suspect toxo

Re: suspect toxo

Stephen Courtney — Mon, 01 Apr 2013 16:54:34 GMT

the one litter I've seen with toxo/neospora ( not entirely sure of the difference without access to a text book) had generalised CNS pathology - malacia of areas of cord and brain - so signs were of multifocal CNS disease

Prognosis is awful as the damage is done, neural cells are killed and won't regenerate.

Re: suspect toxo

John Flynn — Sun, 31 Mar 2013 23:20:53 GMT

I'm thinking aloud, but is this a presumed hindlimb peripheral motor neuron lesion then?

To answer your question, I've only seen one litter of rotties with suspected toxo similar to this and I think they were all euthanased eventually - having said that some had signs of fitting and quite possibly didn't have toxo as we never did CSF titres or rechecked for rising IgG of falling IgM or anything clever.

I had a quick google and only found one case report that sounded similar to yours and it was old enough not to really pay any attention to (hopefully, as not a happy outcome...):

Core DM, Hoff EJ and Milton JL (1983) Hindlimb hyperextension as a result of Toxoplasma gondii polyradiculitis. Journal of the American Animal Hospital Association 19(5): 713-716.

Abstract: "Two four-month-old Labrador Retriever littermates had bilateral hyperextension of the stifles and limited joint mobility. Neurological examination indicated severe lower motor neuron deficits. Electrodiagnostic examination suggested peripheral neuropathy. Both dogs were euthanized. Histological examination revealed a severe Toxoplasma-induced encephalomyelitis and radiculitis."

Another paper had all 4 acute toxo neuro dogs getting better:

Tarlow JM et al. (2005) Emergency presentations of 4 dogs with suspected neurologic toxoplasmosis. Journal of Veterinary Emergency and Critical Care 15(2): 119-127.

so maybe not quite so hopeless then

Re: suspect toxo

a.bardell — Sun, 31 Mar 2013 22:37:01 GMT

Should have pointed out that puppy was initially seen and worked up by our orthopaedic specialist who has ruled out a spinal lesion after x-rays, myolgram etc.

no pain on palpation of spine, withdrawal reflexes absent but can definitely feel pinching of toes as turns and vocalises. anal tone still present adn can move tail a small amt. difficult to tell about urination as not yet house trained, eating adn drinking normally. no other neurological signs noted. has not progressed any further since took over case for bank holiday weekend.

is on toxo doses of clindamycin and was just wanting to know if anyone had seen one of these recover?

On a happier note have just completed c-section to bring 3 more chihuahuas into the world- its always nice to have a happy ending.

Re: suspect toxo

Andrew Kent — Sun, 31 Mar 2013 18:07:50 GMT

I would be really worried about calling this toxo just based on a low positive titre because the significance of toxo is often questionable and this sounds quite severe.

would the owners consider referral for MRI? If there is progressive Neuro signs a spinal lesion seems more likely and would need acting on sooner rather than later.

Andy

Re: suspect toxo

John Flynn — Sun, 31 Mar 2013 15:54:39 GMT

Hi Alexa,

My gut says the same as your gut.

I'd keep an open mind about the significance of 'low positive' toxo titres and the reported clinical signs, but think it's worth treating with clindamycin and you never know.

If there's no other neurological signs, then it sounds like your lesion is caudal to thoracic intumescence, and if there's not ambulatory ability to walk, then that would be a grade 4//5 spinal lesion - I guess the prognosis depends on the cause and whether it can be treated, but in terms of the level of nervous deficit present and the fact its progressing, I'd be worried...

Any pain on spine palpation? Are there withdrawl reflexes present on hindlimbs? Patella reflex? Anal reflex? Voluntary urination? Eating/drinking? Any change in mental state or CN deficits? Not that any of those questions are likely to change case managment or prognosis - just curious!