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Highlights • Cavalier King Charles spaniels with syringomyelia are assumed to experience central neuropathic pain. • In humans with central neuropathic pain, monofilaments were used to evaluate somatosensory function. • The cervical mechanical sensory threshold was quantified with monofilaments in case and control dogs. • Mean mechanical sensory threshold was not significantly different between case and control dogs. • The complete somatosensory profile needs to be characterised in order to assess whether syringomyelia alters sensory thresholds. Abstract It is assumed that Cavalier King Charles spaniels with Chiari-like malformation and syringomyelia experience central neuropathic pain. An association between spinal cord parenchymal lesions and specific clinical signs (e.g. spontaneous and evoked scratching, withdrawal, and paroxysmal pain manifestations with vocalisation) has been suggested. This led to the hypothesis that mechanical sensory threshold is altered in clinical cases. The aim of this study was to quantify the cervical mechanical sensory threshold using Semmes-Weinstein monofilaments in nine Cavalier King Charles spaniels with Chiari-like malformation and assumed syringomyelia-associated central neuropathic pain compared to eight control dogs. Clinical and neurological examination including magnetic resonance imaging was undertaken. Mean mechanical sensory threshold was not significantly different between case and control dogs (t -test on log10 transformed data; P = 0.25). Substantial variation within and between dogs was seen, with individual thresholds ranging from 0.04 to 26 g in case dogs and from 0.02 to 10 g in control dogs. Based on these results, it is unlikely that Cavalier King Charles spaniels with Chiari-like malformation and syringomyelia have increased mechanical sensation characterised by lower mechanical sensory threshold when quantified with Semmes-Weinstein monofilaments. Whether clinical cases experience central neuropathic pain remains unknown. The assessment of sensory function in dogs with assumed central neuropathic pain should be multimodal and include not only mechanical but also tactile and thermal threshold quantification. The use of threshold quantification in a clinical setting is challenging due to an insufficient signal relative to the biological background noise within and between dogs. [ABSTRACT FROM AUTHOR]

Treatment of canine epilepsy is problematic. Few antiepileptic drugs have proven efficacy in dogs and undesirable adverse effects and pharmacoresistance are not uncommon. Consequently, the need for investigation of alternative treatment options is ongoing. The objective of this study was to investigate the efficacy and tolerability of levetiracetam as mono-therapy in dogs with idiopathic epilepsy. The study used a prospective single-blinded parallel group design. Twelve client-owned dogs were included and were randomised to treatment with levetiracetam (30 mg/kg/day or 60 mg/kg/day divided into three daily dosages) or phenobarbital (4 mg/kg/day divided twice daily). Control visits were at days 30, 60 and then every 3 months for up to 1 year. Two or more seizures within 3 months led to an increase in drug dosage (levetiracetam: 10 mg/kg/day, phenobarbital: 1 mg/kg/day). Five of six levetiracetam treated dogs and one of six phenobarbital treated dogs withdrew from the study within 2–5 months due to insufficient seizure control. In the levetiracetam treated dogs there was no significant difference in the monthly number of seizures before and after treatment, whereas in the phenobarbital treated dogs there were significantly ( P  = 0.013) fewer seizures after treatment. Five phenobarbital treated dogs were classified as true responders (≥50% reduction in seizures/month) whereas none of the levetiracetam treated dogs fulfilled this criterion. Adverse effects were reported in both groups but were more frequent in the phenobarbital group. In this study levetiracetam was well tolerated but was not effective at the given doses as mono-therapy in dogs with idiopathic epilepsy. [ABSTRACT FROM AUTHOR]

Perceptions of cancer care are impacted by many factors and differ among individuals. Patients generally want consistent support, effective communication, accessible treatments, and information to manage physical, emotional, and psychosocial needs. Black/African American cancer survivors have expressed concerns about providers ignoring the social and financial implications of cancer care and neglecting to address the generations of mistrust between minority communities and the healthcare system. There is limited information about these perceptions as they relate specifically to radiation therapy which we aim to address with this study. Female breast cancer survivors identifying as Black/African American within the metropolitan Milwaukee area were eligible to participate in a semi-structured interview guided by a demographic questionnaire, a life narrative account, and a residential history. Participants were purposively sampled by neighborhood racial and ethnic composition (majority Black, minority Black, and racially diverse communities) to ensure a diversity of experiences. Interviews were transcribed and analyzed using a codebook developed and refined based on a conceptual model. Individuals worked in assigned pairs to open code each transcript. Data coded as "clinical presentation" or "treatment/healthcare" were pulled and reviewed for discussion of radiation therapy. Within these codes, further thematic analysis was performed to breakdown perceptions of this treatment modality. Fifty Black women were interviewed, 25 from majority, 7 from diverse, and 18 from minority communities. In discussing radiation therapy, six key themes emerged: emotional reactions, logistics of daily treatment, social barriers, side effects, general positive experiences, and general negative experiences. Emotional reactions included feelings of fear, anger, and being overwhelmed. Social barriers related to family obligations, transportation, distance from a treatment center, and racism. Commonly discussed side effects included fatigue, dermatitis, impacts on reconstruction, and long-term cardiotoxicity. Women living in majority Black communities were more likely to discuss side effects and general positive experiences while other themes were more equally explored by majority, minority, and diverse community members alike. Black women have diverse and varied perspectives of radiation therapy during breast cancer treatment. Anticipated themes surrounding logistics, side effects, and overall emotions of treatment were observed. Unique to their experiences, Black women have faced racism and an increased burden of social barriers during their treatment. Further studies exploring the perspectives of Black female cancer survivors are needed to optimize quality of care and outcomes. [ABSTRACT FROM AUTHOR]

The main objective of this study was to estimate the incidence and mortality rates of epilepsy in a large population of insured dogs and to evaluate the importance of a variety of risk factors. Survival time after a diagnosis of epilepsy was also investigated. The Swedish animal insurance database used in this study has previously been helpful in canine epidemiological investigations. More than 2,000,000 dog-years at-risk (DYAR) were available in the insurance database. In total, 5013 dogs had at least one veterinary care claim for epilepsy, and 2327 dogs were euthanased or died because of epilepsy. Based on veterinary care claims the incidence rate of epilepsy (including both idiopathic and symptomatic cases) was estimated to be 18 per 10,000 DYAR. Dogs were followed up until they were 10 (for life insurance claims) or 12 years of age (veterinary care claims). Among the 35 most common breeds in Sweden, the Boxer was at the highest risk of epilepsy with 60.3 cases per 10,000 DYAR, and also had the highest mortality rate of 46.7 per 10,000 DYAR (based on life insurance claims). Overall, males were at a higher risk than females (1.4:1). Median survival time (including euthanasia and death) after diagnosis was 1.5 years. In general, breeds kept solely for companionship lived longer after diagnosis than those kept for dual-purposes, such as hunting and shepherd and working breeds. The study demonstrates marked breed differences in incidence and mortality rates, which are assumed to reflect genetic predisposition to epilepsy. [ABSTRACT FROM AUTHOR]

The objectives of the present study were to investigate survival time, possible predictors of survival and clinical outcome in dogs with ischaemic stroke. A retrospective study of dogs with a previous diagnosis of ischaemic stroke diagnosed by magnetic resonance imaging (MRI) was performed. The association between survival and the hypothesised risk factors was examined using univariable exact logistic regression. Survival was examined using Kaplan-Meier and Cox regression. Twenty-two dogs were identified. Five dogs (23%) died within the first 30 days of the stroke event. Median survival in 30-day survivors was 505 days. Four dogs (18%) were still alive by the end of the study. Right-sided lesions posed a significantly increased risk of mortality with a median survival time in dogs with right-sided lesions of 24 days vs. 602 days in dogs with left sided lesions (P = 0.006). Clinical outcome was considered excellent in seven of 17 (41%) 30-day survivors. Another seven 30-day survivors experienced new acute neurological signs within 6-17 months of the initial stroke event; in two of those cases a new ischaemic stroke was confirmed by MRI. In conclusion, dogs with ischaemic stroke have a fair to good prognosis in terms of survival and clinical outcome. However, owners should be informed of the risk of acute death within 30 days and of the possibility of new neurological events in survivors. Mortality was increased in dogs with right-sided lesions in this study. [ABSTRACT FROM AUTHOR]