Successful Management of Post-Attenuation Neurologic Signs and Portal Hypertension in a Dog with Congenital Portoazygos Shunt

송중현 한국임상수의학회 2024 한국임상수의학회지 Vol.41 No.2

A 6-year-old neutered male Poodle with a body weight of 2.7 kg was diagnosed with a congenital extrahepatic portoazygos shunt presented with progressive hepatic encephalopathy. Five days after surgical attenuation, the patient showed post-attenuation neurological signs (PANS) such as generalized tonic-clonic seizure, dull mentation, and tremor. PANS were successfully managed with antiepileptic drugs, but third-space fluid accumulation (ascites and peripheral edema) and phlebectasia were newly identified, suggesting marked portal hypertension (PHT). Telmisartan, spironolactone, carvedilol, and prednisolone were sequentially administered. Three months after surgery, both abnormal clinicopathological values such as anemia and hypoalbuminemia, and clinical signs completely resolved. Herein, we report successful management strategies for PANS and PHT in a dog following surgical attenuation of a congenital portoazygos shunt.

Grain Foreign Body Embedded in the Spleen and Immune-Mediated Hemolytic Anemia in a Maltese Dog

송중현,장효미,이희천,서정향,강병택,정동인 한국임상수의학회 2017 한국임상수의학회지 Vol.34 No.1

An 8-month-old, intact male Maltese dog was referred to us because of anorexia, diarrhea, and jaundice. Hematologic examination revealed immune-mediated hemolytic anemia, and abdominal ultrasonography revealedheterogeneous changes in mesenteric fat and coarse echotexture in the splenic parenchyma. Septic peritonitis wasdiagnosed on the basis of a bacterial culture test of the peritoneal fluid. Exploratory laparotomy and subsequent omentalbiopsy and splenectomy were performed. On histopathological examination, the omental mass and splenic lesions werediagnosed as grain foreign body granulomas. This report describes a rare case in which a grain foreign body wasembedded in the spleen of a dog.

Acute Progress of Necrotizing Meningoencephalitis in a Dog; Serial Clinical Observation, Magnetic Resonance Imaging, and Histopathological Findings

송중현,문종현,김현수,서정향,박철,소경민,정동인 한국임상수의학회 2016 한국임상수의학회지 Vol.33 No.5

A 13-month-old intact female poodle dog presented with an acute history of circling and seizure episodes. On the basis of the results of neurologic examination combined with magnetic resonance imaging and cerebrospinalfluid analysis (CSF), meningoencephalitis of unknown etiology (MUE) was suspected. Therapy with mycophenolatemofetil plus prednisolone was initiated, following which the clinical signs showed improvement for only one monthbefore gradually worsening again. Acute progression of the clinical disease was observed, and the patient was euthanized91 days after initial presentation. This case was definitively diagnosed as necrotizing meningoencephalitis (NME)according to the results of post-mortem histopathological examination. This report describes the clinical findings, serialmagnetic resonance imaging (MRI) characteristics, and histopathological changes in a case of acute NME.

Lomustine Plus Hydroxyurea Chemotherapy for Primary Intramedullary Spinal Cord Tumor in a Maltese Dog

송중현,유도현,황태성,이희천,안수진,서정향,김영주,정동인 한국임상수의학회 2019 한국임상수의학회지 Vol.36 No.3

A 7-year-old, male Maltese dog with a body weight of 2.8 kg was presented with a history of hind limbs ataxia that progressed to tetraparesis over a one-month period. Based on physical and neurological examinations, tetraparesis with concomitant UMN signs, kyphosis and severe neck pain were identified. On MRI scan, we tentatively diagnosed this patient as a primary intramedullary spinal cord tumor. Therapy with lomustine plus hydroxyurea and prednisolone was initiated and the clinical signs rapidly improved. The patient was regularly checked by MRI scan and the range of the mass was gradually reduced to complete remission for 11 months. About 19 months after treatment, the patient showed anemia and hematochezia which suspected as adverse effects of chemotherapy. The condition was getting worse over 2 months and the patient suddenly expired 657 days after initial presentation. On histopathological examination, the spinal cord sample was identified as a neuronal atrophy without evidence of tumor cell.

Evaluation of Treatment with a Combination of Prednisolone and Mycophenolate Mofetil for Dogs with Immune-Mediated Polyarthritis

송중현 한국임상수의학회 2023 한국임상수의학회지 Vol.40 No.4

Immune-mediated polyarthritis (IMPA) is an inflammatory, noninfec- tious disease that affects two or more joints in dogs. Immunosuppressive doses of prednisolone are considered the initial treatment choice for dogs with IMPA. However, few reports have described the combination of mycophenolate mofetil and prednisolone for treating dogs with IMPA. In this report, we described the cases of three dogs treated with a combination of mycophenolate mofetil and prednisolone. The clinical signs were alleviated in all cases, and C-reactive protein levels were reduced after treatment. Our results show that combination thera- py of mycophenolate mofetil and prednisolone is effective in managing IMPA. However, careful monitoring of the potential adverse effects, including sporadic infections and metabolic diseases, is necessary. In addition, screening tests and appropriate treatments are necessary for proteinuria, a common complication in dogs with IMPA.

Endoscopic Diagnosis and Management of Esophageal Extramedullary Plasmacytoma in a Dog

송중현 한국임상수의학회 2024 한국임상수의학회지 Vol.41 No.1

A 13-year-old spayed female Golden Retriever with clinical signs of weight loss and lethargy presented with two esophageal masses and one sessile polyp on computed tomography and esophagoscopy. Endoscopic snare resection was performed, and histopathological examination was requested. Based on histopathology and immunohistochemistry of multiple myeloma oncogene 1 staining, the patient was diagnosed with esophageal extramedullary plasmacytoma. The patient remained clinically well without any clinical signs during a follow-up period of 12 months. Herein, we report the successful diagnosis and management of esophageal extramedullary plasmacytoma in a dog using endoscopy.

Use of imatinib mesylate in a dog with meningoencephalitis of unknown etiology

송중현,정동인 충북대학교 동물의학연구소 2020 Journal of Biomedical and Translational Research Vol.21 No.3

A 4-year-old, female, Maltese dog with bilateral hind limb ataxia was brought to Gyeongsang National University Animal Medical Center (GAMC). Based on the previous medical and imaging records, the patient was presumptively diagnosed with a primary brain tumor of the right temporo-occipital lobe on magnetic resonance imaging (MRI) in a local animal hospital. Hydroxyurea and prednisolone therapy was initiated, and the neurological signs transiently improved. Approximately 5 months after the treatment, ataxia recurred and the patient was referred to GAMC. Upon admission, MRI at the same anatomic level as in the previous MRI was performed. Results showed inflammatory brain lesions, not brain neoplastic changes. Considering this finding, the dog was tentatively diagnosed with meningoencephalitis of unknown etiology (MUE). We added oral imatinib mesylate (10 mg/kg every 24 h), and the dosage of prednisolone was increased to 1 mg/kg twice daily. Hydroxyurea was discontinued. A rapid improvement in neurological signs was observed after the initiation of imatinib mesylate treatment. Approximately 2 months after the treatment, the size of the inflammatory lesion remarkably decreased on repeat MRI. The patient had been doing well, and there were no overt neurological signs 259 days after the initiation of imatinib mesylate therapy. We describe a case of MUE in a dog that was successfully managed with imatinib mesylate.

Neoadjuvant Chemotherapy and Subsequent Adjuvant Chemotherapy with Hydroxyurea after Craniotomy in a Cat with a Meningioma

송중현 한국임상수의학회 2023 한국임상수의학회지 Vol.40 No.5

An 11-year-old neutered male domestic short-haired cat presented with neurological symptoms that developed over a three-month period. These included mental dullness, vocalization, ataxia, and visual impairment. The pa- tient was diagnosed with a primary intracranial tumor at a local animal hospital. After the first diagnosis, the cat was administered hydroxyurea, prednisolone, omeprazole, and gabapentin for 3 months. After the initiation of medical treat- ment, the patient’s clinical symptoms did not improve and the size of the tumor was static on the second magnetic resonance imaging (MRI). The dosage of hy- droxyurea and prednisolone was increased for two weeks. The patient’s clinical signs improved, and subsequently, a craniotomy was performed. The clinical signs completely resolved six days after surgery. Adjuvant chemotherapy with hydroxyurea was continuously administered after the craniotomy. The patient demonstrated a good clinical status during the nine-month follow-up period. Neoadjuvant chemotherapy has not yet been reported for meningiomas in cats. Further clinical trials with longer follow-up periods and larger patient cohorts will be required to confirm the effectiveness of neoadjuvant chemotherapy with hydroxyurea in feline meningioma.

Unsuccessful treatment of granulomatous meningoencephalomyelitis in a dog with the combination of multiple immunosuppressive agents

송중현,박희태,이정민,송건호 충북대학교 동물의학연구소 2023 Journal of Biomedical and Translational Research Vol.24 No.3

A one-year-old, female, Maltese dog was presented with head tilting, horizontal nystagmus, and tetraparesis. Blindness was first identified, and magnetic resonance imaging (MRI) scanning revealed diffuse lesion which was hyperintense on T2-weighted image over the cerebellum and brainstem. The immunosuppressive therapy had been administered, but the patient had no improvement. Re-performed MRI revealed the progression of the pre-existed inflammatory lesions. Treatment with prednisolone, leflunomide, cyclosporine, and cytosine arabinoside was initiated. However, neurological signs had been progressive, and the patient was euthanized. The histopathological examination revealed the disseminated granulomatous meningoencephalomyelitis (GME). This GME case suggests the importance of initiation of treatment at the appropriate time.

Unilateral Deafness Diagnosed using the Brainstem Auditory Evoked Response Test in a Shih-tzu Dog

지나니,송중현,황태성,이희천,유도현,강병택,정동인 한국임상수의학회 2018 한국임상수의학회지 Vol.35 No.3

A 12-year-old castrated male Shih Tzu presented with suspected hearing loss. The patient had no historyof head trauma or exposure to ototoxic drugs. The results of neurologic and physical examinations were normal. Anotoscopic examination showed that both the tympanic membranes and the external ear canals had a normal appearance. However, the results of brainstem auditory evoked response tests confirmed sensorineural deafness in the right earand indicated conduction disturbances and brainstem abnormalities in the left ear. Magnetic resonance imaging wasperformed to confirm the causes of the conduction disturbances and brainstem abnormalities. Inflammatory changesin the left middle ear were highly suspected to be responsible for the findings in the left ear. The results of theseexaminations confirmed complete hearing loss in the right ear and indicated otitis media in the left ear, which couldhave been the cause of the conduction disturbances.