Unilateral Temporal Atrophy - any ideas?

RE: Unilateral Temporal Atrophy - any ideas?

Neil Wheadon — Sat, 14 Jan 2023 10:36:48 GMT

[quote userid="2131" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/30542/unilateral-temporal-atrophy---any-ideas/240531#240531"]The value of muscle biopsy is going to be small. What's it going to show? That the muscle is atrophied....[/quote]

Yup, these were clinical notes copied and pasted and yes you'll quite right

[quote userid="2131" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/30542/unilateral-temporal-atrophy---any-ideas/240531#240531"]A straight differential blood count would be interesting if it showed a marked eosinophilia, but this is chronic so it probably won't.[/quote]

I'll suggest this

[quote userid="2131" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/30542/unilateral-temporal-atrophy---any-ideas/240531#240531"]I do agree, nerve damage is the most likely. To investigate that further you'd want CT and MRI. If the client's worried about neoplasia and up for that expense, OK, as long as they understand that more than likely there may still be no treatment.[/quote]

Yes a classic case of 'the test isn't a treatment' and 'realistically are we going to remove a tumour from a dogs brain'

Thanks

Neil

RE: Unilateral Temporal Atrophy - any ideas?

Evelyn Barbour-Hill — Sat, 14 Jan 2023 01:30:48 GMT

[quote userid="8958" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/30542/unilateral-temporal-atrophy---any-ideas"]So what to dp
1) Watch and see if anything else developes
2) Biopsy the muscle estimate £320, but would this show anything?
3) Could CT[/quote]

Well, check everything you reasonably can. Careful clinical exam of teeth and temporomandibular joint. Radiograph temporomandibular joint. Your findings may be entirely negative but this is stuff you can easily do.

The value of muscle biopsy is going to be small. What's it going to show? That the muscle is atrophied....

A straight differential blood count would be interesting if it showed a marked eosinophilia, but this is chronic so it probably won't.

The thing is, what are you going to do about it even if you do reach a closer diagnosis?

I do agree, nerve damage is the most likely. To investigate that further you'd want CT and MRI. If the client's worried about neoplasia and up for that expense, OK, as long as they understand that more than likely there may still be no treatment.

RE: Unilateral Temporal Atrophy - any ideas?

Beats — Thu, 12 Jan 2023 19:46:55 GMT

I don't think I'd take this further presently, personally.

Could spell trouble, but I doubt you are going to helpfully and meaningfully intervene.

If biopsying that muscle (I wouldn't here), remember it's below that thin muscle on top of it that you need to cut through first. And check requirements for where you're sending to before you do the biopsy (I've used Edinburgh in past).

I'm yet to personally see a convincing case of hyperthyroid-induced peripheral neuropathy, so I think the chances are low.

My money would be on random (and inconsequential) or neoplastic. Time will differentiate those satisfactorily.