Peer-reviewed veterinary case report
Using neostigmine to diagnose acquired myasthenia gravis in dogs
By Cridge, Harry et al.·Published in Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)·2021·Department of Clinical Sciences, United States·View original on PubMed →
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Original publication title: The clinical utility of neostigmine administration in the diagnosis of acquired myasthenia gravis.
- Species:
- dog
Plain-English summary
A group of 22 dogs and 3 cats showing signs of muscle weakness were tested for a condition called acquired myasthenia gravis (MG) using a medication called neostigmine. The results showed that 16 of the dogs had MG and responded positively to the neostigmine, indicating it helped improve their muscle strength. However, some dogs with other conditions also showed a positive response, which could lead to confusion in diagnosis. The study suggests that using neostigmine is a safe and effective way to help diagnose MG in pets.
People also search for: dog muscle weakness diagnosis · neostigmine for myasthenia gravis in dogs · cat muscle strength test
Abstract
OBJECTIVE: To assess the clinical utility of neostigmine methylsulfate administration in the diagnosis of suspected acquired myasthenia gravis (MG) in dogs and cats. DESIGN: Retrospective study (2017-2019). SETTING: Five university teaching hospitals and 2 private referral hospitals. ANIMALS: Twenty-two dogs and 3 cats. Criteria for inclusion were clinical signs consistent with acquired MG, performance of a neostigmine challenge and acetylcholine receptor antibody titers. INTERVENTIONS: None. MEASUREMENTS & MAIN RESULTS: The route of neostigmine administration was recorded. Response to neostigmine challenge was determined via sequential evaluation of muscle strength and ambulation following administration of neostigmine methylsulfate. Response to neostigmine challenge was compared to acetylcholine receptor antibody titers, which were used as the biochemical gold standard in this study. Sixteen out of 22 dogs were diagnosed with acquired MG. Thirteen of 16 had a strong positive response to neostigmine challenge whereas 3 of 16 had no response. Two out of 3 dogs with polymyositis also had a strong positive response to neostigmine challenge. Weak positive results were seen with intracranial neoplasia (n = 1) and a dog with dilated cardiomyopathy and coxofemoral joint disease (n = 1). One cat was diagnosed with acquired MG and had a positive response to neostigmine challenge. Two cats had no response to neostigmine challenge and were diagnosed with alternate conditions. Two cats were premedicated with glycopyrrolate, one of which had a mild adverse response to neostigmine challenge (sialorrhea and mild transient tremors). Three out of 22 dogs had minimal adverse effects (sialorrhea and 1 dog with muscle tremors). CONCLUSIONS: The neostigmine challenge appears to be safe and viable alternative to the previously utilized edrophonium challenge, particularly when weak positive responses are considered negative for acquired MG. Polymyositis cases may have a false positive response to neostigmine challenge.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/34324776/