VETERINARY MEDICINE& BIOMEDICAL SCIENCES
One of the biggest challenges associ-ated with central nervous
system (CNS) diseases is achieving an accurate diagno-sis. While
magnetic resonance imaging (MRI), computed tomography (CT), and
spinal fluid analysis certainly furnish use-ful clinical data, they
are not always able to provide a definitive diagnosis.
Special-ists, generalists, and clients are often left wondering
about the cause of various im-aging abnormalities and how to affect
rea-sonable treatment plans.
The two MR images to the right illus-trate this frustration.
Both animals were middle age, mixed breed dogs that pre-sented with
gradual onset CNS signs. Both had bright spots within the left
thalamus on T2 MR images and inflam-matory CSF taps. Histopathology
revealed that these animals that seemed so similar were in fact
very different one had ca-nine distemper encephalitis and the other
had granulomatous meningoencephali-tis. Can you guess which is
which? If you and your clients are tired of guess work, read
on.
Image guided stereotactic biopsy rep-resents a minimally
invasive means to achieve definitive diagnoses in patients
with intracranial disease. Data from dogs and humans support a
diagnostic accura-cy exceeding 90% and morbidity of
The principle behind image guided stereo-tactic biopsy is fairly
straightforwardtake an MRI or CT scan that has a lesion and
correlate in to patient anatomy and biopsy in-struments in the
oper-ating room.
Heres how it works:
An animal is put into a head holder and scanned with special
markers, called fidu-cials.
The patient is then transported to the op-erating room where an
infrared camera captures the markers and biopsy tools so they can
be visualized on CT or MRI scans (see image this page).
A brain lesion can then be targeted and reached through a small
(3-5 milimeter) burr hole made through the skull.
Investigators at the College of Veterinary Medicine &
Biomedi-cal Sciences at Texas A&M University partnered with
pediatric neurosurgeons at UT Houston Medical School to adapt image
guided neurosurgical techniques developed in humans to veteri-nary
species. Our desire to innovate this technology came from the
frustration of guessing rather than knowing what the cause of a CNS
lesion is. To our knowledge, we are currently the only hospital in
the Southwest United States with image guided neu-rosurgery
available for companion animals.
Image guided neuro-surgery represents the first step in enhanced
neurodiagnostic and neurosurgical capabili-ties at the College of
Veterinary Medicine & Biomedical Sciences. By September 2011,
the new Diagnostic Imaging and Cancer Treatment Center will be
completed. This fa-cility will contain a 3T MRI (one of 5 available
for animals in the US) and a CT TOMO radio-therapy unit (one of 2
available for animals in North America). In ad-dition, our
continued
collaboration with UT Houston Medical School will allow for
un-paralleled care for animals affected by brain tumor through the
integration of expertise from MDs, PhDs, and board-certified
veterinarians.
We would be glad to talk with you about cases you may wish to
refer for neurodiagnostic or neurosurgical procedures. Please
contact Dr. Jonathan Levine, DVM, DACVIM (Neurology) or Dr. Sharon
Kerwin, DVM, DACVS at 979-845-2351 or via e-mail
[email protected] or [email protected]
Dr. Jon Levine obtained his Bachelor of Sci-ence and Doctor of
Veterinary Medicine de-grees at Cornell University in Ithaca NY. He
went on to do a rotating internship in small animal medicine and
surgery at Colorado State University and a residency in
Neurol-ogy/Neurosurgery at Texas A&M University and the
University of Missouri. Dr. Levines research interests include
spinal cord injury, intervertebral disk herniation, and
neuro-oncology. He has authored nearly 50 peer reviewed
manuscripts, 7 book chapters, and
presented lectures at numerous national vet-erinary meetings.
Dr. Levine has received funding from The American Kennel Club,
National Institutes of Health, Dana Founda-tion, and other groups.
He is a Diplomate of the American College of Veterinary Internal
Medicine (Neurology), an Assistant Professor of
Neurology/Neurosurgery at Texas A&M University, Adjunct
Assistant Professor of Pe-diatrics at UT Houston Medical School,
and affiliated with Mission Connect Foundation.
Visit the VMTH Small Animal Neurology Service on the web at
vetmed.tamu.edu/services/neurology
Faculty Spotlight: Dr. Jonathan Levine
Reconstructed CT images utilized during a stereotactic
biopsy
In recognition of the tough economic times that have hit Texas,
the Veterinary Medical Teaching Hospital at Texas A&M has begun
a fixed price program for cer-tain common surgical diseases. At
this time, the hospital has focused on hemi-laminectomies for
thoracolumbar disk herniation and internal fixation of limb
fractures. These are both limited pro-tocols that can be used only
for animals meeting certain criteria.
1. Hemilaminectomies: $3500
Dogs with thoracolumbar (T8-L7) disk herniation that require
surgical interven-tion are eligible for a fixed price pack-age.
Dogs must be a chondrodystrophoid breed (eg, Dachshund, Pekingese)
or chondrodystrophoid mix, be in otherwise good systemic health,
and have imag-ing evidence of a disk-associated spinal cord
compression. Services included are physical examination,
appropriate blood work, thoracic radiography, MRI (or my-elogram/CT
if MRI not available), spinal fluid analysis, decompressive
surgery, hospitalization, and rehabilitation. The cost for these
services will be $3500.
Dogs participating in the GM 6001 clini-cal trial will be
eligible for additional dis-counts at the completion of enrollment.
The GM 6001 trial is open to acutely (
