Comparison of cerebellomedullary and lumbar cerebrospinal fluid analysis in dogs with neurological disease

• Published in: Journal of veterinary internal medicine Vol. 34; no. 2; pp. 838 - 843
• Main Authors: Lampe, Rachel, Foss, Kari D., Vitale, Samantha, Hague, Devon W., Barger, Anne M.
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01-03-2020; Wiley
• Subjects: Animals; Blood; canine; Cerebrospinal fluid; Cerebrospinal Fluid - cytology; CSF; Diagnostic Tests, Routine - veterinary; Disease; Dog Diseases - cerebrospinal fluid; Dogs; Female; Laboratories; Localization; Male; Nervous system; Nervous System Diseases - cerebrospinal fluid; Nervous System Diseases - veterinary; neurolocalization; neurology; Predictive Value of Tests; Prospective Studies; Proteins; SMALL ANIMAL; Spinal Puncture - veterinary; Statistical analysis; canine; neurolocalization; neurology; CSF
• ISSN: 0891-6640; 1939-1676
• DOI: 10.1111/jvim.15700

Background
Cerebrospinal fluid (CSF) analysis aids in categorizing underlying disease processes in patients with neurologic disease. Convention suggests that CSF should be collected caudal to the lesion. However, little evidence exists to justify this assertion.
Hypothesis/Objectives
Evaluate the clinicopathologic differences between CSF collected from the cerebellomedullary (CM) and lumbar cisterns in dogs presented for evaluation of neurologic disease.
Animals
Fifty‐one client‐owned dogs undergoing magnetic resonance imaging (MRI) and CSF collection for investigation of neurologic disease.
Methods
Cerebrospinal fluid was prospectively collected from the CM and lumbar cisterns in all patients. The total protein (TP) concentration, red blood cell (RBC) count, and total nucleated cell count (TNCC) were analyzed within 30 minutes of collection. Results and cytology findings were interpreted by a single pathologist.
Results
Fifty‐one paired samples were collected. The TNCC (P < .001), RBC (P < .001), and TP (P < .001) were different between collection sites. When grouped by neurolocalization, TP (intracranial, P < .001; cervical, P < .001; thoracolumbar, P < .001) and RBC (intracranial, P < .001; cervical, P ≤ .002; thoracolumbar, P = .006) counts were significantly different. The TNCC was significantly different in the cervical (P = .04) and thoracolumbar localizations (P = .004) but not for intracranial (P = .30) localizations. The pathologist's interpretation differed between sites in 66.7% of the cases (34/51).
Conclusions
In dogs with lesions that neurolocalized to the brain or cervical spinal cord, there may be clinical benefit in collecting fluid from both the CM and lumbar cisterns. In dogs with thoracolumbar myelopathy, CSF collected from the CM cistern may not be representative of the underlying disease process.