Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, UK.
Department of Small Animal Medicine and Surgery, University of Veterinary Medicine, Hannover, Germany.
Vet Rec. 2021 Mar;188(6):e61. doi: 10.1002/vetr.61. Epub 2021 Feb 19.
Although the use of clinical reasoning has been evaluated for several neurological presentations, this approach has not yet been investigated for dogs with vestibular syndrome.
Two hundred and thirty-nine dogs presenting with vestibular syndrome were included in this retrospective study. Univariate analysis of variables (clinical history, signalment, clinical presentation and neurological examination findings) was performed. Variables with p < 0.3 were selected for logistic regression.
Ninety-five percent of dogs were represented by eight conditions: idiopathic vestibular disease (n = 78 dogs), otitis media interna (n = 54), meningoencephalitis of unknown origin (n = 35), brain neoplasia (n = 26), ischaemic infarct (n = 25), intracranial empyema (n = 4), metronidazole toxicity (n = 3) and neoplasia affecting the middle ear (n = 3). Idiopathic vestibular disease was associated with higher age, higher bodyweight, improving clinical signs, pathological nystagmus, facial nerve paresis, absence of Horner's syndrome and a peripheral localisation. Otitis media interna was associated with younger age, male gender, Horner's syndrome, a peripheral localisation and a history of otitis externa. Ischaemic infarct was associated with older age, peracute onset of signs, absence of strabismus and a central localisation.
Discrete clinical features can be used to identify the most likely diagnosis in dogs with vestibular syndrome.
尽管已经评估了几种神经学表现的临床推理应用，但这种方法尚未在患有前庭综合征的犬中进行研究。
本回顾性研究纳入了 239 只患有前庭综合征的犬。对变量（临床病史、品种、临床症状和神经检查结果）进行单变量分析。选择 p<0.3 的变量进行逻辑回归。
8 种疾病代表了 95%的犬：特发性前庭疾病（n=78 只犬）、中耳炎（n=54 只犬）、原因不明的脑膜脑炎（n=35 只犬）、脑肿瘤（n=26 只犬）、缺血性梗死（n=25 只犬）、颅内积脓（n=4 只犬）、甲硝唑毒性（n=3 只犬）和中耳肿瘤（n=3 只犬）。特发性前庭疾病与年龄较大、体重较高、临床症状改善、病理性眼球震颤、面神经麻痹、Horner 综合征缺失和外周定位有关。中耳炎与年龄较小、雄性、Horner 综合征、外周定位和外耳炎病史有关。缺血性梗死与年龄较大、发病急骤、无斜视和中央定位有关。
在患有前庭综合征的犬中，可以使用离散的临床特征来确定最可能的诊断。
