124 results on '"Flegel, Thomas"'
Search Results
2. Application accuracy of a frameless optical neuronavigation system as a guide for craniotomies in dogs
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Gutmann, Sarah, Heiderhoff, Miriam, Möbius, Robert, Siegel, Tanja, and Flegel, Thomas
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- 2023
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3. Interleukin-31 in serum and cerebrospinal fluid of dogs with syringomyelia
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Lemke, Laura, Carlson, Regina, Flegel, Thomas, Volk, Andrea, Volk, Holger Andreas, Tipold, Andrea, and Nessler, Jasmin Nicole
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- 2023
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4. Mystery of fatal ‘staggering disease’ unravelled: novel rustrela virus causes severe meningoencephalomyelitis in domestic cats
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Matiasek, Kaspar, Pfaff, Florian, Weissenböck, Herbert, Wylezich, Claudia, Kolodziejek, Jolanta, Tengstrand, Sofia, Ecke, Frauke, Nippert, Sina, Starcky, Philip, Litz, Benedikt, Nessler, Jasmin, Wohlsein, Peter, Baumbach, Christina, Mundhenk, Lars, Aebischer, Andrea, Reiche, Sven, Weidinger, Pia, Olofsson, Karin M., Rohdin, Cecilia, Weissenbacher-Lang, Christiane, Matt, Julia, Rosati, Marco, Flegel, Thomas, Hörnfeldt, Birger, Höper, Dirk, Ulrich, Rainer G., Nowotny, Norbert, Beer, Martin, Ley, Cecilia, and Rubbenstroth, Dennis
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- 2023
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5. Comparative Assessment of Computed Tomography and Magnetic Resonance Imaging of Spider Morph and Wild Type Ball Pythons (Python regius) for Evaluation of the Morphological Correlate of Wobble Syndrome
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Schrenk, Fabian, Starck, J. Matthias, Flegel, Thomas, Kiefer, Ingmar, Tebrün, Wiebke, and Pees, Michael
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- 2022
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6. Retrospective study of partial lateral corpectomy to treat thoracic and lumbar intervertebral disc herniation in 12 cats.
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Tyroller, Florian, Wennemuth, Jan, Forterre, Franck, Flegel, Thomas, Markert, Carina, Kiefer, Ingmar, and Wunderlin, Nadja
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Objectives: The aim of this study was to describe the safety and effectiveness of thoracic or lumbar partial lateral corpectomy (PLC) in cats with spinal cord compression due to intervertebral disc herniation (IVH). Methods: A retrospective study was conducted of 12 client-owned cats from two academic and one private referral veterinary centres. Cross-sectional imaging was available in 12 cats for evaluation of disc herniation. Nine cats had postoperative imaging for evaluation of slot creation and decompression. Neurological examination was performed for assessment of pre- and postoperative status. Complications were evaluated. Results: Seven cats had severe (>50%), four moderate (>20 to <50%) and one mild (<20%) spinal cord compression on cross-sectional imaging. IVH occurred at Th12–13 in five cases, at L1–2 in two cases and at Th3–4, Th13–L1, L4–5 and L5–6 in one case each. After PLC, two cats had insufficient decompression (>20% remaining spinal cord compression), five had good decompression (<20% remaining spinal cord compression) and complete decompression (normal shape of the spinal cord) was achieved in two cats. Outcomes included five cats with an excellent result, three with significant improvement, one with mild improvement and three cats that died intra- or postoperatively due to extensive intraoperative bleeding. One cat was euthanased as a result of neurological deterioration 5 months postoperatively. The median follow-up period was 13.2 months (range 0 days to 84 months). Conclusions and relevance: PLC in cats offers a potential treatment option for IVH to decompress the spinal cord. Fatal haemorrhage associated with this surgery is a significant risk, as occurred in 25% of the cats in this study. Surgeons should especially be aware of the potential for intraoperative haemorrhage and the need for sufficient slot creation to achieve sufficient spinal cord decompression and avoid complications. [ABSTRACT FROM AUTHOR]
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- 2024
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7. Machine learning algorithms predict canine structural epilepsy with high accuracy.
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Flegel, Thomas, Neumann, Anja, Holst, Anna-Lena, Kretzschmann, Olivia, Loderstedt, Shenja, Tästensen, Carina, Gutmann, Sarah, Dietzel, Josephine, Becker, Lisa Franziska, Kalliwoda, Theresa, Weiß, Vivian, Kowarik, Madlene, Böttcher, Irene Christine, and Martin, Christian
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MACHINE learning ,RANDOM forest algorithms ,SCIENTIFIC method ,BAYESIAN analysis ,FEATURE selection ,EPILEPSY - Abstract
Introduction: Clinical reasoning in veterinary medicine is often based on clinicians' personal experience in combination with information derived from publications describing cohorts of patients. Studies on the use of scientific methods for patient individual decision making are largely lacking. This applies to the prediction of the individual underlying pathology in seizuring dogs as well. The aim of this study was to apply machine learning to the prediction of the risk of structural epilepsy in dogs with seizures. Materials and methods: Dogs with a history of seizures were retrospectively as well as prospectively included. Data about clinical history, neurological examination, diagnostic tests performed as well as the final diagnosis were collected. For data analysis, the Bayesian Network and Random Forest algorithms were used. A total of 33 features for Random Forest and 17 for Bayesian Network were available for analysis. The following four feature selection methods were applied to select features for further analysis: Permutation Importance, Forward Selection, Random Selection and Expert Opinion. The two algorithms Bayesian Network and Random Forest were trained to predict structural epilepsy using the selected features. Results: A total of 328 dogs of 119 different breeds were identified retrospectively between January 2017 and June 2021, of which 33.2% were diagnosed with structural epilepsy. An overall of 89,848 models were trained. The Bayesian Network in combination with the Random feature selection performed best. It was able to predict structural epilepsy with an accuracy of 0.969 (sensitivity: 0.857, specificity: 1.000) among all dogs with seizures using the following features: age at first seizure, cluster seizures, seizure in last 24 h, seizure in last 6 month, and seizure in last year. Conclusion: Machine learning algorithms such as Bayesian Networks and Random Forests identify dogs with structural epilepsy with a high sensitivity and specificity. This information could provide some guidance to clinicians and pet owners in their clinical decision-making process. [ABSTRACT FROM AUTHOR]
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- 2024
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8. Usefulness of neurological assessment scales in prognosis of meningoencephalitis of unknown origin in Yorkshire Terriers
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Brewińska, Laura, primary, Banasik, Aleksandra, additional, Czopowicz, Michał, additional, Płonek, Marta, additional, Giza, Elżbieta, additional, Czerwik, Adriana, additional, Olszewska, Agnieszka, additional, Flegel, Thomas, additional, and Wrzosek, Marcin, additional
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- 2024
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9. A concept for a 3D-printed patient-specific stereotaxy platform for brain biopsy -a canine cadaver study-
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Müller, Marcel, Winkler, Dirk, Möbius, Robert, Sauerstein, Tobias, Scholz, Sebastian, Gutmann, Sarah, Flegel, Thomas, Meixensberger, Jürgen, Drossel, Welf-Guntram, and Grunert, Ronny
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- 2019
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10. A stereotaxic breed-averaged, symmetric T2w canine brain atlas including detailed morphological and volumetrical data sets
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Nitzsche, Björn, Boltze, Johannes, Ludewig, Eberhard, Flegel, Thomas, Schmidt, Martin J., Seeger, Johannes, Barthel, Henryk, Brooks, Olivia W., Gounis, Matthew J., Stoffel, Michael H., and Schulze, Sabine
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- 2019
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11. Neutrophil extracellular traps in CSF and serum of dogs with steroid-responsive meningitis-arteritis
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Wohlsein, Jan Christian, primary, Meurer, Marita, additional, Mörgelin, Matthias, additional, Nessler, Jasmin Nicole, additional, Flegel, Thomas, additional, Schenk, Henning Christian, additional, Jurina, Konrad, additional, Rentmeister, Kai, additional, Fischer, Andrea, additional, Gödde, Thomas, additional, Baumgärtner, Wolfgang, additional, von Köckritz-Blickwede, Maren, additional, and Tipold, Andrea, additional
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- 2024
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12. Clinical Signs in 166 Beagles with Different Genotypes of Lafora
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Flegel, Thomas, primary, Dirauf, Christine, additional, Kehl, Alexandra, additional, Dietzel, Josephine, additional, Holtdirk, Annette, additional, Langbein-Detsch, Ines, additional, and Müller, Elisabeth, additional
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- 2024
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13. Client's understanding of instructions for small animals in a veterinary neurological referral center.
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Flegel, Thomas, Dobersek, Katharina, Bayer, Sabrina, Becker, Lisa F., Loderstedt, Shenja, Böttcher, Irene C., Dietzel, Josephine, Tästensen, Carina, Kalliwoda, Theresa, Harkenthal, Marie A., Kühnapfel, Andreas, Weiß, Vivian, and Gutmann, Sarah
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DRUG side effects , *CAT owners , *EDUCATIONAL attainment , *NEUROLOGICAL disorders - Abstract
Background: It is not known how much information clients retrieve from discharge instructions. Objective: To investigate client's understanding of discharge instructions and influencing factors. Animals: Dogs and cats being hospitalized for neurological diseases. Methods: Clients were presented questionnaires regarding their pet's disease, diagnostics, treatments, prognosis and discharge instructions at time of discharge and 2 weeks later. The same questions were answered by discharging veterinarians at time of discharge. Clients answered additional questions regarding the subjective feelings during discharge conversation. Data collected included: data describing discharging veterinarian (age, gender, years of clinical experience, specialist status), data describing the client (age, gender, educational status). Raw percentage of agreement (RPA) between answers of clinicians and clients as well as factors potentially influencing the RPA were evaluated. Results: Of 230 clients being approached 151 (65.7%) and 70 (30.4%) clients responded to the first and second questionnaire, respectively (130 dog and 30 cat owners). The general RPA between clinician's and client's responses over all questions together was 68.9% and 66.8% at the 2 time points. Questions regarding adverse effects of medication (29.0%), residual clinical signs (35.8%), and confinement instructions (36.8%) had the lowest RPAs at the first time point. The age of clients (P =.008) negatively influenced RPAs, with clients older than 50 years having lower RPA. Conclusions and Clinical Importance: Clients can only partially reproduce information provided at discharge. Only clients' increasing age influenced recall of information. Instructions deemed to be important should be specifically stressed during discharge. [ABSTRACT FROM AUTHOR]
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- 2024
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14. Prevalence of nonconvulsive seizures and nonconvulsive status epilepticus in dogs and cats with a history of cluster seizures: A retrospective study
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Tästensen, Carina, primary, Gutmann, Sarah, additional, Loderstedt, Shenja, additional, Flegel, Thomas, additional, Demeny, Helga, additional, and Baum, Petra, additional
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- 2023
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15. Generalized myoclonic epilepsy with photosensitivity in juvenile dogs caused by a defective DIRAS family GTPase 1
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Wielaender, Franziska, Sarviaho, Riika, James, Fiona, Hytönen, Marjo K., Cortez, Miguel A., Kluger, Gerhard, Koskinen, Lotta L. E., Arumilli, Meharji, Kornberg, Marion, Bathen-Noethen, Andrea, Tipold, Andrea, Rentmeister, Kai, Bhatti, Sofie F. M., Hülsmeyer, Velia, Boettcher, Irene C., Tästensen, Carina, Flegel, Thomas, Dietschi, Elisabeth, Leeb, Tosso, Matiasek, Kaspar, Fischer, Andrea, and Lohi, Hannes
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- 2017
16. ChatGPT and scientific papers in veterinary neurology; is the genie out of the bottle?
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Abani, Samira, primary, Volk, Holger Andreas, additional, De Decker, Steven, additional, Fenn, Joe, additional, Rusbridge, Clare, additional, Charalambous, Marios, additional, Goncalves, Rita, additional, Gutierrez-Quintana, Rodrigo, additional, Loderstedt, Shenja, additional, Flegel, Thomas, additional, Ros, Carlos, additional, Klopmann, Thilo von, additional, Schenk, Henning Christian, additional, Kornberg, Marion, additional, Meyerhoff, Nina, additional, Tipold, Andrea, additional, and Nessler, Jasmin Nicole, additional
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- 2023
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17. Relationship between magnetic resonance imaging findings and histological grade in spinal peripheral nerve sheath tumors in dogs
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Morabito, Simona, primary, Specchi, Swan, additional, Di Donato, Pamela, additional, Pollard, Danica, additional, Dennis, Ruth, additional, De Risio, Luisa, additional, Bacon, Nicholas J., additional, Potamopoulou, Maria, additional, Rupp, Stefan, additional, Corlazzoli, Daniele, additional, Ribeiro, João, additional, Cozzi, Francesca, additional, Jurina, Konrad, additional, Cappello, Rodolfo, additional, Mercuriali, Edy, additional, Beckmann, Katrin, additional, Flegel, Thomas, additional, Menchetti, Marika, additional, König, Florian, additional, Matiasek, Kaspar, additional, and Rosati, Marco, additional
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- 2023
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18. Nodo-paranodopathy, internodopathy and cleftopathy: Target-based reclassification of Guillain–Barré-like immune-mediated polyradiculoneuropathies in dogs and cats
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Gross, Simone, Fischer, Andrea, Rosati, Marco, Matiasek, Lara, Corlazzoli, Daniele, Cappello, Rodolfo, Porcarelli, Laura, Harcourt-Brown, Tom, Jurina, Konrad, Garosi, Laurent, Flegel, Thomas, Quitt, Pia, Molin, Jessica, Huelsmeyer, Velia-Isabel, Schenk, Henning, Gandini, Gualtiero, Gnirs, Kirsten, Blot, Stéphane, Jeandel, Aurélien, Baroni, Massimo, Loderstedt, Shenja, Abbiati, Gianluca, Leithaeuser, Carola, Schulze, Sabine, Kornberg, Marion, Lowrie, Mark, and Matiasek, Kaspar
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- 2016
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19. Relationship between magnetic resonance imaging findings and histological grade in spinal peripheral nerve sheath tumors in dogs
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Morabito, Simona; https://orcid.org/0000-0001-6148-4000, Specchi, Swan, Di Donato, Pamela, Pollard, Danica, Dennis, Ruth, De Risio, Luisa; https://orcid.org/0000-0001-9005-4165, Bacon, Nicholas J, Potamopoulou, Maria, Rupp, Stefan, Corlazzoli, Daniele, Ribeiro, João; https://orcid.org/0000-0003-2472-2895, Cozzi, Francesca, Jurina, Konrad, Cappello, Rodolfo, Mercuriali, Edy, Beckmann, Katrin; https://orcid.org/0000-0002-1823-7845, Flegel, Thomas; https://orcid.org/0000-0001-9892-0224, Menchetti, Marika, König, Florian, Matiasek, Kaspar, Rosati, Marco; https://orcid.org/0000-0002-1485-1610, Morabito, Simona; https://orcid.org/0000-0001-6148-4000, Specchi, Swan, Di Donato, Pamela, Pollard, Danica, Dennis, Ruth, De Risio, Luisa; https://orcid.org/0000-0001-9005-4165, Bacon, Nicholas J, Potamopoulou, Maria, Rupp, Stefan, Corlazzoli, Daniele, Ribeiro, João; https://orcid.org/0000-0003-2472-2895, Cozzi, Francesca, Jurina, Konrad, Cappello, Rodolfo, Mercuriali, Edy, Beckmann, Katrin; https://orcid.org/0000-0002-1823-7845, Flegel, Thomas; https://orcid.org/0000-0001-9892-0224, Menchetti, Marika, König, Florian, Matiasek, Kaspar, and Rosati, Marco; https://orcid.org/0000-0002-1485-1610
- Abstract
BackgroundPeripheral nerve sheath tumors (PNSTs) are a group of neoplasms originating from Schwann cells or pluripotent cell of the neural crest. Therapeutic options and prognosis are influenced by their degree of malignancy and location.Hypothesis/ObjectivesIdentify magnetic resonance imaging (MRI) features predictive of PNST histologic grade.AnimalsForty‐four dogs with histopathological diagnosis of spinal PNSTs and previous MRI investigation.MethodsA multicenter retrospective study including cases with (a) histopathologic diagnosis of PNST and (b) MRI studies available for review. Histologic slides were reviewed and graded by a board‐certified pathologist according to a modified French system (FNCLCC) for grading soft tissue sarcomas. The MRI studies were reviewed by 2 board‐certified radiologists blinded to the grade of the tumor and the final decision on the imaging characteristics was reached by consensus. Relationships between tumor grade and histological and MRI findings were assessed using statistical analysis.ResultsForty‐four cases met inclusion criteria; 16 patients were PNSTs Grade 1 (low‐grade), 19 were PNSTs Grade 2 (medium‐grade), and 9 were PNSTs Grade 3 (high‐grade). Large volume (P = .03) and severe peripheral contrast enhancement (P = .04) were significantly associated with high tumor grade. Degree of muscle atrophy, heterogeneous signal and tumor growth into the vertebral canal were not associated with grade.Conclusions and Clinical ImportanceGrade of malignancy was difficult to identify based on diagnostic imaging alone. However, some MRI features were predictive of high‐grade PNSTs including tumor size and peripheral contrast enhancement.
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- 2023
20. Prevalence of nonconvulsive seizures and nonconvulsive status epilepticus in dogs and cats with a history of cluster seizures: A retrospective study.
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Tästensen, Carina, Gutmann, Sarah, Loderstedt, Shenja, Flegel, Thomas, Demeny, Helga, and Baum, Petra
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STATUS epilepticus ,DOGS ,CAT diseases ,SEIZURES (Medicine) ,VETERINARY medicine ,CATS ,EPILEPSY - Abstract
Background: Nonconvulsive seizures (NCS) and nonconvulsive status epilepticus (NCSE) are frequently observed in human patients. Diagnosis of NCS and NCSE only can be achieved by the use of electroencephalography (EEG). Electroencephalographic monitoring is rare in veterinary medicine and consequently there is limited data on frequency of NCS and NCSE. Objectives: Determine the prevalence of NCS and NCSE in dogs and cats with a history of cluster seizures. Animals: Twenty‐six dogs and 12 cats. Methods: Retrospective study. Medical records of dogs and cats with cluster seizures were reviewed. Electroencephalography was performed in order to identify electrographic seizure activity after the apparent cessation of convulsive seizure activity. Results: Nonconvulsive seizures were detected in 9 dogs and 2 cats out of the 38 patients (29%). Nonconvulsive status epilepticus was detected in 4 dogs and 2 cats (16%). Five patients had both NCS and NCSE. A decreased level of consciousness was evident in 6/11 patients with NCS, 3/6 also had NCSE. Mortality rate for patients with NCS (73%) and NCSE (67%) was much higher than that for patients with no seizure activity on EEG (27%). Conclusion and Clinical Importance: Prevalence of NCS and NCSE is high in dogs and cats with a history of cluster seizures. Nonconvulsive seizures and NCSE are difficult to detect clinically and are associated with higher in hospital mortality rates. Results indicate that prompt EEG monitoring should be performed in dogs and cats with cluster seizures. [ABSTRACT FROM AUTHOR]
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- 2024
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21. A loss-of-function variant in canine GLRA1 associates with a neurological disorder resembling human hyperekplexia
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Heinonen, Tiina J, primary, Flegel, Thomas, additional, Müller, Hanna, additional, Kehl, Alexandra, additional, Hundi, Sruthi, additional, Matiasek, Kaspar, additional, Lohi, Hannes, additional, and Hytönen, Marjo, additional
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- 2023
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22. ACVIMconsensus statement on diagnosis and management of acute canine thoracolumbar intervertebral disc extrusion
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Olby, Natasha J., primary, Moore, Sarah A., additional, Brisson, Brigitte, additional, Fenn, Joe, additional, Flegel, Thomas, additional, Kortz, Gregg, additional, Lewis, Melissa, additional, and Tipold, Andrea, additional
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- 2022
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23. Case Report: Clinical Use of a Patient-Individual Magnetic Resonance Imaging-Based Stereotactic Navigation Device for Brain Biopsies in Three Dogs
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Gutmann, Sarah, primary, Flegel, Thomas, additional, Müller, Marcel, additional, Möbius, Robert, additional, Matiasek, Kaspar, additional, König, Florian, additional, Winkler, Dirk, additional, and Grunert, Ronny, additional
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- 2022
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24. Biopsy Characteristics, Subtypes, and Prognostic Features in 107 Cases of Feline Presumed Immune-Mediated Polyneuropathy
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Kolb, Ninja, primary, Matiasek, Kaspar, additional, van Renen, Jana, additional, Fischer, Andrea, additional, Zablotski, Yury, additional, Wieländer, Franziska, additional, Nessler, Jasmin, additional, Tipold, Andrea, additional, Cappello, Rodolfo, additional, Flegel, Thomas, additional, Loderstedt, Shenja, additional, Dietzel, Josephine, additional, Gnirs, Kirsten, additional, Rentmeister, Kai, additional, Rupp, Stephan, additional, von Klopmann, Thilo, additional, Steffen, Frank, additional, Jurina, Konrad, additional, Del Vecchio, Omar V., additional, Deutschland, Martin, additional, König, Florian, additional, Gandini, Gualtiero, additional, Harcourt-Brown, Tom, additional, Kornberg, Marion, additional, Bianchi, Ezio, additional, Gagliardo, Teresa, additional, Menchetti, Marika, additional, Schenk, Henning, additional, Tabanez, Joana, additional, and Rosati, Marco, additional
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- 2022
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25. Mystery of fatal ‘Staggering disease’ unravelled: Novel rustrela virus causes severe encephalomyelitis in domestic cats
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Matiasek, Kaspar, primary, Pfaff, Florian, additional, Weissenböck, Herbert, additional, Wylezich, Claudia, additional, Kolodziejek, Jolanta, additional, Tengstrand, Sofia, additional, Ecke, Frauke, additional, Nippert, Sina, additional, Starcky, Philip, additional, Litz, Benedikt, additional, Nessler, Jasmin, additional, Wohlsein, Peter, additional, Baumbach, Christina, additional, Mundhenk, Lars, additional, Aebischer, Andrea, additional, Reiche, Sven, additional, Weidinger, Pia, additional, Olofsson, Karin M., additional, Rohdin, Cecilia, additional, Weissenbacher-Lang, Christiane, additional, Matt, Julia, additional, Rosati, Marco, additional, Flegel, Thomas, additional, Hörnfeldt, Birger, additional, Höper, Dirk, additional, Ulrich, Rainer G., additional, Nowotny, Norbert, additional, Beer, Martin, additional, Ley, Cecilia, additional, and Rubbenstroth, Dennis, additional
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- 2022
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26. Clinical Course and Diagnostic Findings of Biopsy Controlled Presumed Immune-Mediated Polyneuropathy in 70 European Cats
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van Renen, Jana, primary, Fischer, Andrea, additional, Kolb, Ninja, additional, Wielaender, Franziska, additional, Zablotski, Yury, additional, Nessler, Jasmin, additional, Tipold, Andrea, additional, Cappello, Rodolfo, additional, Flegel, Thomas, additional, Loderstedt, Shenja, additional, Gnirs, Kirsten, additional, Rentmeister, Kai, additional, Rupp, Stephan, additional, von Klopmann, Thilo, additional, Steffen, Frank, additional, Jurina, Konrad, additional, Del Vecchio, Omar V., additional, Deutschland, Martin, additional, König, Florian, additional, Gandini, Gualtiero, additional, Harcourt-Brown, Tom, additional, Kornberg, Marion, additional, Bianchi, Ezio, additional, Gagliardo, Teresa, additional, Menchetti, Marika, additional, Schenk, Henning, additional, Tabanez, Joana, additional, Matiasek, Kaspar, additional, and Rosati, Marco, additional
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- 2022
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27. Accuracy of a magnetic resonance imaging‐based 3D printed stereotactic brain biopsy device in dogs
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Gutmann, Sarah, Winkler, Dirk, Müller, Marcel, Möbius, Robert, Fischer, Jean-Pierre, Böttcher, Peter, Kiefer, Ingmar, Grunert, Ronny, and Flegel, Thomas
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brain biopsy ,lcsh:Veterinary medicine ,canine ,personalized ,lcsh:SF600-1100 ,3D printing ,neurosurgery ,600 Technik, Medizin, angewandte Wissenschaften::630 Landwirtschaft::632 Schäden, Krankheiten, Schädlinge an Pflanzen ,MRI - Abstract
Background: Brain biopsy of intracranial lesions is often necessary to determine specific therapy. The cost of the currently used stereotactic rigid frame and optical tracking systems for brain biopsy in dogs is often prohibitive or accuracy is not sufficient for all types of lesion. Objectives: To evaluate the application accuracy of an inexpensive magnetic resonance imaging‐based personalized, 3D printed brain biopsy device. Animals: Twenty‐two dog heads from cadavers were separated into 2 groups according to body weight (20 kg). Methods: Experimental study. Two target points in each cadaver head were used (target point 1: caudate nucleus, target point 2: piriform lobe). Comparison between groups was performed using the independent Student's t test or the nonparametric Mann‐Whitney U Test. Results: The total median target point deviation was 0.83 mm (range 0.09‐2.76 mm). The separate median target point deviations for target points 1 and 2 in all dogs were 0.57 mm (range: 0.09‐1.25 mm) and 0.85 mm (range: 0.14‐2.76 mm), respectively. Conclusion and Clinical Importance: This magnetic resonance imaging‐based 3D printed stereotactic brain biopsy device achieved an application accuracy that was better than the accuracy of most brain biopsy systems that are currently used in veterinary medicine. The device can be applied to every size and shape of skull and allows precise positioning of brain biopsy needles in dogs.
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- 2020
28. Case Report: Clinical Use of a Patient-Individual Magnetic Resonance Imaging-Based Stereotactic Navigation Device for Brain Biopsies in Three Dogs
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Gutmann, Sarah, Flegel, Thomas, Müller, Marcel, Möbius, Robert, Matiasek, Kaspar, König, Florian, Winkler, Dirk, Grunert, Ronny, Gutmann, Sarah, Flegel, Thomas, Müller, Marcel, Möbius, Robert, Matiasek, Kaspar, König, Florian, Winkler, Dirk, and Grunert, Ronny
- Abstract
Three-dimensional (3D) printing techniques for patient-individual medicine has found its way into veterinary neurosurgery. Because of the high accuracy of 3D printed specific neurosurgical navigation devices, it seems to be a safe and reliable option to use patient- individual constructions for sampling brain tissue. Due to the complexity and vulnerability of the brain a particularly precise and safe procedure is required. In a recent cadaver study a better accuracy for the 3D printed MRI-based patient individual stereotactic brain biopsy device for dogs is determined compared to the accuracies of other biopsy systems which are currently used in veterinary medicine. This case report describes the clinical use of this 3D printed MRI-based patient individual brain biopsy device for brain sampling in three dogs. The system was characterized by a simple handling. Furthermore, it was an effective and reliable tool to gain diagnostic brain biopsy samples in dogs with no significant side effects.
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- 2022
29. Clinical Course and Diagnostic Findings of Biopsy Controlled Presumed Immune-Mediated Polyneuropathy in 70 European Cats
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van Renen, Jana, Fischer, Andrea, Kolb, Ninja, Wielaender, Franziska, Zablotski, Yury, Nessler, Jasmin, Tipold, Andrea, Cappello, Rodolfo, Flegel, Thomas, Loderstedt, Shenja, Gnirs, Kirsten, Rentmeister, Kai, Rupp, Stephan, von Klopmann, Thilo, Steffen, Frank, Jurina, Konrad, Del Vecchio, Omar V, Deutschland, Martin, König, Florian, Gandini, Gualtiero, Harcourt-Brown, Tom, Kornberg, Marion, Bianchi, Ezio, Gagliardo, Teresa, Menchetti, Marika, Schenk, Henning, Tabanez, Joana, Matiasek, Kaspar, Rosati, Marco, van Renen, Jana, Fischer, Andrea, Kolb, Ninja, Wielaender, Franziska, Zablotski, Yury, Nessler, Jasmin, Tipold, Andrea, Cappello, Rodolfo, Flegel, Thomas, Loderstedt, Shenja, Gnirs, Kirsten, Rentmeister, Kai, Rupp, Stephan, von Klopmann, Thilo, Steffen, Frank, Jurina, Konrad, Del Vecchio, Omar V, Deutschland, Martin, König, Florian, Gandini, Gualtiero, Harcourt-Brown, Tom, Kornberg, Marion, Bianchi, Ezio, Gagliardo, Teresa, Menchetti, Marika, Schenk, Henning, Tabanez, Joana, Matiasek, Kaspar, and Rosati, Marco
- Abstract
There is a paucity of information on the clinical course and outcome of young cats with polyneuropathy. The aim of the study was to describe the clinical features, diagnostic investigations, and outcome of a large cohort of cats with inflammatory polyneuropathy from several European countries. Seventy cats with inflammatory infiltrates in intramuscular nerves and/or peripheral nerve biopsies were retrospectively included. Information from medical records and follow up were acquired via questionnaires filled by veterinary neurologists who had submitted muscle and nerve biopsies (2011–2019). Median age at onset was 10 months (range: 4–120 months). The most common breed was British short hair (25.7%), followed by Domestic short hair (24.3%), Bengal cat (11.4%), Maine Coon (8.6%) and Persian cat (5.7%), and 14 other breeds. Male cats were predominantly affected (64.3%). Clinical signs were weakness (98.6%) and tetraparesis (75.7%) in association with decreased withdrawal reflexes (83.6%) and, less commonly, cranial nerve signs (17.1%), spinal pain/hyperesthesia (12.9%), and micturition/defecation problems (14.3%). Onset was sudden (30.1%) or insidious (69.1%), and an initial progressive phase was reported in 74.3%. Characteristic findings on electrodiagnostic examination were presence of generalized spontaneous electric muscle activity (89.6%), decreased motor nerve conduction velocity (52.3%), abnormal F-wave studies (72.4%), pattern of temporal dispersion (26.1%) and unremarkable sensory tests. The clinical course was mainly described as remittent (49.2%) or remittent-relapsing (34.9%), while stagnation, progressive course or waxing and waning were less frequently reported. Relapses were common and occurred in 35.7% of the cats' population. An overall favorable outcome was reported in 79.4% of patients. In conclusion, young age at the time of diagnosis and sudden onset of clinical signs were significantly associated with recovery (p < 0.05). Clinical and electrodia
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- 2022
30. Biopsy Characteristics, Subtypes, and Prognostic Features in 107 Cases of Feline Presumed Immune-Mediated Polyneuropathy
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Kolb, Ninja, Matiasek, Kaspar, van Renen, Jana, Fischer, Andrea, Zablotski, Yury, Wieländer, Franziska, Nessler, Jasmin, Tipold, Andrea, Cappello, Rodolfo, Flegel, Thomas, Loderstedt, Shenja, Dietzel, Josephine, Gnirs, Kirsten, Rentmeister, Kai, Rupp, Stephan, von Klopmann, Thilo, Steffen, Frank, Jurina, Konrad, Del Vecchio, Omar V, Deutschland, Martin, König, Florian, Gandini, Gualtiero, Harcourt-Brown, Tom, Kornberg, Marion, Bianchi, Ezio, Gagliardo, Teresa, Menchetti, Marika, Schenk, Henning, Tabanez, Joana, Rosati, Marco, Kolb, Ninja, Matiasek, Kaspar, van Renen, Jana, Fischer, Andrea, Zablotski, Yury, Wieländer, Franziska, Nessler, Jasmin, Tipold, Andrea, Cappello, Rodolfo, Flegel, Thomas, Loderstedt, Shenja, Dietzel, Josephine, Gnirs, Kirsten, Rentmeister, Kai, Rupp, Stephan, von Klopmann, Thilo, Steffen, Frank, Jurina, Konrad, Del Vecchio, Omar V, Deutschland, Martin, König, Florian, Gandini, Gualtiero, Harcourt-Brown, Tom, Kornberg, Marion, Bianchi, Ezio, Gagliardo, Teresa, Menchetti, Marika, Schenk, Henning, Tabanez, Joana, and Rosati, Marco
- Abstract
Inflammatory polyradiculoneuropathy (IMPN) is one of the causes of sudden onset of neuromuscular signs such as para-/tetraparesis in young cats. Even though most cases have a favorable outcome, persistent deficits, relapses, and progressive courses are occasionally seen. As clinical presentation does not always appear to predict outcome and risk of recurrence, this study was initiated to screen for prognostic biopsy findings in a large cohort of histologically confirmed IMPN cases with clinical follow-up. In total, nerve and muscle specimens of 107 cats with biopsy diagnosis of presumed autoreactive inflammatory polyneuropathy and 22 control cases were reviewed by two blinded raters for a set of 36 histological parameters. To identify patterns and subtypes of IMPN, hierarchical k-means clustering of 33 histologic variables was performed. Then, the impact of histological parameters on IMPN outcome was evaluated via an univariate analysis to identify variables for the final multivariate model. The data on immediate outcome and follow-up were collected from submitting neurologists using a purpose-designed questionnaire. Hierarchical k-means clustering sorted the tissues into 4 main categories: cluster 1 (44/129) represents a purely inflammatory IMPN picture, whereas cluster 2 (47/129) was accompanied by demyelinating features and cluster 3 (16/129) by Wallerian degeneration. Cluster 4 (22/129) reflects normal tissues from non-neuropathic control cats. Returned questionnaires provided detailed information on outcome in 63 animals. They were categorized into recovered and non-recovered. Thereby, fiber-invasive infiltrates by mononuclear cells and mild fiber loss in intramuscular nerve branches correlated with higher probabilities of recovery. Remyelination in semithin sections, on the other hand, is correlated with a less favorable outcome. Animals grouping in cluster 1 had a tendency to a higher probability of recovery compared to other clusters. In conclusion, diagnosi
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- 2022
31. Comparative assessment of computed tomography and magnetic resonance imaging of the spider morph of Python regius and wild type Python regius to evaluate the morphological correlate of the wobble syndrome.
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Tebruen, Wiebke, primary, Schrenk, Fabian, additional, Flegel, Thomas, additional, Starck, Matthias J., additional, and Pees, Michael, additional
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- 2022
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32. A retrospective case series of clinical signs in 28 Beagles with Lafora disease
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Flegel, Thomas, primary, Kornberg, Marion, additional, Mühlhause, Franziska, additional, Neumann, Sophie, additional, Fischer, Andrea, additional, Wielaender, Franziska, additional, König, Florian, additional, Pakozdy, Akos, additional, Quitt, Pia R., additional, Trapp, Andrea M., additional, Jurina, Konrad, additional, Steffen, Frank, additional, Rentmeister, Kai W., additional, Flieshardt, Cornelia, additional, and Dietzel, Josephine, additional
- Published
- 2021
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33. ACVIM consensus statement on diagnosis and management of acute canine thoracolumbar intervertebral disc extrusion.
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Olby, Natasha J., Moore, Sarah A., Brisson, Brigitte, Fenn, Joe, Flegel, Thomas, Kortz, Gregg, Lewis, Melissa, and Tipold, Andrea
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SURGICAL decompression ,POSTOPERATIVE care ,CONSENSUS (Social sciences) ,COST effectiveness ,DIAGNOSIS - Abstract
Background: Thoracolumbar intervertebral disc extrusion (TL‐IVDE) is the most common cause of acute paraparesis and paraplegia in dogs; however, guidelines on management of the condition are lacking. Objectives: To summarize the current literature as it relates to diagnosis and management of acute TL‐IVDE in dogs, and to formulate clinically relevant evidence‐based recommendations. Animals: None. Methods: A panel of 8 experts was convened to assess and summarize evidence from the peer‐reviewed literature in order to develop consensus clinical recommendations. Level of evidence available to support each recommendation was assessed and reported. Results: The majority of available literature described observational studies. Most recommendations made by the panel were supported by a low or moderate level of evidence, and several areas of high need for further study were identified. These include better understanding of the ideal timing for surgical decompression, expected surgical vs medical outcomes for more mildly affected dogs, impact of durotomy on locomotor outcome and development of progressive myelomalacia, and refining of postoperative care, and genetic and preventative care studies. Conclusions and Clinical Importance: Future efforts should build on current recommendations by conducting prospective studies and randomized controlled trials, where possible, to address identified gaps in knowledge and to develop cost effectiveness and number needed to treat studies supporting various aspects of diagnosis and treatment of TL‐IVDE. [ABSTRACT FROM AUTHOR]
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- 2022
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34. Steroid-responsive meningitis-arteritis in dogs in Germany: Are there epidemiological or clinical factors influencing recurrence rate?
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Hilpert, Elisabeth, additional, Tipold, Andrea, additional, Meyerhoff, Nina, additional, Schwerdt, Johannes, additional, Winkler, Sandra, additional, Jurina, Konrad, additional, Fischer, Andrea, additional, Kornberg, Marion, additional, Parzefall, Birgit, additional, and Flegel, Thomas, additional
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- 2020
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35. Auf die Rasse geblickt: Steroidresponsive Meningitis/Arteriitis beim Hund
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Flegel, Thomas, additional
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- 2020
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36. Accuracy of a new MRI-based patient-individual stereotactic brain biopsy device in the dog
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Hanemann, Sarah, Winkler, Dirk, Müller, Marcel, Möbius, Robert, Fischer, Jean-Pierre, Böttcher, Peter, Kiefer, Ingmar, Grunert, Ronny, and Flegel, Thomas
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- 2018
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37. Breed-Specific Magnetic Resonance Imaging Characteristics of Necrotizing Encephalitis in Dogs
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Flegel, Thomas
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necrotizing encephalitis, necrotizing leucoencephalitis, necrotizing meningoencephalitis, magnetic resonance imaging, breed specific magnetic resonance imaging ,lcsh:Veterinary medicine ,General Veterinary ,breed specific magnetic resonance imaging ,ddc:630 ,lcsh:SF600-1100 ,necrotizing encephalitis ,magnetic resonance imaging ,Veterinary Science ,Review ,necrotizing leucoencephalitis ,necrotizing meningoencephalitis - Abstract
Diagnosing necrotizing encephalitis, with its subcategories of necrotizing leukoencephalitis and necrotizing meningoencephalitis, based on magnetic resonance imaging alone can be challenging. However, there are breed-specific imaging characteristics in both subcategories that allow establishing a clinical diagnosis with a relatively high degree of certainty. Typical breed specific imaging features, such as lesion distribution, signal intensity, contrast enhancement, and gross changes of brain structure (midline shift, ventriculomegaly, and brain herniation) are summarized here, using current literature, for the most commonly affected canine breeds: Yorkshire Terrier, French Bulldog, Pug, and Chihuahua.
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- 2017
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38. Accuracy study of a 3D printed patient specific brain biopsy system for veterinary medicine
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Müller, Marcel, Winkler, Dirk, Möbius, Robert, Flegel, Thomas, Hanemann, Sarah, Scholz, Sebastian, Grunert, Ronny, and Publica
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brain biopsy ,patient spezific ,3D printed - Abstract
The sampling of brain tissue in veterinary medicine usually underlies a freehand performance without exact localization. The aim of the project was the accuracy evaluation of a 3D-printed subject specific system for brain biopsy in dogs. At the beginning of the procedure, three small bone screws were fixed (bilateral and occipital/frontal) to the dog skull. Subsequently, three MR-markers filled with contrast agent were adapted and MRI scans performed (layer-thickness 1.0 mm). Within the MR images the coordinates of the target and entry point are determined by the surgeon. For evaluation an additional pre-CT (layer-thickness 0.7 mm) was realized. After image recording the MR-markers were removed. Due to a self-made algorithm a patient individual template was constructed. The final biopsy device made of ABS M30 was produced by a 3D printer (FDM).To perform the biopsy the device was connected with the already embedded bone screws. Through a guidance track the skull was minimally invasive accessed at the intended location. Controlled by a depth stop the biopsy needle could be exactly moved in a desired direction up to the target point. A further post-CT (thickness 0.7 mm) with inserted needle was performed to determine the final position of the biopsy needle tip. For receiving information about the difference between preoperative planned and achieved tip position the pre-CT was matched with the post-CT. Therefor 10 dog cadavers (n=20 target points) were applied. The results showed an accuracy of 0.58 mm ± 0.34 mm (ranging from 0.09 mm to 1.17 mm) between the preoperative planned and the achieved needle position. A patient specific 3D-printed biopsy system based on MR images was developed which enables a high precise brain biopsy. Moreover, the system matches up to current costly diagnosis techniques of image-guided neurosurgery and robot systems. Prospectively, it shall be transferred to human medicine.
- Published
- 2017
39. Th17-skewed immune response and cluster of differentiation 40 ligand expression in canine steroid-responsive meningitis-arteritis, a large animal model for neutrophilic meningitis
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Freundt-Revilla, Jessica, Maiolini, Arianna, Carlson, Regina, Beyerbach, Martin, Rentmeister, Kai, Flegel, Thomas, Fischer, Andrea, and Tipold, Andrea
- Subjects
Cellular and Molecular Neuroscience ,Neurology ,630 Agriculture ,Immunology ,610 Medicine & health - Abstract
BACKGROUND: Steroid-responsive meningitis-arteritis (SRMA) is an immune-mediated disorder characterized by neutrophilic pleocytosis and an arteritis particularly in the cervical leptomeninges. Previous studies of the disease have shown increased levels of IL-6 and TGF-ß1 in cerebrospinal fluid (CSF). In the presence of these cytokines, naive CD4+ cells differentiate into Th17 lymphocytes which synthesize interleukin 17 (IL-17). It has been shown that IL-17 plays an active role in autoimmune diseases, it induces and mediates inflammatory responses and has an important role in recruitment of neutrophils. The hypothesis of a Th17-skewed immune response in SRMA should be supported by evaluating IL-17 and CD40L, inducing the vasculitis. METHODS: An enzyme-linked immunosorbent assay (ELISA) was performed to measure IL-17 and CD40L in serum and CSF from a total of 79 dogs. Measurements of patients suffering from SRMA in the acute state (SRMA A) were compared with levels of patients under treatment with steroids (SRMA T), recurrence of the disease (SRMA R), other neurological disorders, and healthy dogs, using the two-part test. Additionally, secretion of IL-17 and interferon gamma (IFN-γ) from the peripheral blood mononuclear cells (PBMCs) was confirmed by an enzyme-linked immunospot (ELISpot) assay. RESULTS: Significant higher levels of IL-17 were found in CSF of dogs with SRMA A compared with SRMA T, other neurological disorders and healthy dogs (p
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- 2017
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40. Genauigkeit eines neuen MRT-basierten patientenindividuellen stereotaktischen Gehirnbiopsiesystems für Hunde
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Gutmann, Sarah, Winkler, Dirk, Müller, Marcel, Möbius, Robert, Fischer, Jean-Pierre, Böttcher, P., Kiefer, Ingmar, Grunert, Ronny, and Flegel, Thomas
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- 2017
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41. Subokzipitale Punktion des Subarachnoidalraums beim Hund
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Flegel, Thomas, additional and Hanemann, Sarah, additional
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- 2017
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42. Prävalenz und Risikofaktoren bei der Entstehung akuter Pankreatitiden bei Hunden mit einem Bandscheibenvorfall
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Flegel, Thomas, Tipold, Andrea, Universität Leipzig, Müller, Marie-Kerstin, Flegel, Thomas, Tipold, Andrea, Universität Leipzig, and Müller, Marie-Kerstin
- Abstract
Einleitung: Der Verdacht, dass Hunde mit einem Bandscheibenvorfall eine Prädisposition für die Entstehung einer Pankreatitis haben könnten, wurde in der Veterinärmedizin bereits in den frühen 1980er Jahren diskutiert. Trotz dieser bereits vor vielen Jahren erhobenen Vermutungen, wurde der Zusammenhang zwischen der Entstehung einer Pankreatitis und einem zeitgleich vorliegenden Bandscheibenvorfall auch im Hinblick auf mögliche Risikofaktoren wie dem Einfluss der Narkose oder dem Einsatz von Medikamenten (v. a. Glukokortikoide und nichtsteroidale Antiphlogistika) bisher nicht näher untersucht. Ziele der Untersuchungen: Im Rahmen der vorliegenden prospektiven Studie sollte untersucht werden, ob Bandscheibenvorfälle ein Risikofaktor für die Entstehung einer Pankreatitis beim Hund darstellen. Ferner sollte geklärt werden, ob die Narkose und die Gabe von Glukokortikoiden und/oder nichtsteroidalen Antiphlogistika zusätzlich das Risiko der Entstehung einer Pankreatitis bei Hunden mit einem Bandscheibenvorfall erhöhen. Material und Methoden: Insgesamt wurden 106 Hunde, bei denen aufgrund der klinischen Symptome der Verdacht einer Rückenmarksläsion bestand, an fünf aufeinander folgenden Tagen klinisch untersucht. Besonderes Augenmerk wurde hierbei auf Symptome gelegt, welche typischerweise bei Pankreatitiden zu beobachten sind (reduziertes Allgemeinbefinden, Schwäche, Anorexie, dolentes Abdomen, Vomitus, Regurgitieren, Diarrhoe, Fieber, Dehydratation). Ferner wurde am Tag 0 und Tag 4 der stationären Aufnahme die Konzentration der caninen pankreasspezifischen Lipase im Serum gemessen (Spec cPL und Snap cPL). Am Tag 0 wurde von dem Vorliegen einer Pankreatitis ausgegangen, wenn klinische Befunde im Sinne einer Pankreatitis sowie eine abnorm erhöhte Konzentration der caninen pankreasspezifischen Lipase im Serum (>400 μg/L) auffällig waren. Am Tag 4 erfolgte zudem eine sonographische Untersuchung des Abdomens. Somit basierte die Diagnosestellung einer Pankreatitis an diesem Tag a, Objective: The suspicion that dogs with intervertebral disc disease are at greater risk of developing pancreatitis is being discussed in veterinary medicine since the early 1980s. So far no study has been published examining the correlation between intervertebral disk disease and the development of pancreatitis in dogs, especially in combination with general anaesthesia and anti-inflammatory medication (glucocorticoids and/or nonsteroidal anti-inflammatory drugs). The aim of this study was therefore 1) to evaluate intervertebral disk disease as possible risk factor of pancreatitis and 2) to ascertain if general anaesthesia and the administration of glucocorticoids and/or nonsteroidal anti-inflammatory drugs further increase the risk of pancreatitis in dogs with intervertebral disk disease. Material and methods: One hundred and six dogs with symptoms associated with spinal cord injury were clinically examined over a period of five days. Special attention was payed to symptoms usually seen with pancreatitis such as anorexia, vomitus and abdominal pain. Furthermore the concentration of canine pancreatic lipase in the blood serum was measured with Spec cPL and Snap cPL at day 0 and day 4 after admission. At day 0 the diagnosis of pancreatitis was based on clinical symptoms associated with pancreatitis in combination with an increased concentration of canine pancreatic lipase in the blood serum (>400 μg/L). A sonography of the pancreas was performed at day 4 to evaluate the organ itself and the surrounding tissue for lesions associated with pancreatitis. Therefore the diagnosis of pancreatitis at day 4 was based on positive results in at least two of the three following criteria: symptoms associated with pancreatitis, elevation of the concentration of canine pancreatic lipase in the blood serum, sonographic changes of the pancreas parenchyma and the surrounding tissue associated with pancreatitis. For statistical analysis questionable results in one or more of these crit
- Published
- 2017
43. Th17-skewed immune response and cluster of differentiation 40 ligand expression in canine steroid-responsive meningitis-arteritis, a large animal model for neutrophilic meningitis
- Author
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Freundt-Revilla, Jessica, primary, Maiolini, Arianna, additional, Carlson, Regina, additional, Beyerbach, Martin, additional, Rentmeister, Kai, additional, Flegel, Thomas, additional, Fischer, Andrea, additional, and Tipold, Andrea, additional
- Published
- 2017
- Full Text
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44. Multiple thorakolumbale partielle laterale Korpektomien bei 17 Hunden
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Münch, Maria, primary, Held, Karina, primary, Salger, Florian, primary, Ziegler, Luisa, primary, Böttcher, Peter, primary, and Flegel, Thomas, additional
- Published
- 2016
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45. Ermittlung der Genauigkeit der Neurolokalisation durch den Vergleich mit dem Ergebnis der durchgeführten Diagnostik bei 214 Hunden
- Author
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Flegel, Thomas, Universität Leipzig, Löffler, Carina, Flegel, Thomas, Universität Leipzig, and Löffler, Carina
- Abstract
Die neurologische Untersuchung stellt die Grundlage der klinischen Neurologie dar und führt durch die Festlegung einer Neurolokalisation (neuroanatomischen Diagnose) zur Eingrenzung eines Krankheitsprozesses auf eine bestimmte Region im Nervensystem. Basierend auf der Neurolokalisation erfolgt die weitere klinische Aufarbeitung des Patienten wie die Erstellung einer Liste an möglichen Differentialdiagnosen und notwendigen diagnostischen Maßnahmen zum Nachweis der Erkrankung im Nervensystem. In der veterinärmedizinischen Literatur existieren zum jetzigen Zeitpunkt nur wenige Angaben über die Genauigkeit der festgelegten Neurolokalisation. Die wenigen vorliegenden Studien analysierten zudem lediglich die Genauigkeit der Neurolokalisation in ausgewählten Segmenten des Nervensystems. Das Ziel dieser prospektiven Studie war es daher, das Ergebnis der neurologischen Untersuchung (Neurolokalisation) mit dem Ergebnis weiterführender diagnostischer Maßnahmen zu vergleichen und dabei die Genauigkeit der Neurolokalisation zu ermitteln. Weiterhin wurde untersucht, ob Faktoren wie die Körpermasse des Patienten, die klinische Erfahrung des Untersuchers und die Lokalisation im Nervensystem einen Einfluss auf den Grad der Übereinstimmung zwischen Neurolokalisation und tatsächlich ermittelter Lokalisation der Läsion haben. Es wurde bei 214 Hunden verschiedener Hunderassen eine vollständige neurologische Untersuchung durch einen Tierarzt aus der Abteilung Neurologie der Klinik für Kleintiere durchgeführt. Mit Hilfe der neurologischen Untersuchung wurde bei jedem Tier eine Neurolokalisation festgelegt. Danach erfolgte die diagnostische Aufarbeitung jedes Patienten der Studie in der Klinik für Kleintiere zum Nachweis einer Läsion im Nervensystem. Im Anschluss an die Diagnostik wurde die Übereinstimmung zwischen der festgelegten Neurolokalisation und der nachgewiesene Lokalisation der Läsion ermittelt. Bei den 214 Hunden wurden, resultierend aus der neurologischen Untersuchung, insgesam
- Published
- 2015
46. Akustisch evozierte Hirnstammpotentiale bei Hunden zur Untersuchung der primär sekretorischen Otitis media im Rahmen der laserassistierten Chirurgie des Brachyzephalen Syndroms
- Author
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Flegel, Thomas, Tipold, Andrea, Universität Leipzig, Truar, Katrin, Flegel, Thomas, Tipold, Andrea, Universität Leipzig, and Truar, Katrin
- Abstract
Durch die höhere Verfügbarkeit von Schnittbildverfahren in der Kleintiermedizin treten Flüssigkeitsansammlungen in der Bulla tympanica immer häufiger als Zufallsbefund bei Hunden, insbesondere bei brachyzephalen Rassen, auf. Aufgrund der fehlenden klinischen Symptome der Patienten ist eine akute Entzündung unwahrscheinlich. Daher bezeichnen neuere Studien diese Flüssigkeitsansammlung als primär sekretorische Otitis media (PSOM). In der vorliegenden Studie wurde untersucht, ob Hunde der Rassen Mops und Französische Bulldogge mit einer primär sekretorischen Otitis media einen konduktiven Hörverlust für das betroffene Ohr im Vergleich zu „Ohr gesunden“ Hunden ihrer Rasse zeigen. Des Weiteren wurde untersucht, ob Französische Bulldoggen signifikant häufiger eine primär sekretorische Otitis media als Hunde der Rasse Mops zeigen. Es wurden bei jeweils 41 Hunde der Rasse Mops und Französische Bulldogge, die zur chirurgischen Versorgung des Brachyzephalen Syndroms vorgestellt wurden, die frühen akustisch evozierten Potentiale (FAEP) abgeleitet. Des Weiteren erfolgte bei allen Patienten eine Computertomographie des Kopfes, eine Otoskopie und ggf. eine Punktion der Bulla tympanica inklusive einer Zytologie und bakteriologischen Untersuchung des Sekrets. In der vorliegenden Studie konnte kein konduktiver Hörverlust für die Hunde mit einer PSOM nachgewiesen werden. Es zeigte sich nur eine Verlängerung der Latenz der Welle I bei Vorliegen einer PSOM, jedoch ohne dass eine signifikant erhöhte Hörschwelle für diese Patienten festgestellt werden konnte. Als Ursache für die Verlängerung der Latenz der Welle I kommt sowohl die beschriebene Füllung der Bulla als auch ein stenotischer Gehörgang in Frage. Die Hörschwelle ist zwar bei den Hunden mit einer PSOM tendenziell höher als bei den Patienten ohne Füllung der Bullae, allerdings konnte hierfür kein signifikanter Unterschied nachgewiesen werden. Bei 40 % der untersuchten Patienten mit einseitiger PSOM konnte für beide Ohren dieselbe, Because of the increased availability of cross-sectional imaging modalities in small animal medicine the incidental finding of material in the middle ear is more common, especially in brachycephalic dogs. Because the animals show no clinical signs, an acute inflammation is unlikely. Therefore recent studies term it as primary secretory otitis media (PSOM). The aim of the current study was to determine whether brachycephalic dogs with PSOM show a conductive hearing loss compared to brachycephalic dogs without changes in the middle ear. Additionally it was evaluated whether French bulldogs suffer from PSOM more frequent than pugs. BAER was recorded in 41 pugs and 41 French bulldogs, which were under general anesthesia because of the surgical correction of the brachycephalic syndrome. In all patients a computed tomography of the head, an otoscopy and if possible a myringotomy with aspiration of the fluid in the middle ear was performed. If fluid was available a cytological examination and a bacterial culture of the fluid was initiated. In the current study no conductive hearing loss was detected in brachycephalic dogs with PSOM. The latencies of wave I were increased in patients with PSOM, although the thresholds of hearing were not increased. The increased latencies of wave I can be explained by the fluid in the middle ear as well as the stenotic external ear canal. The thresholds of hearing in dogs with PSOM were tendentially higher than in dogs without fluid in the middle ear, but the correlation was not significant. In 40 % of the patients with PSOM in one ear the threshold of hearing in both ears is at the same level. Therefore there is no strict correlation between fluid in the middle ear and an increased threshold of hearing on the affected side. This could be explained by a sensorineural hearing loss caused by chronic inflammation of the middle ear. Until now a chronic inflammation as a cause of sensorineural hearing loss has only been described in human medici
- Published
- 2015
47. Multiple thorakolumbale partielle laterale Korpektomien bei 17 Hunden
- Author
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Flegel, Thomas, Münch, Maria, Held, Karina, Salger, Florian, Ziegler, Luisa, and Böttcher, Peter
- Published
- 2016
- Full Text
- View/download PDF
48. Prävalenz und Risikofaktoren bei der Entstehung akuter Pankreatitiden bei Hunden mit einem Bandscheibenvorfall
- Author
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Müller, Marie-Kerstin, Flegel, Thomas, Tipold, Andrea, and Universität Leipzig
- Subjects
intervertebral disc disease, pancreatitis, dog, risk factors ,ddc:636.089 ,Bandscheibenvorfall, Pankreatitis, Hund, Risikofaktoren - Abstract
Einleitung: Der Verdacht, dass Hunde mit einem Bandscheibenvorfall eine Prädisposition für die Entstehung einer Pankreatitis haben könnten, wurde in der Veterinärmedizin bereits in den frühen 1980er Jahren diskutiert. Trotz dieser bereits vor vielen Jahren erhobenen Vermutungen, wurde der Zusammenhang zwischen der Entstehung einer Pankreatitis und einem zeitgleich vorliegenden Bandscheibenvorfall auch im Hinblick auf mögliche Risikofaktoren wie dem Einfluss der Narkose oder dem Einsatz von Medikamenten (v. a. Glukokortikoide und nichtsteroidale Antiphlogistika) bisher nicht näher untersucht. Ziele der Untersuchungen: Im Rahmen der vorliegenden prospektiven Studie sollte untersucht werden, ob Bandscheibenvorfälle ein Risikofaktor für die Entstehung einer Pankreatitis beim Hund darstellen. Ferner sollte geklärt werden, ob die Narkose und die Gabe von Glukokortikoiden und/oder nichtsteroidalen Antiphlogistika zusätzlich das Risiko der Entstehung einer Pankreatitis bei Hunden mit einem Bandscheibenvorfall erhöhen. Material und Methoden: Insgesamt wurden 106 Hunde, bei denen aufgrund der klinischen Symptome der Verdacht einer Rückenmarksläsion bestand, an fünf aufeinander folgenden Tagen klinisch untersucht. Besonderes Augenmerk wurde hierbei auf Symptome gelegt, welche typischerweise bei Pankreatitiden zu beobachten sind (reduziertes Allgemeinbefinden, Schwäche, Anorexie, dolentes Abdomen, Vomitus, Regurgitieren, Diarrhoe, Fieber, Dehydratation). Ferner wurde am Tag 0 und Tag 4 der stationären Aufnahme die Konzentration der caninen pankreasspezifischen Lipase im Serum gemessen (Spec cPL und Snap cPL). Am Tag 0 wurde von dem Vorliegen einer Pankreatitis ausgegangen, wenn klinische Befunde im Sinne einer Pankreatitis sowie eine abnorm erhöhte Konzentration der caninen pankreasspezifischen Lipase im Serum (>400 μg/L) auffällig waren. Am Tag 4 erfolgte zudem eine sonographische Untersuchung des Abdomens. Somit basierte die Diagnosestellung einer Pankreatitis an diesem Tag auf dem Vorliegen von zwei der folgenden drei Kriterien: klinische Befunde im Sinne einer Pankreatitis, abnorm erhöhte Konzentration der caninen pankreasspezifischen Lipase im Serum, sonographische Hinweise für das Vorliegen einer Pankreatitis. Im Rahmen der statistischen Auswertung wurden zudem auch Patienten erfasst, welche in einem oder in mehreren der oben genannten Kriterien ein fragliches Ergebnis aufwiesen. Entsprechend ihrer neurologischen Ausfallserscheinungen sowie der Befunde im Rahmen der bildgebenden Diagnostik (Myelographie, Computertomographie, Kernspintomographie) wurden die Patienten in eine der folgenden drei Untersuchungsgruppen eingeteilt: 1. Hunde mit einem chirurgisch versorgten Bandscheibenvorfall (n = 71) 2. Hunde mit einem konservativ therapierten Bandscheibenvorfall (n = 20) und 3. Hunde mit einer akuten intramedullären Läsion (n = 15). Die statistische Auswerte erfolgte aufgrund der geringen Stichprobengrößen vorwiegend deskriptiv. Die Daten wurden mittels des Shapiro-Wilk-Tests auf Normalverteilung überprüft, die durchgeführten Gruppenvergleiche erfolgten unter Verwendung des Kruskal-Wallis und Mann-Whitney-U-Tests. Zudem wurden die betrachteten Merkmale mit dem Fisher Test und dem Chi-Quadrat-Test auf Unabhängigkeit überprüft. Das Signifikanzniveau wurde für alle Tests mit p < 0,05 festgelegt. Ergebnisse: Basierend auf den klinischen Symptomen und der Konzentration der caninen pankreasspezifischen Lipase im Serum konnte insgesamt am Tag 0 bei vier Hunden (3,8 %) eine Pankreatitis diagnostiziert werden. Am Tag 4 waren es, basierend auf den drei Kriterien, welche für die Diagnosestellung einer Pankreatitis herangezogen werden, insgesamt acht Patienten (7,5 %). Hunde mit einem Bandscheibenvorfall (chirurgisch beziehungsweise konservativ therapiert) wiesen am Tag 0 beziehungsweise Tag 4 in 4,3 % (n = 4) beziehungsweise 7,7 % (n = 7) der Fälle eine Pankreatitis auf. Aufgrund der geringen Häufigkeiten in den einzelnen Untersuchungsgruppen, war eine Berechnung eines signifikanten Unterschieds zwischen den Gruppen nicht möglich. Hinsichtlich einer möglichen Korrelation zwischen einer Narkose und der Entstehung einer Pankreatitis bei Hunden mit einer Rückenmarksläsion konnte kein signifikanter Zusammenhang festgestellt werden. Auch die Gabe von Glukokortikoiden und/oder nichtsteroidalen Antiphlogistika hatte hier keinen signifikanten Einfluss auf die Entstehung einer Pankreatitis. Schlussfolgerung: Vergleicht man die Ergebnisse der vorliegenden Studie mit der in der Literatur angegebenen Prävalenz für akute Pankreatitiden beim Hund (0,7-3,5 %), so kann geschlussfolgert werden, dass eine Rückenmarksläsion, insbesondere ein Bandscheibenvorfall, als Risikofaktor für die Entstehung einer akuten Pankreatitis beim Hund in Betracht gezogen werden muss. Demgegenüber erhöhen weder die Narkose noch die Gabe von Glukokortikoiden und/oder nichtsteroidalen Antiphlogistika zusätzlich das Risiko der Entstehung einer Pankreatitis bei Hunden mit einer Rückenmarksläsion. Objective: The suspicion that dogs with intervertebral disc disease are at greater risk of developing pancreatitis is being discussed in veterinary medicine since the early 1980s. So far no study has been published examining the correlation between intervertebral disk disease and the development of pancreatitis in dogs, especially in combination with general anaesthesia and anti-inflammatory medication (glucocorticoids and/or nonsteroidal anti-inflammatory drugs). The aim of this study was therefore 1) to evaluate intervertebral disk disease as possible risk factor of pancreatitis and 2) to ascertain if general anaesthesia and the administration of glucocorticoids and/or nonsteroidal anti-inflammatory drugs further increase the risk of pancreatitis in dogs with intervertebral disk disease. Material and methods: One hundred and six dogs with symptoms associated with spinal cord injury were clinically examined over a period of five days. Special attention was payed to symptoms usually seen with pancreatitis such as anorexia, vomitus and abdominal pain. Furthermore the concentration of canine pancreatic lipase in the blood serum was measured with Spec cPL and Snap cPL at day 0 and day 4 after admission. At day 0 the diagnosis of pancreatitis was based on clinical symptoms associated with pancreatitis in combination with an increased concentration of canine pancreatic lipase in the blood serum (>400 μg/L). A sonography of the pancreas was performed at day 4 to evaluate the organ itself and the surrounding tissue for lesions associated with pancreatitis. Therefore the diagnosis of pancreatitis at day 4 was based on positive results in at least two of the three following criteria: symptoms associated with pancreatitis, elevation of the concentration of canine pancreatic lipase in the blood serum, sonographic changes of the pancreas parenchyma and the surrounding tissue associated with pancreatitis. For statistical analysis questionable results in one or more of these criteria were also documented. According to the neurologic symptoms and the findings of diagnostic imaging (myelography, computed tomography and magnetic resonance imaging), dogs were categorized in one of the following groups: 1. dogs with surgically treated intervertebral disk disease (n = 71), 2. dogs with medically treated intervertebral disk disease (n = 20), 3. dogs with an acute intramedullary lesion (n = 15). Due to the small sample size, statistics were primarily performed descriptively. Data were tested for normal distribution using the Shapiro-Wilk test. If Group comparisons were feasible, they were performed using the Kruskal-Wallis test and the Mann-Whitney-U test. Fisher test and the Chi-Square test were used to test for association between group affiliation and possible risk factors for the development of pancreatitis. A value of P < 0.5 was considered significant for all analysis. Results: Based on clinical symptoms and an elevated concentration of the canine pancreatic lipase (> 400μg/l) at day 0, four dogs (3.8 %) were diagnosed with pancreatitis. According to the clinical symptoms, the concentration of the canine pancreatic lipase and sonographic changes, a total number of eight dogs (7.5 %) were diagnosed with pancreatitis at day 4. Considering only the dogs with intervertebral disk disease (surgically and medically treated) 4.3 % (n = 4) and 7.7 % (n = 7) were diagnosed with pancreatitis at day 0 and day 4, respectively. Due to the small sample size, the calculation of significant differences between the three subgroups was not feasible. There was no significant correlation between general anaesthesia and the development of pancreatitis. Furthermore, the administration of glucocorticoids and/or nonsteroidal anti-inflammatory drugs is not significantly associated with the genesis of pancreatitis.
- Published
- 2016
49. Akustisch evozierte Hirnstammpotentiale bei Hunden zur Untersuchung der primär sekretorischen Otitis media im Rahmen der laserassistierten Chirurgie des Brachyzephalen Syndroms
- Author
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Truar, Katrin, Flegel, Thomas, Tipold, Andrea, and Universität Leipzig
- Subjects
brachycephalic syndrome, BAER, primary secretory otitis media (PSOM), pug, French bulldog ,ddc:636.089 ,Brachyzephalen Syndrom, FAEP, Primär sekretorische Otitis media (PSOM), Mops, Französische Bulldogge - Abstract
Durch die höhere Verfügbarkeit von Schnittbildverfahren in der Kleintiermedizin treten Flüssigkeitsansammlungen in der Bulla tympanica immer häufiger als Zufallsbefund bei Hunden, insbesondere bei brachyzephalen Rassen, auf. Aufgrund der fehlenden klinischen Symptome der Patienten ist eine akute Entzündung unwahrscheinlich. Daher bezeichnen neuere Studien diese Flüssigkeitsansammlung als primär sekretorische Otitis media (PSOM). In der vorliegenden Studie wurde untersucht, ob Hunde der Rassen Mops und Französische Bulldogge mit einer primär sekretorischen Otitis media einen konduktiven Hörverlust für das betroffene Ohr im Vergleich zu „Ohr gesunden“ Hunden ihrer Rasse zeigen. Des Weiteren wurde untersucht, ob Französische Bulldoggen signifikant häufiger eine primär sekretorische Otitis media als Hunde der Rasse Mops zeigen. Es wurden bei jeweils 41 Hunde der Rasse Mops und Französische Bulldogge, die zur chirurgischen Versorgung des Brachyzephalen Syndroms vorgestellt wurden, die frühen akustisch evozierten Potentiale (FAEP) abgeleitet. Des Weiteren erfolgte bei allen Patienten eine Computertomographie des Kopfes, eine Otoskopie und ggf. eine Punktion der Bulla tympanica inklusive einer Zytologie und bakteriologischen Untersuchung des Sekrets. In der vorliegenden Studie konnte kein konduktiver Hörverlust für die Hunde mit einer PSOM nachgewiesen werden. Es zeigte sich nur eine Verlängerung der Latenz der Welle I bei Vorliegen einer PSOM, jedoch ohne dass eine signifikant erhöhte Hörschwelle für diese Patienten festgestellt werden konnte. Als Ursache für die Verlängerung der Latenz der Welle I kommt sowohl die beschriebene Füllung der Bulla als auch ein stenotischer Gehörgang in Frage. Die Hörschwelle ist zwar bei den Hunden mit einer PSOM tendenziell höher als bei den Patienten ohne Füllung der Bullae, allerdings konnte hierfür kein signifikanter Unterschied nachgewiesen werden. Bei 40 % der untersuchten Patienten mit einseitiger PSOM konnte für beide Ohren dieselbe Hörschwelle bestimmt werden, so dass eine Füllung der Bulla tympanica nicht immer zu einer vorhersagbaren Veränderung der Hörschwelle führen muss. Eine mögliche Erklärung für diesen Umstand ist ein sensorineuraler Hörverlust, der durch eine chronische Entzündung des Mittelohres zustande kommt. Dies ist bisher nur in der Humanmedizin beschrieben und die Pathogenese ist noch unklar. Die Ergebnisse zeigen zusätzlich, dass Französische Bulldoggen signifikant häufiger von einer PSOM betroffen sind. Die Ursache für diese Häufung könnte ein dickerer weicher Gaumen der Französischen Bulldoggen im Vergleich zu Hunden der Rasse Mops sein, durch den es zu einer Funktionsstörung der Tuba auditiva kommen könnte. Beim Vergleich der Hunde ohne Vorliegen einer Füllung konnte festgestellt werden, dass Französische Bulldoggen eine höhere Hörschwelle und eine längere Latenz der Welle I als Hunde der Rasse Mops aufweisen. Bei beiden Rassen ist zusätzlich auffällig, dass die Hörschwelle um 30 dB höher liegt als bei Hunden anderer Rassen (SHIU et al. 1997). Alle brachyzephalen Hunde dieser Studie zeigen somit ein im Vergleich zu anderen Rassen vermindertes Hörvermögen, das aber durch eine PSOM nicht weiter verschlechtert wird. Der Symptomenkomplex Brachyzephalen Syndrom muss nach der vorliegenden Studie durch die Symptome vermindertes Hörvermögen und das Vorliegen einer PSOM ergänzt werden. Die klinischen Auswirkungen des Hörverlusts, wie etwa eine starke Anhänglichkeit, könnten bei Hunden dieser Rassen übersehen werden, da dies als gewünschter Charakterzug der Rassen interpretiert wird und nicht als mögliches Symptom einer Erkrankung wahrgenommen wird. Because of the increased availability of cross-sectional imaging modalities in small animal medicine the incidental finding of material in the middle ear is more common, especially in brachycephalic dogs. Because the animals show no clinical signs, an acute inflammation is unlikely. Therefore recent studies term it as primary secretory otitis media (PSOM). The aim of the current study was to determine whether brachycephalic dogs with PSOM show a conductive hearing loss compared to brachycephalic dogs without changes in the middle ear. Additionally it was evaluated whether French bulldogs suffer from PSOM more frequent than pugs. BAER was recorded in 41 pugs and 41 French bulldogs, which were under general anesthesia because of the surgical correction of the brachycephalic syndrome. In all patients a computed tomography of the head, an otoscopy and if possible a myringotomy with aspiration of the fluid in the middle ear was performed. If fluid was available a cytological examination and a bacterial culture of the fluid was initiated. In the current study no conductive hearing loss was detected in brachycephalic dogs with PSOM. The latencies of wave I were increased in patients with PSOM, although the thresholds of hearing were not increased. The increased latencies of wave I can be explained by the fluid in the middle ear as well as the stenotic external ear canal. The thresholds of hearing in dogs with PSOM were tendentially higher than in dogs without fluid in the middle ear, but the correlation was not significant. In 40 % of the patients with PSOM in one ear the threshold of hearing in both ears is at the same level. Therefore there is no strict correlation between fluid in the middle ear and an increased threshold of hearing on the affected side. This could be explained by a sensorineural hearing loss caused by chronic inflammation of the middle ear. Until now a chronic inflammation as a cause of sensorineural hearing loss has only been described in human medicine, not in veterinary medicine. The pathogenesis is still unknown. The results show that French bulldogs suffer more frequently from the PSOM than pugs. French bulldogs usually show a bigger soft palate than pugs which could result in a dysfunction of the tuba auditiva. Hence the bigger soft palate could be causing the increased prevalence of PSOM in French bulldogs. Compared to pugs without PSOM, French bulldogs without PSOM show an increased latency of wave I as well as an increased threshold of hearing. Additionally for both breeds an increase in the threshold of hearing by 30 dB compared to normocephalic breeds could be detected (SHIU et al. 1997). It is remarkable that French bulldogs as well as pugs show a hearing loss without correlation to the PSOM. In conclusion hearing loss has to be added to the characteristic triad of symptoms of the brachycephalic syndrome. Clinical signs of hearing loss like loyalty to the owner could be misinterpreted especially in these breeds, since this is a favored behavior of these dogs.
- Published
- 2015
50. Ermittlung der Genauigkeit der Neurolokalisation durch den Vergleich mit dem Ergebnis der durchgeführten Diagnostik bei 214 Hunden
- Author
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Löffler, Carina, Flegel, Thomas, and Universität Leipzig
- Subjects
Neurolokalisation, Hund ,ddc:636.089 ,neurolocalisation, dog - Abstract
Die neurologische Untersuchung stellt die Grundlage der klinischen Neurologie dar und führt durch die Festlegung einer Neurolokalisation (neuroanatomischen Diagnose) zur Eingrenzung eines Krankheitsprozesses auf eine bestimmte Region im Nervensystem. Basierend auf der Neurolokalisation erfolgt die weitere klinische Aufarbeitung des Patienten wie die Erstellung einer Liste an möglichen Differentialdiagnosen und notwendigen diagnostischen Maßnahmen zum Nachweis der Erkrankung im Nervensystem. In der veterinärmedizinischen Literatur existieren zum jetzigen Zeitpunkt nur wenige Angaben über die Genauigkeit der festgelegten Neurolokalisation. Die wenigen vorliegenden Studien analysierten zudem lediglich die Genauigkeit der Neurolokalisation in ausgewählten Segmenten des Nervensystems. Das Ziel dieser prospektiven Studie war es daher, das Ergebnis der neurologischen Untersuchung (Neurolokalisation) mit dem Ergebnis weiterführender diagnostischer Maßnahmen zu vergleichen und dabei die Genauigkeit der Neurolokalisation zu ermitteln. Weiterhin wurde untersucht, ob Faktoren wie die Körpermasse des Patienten, die klinische Erfahrung des Untersuchers und die Lokalisation im Nervensystem einen Einfluss auf den Grad der Übereinstimmung zwischen Neurolokalisation und tatsächlich ermittelter Lokalisation der Läsion haben. Es wurde bei 214 Hunden verschiedener Hunderassen eine vollständige neurologische Untersuchung durch einen Tierarzt aus der Abteilung Neurologie der Klinik für Kleintiere durchgeführt. Mit Hilfe der neurologischen Untersuchung wurde bei jedem Tier eine Neurolokalisation festgelegt. Danach erfolgte die diagnostische Aufarbeitung jedes Patienten der Studie in der Klinik für Kleintiere zum Nachweis einer Läsion im Nervensystem. Im Anschluss an die Diagnostik wurde die Übereinstimmung zwischen der festgelegten Neurolokalisation und der nachgewiesene Lokalisation der Läsion ermittelt. Bei den 214 Hunden wurden, resultierend aus der neurologischen Untersuchung, insgesamt 237 Neurolokalisationen im gesamten Nervensystem festgelegt. Mit Hilfe der diagnostischen Maßnahmen konnten bei den 214 Hunden 221 Läsionen im gesamten Nervensystem nachgewiesen werden. Die allgemeine Übereinstimmung zwischen festgelegter Neurolokalisation und nachgewiesener Lokalisation der Läsion lag bei 71 Prozent. Bei 13 Prozent (27/214) der untersuchten Hunde stimmte die Neurolokalisation nicht mit der Lokalisation der Läsion überein. Bei 16 Prozent (35/214) der Patienten konnte keine Läsion im Nervensystem mit Hilfe der diagnostischen Maßnahmen ermittelt werden. Dies bedeutete nicht, dass der Patient keine neurologische Erkrankung hatte, sondern vielmehr dass eine Reihe von neurologischen Erkrankungen existieren, die selbst mit modernster Technik nicht nachweisbar sind. Anhand der Untersuchungen der vorliegenden Arbeit wurde festgestellt, dass die klinische Erfahrung des Untersuchers und die Körpermasse des Patienten keinen Einfluss auf die Übereinstimmung zwischen Neurolokalisation und in der Diagnostik nachgewiesener Lokalisation der Läsion hatten. Das Rückenmarksegment Th3-L3 erwies sich als Lokalisation mit der höchsten Übereinstimmung zwischen neuroanatomischer Diagnose (Neurolokalisation) und Lokalisation der Läsion. Schlussfolgernd aus den Ergebnissen dieser Arbeit kann man sagen, dass die Neurolokalisation mit einer Genauigkeit von 71 Prozent eine relativ verlässliche Grundlage für die weitere diagnostische Aufarbeitung eines Patienten ist. Jedoch hat diese Arbeit auch Schwachstellen der neurologischen Untersuchung aufgedeckt. So war beispielsweise die Untersuchung des Flexorreflexes der Vorder- und Hintergliedmaßen zur Festlegung der Neurolokalisation im Bereich der vier Rückenmarkssegmente eine nicht zu unterschätzende Fehlerquelle. Diese Erkenntnis sollte sich in Zukunft auf eine Ausweitung der diagnostischen Maßnahmen im Falle eines fehlenden Nachweises einer Läsion auswirken. Die Ergebnisse dieser Studie zeigen außerdem, dass die Grundkenntnis über die Funktionalität der einzelnen anatomischen Strukturen des Nervensystems sowie die intensive Kenntnis über die Grundelemente der neurologischen Untersuchung ausreichend sind für eine zuverlässige Festlegung der Neurolokalisation.
- Published
- 2015
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