Peer-reviewed veterinary case report
Dog with brain damage from rapid salt fix recovers with care
By Harris, Stephanie et al.·Published in Frontiers in veterinary science·2023·Department of Clinical Sciences, United States·View original on PubMed →
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Original publication title: Case report: Recovery and sequential imaging of a patient with osmotic demyelination syndrome.
- Species:
- dog
Plain-English summary
A 4-year-old neutered male Australian Shepherd was brought to the emergency vet after suddenly showing strange behavior and neurological issues. Just a week earlier, he had been treated for low adrenal function (hypoadrenocorticism), and it turned out his symptoms were due to a condition called osmotic demyelination syndrome, which can happen when sodium levels are corrected too quickly. He needed intensive care, including sedation and careful monitoring, but after a week in the hospital, he was able to go home. Four and a half months later, he was doing well with no neurological problems, although follow-up imaging showed some lingering brain lesions that were improving.
People also search for: dog sudden behavior change · Australian Shepherd neurological signs · osmotic demyelination syndrome in dogs · dog brain MRI results · treatment for dog brain lesions
Abstract
A 4-year-old neutered-male Australian Shepherd was presented to an emergency and referral hospital for an acute onset of neurologic signs and abnormal mentation. Seven days prior, the patient had been diagnosed with hypoadrenocorticism and was treated accordingly at another hospital. Based on recent clinical history, the neurologic signs were consistent with thalamic and brainstem deficits and suspected to be caused by osmotic demyelination syndrome secondary to rapid correction of hyponatremia. A brain MRI confirmed lesions consistent with osmotic demyelination syndrome. The patient's clinical signs initially worsened, and he required intensive nursing care with multimodal sedation, close monitoring of electrolytes and tailored fluid therapy. The patient recovered and was discharged on day seven of hospitalization. Four and a half months later, re-evaluation of the patient showed complete resolution of the neurological deficits with a now unremarkable neurological exam, and follow-up MRI revealed still present, yet improved bilateral thalamic lesions. This is the first known veterinary case report of sequential brain imaging of a dog that has recovered from osmotic demyelination syndrome. In humans, patients can have evidence of near to full clinical recovery, yet imaging findings may still be abnormal several months after recovery. This report details similar imaging findings in a canine with improved clinical signs, despite persistent lesions on brain MRI. Prognosis of canines with osmotic demyelination syndrome may be better than previously perceived, despite the severity of clinical signs and brain lesions apparent on MRI.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/37187927/