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Introduction
Current institution
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December 2006 - present
July 2014 - present
July 1998 - June 2001
Publications
Publications (108)
A 2-year-old, male neutered, domestic short-hair cat presented with a 1-month history of non-specific pain, inappetence and paraparesis with a plantigrade gait. MR and CT imaging revealed a left-sided contrast-enhancing extradural mass at the T1-T2 intervertebral disc space, causing severe spinal cord compression. Materialise Mimics 3D medical imag...
An adult spayed female Boxer dog was presented with a one-week history of anorexia, progressive central vestibular signs, and a grade III/VI systolic heart murmur. Magnetic resonance imaging revealed obstructive hydrocephalus at the level of the mesencephalic aqueduct, while echocardiography and elevated troponin levels suggested an infiltrative ca...
Canine protothecosis is a rare disease caused by saprophytic unicellular achlorophyllous aerobic algae that are ubiquitous in the environment. We report a novel case of neurological and cardiological manifestations associated with disseminated protothecosis. An adult spayed female Boxer dog was presented with a 1-week history of anorexia, progressi...
Ketamine is an injectable anesthetic agent with analgesic and antidepressant effects that can prevent maladaptive pain. Ketamine is metabolized by the liver into norketamine, an active metabolite. Prior rodent studies have suggested that norketamine is thought to contribute up to 30% of ketamine's analgesic effect. Ketamine is usually administered...
Objective Surgical stabilization to treat fractures, luxations, and congenital malformations in the thoracic spine can be difficult due to its unique anatomy and surrounding structures. Our objective was to document the morphometrics of the thoracic vertebrae relating to an ideal trajectory for dorsolateral implant placement in a variety of dog siz...
Background
Intervertebral disc herniation (IVDH) is the most common spinal cord disease in dogs. Little information is available regarding the clinical presentation of nerve root signature (NRS) associated with cervical IVDH.
Hypothesis/Objective
To detail the clinical and magnetic resonance imaging (MRI) findings in dogs with NRS associated with...
Malignant gliomas are devastating intracranial tumors with dismal prognoses that impose unique therapeutic challenges. Treatment options include surgical resection, radiation, and chemotherapy, but efficacy is limited and carries associated morbidity. Promise persists for newer modalities, such as immune-based platforms, but obstacles include limit...
Laser interstitial thermal therapy (LITT) is a minimally-invasive technique for the treatment of intracranial tumors that uses a stereotactically-guided laser and real-time magnetic resonance imaging (MRI) to monitor ablation progress. Previous applications of gold nanostars (GNS) in laser ablation of tumors have studied extracranial tumors only an...
Background
Atlanto-axial (AA) subluxation can be a complex syndrome in dogs. Accurate identification and assessment of this condition are key to providing treatment and resolution.
Aim
The purpose of this retrospective study was to describe the magnetic resonance imaging (MRI) characteristics of AA subluxation and associated neurologic deficits....
Purpose:
Laser interstitial thermal therapy (LITT) is an effective minimally-invasive treatment option for intracranial tumors. Our group produced plasmonics-active gold nanostars (GNS) designed to preferentially accumulate within intracranial tumors and amplify the ablative capacity of LITT.
Experimental design:
The impact of GNS on LITT covera...
Background
Pituitary apoplexy refers to hemorrhage or infarction within the pituitary gland resulting in acute neurological abnormalities. This condition is poorly described in dogs.
Objectives
To document presenting complaints, examination findings, endocrinopathies, magnetic resonance imaging (MRI), treatments, and outcomes of dogs with pituitar...
Objective:
To investigate the feasibility and pharmacokinetics of cytarabine delivery as a subcutaneous continuous-rate infusion with the Omnipod system.
Animals:
6 client-owned dogs diagnosed with meningoencephalomyelitis of unknown etiology were enrolled through the North Carolina State University Veterinary Hospital.
Procedures:
Cytarabine...
Background:
Histopathological evaluation of tumors is a subjective process, but studies of inter-pathologist agreement are uncommon in veterinary medicine. The Comparative Brain Tumor Consortium (CBTC) recently published diagnostic criteria for canine gliomas.
Objective:
To assess the degree of inter-pathologist agreement on intracranial canine...
Intracranial extra‐axial histiocytic sarcoma shares common MRI features with meningioma. As histiocytic sarcoma carries a generally worse prognosis than meningioma, the ability to differentiate between these two neoplasms is of clinical value. The aim of this retrospective diagnostic accuracy and observer agreement study was to evaluate the accurac...
Objective
To describe neurologic signs, diagnostic imaging findings, potential treatments, and outcomes in dogs with subaxial cervical articular process subluxation and dislocation, or a “locked facet.”
Study design
Retrospective case series.
Animals
Ten client-owned dogs.
Methods
Dogs with a diagnosis of cervical locked facets were identified t...
Evasion of the immune response is an integral part of the pathogenesis of glioma. In humans, important mechanisms of immune evasion include recruitment of regulatory T cells (Tregs) and polarization of macrophages toward an M2 phenotype. Canine glioma has a robust immune cell infiltrate that has not been extensively characterized. The purpose of th...
Background
Vascular endothelial growth factor (VEGF) is a key molecular driver of angiogenesis and vascular permeability and is expressed by a wide variety of neoplasms. Although blood VEGF concentrations have been quantified in intracranial tumors of dogs, cerebrospinal fluid (CSF) VEGF concentration might be a more sensitive biomarker of disease....
Background:
Cytarabine (CA) is used to treat dogs with meningoencephalitis of unknown etiology (MUE) by subcutaneous or intravenous administration.
Aim:
The objective was to investigate transdermal iontophoresis and rectal administration as alternative routes of CA delivery.
Methods:
Two client-owned dogs with MUE were studied. The ActivaPatch...
Objective:
To evaluate outcomes and prognostic factors after decompressive hemilaminectomy in paraplegic medium to large breed dogs with extensive epidural hemorrhage (DEEH) and thoracolumbar intervertebral disc extrusion (TL-IVDE).
Study design:
Retrospective, cohort, descriptive study.
Animals:
Fifty-nine client-owned dogs.
Methods:
Medica...
Audience response devices are useful tools that can improve student engagement and learning during instructional sessions. The purpose of this article is to describe our experience with a new cloud-based application known as Top Hat, which includes audience response tools in its application suite. The software was used in a multi-specialty, multi-i...
Objective
To assess the accuracy of three‐dimensionally (3‐D) printed drill guides in constraining the trajectory of drill tracts for implants in canine thoracic vertebrae.
Study design
Experimental ex vivo study.
Sample population
Five canine thoracic vertebral column specimens.
Methods
Guides to constrain drill trajectories were designed on th...
Objective
To evaluate the safety and accuracy of a unilateral three‐dimensionally printed animal‐specific drill guide (3DASDG) design for unilateral stabilization in the thoracolumbar vertebral column of dogs compared to a bilateral design.
Study design
Cadaveric study.
Sample population
Fifty‐two corridors in one canine cadaver.
Methods
Two 3DA...
Background
Midazolam delivered by continuous rate infusion (CRI) might be effective in dogs with cluster seizures (CS) or status epilepticus (SE).
Objective
To describe the use and safety of midazolam CRI in dogs with CS or SE.
Animals
One‐hundred six client‐owned dogs presenting to a veterinary teaching hospital with CS or SE.
Methods
Retrospec...
BACKGROUND
Glioblastoma patient survival statistics have remained unchanged for more than three decades. Despite tumor resection and chemoradiotherapy, recurrence is inevitable. Moreover, the invasive behavior of glioblastoma confounds treatment. To improve patient survival statistics, a targeted therapy that can home to distant tumor foci is despe...
Background
Cerebrospinal fluid (CSF) lactate concentrations increase after seizure activity in many human patients independent of the underlying disease process. The effect of seizure activity on CSF lactate concentration in dogs is unknown.
Hypothesis/Objectives
Cerebrospinal fluid lactate concentration is unaffected by seizure activity in dogs a...
Background
Traumatic skull fractures (TSF) are relatively frequent in dogs and cats, but little information is available regarding their clinical and imaging features.
Hypothesis/Objectives
To describe the neurological and computed tomographic (CT) features of a large cohort of dogs and cats with TSF.
Animals
Ninety‐one dogs and 95 cats with TSF...
In this study, we take an important step toward clinical translation by generating the first canine‐induced neural stem cells (iNSCs). We explore key aspects of scale‐up, persistence, and safety of personalized iNSC therapy in autologous canine surgery models. iNSCs are a promising new approach to treat aggressive cancers of the brain, including th...
Diffusion tensor imaging (DTI) quantifies microstructural lesion characteristics but impact of the interval between spinal cord injury (SCI) and examination on imaging characteristics is unclear. Our objective was to investigate the impact of duration of injury on DTI indices in dogs with acute, spontaneous SCI due to thoracolumbar intervertebral d...
Inflammation of the meninges, known as meningitis, may remain confined to the structures, or may also involve the underlying brain and/or spinal cord, termed meningoencephalitis and meningomyelitis respectively. Environmental conditions and exposures play an important role in the transmission of many of the infectious organisms that cause meningoen...
Background
Retrospective research recently identified a possible relationship between duration of surgery and outcome in severely affected dogs treated surgically for acute thoracolumbar intervertebral disk herniation (TL‐IVDH).
Hypothesis
That increased duration of surgery is associated with poorer outcome in dogs with absent pain perception trea...
Background:
Progressive myelomalacia (PMM) is a usually fatal complication of acute intervertebral disc extrusion (IVDE) in dogs but its risk factors are poorly understood. The objective of this retrospective case-control study was to identify risk factors for PMM by comparing dogs with complete sensorimotor loss following IVDE that did and did no...
Background
Cerebrospinal fluid (CSF) lactate is frequently used as a biomarker in humans with inflammatory central nervous system (CNS) disorders including bacterial meningitis and autoimmune disorders such as multiple sclerosis.
Hypothesis
Cerebrospinal fluid lactate concentrations are increased in a subset of dogs with inflammatory CNS disorders...
Background
Presumed autoimmune diseases affecting the central nervous system (CNS) of dogs are common. In people, antibodies against neuronal cell surface antigens that are associated with a wide variety of neurological syndromes have been identified. The presence of cerebrospinal fluid (CSF) autoantibodies that target neuronal cell surface protein...
The purpose of this retrospective study was to compare findings from analyses of paired samples of cerebrospinal fluid (CSF) from cerebellomedullary cistern and lumbar cistern in dogs. Tests of fluid collected from the lumbar cistern were more sensitive for identifying pleocytosis and elevated protein concentrations compared to the fluid from the c...
Background
Steroid‐responsive meningitis‐arteritis (SRMA) is a common inflammatory neurologic disorder of dogs for which certain breeds are predisposed.
Objectives
To determine whether breed differences exist in clinical features, treatment response, and relapse in a population of North American dogs with SRMA, and to evaluate the effect of diseas...
Background
A noninvasive biomarker is needed to predict recovery from severe spinal cord injury (SCI) because of thoracolumbar intervertebral disc extrusion (TL‐IVDE). Proteins released from neural and glial cells can be detected in the blood and show promise as prognostic tools, but their concentration is influenced by time after injury.
Hypothes...
Supporting Information Data S1
Studies have shown that cerebrospinal fluid (CSF) lactate is elevated in human patients with a variety of neurological conditions including inflammatory central nervous system (CNS) disorders, neurodegenerative diseases and after seizure activity. CSF lactate has been shown to be particularly useful in differentiating bacterial from sterile meningi...
Healthy eating is a challenge for most college students, and students in the field of veterinary medicine are no exception. Health experts have recommended that universities emphasize the importance of healthy eating and promote healthy eating habits among students. However, before we can begin offering targeted interventions to promote healthy eat...
Superabsorbent sodium polyacrylate polymeric hydrogels that retain large amounts of liquids are used in disposable diapers, sanitary napkins, and other applications. These polymers are generally considered “nontoxic” with acute oral median lethal doses (LD50) >5 g/kg. Despite this favorable toxicity profile, we identified a novel toxic syndrome in...
Background
Experimental evidence shows benefit of rehabilitation after spinal cord injury (SCI) but there are limited objective data on the effect of rehabilitation on recovery of dogs after surgery for acute thoracolumbar intervertebral disc herniations (TL‐IVDH).
Objective
Compare the effect of basic and intensive post‐operative rehabilitation p...
Background:
Cerebrospinal fluid (CSF) lactate concentration may be a useful diagnostic and prognostic biomarker in dogs. Previous studies have used methods requiring relatively large sample volumes or prolonged storage prior to analysis. An effective method to immediately quantify lactate in smaller CSF volumes would be beneficial.
Objectives:
T...
Spinal cord injury (SCI) due to acute intervertebral disc extrusions (IVDE) is common in dogs and is treated by surgical decompression. Dogs with sensorimotor complete injuries have an incomplete recovery. Pulsed electromagnetic fields (PEMF) reduce postoperative pain through anti-inflammatory effects and there is growing evidence for neuroprotecti...
Supplementary Data 2: Rehabilitation protocol details, and feasibility scoring Basic rehabilitation protocol
Objective:
To characterize ocular and neurologic findings, causes, and treatment outcomes of dogs with optic neuritis.
Procedure:
Medical records from dogs with a diagnosis of optic neuritis at North Carolina State University, College of Veterinary Medicine, Veterinary Hospital between 1983 and 2016 were reviewed.
Results:
Ninety-six cases (20...
Background:
Progressive myelomalacia (PMM) is a catastrophic disease associated with acute intervertebral disc extrusion (IVDE). Published data on the clinical characteristics of this disease are limited.
Objective:
To describe the onset and progression of clinical signs of PMM in a large case cohort.
Animals:
Fifty-one dogs, 18 with histopath...
Background
Outcome of acute experimental spinal cord injury is strongly associated with tissue perfusion and oxygenation. Cardiopulmonary depression could affect outcome in dogs undergoing general anesthesia for surgical treatment of thoracolumbar intervertebral disk extrusion (IVDE).
Hypothesis/Objectives
To evaluate the effects of general anest...
Data S1. Effect of Cranberry Extract on Myelopathy‐Associated Urinary Tract Infections Client Take‐ Home Questionnaire.
Data S3. Investigation of different parameters potentially associated with bacteriuria.
Data S2. Investigation of different parameters potentially associated with urinary tract infections
Fig S1. A receiver operating characteristic (ROC) curve for the ridge regression model in Table 5 of the manuscript. The area under the curve is 0.94.
Data S1. EDA for outcome measures associated with GA.
Table S1. Results of tests of bivariate associations between patient variables and final outcome for all dogs.
Objective:
To compare the Lactate Plus handheld monitor to a reference blood gas analyzer for determining plasma lactate concentrations in canine whole blood.
Design:
Prospective observational study.
Setting:
University teaching hospital.
Animals:
Ninety-four dogs hospitalized or admitted through the emergency service provided 125 blood samp...
Background:
Dogs with spinal cord injury are at increased risk of developing bacteriuria due to increased residual urine volume. Cranberry extract inhibits binding of E. coli to uroepithelial cells, potentially reducing risk of bacteriuria.
Hypothesis:
Cranberry extract reduces risk of bacteriuria in dogs after acute TL-IVDH.
Animals:
Client-o...
A two-year-old female spayed Vizsla presented with progressive ataxia and visual deficits of three weeks’ duration and chronic intermittent large bowel diarrhoea. Protothecal organisms were identified on cytology of rectal scrapings and aspirates of intra-abdominal lymph nodes and Prototheca species were cultured from cerebrospinal fluid.
Treatment...
Background:
Quantification of brain herniation on MRI and its immediate clinical implications are poorly described.
Objectives:
Define the normal position of caudal fossa structures on brain MRIs in dogs and cats utilizing morphometry, compare this to dogs and cats with caudal transtentorial herniation (CTH), foramen magnum herniation (FMH) or b...
Prospective data on the recovery of coordination in dogs suffering acute thoracolumbar intervertebral disc herniations (TL-IVDH) are limited. The purpose of this study was to use treadmill based and open field scores (OFS) to quantify recovery of stepping ability and forelimb, hindlimb coordination in the 6 weeks following surgical decompression of...
Data S1. Instructions on drug reconstitution.
Data S2. Study paperwork provided to each center.
Data S3. Open field gait score modified from Ref.19
Data S5.
P values from comparisons of primary and secondary outcome measures between each group at each time point.
Data S4. Signs of PMM in 11 dogs that were euthanized for this problem.
Data S1. Clinical summary of control population.
Background:
Acute intervertebral disk herniation (IVDH) is a common cause of spinal cord injury in dogs and currently there is no proven medical treatment to counter secondary injury effects. Use of methylprednisolone sodium succinate (MPSS) or polyethylene glycol (PEG) as neuroprotectants is advocated but controversial because neither treatment h...
Reports of histiocytic sarcoma (HS) involving the central nervous system (CNS) are sparse and consist mainly of case reports describing 1-3 animals.
The objective of this study was to report the signalments, clinical signs, clinicopathologic and diagnostic imaging findings, treatment, and outcome of a series of dogs with HS and CNS involvement.
Nin...
Data S1. MRI scoring sheet for CNS histiocytic sarcoma.
Necrotizing meningoencephalitis (NME) affects toy and small breed dogs causing progressive, often fatal, inflammation and necrosis in the brain. Genetic risk loci for NME previously were identified in pug dogs, particularly associated with the dog leukocyte antigen (DLA) class II complex on chromosome 12, but have not been investigated in other sus...
To evaluate and compare perioperative morbidity and mortality in dogs undergoing cervical and thoracolumbar spinal surgery.
Prospective case series.
157 dogs undergoing cervical or thoracolumbar spinal surgery.
Data were collected sequentially on canine cases presented from the Neurology Section of the North Carolina State University Veterinary Tea...
A 7 yr old castrated male Great Dane presented with a history of progressive myelopathy following the intramuscular injection of melarsomine dihydrochloride 8 wk previously. MRI revealed paraspinal and epidural abscesses at the 13th thoracic (T13) and first lumbar (L1) disc space. The dog's condition worsened despite medical management, necessitati...
Stereotactic radiosurgery (SRS) is a procedure that delivers a single large radiation dose to a well-defined target. Here, we describe a frameless SRS technique suitable for intracranial targets in canines. Medical records of dogs diagnosed with a primary intracranial tumour by imaging or histopathology that underwent SRS were retrospectively revie...
The classification of epileptic seizures and epilepsy is a controversial and dynamic topic that has undergone many iterations in human medicine. The International League against Epilepsy is a multinational organization that has formed a number of task forces and subcommittees to study this issue, and has ratified several reports outlining recommend...
Objective:
To identify matrix metalloproteinase (MMP)-2 and -9 in CSF from dogs with intracranial tumors.
Sample:
CSF from 55 dogs with intracranial tumors and 37 control dogs.
Procedures:
Latent and active MMP-2 and -9 were identified by use of gelatin zymography. The presence of MMPs in the CSF of dogs with intracranial tumors was compared w...
Objective:
To isolate and characterize neural stem and progenitor cell populations in the brain of adult dogs.
Animals:
7 healthy adult dogs.
Procedures:
Dogs (age, 10 to 60 months) were euthanized for reasons unrelated to the study. The subventricular zone (SVZ) adjacent to the lateral ventricles and subgranular zone (SGZ) of the hippocampus...
There is little evidence-based information available to guide treatment of refractory epilepsy in dogs. The antiepileptic drug levetiracetam (LEV) is administered to dogs, although its safety and efficacy are unknown.
To evaluate the safety and efficacy of LEV as adjunctive therapy for refractory epilepsy in dogs.
Thirty-four client-owned dogs with...
To determine whether changes in the cutaneous trunci muscle (CTM) reflex are an early predictor of outcome in dogs with severe acute thoracolumbar intervertebral disc extrusion (IVDE).
Multicenter prospective cohort study.
Dogs (n = 36) with acute IVDE causing paraplegia, loss of nociception in pelvic limbs and tail, and an abnormal CTM reflex post...
Meningiomas are the most common intracranial tumors in dogs. A variety of inflammatory cells have been shown to invade these tumors in people, but little is known about interactions between the immune system and naturally occurring brain tumors in dogs. The purpose of this study was to investigate the presence of a variety of immune cell subsets wi...
Musulin, S. E., Mariani, C. L., Papich, M. G. Diazepam pharmacokinetics after nasal drop and atomized nasal administration in dogs. J. vet. Pharmacol. Therap.34, 17–24.
The standard of care for emergency therapy of seizures in veterinary patients is intravenous (i.v.) administration of benzodiazepines, although rectal administration of diazepam is...
Adipose tissue-derived stromal cells (ADSCs) have been identified as a powerful stem cell source for cellular transplantation therapy. The dog is increasingly used as a model of human neurological disease; however, few studies have reported induction of canine ADSCs to neural lineages. We characterized canine ADSCs and investigated whether they cou...
Human diffuse and anaplastic astrocytomas, well-differenti-ated and anaplastic oligodendrogliomas and secondary glio-blastomas frequently (>70%) contain somatic mutations ofthe R132 codon of the cytoplasmic NADPþ-dependent iso-citrate dehydrogenase (IDH1) or the corresponding R172codon in its homolog, IDH2.
Meningiomas are extraaxial tumors that arise from the arachnoid layer of the meninges. Seizures are the most common clinical sign in dogs; cats more often present with mentation changes, vision loss, and gait abnormalities. Meningiomas in both species grow slowly and have an insidious onset of clinical signs. These tumors are more likely to be mali...
Meningiomas are extraaxial tumors that arise from the arachnoid layer of the meninges. Seizures are the most common clinical sign in dogs; cats more often present with mentation changes, vision loss, and gait abnormalities. Meningiomas in both species typically have an insidious onset of clinical signs due to their slow growth. Therapy can target t...
The thymidine analog bromodeoxyuridine (BrdU) is incorporated into newly synthesized DNA and has been shown to increase the susceptibility of incorporating cells to ionizing radiation. However, in the absence of secondary stressors, BrdU is thought to substitute relatively benignly for thymidine and is commonly used to "birth-date" proliferative ce...
Nonspecific stimulation of cells of the immune system may be useful in generating an anti-tumor response for a variety of cancers and may work synergistically with currently available cytotoxic therapies. In this study we examined the response of syngeneic rat gliomas to treatment with several nonspecific stimulators of dendritic cells and macropha...
This article will focus on specifics of performing the neurologic examination and neurodiagnostic testing in reptiles, and how these examinations differ from those performed in more conventional species. Physical examination and history are discussed, as well as invasive and noninvasive testing modalities.
An 11-year-old, spayed female giant schnauzer was presented for evaluation of chronic, progressive tetraparesis. Diagnostic imaging was consistent with intervertebral disk protrusion, and surgical decompression and stabilization were performed. Postoperatively the dog did not improve, and further imaging suggested an intramedullary mass at the leve...
Immunotherapy holds great promise for the treatment of invasive brain tumors, and we are interested specifically in evaluating immune stimulation of microglial cells as one potential strategy. In order to better understand the tumor fighting capabilities of microglial cells, we have compared the responses of syngeneic (Fisher 344) and allogeneic (W...
Microglial cells comprise a network of endogenous immunocompetent cells that pervade the brain and spinal cord. The primary function of this system is to provide continuous surveillance of the parenchyma and protect the central nervous system (CNS) during injury and disease. Here we discuss the involvement of microglia during brain aging and aging-...
To determine clinical signs, results of diagnostic testing, underlying cause, and outcome in cats with seizures.
Retrospective study.
17 cats with seizures.
Only those cats in which an underlying metabolic abnormality causing the seizures had been identified, diagnostic imaging of the brain and CSF analysis had been done, or a necropsy had been per...
Lorazepam is a long-acting benzodiazepine that interacts with a high degree of affinity for the GABA receptor complex. This high affinity binding in turn leads to a prolonged duration of action. There are no published clinical studies documenting its duration of action in dogs or its ability to control seizures. The purpose of this study was to com...
Objective: To report a dog experiencing full recovery after delayed neurological sequelae secondary to smoke inhalation, and to review the related literature.
Case summary: A 1-year-old Australian shepherd dog was found unconscious in a house fire. Although recovery after initial therapy was reportedly complete, the dog's condition acutely worsened...
