title: Associations between cerebrospinal fluid biomarkers and long-term neurologic outcome in dogs with acute intervertebral disk herniation.
abstract: OBJECTIVE
  To examine associations between CSF biomarkers, initial neurologic dysfunction, and long-term ambulatory outcome in dogs with acute intervertebral disk herniation (IVDH).
  
  
  METHODS
  Prospective clinical study.
  
  
  METHODS
  54 dogs with acute thoracolumbar IVDH and 16 clinically normal dogs.
  
  
  METHODS
  For each dog, variables, including CSF myelin basic protein (MBP), lactate, calcium, glucose, and total protein concentrations; nucleated cell count; and creatine kinase (CK) and aspartate aminotransferase activities, were measured. For dogs with thoracolumbar IVDH, initial neurologic function was characterized by use of a modified Frankel score (MFS; determined on a scale of 0 to 5, where 0 represented paraplegia with no deep nociception and 5 represented paraspinal hyperesthesia only). Long-term follow-up was assessed.
  
  
  RESULTS
  Among dogs with thoracolumbar IVDH, those with CSF CK activity ≤ 38 U/L had a 35-fold increase in the odds of long-term ambulation, compared with the odds in dogs with CSF CK activity > 38 U/L, adjusting for neurologic functioning at the evaluation. The CSF lactate, calcium, and glucose concentrations and aspartate aminotransferase activity were not predictive of long-term ambulatory outcome. Data analysis revealed that long-term functional recovery was > 98% for affected dogs, regardless of their initial MFS, when CSF CK activity was ≤ 38 U/L and MBP concentration was ≤ 3 ng/mL.
  
  
  CONCLUSIONS
  In dogs with acute thoracolumbar IVDH, CSF CK activity and MBP concentration appeared to be prognostic indicators and, along with initial MFS, can be used to predict long-term ambulatory outcome.
authors.affiliation: Departments of Veterinary Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843, USA. twitsberger@cvm.tamu.edu
authors.forename: Tige H
authors.initials: TH
authors.lastname: Witsberger
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Levine
authors.forename: Geoffrey T
authors.initials: GT
authors.lastname: Fosgate
authors.forename: Margaret R
authors.initials: MR
authors.lastname: Slater
authors.forename: Sharon C
authors.initials: SC
authors.lastname: Kerwin
authors.forename: Karen E
authors.initials: KE
authors.lastname: Russell
authors.forename: Gwendolyn J
authors.initials: GJ
authors.lastname: Levine
mesh_terms: D000818:Animals; D001219:Aspartate Aminotransferases / Q000134:cerebrospinal fluid* / Q000378:metabolism; D015415:Biomarkers / Q000134:cerebrospinal fluid; D003402:Creatine Kinase / Q000134:cerebrospinal fluid* / Q000378:metabolism; D004283:Dog Diseases / Q000134:cerebrospinal fluid* / Q000378:metabolism; D004285:Dogs; D005260:Female; D055959:Intervertebral Disc Degeneration / Q000134:cerebrospinal fluid / Q000378:metabolism / Q000662:veterinary*; D008297:Male
chemical_list: D015415:Biomarkers; D001219:Aspartate Aminotransferases; D003402:Creatine Kinase