Sparks C R, Cerda-Gonzalez S, Griffith E H, Lascelles B D X, Olby N J
Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC.
Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY.
J Vet Intern Med. 2018 Jan;32(1):331-339. doi: 10.1111/jvim.14856. Epub 2017 Nov 4.
Chiari-like malformation (CM) and syringomyelia (SM) cause a pain syndrome in Cavalier King Charles spaniels (CKCS). Clinical signs are not consistently apparent on neurologic examination, and owner reporting of signs provides vital clinical history. However, owner questionnaires for this disease are not well developed.
To develop a tool to capture owner-reported clinical signs for use in clinical trials and to compare owner-reported signs with the presence of pain on neurologic examination and SM on magnetic resonance imaging (MRI).
Fifty client-owned CKCS.
Owners completed a questionnaire and pain/scratch map. Each dog underwent a neurologic examination and craniocervical magnetic resonance imaging (MRI). Questionnaire responses were developed into scores, area of shading for pain/scratch maps was measured, and consistency of responses between these tools was assessed. Owner-reported findings were compared with neurologic examination findings and presence and severity of SM on MRI.
Thirty-three dogs were symptomatic and 17 asymptomatic; 30 had SM. The most common sign of pain was crying out when lifted (n = 11). Extent of shaded areas on maps positively correlated with questionnaire scores for pain (r = 0.213, P = 0.006) and scratch (r = 0.104, P = 0.089). Owner-reported findings were not significantly associated with presence or severity of SM or neurologic examination findings. Owner-reported lateralization of signs was significantly associated with SM lateralization (P < 0.0001).
The questionnaire and maps may be useful for clinical trials. Lack of association of owner-reported signs with SM highlights our lack of understanding of the pathophysiology of pain in this disease.
类Chiari畸形(CM)和脊髓空洞症(SM)可导致查理士王小猎犬(CKCS)出现疼痛综合征。神经系统检查时临床症状并不总是明显,主人对症状的报告提供了重要的临床病史。然而,针对这种疾病的主人调查问卷尚未完善。
开发一种工具来收集主人报告的临床症状,用于临床试验,并将主人报告的症状与神经系统检查时的疼痛情况以及磁共振成像(MRI)显示的脊髓空洞症情况进行比较。
50只客户拥有的查理士王小猎犬。
主人完成一份问卷和疼痛/抓挠图谱。每只狗都接受了神经系统检查和颅颈磁共振成像(MRI)。问卷回答被转化为分数,测量疼痛/抓挠图谱的阴影面积,并评估这些工具之间回答的一致性。将主人报告的结果与神经系统检查结果以及MRI上脊髓空洞症的存在和严重程度进行比较。
33只狗有症状,17只无症状;30只患有脊髓空洞症。最常见的疼痛迹象是抱起时大声叫(n = 11)。图谱上阴影区域的范围与疼痛问卷分数(r = 0.213,P = 0.006)和抓挠问卷分数(r = 0.104,P = 0.089)呈正相关。主人报告的结果与脊髓空洞症的存在或严重程度以及神经系统检查结果无显著关联。主人报告的症状侧别与脊髓空洞症侧别显著相关(P < 0.0001)。
该问卷和图谱可能对临床试验有用。主人报告的症状与脊髓空洞症缺乏关联,凸显了我们对这种疾病疼痛病理生理学的了解不足。