Witsberger, Tige H.Levine, Jonathan M.Fosgate, Geoffrey TheodoreSlater, Margaret R.Kerwin, Sharon C.Russell, Karen E.Levine, Gwendolyn J.2012-05-282012-05-282012-03-01Witsberger, TH, Levine, JM, Fosgate, GT, Slater, MR, Kerwin, SC, Russell, KE & Levine, GJ 2012, 'Associations between cerebrospinal fluid biomarkers and long-term neurologic outcome in dogs with acute intervertebral disk herniation', Journal of the American Veterinary Medical Association, vol. 240, no. 5, pp. 555-562.0003-14886603440077http://hdl.handle.net/2263/18926Presented as a poster at the American College of Veterinary Surgeons Symposium, Washington, DC, October 2009.OBJECTIVE: To examine associations between CSF biomarkers, initial neurologic dysfunction, and long-term ambulatory outcome in dogs with acute intervertebral disk herniation (IVDH). DESIGN: Prospective clinical study. ANIMALS: 54 dogs with acute thoracolumbar IVDH and 16 clinically normal dogs. PROCEDURES: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 longterm 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 AND CLINICAL RELEVANCE: 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. (J Am Vet Med Assoc 2012;240:555–562)enAmerican Veterinary Medical AssociationLong-term neurologic outcomeInitial neurologic dysfunctionAcute intervertebral disk herniation (IVDH)CSF biomarkersIVDHDogs -- DiseasesCerebrospinal fluidIntervertebral disk -- HerniaVeterinary neurologyArticle