The righting reflex was tested by placing a defensively curled hedgehog in dorsal recumbency on a roll of tape and recording the time to begin the first attempt and the time to successfully right itself to a standing position (Supplementary Video S2, available at: avmajournals.avma.org/doi/suppl/10.2460/javma.258.9.971). Hemiwalking, hopping, and wheelbarrowing were performed while each hedgehog was gently restrained at the junction of the mantle and haired skin laterally on or above a nonslip surface (Supplementary Figure S6, available at: avmajournals.avma.org/doi/suppl/10.2460/javma.258.9.971). Proprioception was partly assessed during testing of depth perception. In particular, the hedgehog was monitored for knuckling of the paws, lameness, and ataxia during descent from the platforms. Paw replacement, tactile and visual placing, and extensor postural thrust were unable to be performed because of hedgehog anatomy and rapid adoption of a defensive posture.

Data analysis

Descriptive statistics were determined with use of statistical software.b Data for the time to begin exploration of a novel environment and to complete the righting reflex were reported as median and range unless otherwise specified. The number of animals at the second examination with repeatable findings from the first examination was reported.

Results

Observation

Mentation and behavior—When placed into the novel environment (kennel), hedgehogs quickly unrolled and began to explore their surroundings but readily adopted defensive postures when approached or stimulated by auditory or tactile stimuli (Table 1). This posture was characterized by the hedgehog crouching low to the ground and contracting the frontodorsalis muscle, resulting in the spines being pulled down over the eyes and face (Supplementary Video S3, available at: avmajournals.avma.org/doi/suppl/10.2460/javma.258.9.971) and the mantle covering the limbs. Most hedgehogs also vocalized, characterized by hissing and snorting, during defensive posturing. Once stimulation ceased, the animals returned to a normal body position and resumed exploring the environment. Consistently observed behaviors included sniffing and rapid licking of the nares and environmental surfaces. Additionally, 3 hedgehogs self-anointed, a unique behavior of hedgehogs in which foamy saliva is rapidly produced and applied to the spines with the tongue.

Table 1

Median (range) time elapsed (seconds) for 12 adult African pygmy hedgehogs to begin to explore a novel environment (60-cm3 stainless steel small animal kennel) and, after placement in dorsal recumbency on a support, to begin their first attempt to right themselves and to successfully right themselves (righting reflex) as parts of 2 modified neurologic examinations performed at least 1 week apart.

Neurologic examination
Variable First Second
Time to begin exploring novel environment (s) Righting reflex 10 (2–77) 13 (0–143)
Time to begin first attempt (s) 20 (2–65) 37 (1–110)
Time to successful righting (s) 53 (28–132) 53 (12–157)

Gait analysis, proprioception, and depth perception—All hedgehogs maintained a crouched gait, with their elbow and hock joints hidden under the skin of the mantle during ambulation (Supplementary Video S4, available at: avmajournals.avma.org/doi/suppl/10.2460/javma.258.9.971). After several minutes of exploration, 3 hedgehogs adopted a walking position with their ventrum further raised off the ground, such that the elbow and hock joints were seen. No animals knuckled on their paws (normal proprioception) or were ataxic, paretic, or lame on and at descent from the platforms during real-time observation and in the video recordings played at regular and slow speed. However, many animals initially seemed hesitant to descend the first platform (ie, they would repeatedly approach the edge but turn away), but after the first descent, the second descent from the second platform to the floor was noticeably faster. Successful descension from the platforms, therefore, indicated that all hedgehogs had appropriate depth perception. Additionally, all hedgehogs approached and extended their heads over but would not step off the kennel edge, which also indicated appropriate depth perception.

Cranial nerves

Facial symmetry, as judged by the appearance of the palpebral fissures, eye position within the orbit, ear position, and nares movement, was normal in all animals. A head tilt was not identified in any animal. Strabismus was difficult to evaluate because of the uniform dark eyes in this species. The menace response was absent in real time and in the videos for all hedgehogs (Table 2). Most initially contracted the frontodorsalis muscle when their faces were approached; however, after a few attempts, they were less often in a defensive posture, permitting their eyes to be completely seen during the test. All hedgehogs responded to both visual and auditory stimuli by rapidly adopting a defensive posture with a contracted frontodorsalis muscle and limbs tucked under a partially contracted mantle. A palpebral reflex was present in all hedgehogs, with blinking occurring rapidly after contacting the canthi. Ear pinnal sensation was present in all animals. Facial sensation was inconsistent in most, with only 2 that responded by contracting the frontodorsalis muscle at the time of the first examination; response to facial stimulation was not observed for all hedgehogs at the time of the second examination. Rapid tongue movement over the nares was present in all animals.

Table 2

Neurologic examination findings for the hedgehogs of Table 1.

No. of hedgehogs with a positive response
Neurologic examination Nerves or muscles evaluated* First examination Second examination
Cranial nerves
Menace response CN II, CN VII 0 0
Palpebral reflex CN V, CN VII 12 12
Facial sensation CN V, CN VII 2 0
Ear pinnal sensation CN V, CN VII 12 12
Facial symmetry CN VII 12 12
Visual response CN II 12 12
Auditory response CN VIII 12 12
Tongue movement CN XII 12 12
Spinal reflexes
Thoracic limb withdrawal reflex C6 through T2; axillary, musculocutaneous, median, and ulnar nerves; flexor muscles of the thoracic limb 12 9
Pelvic limb withdrawal reflex L4 through S2, sciatic nerve, flexor muscles of the pelvic limb 12 5
Postural reactions
Righting reflex 12 12
Hemiwalking 11 11
Thoracic limb hopping 12 11
Pelvic limb hopping 11 9
Wheelbarrowing 12 11

Constituents of the normal brachial and lumbar intumescences and plexus are unknown for hedgehogs; therefore, anatomic information was extrapolated from that for dogs.

CN = Cranial nerve.

Spinal reflexes

Subjectively, assessment of these withdrawal reflexes required more time than the other portions of the neurologic examination. Although all hedgehogs withdrew their thoracic and pelvic limbs after application of gentle pressure, withdrawal repeatability was low for most (Table 2). The withdrawal reflexes of the thoracic limbs were the first to be evaluated because the thoracic limbs were the first to be extended from the contracted mantle as each hedgehog began righting itself from dorsal recumbency. The withdrawal reflexes of the pelvic limbs were more challenging to assess because they were difficult to grasp from a semicontracted mantle. Also, repeated attempts to grasp the limbs for testing often increased the defensiveness of hedgehogs, making assessment impossible.

Postural reactions

All hedgehogs rapidly attempted to and completely righted themselves after being placed in dorsal recumbency (Tables 1 and 2). Assessment of hemiwalking, hopping, and wheelbarrowing was possible for most hedgehogs, although a few minutes of handling was often required before they undid their defensive posture. The head was extended first, followed by the thoracic limbs. The pelvic limbs were always extended last and often remained retracted in the mantle for several minutes while the head was extended and the thoracic limbs were on the floor (Supplementary Figure S6). Therefore, hopping with the pelvic limbs was the most difficult and least repeatable postural reaction to assess.

Discussion

The present study revealed that portions of the standard neurologic examination of dogs and cats could be successfully applied to African pygmy hedgehogs. Other portions of the neurologic examination required modification or could not be performed because of the unique anatomy and defensive nature of hedgehogs. Particularly, assessment of spinal reflexes and postural reactions of the pelvic limbs was challenging. Additionally, more time and patience were required to perform many of the assessments, compared with the time anecdotally required for dogs and cats. However, with adequate time, the hedgehogs undid their defensive postures with handling such that they were then successfully examined. Minimizing stress during examination of small exotic pets is important to remember because these pets may interpret restraint as a predatory action. The observational portion of the neurologic examination of the hedgehogs in the present study was performed first, and the hands-on portion of the examination was kept as brief as possible in an attempt to minimize stress.

In the present study, hedgehogs rapidly adopted a defensive posture to various stimuli, including the approach of novel objects, loud sounds, and tactile stimuli such as handling. This defensive posture is well documented and typically is a major challenge when working with these animals.1 In the authors' experience, pet hedgehogs rarely allow unfamiliar people to freely handle them without adopting a defensive posture, and a hedgehog that is normally defensive but becomes suddenly amenable to handling may be severely ill.

During exploration of the novel environment, hedgehogs ambulated in a crouched body position with the proximal portions of their thoracic and pelvic limbs hidden within the mantle, possibly to quickly adopt a defensive posture in response to a perceived threat. Yet debilitated hedgehogs have been reported to crouch when ambulating.1 On the basis of the findings of the present study, veterinarians should cautiously interpret a hedgehog's gait because it may differ with a hedgehog's familiarity of the environment or health status.

Normal mentation can most likely be extrapolated from the adoption of a defensive posture with stimulation as well as demonstration of normal exploratory behavior. Hedgehogs with impaired mentation may have different neurologic examination findings versus those obtained for healthy hedgehogs in the present study. Applying the findings of the present study to healthy hedgehogs and those with neurologic disease in a clinical setting is necessary.

All hedgehogs lacked a menace response in the present study. This is commonly encountered in small exotic mammals and has been reported for ferrets,13 chinchillas,14 and rabbits.13,15 As the examiner attempted to elicit a menace response, each hedgehog rapidly contracted its frontodorsalis muscle and subsequently covered its eyes with the mantle. This action is likely a cortically mediated defensive response against a perceived ocular insult, similar to withdrawal of the head by a dog or cat with an attempt at eliciting a menace response.

Overall, evaluation of the spinal reflexes was limited in hedgehogs. However, the limb withdrawal reflexes could be assessed, especially as hedgehogs began to right themselves from dorsal recumbency on a support (roll of tape). The authors recommend initally testing proprioception indirectly, with placement of each animal on raised platforms as used in the present study or on a platform with a small set of steps, with observation in real time and later through review of video recordings. If a hedgehog is amenable to being held, the hopping test can then be performed by holding it at the border of its mantle and ventrum.

In conclusion, neurologic examinations can be performed with African pygmy hedgehogs. The neurologic examination findings for healthy African pygmy hedgehogs obtained in the present study may be useful for comparison with those for African pygmy hedgehogs with suspected neurologic disease.

Acknowledgments

Funded by the Companion Animal Research Fund, School of Veterinary Medicine, University of Wisconsin-Madison.

The authors declare that there were no conflicts of interest.

Footnotes

a.

iPhone X, Apple Inc, Cupertino, Calif.

b.

SigmaPlot, version 13, Systat Software Inc, San Jose, Calif.

References

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    Doss G, Carpenter J. African pygmy hedgehogs. In: Quesenberry K, Orcutt C, Mans C, et al., eds. Ferrets, rabbits, and rodents: clinical medicine and surgery. 4th ed. St Louis: Elsevier, 2021;401415.

    • Search Google Scholar
    • Export Citation
  • 2.

    Graesser D, Spraker TR, Dressen P, et al. Wobbly hedgehog syndrome in African pygmy hedgehogs (Atelerix spp). J Exot Pet Med 2006;15:5965.

  • 3.

    Díaz-Delgado J, Whitley DB, Storts RW, et al. The pathology of wobbly hedgehog syndrome. Vet Pathol 2018;55:711718.

  • 4.

    Raymond JT, Aguilar R, Dunker F, et al. Intervertebral disc disease in African hedgehogs (Atelerix albiventris): four cases. J Exot Pet Med 2009;18:220223.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Benneter SS, Summers BA, Schulz-Schaeffer WJ, et al. Mixed glioma (oligoastrocytoma) in the brain of an African hedgehog (Atelerix albiventris). J Comp Pathol 2014;151:420424.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6.

    Ogihara K, Suzuki K, Madarame H. Primary histiocytic sarcoma of the brain in an African hedgehog (Atelerix albiventris). J Comp Pathol 2017;157:241245.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Muñoz-Gutiérrez JF, Garner MM, Kiupel M. Primary central nervous system neoplasms in African hedgehogs. J Vet Diagn Invest 2018;30:715720.

  • 8.

    Nakata M, Miwa Y, Itou T, et al. Astrocytoma in an African hedgehog (Atelerix albiventris) suspected wobbly hedgehog syndrome. J Vet Med Sci 2011;73:13331335.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9.

    Gibson CJ, Parry NMA, Jakowski RM, et al. Anaplastic astrocytoma in the spinal cord of an African pygmy hedgehog (Atelerix albiventris). Vet Pathol 2008;45:934938.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10.

    Völker I, Schwarze I, Brezina TE, et al. Oligodendroglioma with neuronal differentiation in an 8-month-old African hedgehog (Atelerix albiventris). Tierarztl Prax Ausg K Kleintiere Heimtiere 2016;44:348354.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11.

    Kondo H, Yamamoto N, Seino N, et al. Cerebral meningioma in an African pygmy hedgehog (Atelerix albiventris). J Exot Pet Med 2018;28:5658.

  • 12.

    Rylander H. The neurologic examination in companion animals: Part 1: performing the examination. Todays Vet Pract 2013;3(1):1822.

  • 13.

    Mancinelli E. Neurologic examination and diagnostic testing in rabbits, ferrets, and rodents. J Exot Pet Med 2015;24:5264.

  • 14.

    Snow R, Mans C, Rylander H. Neurologic examination in healthy chinchillas (Chinchilla lanigera). Lab Anim 2017;51:629635.

  • 15.

    Warnefors E, Rueløkke ML, Gredal H. Results of a modified neurologic examination in 26 healthy rabbits. J Exot Pet Med 2019;30:5459.

  • 1.

    Doss G, Carpenter J. African pygmy hedgehogs. In: Quesenberry K, Orcutt C, Mans C, et al., eds. Ferrets, rabbits, and rodents: clinical medicine and surgery. 4th ed. St Louis: Elsevier, 2021;401415.

    • Search Google Scholar
    • Export Citation
  • 2.

    Graesser D, Spraker TR, Dressen P, et al. Wobbly hedgehog syndrome in African pygmy hedgehogs (Atelerix spp). J Exot Pet Med 2006;15:5965.

  • 3.

    Díaz-Delgado J, Whitley DB, Storts RW, et al. The pathology of wobbly hedgehog syndrome. Vet Pathol 2018;55:711718.

  • 4.

    Raymond JT, Aguilar R, Dunker F, et al. Intervertebral disc disease in African hedgehogs (Atelerix albiventris): four cases. J Exot Pet Med 2009;18:220223.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Benneter SS, Summers BA, Schulz-Schaeffer WJ, et al. Mixed glioma (oligoastrocytoma) in the brain of an African hedgehog (Atelerix albiventris). J Comp Pathol 2014;151:420424.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6.

    Ogihara K, Suzuki K, Madarame H. Primary histiocytic sarcoma of the brain in an African hedgehog (Atelerix albiventris). J Comp Pathol 2017;157:241245.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Muñoz-Gutiérrez JF, Garner MM, Kiupel M. Primary central nervous system neoplasms in African hedgehogs. J Vet Diagn Invest 2018;30:715720.

  • 8.

    Nakata M, Miwa Y, Itou T, et al. Astrocytoma in an African hedgehog (Atelerix albiventris) suspected wobbly hedgehog syndrome. J Vet Med Sci 2011;73:13331335.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9.

    Gibson CJ, Parry NMA, Jakowski RM, et al. Anaplastic astrocytoma in the spinal cord of an African pygmy hedgehog (Atelerix albiventris). Vet Pathol 2008;45:934938.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10.

    Völker I, Schwarze I, Brezina TE, et al. Oligodendroglioma with neuronal differentiation in an 8-month-old African hedgehog (Atelerix albiventris). Tierarztl Prax Ausg K Kleintiere Heimtiere 2016;44:348354.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11.

    Kondo H, Yamamoto N, Seino N, et al. Cerebral meningioma in an African pygmy hedgehog (Atelerix albiventris). J Exot Pet Med 2018;28:5658.

  • 12.

    Rylander H. The neurologic examination in companion animals: Part 1: performing the examination. Todays Vet Pract 2013;3(1):1822.

  • 13.

    Mancinelli E. Neurologic examination and diagnostic testing in rabbits, ferrets, and rodents. J Exot Pet Med 2015;24:5264.

  • 14.

    Snow R, Mans C, Rylander H. Neurologic examination in healthy chinchillas (Chinchilla lanigera). Lab Anim 2017;51:629635.

  • 15.

    Warnefors E, Rueløkke ML, Gredal H. Results of a modified neurologic examination in 26 healthy rabbits. J Exot Pet Med 2019;30:5459.

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