Proceedings 31st Symposium ESVN-ECVN

A 1‐year‐old, female Pug dog was presented with a month history of progressive truncal swaying, ataxia, right‐sided head tilt, altered mentation, right eye exophthalmia, and conjunctival hyperaemia. Neurological examination revealed obtunded mentation, mild ambulatory tetraparesis and vestibulo‐cerebellar ataxia, occasional truncal swaying with the tendency to fall on both sides and generalised whole body tremors. The postural responses were markedly delayed to absent in all limbs. Menace response was absent bilaterally. The findings indicated a multifocal intracranial lesion affecting the central vestibular system (cerebellum and brainstem) and forebrain. Magnetic resonance imaging (MRI) detected multiple haemorrhagic lesions in the forebrain, thalamus, mesencephalon and metencephalon. Cerebrospinal fluid (CSF) collection was not performed due to the increased risk of bleeding. Baermann test and zinc sulfate flotation with centrifugation performed on faecal samples were positive for lungworm larvae and an antigenic test confirmed Angiostrongylus vasorum infection. Anthelmintic treatment was started with consequent marked clinical improvement. Seventy days later the dog was clinically normal and no larvae were detected on Baermann test. Repeat MRI of the brain revealed marked improvement of the haemorrhagic lesions. CSF then showed marked eosinophilic pleocytosis and anthelmintic treatment was restarted. Follow up CSF analysis 4 months after first presentation revealed resolution of the eosinophilic pleocytosis.