Dr Clare Rusbridge

Reader in Veterinary Neurology

Qualifications: BVMS DECVN PhD MRCVS RCVS and European Specialist in Veterinary Neurology

Email:

Further information

Biography

Clare graduated from the University of Glasgow in 1991 and following an internship at the University of Pennsylvania and general practice in Cambridgeshire, she completed a BSAVA/Petsavers Residency and then became Staff Clinician in Neurology at the Royal Veterinary College. Clare became a Diplomate of the European College of Veterinary Neurology in 1996 and a RCVS Specialist in 1999. In 2007 Clare was awarded a PhD from Utrecht University for my thesis on Chiari-like malformation & Syringomyelia - a painful disease occurring in some toy breed dogs. For 16 years Clare operated a neurology and neurosurgery referral service at the Stone Lion Veterinary Hospital in Wimbledon.  In September 2013 she joined Fitzpatrick Referrals and the University of Surrey which allows me to continue my clinical and research work. Clare's professional interests include neuropathic pain, inherited diseases, epilepsy and rehabilitation following spinal injury. She treats many animals with painful and/or distressing inherited disease which motivates her research aiming to find a better way of diagnosing, treating and preventing these conditions. In 2011 Clare was awarded the J. A. Wright (a.k.a. James Herriot) Memorial Award by The Blue Cross Animal Welfare Charity for her work with the Cavalier King Charles spaniel society with regard to syringomyelia.  Clare have written over 50 scientific papers, contributed to several veterinary textbooks and has edited a medical textbook on syringomyelia.

Research Interests

1. Pathogenesis, diagnosis, and treatment of syringomyelia
In 1997 Clare identified and described inherited canine Chiari-like malformation and syringomyelia (CMSM) in cavalier King Charles spaniels. Since then, she has initiated many collaborative projects designed to improve our understanding of the phenotypical and genetic nature of CMSM. Current collaborations, together with research assistant Penny Knowler, include:
a) a statistical genetic analysis of whole canine genome scans and establishment of a large DNA collection of dogs affected with CMSM. A collaboration with Dr Z Kibar and Dr. G. Rouleau University of Montreal and currently funded by Canadian Institutes of Health Research
b) investigation of systemic fibrosis in the CKCS with Dr P Watson, Cambridge University currently funded by BSAVA Petsavers
c) Studies with Dr H Volk, Royal Veterinary College of the pathogenic relationship between CM and SM; the effect of CMSM and part of a multicenter trial for novel neuropathic analgesics.
d) The effect of neuropathic pain on neurobiology and behavior in collaboration with Prof Mike Mendl and Dr Jo Murrell, Bristol University.
e) Syringomyelia in the Griffon Bruxellois a study with Drs M Kent, S Platt, SJ Schatzberg University of Georgia
f) The database established by Penny Knowler and myself of 1400 SM affected CKCS collected over 12 years was used by colleagues Drs S Blott and T Lewis in the Animal Health Trust UK to create a computer program generating estimated breeding values for dogs to allow dog breeders the opportunity to select individuals that confer less risk of early onset SM.

2. Expanded repeat in canine epilepsy
Clare was the chief veterinary collaborator for a project on canine Lafora disease. After identifying this rare progressive epilepsy in a canine patient, she established links with Dr. Berge Minassian of the Hospital for Sick Children, University of Toronto to study the mutation causing the disease. Clare established a nationwide program of DNA collection from affected dogs and their relatives to conduct a genome scan and characterisation of the mutation. The successful outcome was the first description of a mutation causing canine epilepsy and the first example of a tandem repeat expansion outside of humans. In addition, a test for detection of affected and carrier dogs was established to enable a controlled breeding program in miniature wire haired Dachshunds and Bassett Hounds. In the near future they hope to establish a preventative treatment program.

3. Feline orofacial pain syndrome (FOPS)
This is a novel description of condition in cats analogous to (inherited) trigeminal neuralgia in humans. In addition to describing the phenotypical condition, Clare established the collection of DNA from affected animals and, in collaboration with Dr L Lyons (University of California) and Dr R Malik (University of Sidney) they are investigating the genetics of this disease. Preliminary data that suggests an association on two chromosomes requires further investigation.

4. Polymyositis in Hungarian Vizsla Dogs 
Clare has described the disease and established a DNA collection from the Hungarian Vizsla dog breed with genetic susceptibility to polymyositis and other autoimmune diseases. In collaboration with Fitzpatrick referrals neurology resident Anna Taura,  Di Addicott of the Hungarian Vizsla Breed Club and Dr L Kennedy and Dr J Massey of Companion Animal DNA Archive, Manchester University. Preliminary work has identified a haplotype which was significantly raised frequency in affected cases compared to controls.

Publications

Journal articles

  • Grant D, Rusbridge C. (2014) 'Topiramate in the management of feline idiopathic ulcerative dermatitis in a two-year-old cat'. Veterinary Dermatology, 25 (3)

    Abstract

    Background: Feline idiopathic ulcerative dermatosis is a rare, poorly understood condition characterized by self-trauma. The lesion presents as a nonhealing, crusted ulcer, which occurs most commonly on the dorsal midline of the neck or between the scapulae. Animal: A 2-year-old female neutered domestic short hair cat was presented with an ulcerative dermatosis affecting the dorsal midline. Previous investigations had failed to identify the cause, and the lesion was resistant to treatment. Methods and results: Diagnosis was based on clinical findings and confirmed by histopathology showing epidermal ulceration and superficial necrosis with a mild dermal infiltrate together with subepidermal fibrosis. The cat had been fed a commercial hypoallergenic diet for 6 months, which had successfully managed its chronic diarrhoea. Deep skin scrapings, cytology and fungal culture failed to demonstrate pathogens. Conclusions and clinical importance: Remission was obtained within 4 weeks and has been maintained over a 30 month period with topiramate (5 mg/kg orally twice daily), an anti-epileptic drug used in human medicine. Attempts to withdraw this therapy led to relapse within 24 h on two occasions. To the best of the authors' knowledge, this is the first case report of the use of this drug for feline idiopathic ulcerative dermatosis. © 2014 ESVD and ACVD.

  • Grant D, Rusbridge C. (2014) 'Topiramate in the management of feline idiopathic ulcerative dermatitis in a two-year-old cat.'. Vet Dermatol, England: 25 (3), pp. 226-e60.

    Abstract

    Feline idiopathic ulcerative dermatosis is a rare, poorly understood condition characterized by self-trauma. The lesion presents as a nonhealing, crusted ulcer, which occurs most commonly on the dorsal midline of the neck or between the scapulae.

  • Knowler SP, McFadyen AK, Freeman C, Kent M, Platt SR, Kibar Z, Rusbridge C. (2014) 'Quantitative analysis of Chiari-like malformation and syringomyelia in the griffon bruxellois dog.'. PLoS One, United States: 9 (2)

    Abstract

    This study aimed to develop a system of quantitative analysis of canine Chiari-like malformation and syringomyelia on variable quality MRI. We made a series of measurements from magnetic resonance DICOM images from Griffon Bruxellois dogs with and without Chiari-like malformation and syringomyelia and identified several significant variables. We found that in the Griffon Bruxellois dog, Chiari-like malformation is characterized by an apparent shortening of the entire cranial base and possibly by increased proximity of the atlas to the occiput. As a compensatory change, there appears to be an increased height of the rostral cranial cavity with lengthening of the dorsal cranial vault and considerable reorganization of the brain parenchyma including ventral deviation of the olfactory bulbs and rostral invagination of the cerebellum under the occipital lobes.

  • Lemay P, Knowler SP, Bouasker S, Nédélec Y, Platt S, Freeman C, Child G, Barreiro LB, Rouleau GA, Rusbridge C, Kibar Z. (2014) 'Quantitative trait loci (QTL) study identifies novel genomic regions associated to Chiari-like malformation in Griffon Bruxellois dogs.'. PLoS One, United States: 9 (4)

    Abstract

    Chiari-like malformation (CM) is a developmental abnormality of the craniocervical junction that is common in the Griffon Bruxellois (GB) breed with an estimated prevalence of 65%. This disease is characterized by overcrowding of the neural parenchyma at the craniocervical junction and disturbance of cerebrospinal fluid (CSF) flow. The most common clinical sign is pain either as a direct consequence of CM or neuropathic pain as a consequence of secondary syringomyelia. The etiology of CM remains unknown but genetic factors play an important role. To investigate the genetic complexity of the disease, a quantitative trait locus (QTL) approach was adopted. A total of 14 quantitative skull and atlas measurements were taken and were tested for association to CM. Six traits were found to be associated to CM and were subjected to a whole-genome association study using the Illumina canine high density bead chip in 74 GB dogs (50 affected and 24 controls). Linear and mixed regression analyses identified associated single nucleotide polymorphisms (SNPs) on 5 Canis Familiaris Autosomes (CFAs): CFA2, CFA9, CFA12, CFA14 and CFA24. A reconstructed haplotype of 0.53 Mb on CFA2 strongly associated to the height of the cranial fossa (diameter F) and an haplotype of 2.5 Mb on CFA14 associated to both the height of the rostral part of the caudal cranial fossa (AE) and the height of the brain (FG) were significantly associated to CM after 10 000 permutations strengthening their candidacy for this disease (P = 0.0421, P = 0.0094 respectively). The CFA2 QTL harbours the Sall-1 gene which is an excellent candidate since its orthologue in humans is mutated in Townes-Brocks syndrome which has previously been associated to Chiari malformation I. Our study demonstrates the implication of multiple traits in the etiology of CM and has successfully identified two new QTL associated to CM and a potential candidate gene.

  • Driver CJ, Volk HA, Rusbridge C, Van Ham LM. (2013) 'An update on the pathogenesis of syringomyelia secondary to Chiari-like malformations in dogs'. Veterinary Journal, 198 (3), pp. 551-559.

    Abstract

    Syringomyelia (SM) is a spinal cord disease that can cause neuropathic pain in dogs. The pathogenesis of SM secondary to Chiari-like malformation (CM) has been the focus of intense research in recent years. The gulf in our understanding of CM/SM in dogs relative to the analogous human condition has progressively narrowed. CM is primarily a disease of abnormal geometric morphometry affecting the caudal cranial fossa and the brain parenchyma contained within it. This review describes how advanced imaging techniques have revealed a series of morphometric abnormalities associated with CM/SM. The series is presented in a logical order to help describe the pathogenesis of CM and the subsequent formation of syringes, with particular reference to the concepts of craniospinal compliance and cerebrospinal fluid pulse pressure timing. © 2013 Elsevier Ltd.

  • Driver CJ, Volk HA, Rusbridge C, Van Ham LM. (2013) 'An update on the pathogenesis of syringomyelia secondary to Chiari-like malformations in dogs'. Veterinary Journal,

    Abstract

    Syringomyelia (SM) is a spinal cord disease that can cause neuropathic pain in dogs. The pathogenesis of SM secondary to Chiari-like malformation (CM) has been the focus of intense research in recent years. The gulf in our understanding of CM/SM in dogs relative to the analogous human condition has progressively narrowed. CM is primarily a disease of abnormal geometric morphometry affecting the caudal cranial fossa and the brain parenchyma contained within it. This review describes how advanced imaging techniques have revealed a series of morphometric abnormalities associated with CM/SM. The series is presented in a logical order to help describe the pathogenesis of CM and the subsequent formation of syringes, with particular reference to the concepts of craniospinal compliance and cerebrospinal fluid pulse pressure timing. © 2013 Elsevier Ltd. All rights reserved.

  • Rusbridge C. (2013) 'Choosing the right drug 2. Anticonvulsants used for second-line therapy, other anticonvulsants and alternative therapies'. In Practice, 35 (4), pp. 183-189.

    Abstract

    Many epileptic patients will have satisfactory seizure control using the first-line anticonvulsants phenobarbital and/or bromide, as discussed in the first article of this series (In Practice, March 2013, vol 35, pp 106-113). However, some patients will continue to have an unacceptable number or severity of seizures despite adequate drug serum concentrations. Some patients have a compromised quality of life because of the adverse effects of their medication. In this article, the anticonvulsant drugs used for second-line therapy are discussed, together with other anticonvulsants and alternative therapies.

  • Shaw TA, Driver CJ, Volk HA, McGonnell IM, Rusbridge C. (2013) 'Caudal cranial fossa partitioning in Cavalier King Charles spaniels'. Veterinary Record, 172 (13), pp. 341-341.
  • McGuinness SJ, Friend EJ, Knowler SP, Rusbridge C, Jeffery ND. (2013) 'Progression of otitis media with effusion in the Cavalier King Charles spaniel'. Veterinary Record, 172 (12), pp. 315-315.
  • Rusbridge C. (2013) 'Choosing the right drug 1. Anticonvulsants used for first-line therapy'. In Practice, 35 (3), pp. 106-113.

    Abstract

    This article aims to give the general practitioner a step by step approach to first-line medical management of epilepsy in both cats and dogs. The licensed drugs, bromide and phenobarbital, are discussed in detail with particular reference to the common problems that might be observed. A second article in this two-part series, to be published in a subsequent issue of In Practice, will discuss second-line medical management of epilepsy.

  • Massey J, Rothwell S, Rusbridge C, Tauro A, Addicott D, Chinoy H, Cooper RG, Ollier WE, Kennedy LJ. (2013) 'Association of an MHC class II haplotype with increased risk of polymyositis in Hungarian Vizsla dogs.'. PLoS One, United States: 8 (2)

    Abstract

    A breed-specific polymyositis is frequently observed in the Hungarian Vizsla. Beneficial clinical response to immunosuppressive therapies has been demonstrated which points to an immune-mediated aetiology. Canine inflammatory myopathies share clinical and histological similarities with the human immune-mediated myopathies. As MHC class II associations have been reported in the human conditions we investigated whether an MHC class II association was present in the canine myopathy seen in this breed. 212 Hungarian Vizsla pedigree dogs were stratified both on disease status and degree of relatedness to an affected dog. This generated a group of 29 cases and 183 "graded" controls: 93 unaffected dogs with a first degree affected relative, 44 unaffected dogs with a second degree affected relative, and 46 unaffected dogs with no known affected relatives. Eleven DLA class II haplotypes were identified, of which, DLA-DRB1*02001/DQA1*00401/DQB1*01303, was at significantly raised frequency in cases compared to controls (OR = 1.92, p = 0.032). When only control dogs with no family history of the disease were compared to cases, the association was further strengthened (OR = 4.08, p = 0.00011). Additionally, a single copy of the risk haplotype was sufficient to increase disease risk, with the risk substantially increasing for homozygotes. There was a trend of increasing frequency of this haplotype with degree of relatedness, indicating low disease penetrance. These findings support the hypothesis of an immune-mediated aetiology for this canine myopathy and give credibility to potentially using the Hungarian Vizsla as a genetic model for comparative studies with human myositis.

  • Rutherford L, Volk HA, Wessmann A, Rusbridge C, McGonnell IM, Abeyesinghe S, Burn C. (2012) 'Questionnaire-based behaviour analysis of Cavalier King Charles spaniels with neuropathic pain due to Chiari-like malformation and syringomyelia'. Veterinary Journal, 194 (3), pp. 294-298.

    Abstract

    Chiari-like malformation (CM)/syringomyelia (SM) is a disease complex recognised in Cavalier King Charles spaniels (CKCSs) that can lead to neuropathic pain (NeP). In humans, NeP is associated with anxiety, depression and reduced quality of life (QoL). In this study, databases of three specialist veterinary centres were searched and CKCS breed societies and health forums were contacted to identify CKCS with an imaging diagnosis of CM/SM. Owners completed questionnaires on behaviour, signalment, general health status, NeP and QoL. Data were analysed from 122 dogs out of 564 questionnaires completed, after incomplete questionnaires and data from dogs that had other potentially debilitating disease processes were excluded. NeP severity score was significantly and positively correlated with 'stranger-directed' fear (r=0.28), non-social fear (r=0.34), 'separation-related' behaviour (r=0.38), attachment behaviour (r=0.24), excitability (r=0.21) and proxy for pain sensation (r=0.29). Increased NeP was also significantly associated with decreased QoL (r=0.47), ability to settle (r=0.26) and willingness to exercise (r=0.50). Severity of NeP was positively associated with certain fear-associated behaviour and with decreased owner-perceived QoL. Thus, neurobehavioural changes should be considered in the management of NeP in CKCS with CM/SM. © 2012 Elsevier Ltd.

  • Plessas IN, Driver CJ, Chandler KE, Brodbelt DC, Volk HA, Rusbridge C, Craig A, McGonnell IM. (2012) 'Long-term outcome of Cavalier King Charles spaniel dogs with clinical signs associated with Chiari-like malformation and syringomyelia'. Veterinary Record, 171 (20), pp. 501-501.

    Abstract

    The disease complex Chiari-like malformation (CM) and syringomyelia (SM) has been associated with the development of neuropathic pain (NeP), and commonly affects Cavalier King Charles spaniels (CKCS). This prospective cohort study followed 48 CKCSs with CM and/or SM and clinical signs suggestive of NeP for a period of 39 (±14.3) months from diagnosis. At the end of the study, 36 dogs were still alive; five dogs died of an unrelated or unknown cause, and seven were euthanased due to severe clinical signs suggestive of NeP. During the follow-up period, the clinical signs of scratching, facial rubbing behaviour, vocalisation and exercise ability were evaluated. Nine out of 48 dogs stopped scratching (P<0.001), but there was no statistically significant change in the number of dogs exhibiting exercise intolerance, vocalisation or facial rubbing behaviour. The overall severity of clinical signs based on a visual analogue scale (VAS) (0 mm: no clinical signs 100 mm: severe clinical signs) increased (from median 75 mm (interquartile ranges (IQR) 68-84) to 84 mm (IQR 71.5-91), P<0.001). A quarter of the dogs were static or improved. In general, the majority of the owners felt that the quality of life of their dogs was acceptable. Medical treatments received were gabapentin or pregabalin and/or intermittently, carprofen. The owner's perception of their animal's progress, and progress based on VAS, had strong positive correlation (Spearman's rank correlation (s) 0.74, P<0.001). Overall, this study suggests that clinical signs suggestive of NeP progress in three-quarters of CKCSs with CM and/or SM.

  • Hu HZ, Rusbridge C, Constantino-Casas F, Jeffery N. (2012) 'Distribution of substance P and calcitonin gene-related peptide in the spinal cord of Cavalier King Charles Spaniels affected by symptomatic syringomyelia'. Research in Veterinary Science, 93 (1), pp. 318-320.

    Abstract

    The causes of clinical signs associated with syringomyelia in the Cavalier King Charles Spaniel (CKCS) are incompletely understood. In this study we compared expression of two pain-related neuropeptides: substance P (SP) and calcitonin gene related peptide (CGRP), in the spinal cord dorsal horn of normal dogs with that in CKCS with and without clinical signs of syringomyelia. There was a decrease in expression of both peptides in CKCS with 'symptomatic' syringomyelia that was also associated with significant asymmetry in SP-I and similar, though non-significant, asymmetry in CGRP-I compared with other groups. The asymmetric distribution of these pain-related peptides may be a consequence of syrinx-associated damage to grey matter but may also play a role in generation of pain. © 2011 Elsevier Ltd.

  • Hu HZ, Constantino-Casas F, Jeffery N, Rusbridge C. (2012) 'Histopathological Investigation of Syringomyelia in the Cavalier King Charles Spaniel'. Journal of Comparative Pathology, 146 (2-3), pp. 192-201.

    Abstract

    Syringomyelia (SM) in Cavalier King Charles spaniels (CKCSs) is identified commonly on magnetic resonance images and is sometimes associated with clinical signs of pain and cervical hyperaesthesia. However, the mechanism by which SM develops in this breed has not been fully elucidated and the associated effects on spinal cord structure have not been reported previously. The aims of this study were to describe changes found in the spinal cord of CKCSs, to compare findings between symptomatic and asymptomatic dogs and to determine whether syrinx formation was associated with tissue destruction. Anomalies of the central canal were found in all specimens and many dogs had grossly visible fluid-filled cavities within the spinal cord. Prominent microscopical findings were spongy degenerative changes associated with neuronal necrosis and Wallerian degeneration. The ependyma was discontinuous in many specimens, notably in symptomatic individuals, and there was evidence of angiogenesis and fibrous tissue proliferation around blood vessels adjacent to syrinx cavities. Compared with two different samples of the normal dog population, dogs with syrinxes had significantly less grey matter, although this decrease was associated with generalized loss of spinal cord area. Therefore, SM is associated with degenerative changes in the spinal cord and may develop through primary disruption of ependymal integrity followed by vascular hypertrophy and proliferation. Glial and fibrous proliferation appears to be associated with expression of clinical signs. © 2011 Elsevier Ltd.

  • Shaw TA, McGonnell IM, Driver CJ, Rusbridge C, Volk HA. (2012) 'Increase in cerebellar volume in Cavalier King Charles Spaniels with Chiari-like malformation and its role in the development of syringomyelia.'. PLoS One, United States: 7 (4)

    Abstract

    Previous research in Cavalier King Charles Spaniels (CKCS) has found that Chiari-like malformation and syringomyelia (CM/SM) are associated with a volume mismatch between the caudal cranial fossa (CCF) and the brain parenchyma contained within. The objectives of this study were to i) compare cerebellar volume in CKCS (a "high risk' group which frequently develops CM/SM), small breed dogs (medium risk--occasionally develop CM/SM), and Labradors (low risk--CM/SM not reported); ii) evaluate a possible association between increased cerebellar volume and CM/SM in CKCS; iii) investigate the relationship between increased cerebellar volume and crowding of the cerebellum in the caudal part of the CCF (i.e. the region of the foramen magnum). Volumes of three-dimensional, magnetic resonance imaging derived models of the CCF and cerebellum were obtained from 75 CKCS, 44 small breed dogs, and 31 Labradors. As SM is thought to be a late onset disease process, two subgroups were formed for comparison: 18 CKCS younger than 2 years with SM (CM/SM group) and 13 CKCS older than 5 years without SM (CM group). Relative cerebellar volume was defined as the volume of the cerebellum divided by the total volume of brain parenchyma. Our results show that the CKCS has a relatively larger cerebellum than small breed dogs and Labradors and provide evidence that increased cerebellar volume in CKCS is associated with crowding of cerebellum in the caudal part of the CCF. In CKCS there is an association between increased cerebellar volume and SM. These findings have implications for the understanding of the pathological mechanisms of CM/SM, and support the hypothesis that it is a multifactorial disease process governed by increased cerebellar volume and failure of the CCF to reach a commensurate size.

  • Driver CJ, De Risio L, Hamilton S, Rusbridge C, Dennis R, McGonnell IM, Volk HA. (2012) 'Changes over time in craniocerebral morphology and syringomyelia in cavalier King Charles spaniels with Chiari-like malformation.'. BMC Vet Res, England: 8

    Abstract

    Chiari-like malformation (CM) and syringomyelia is a neurological disease complex with high prevalence in cavalier King Charles spaniels (CKCS). The natural progression of this disease with time has not been described. The objectives of this study were to i) determine if syringomyelia progresses with time ii) determine if features of craniocrebral morphology previously associated with CM are progressive (including caudal cranial fossa volume, caudal cranial fossa parenchymal volume, ventricular dimensions, height of the foramen magnum and degree of cerebellar herniation). A retrospective morphometric analysis was undertaken in 12 CKCS with CM for which repeat magnetic resonance images were available without surgical intervention.

  • Knowler SP, Rusbridge C, McFadyen AK. (2011) 'Effectiveness of breeding guidelines for reducing the prevalence of syringomyelia'. Veterinary Record, 169 (26), pp. 681-681.

    Abstract

    Several toy breed dogs are predisposed to syringomyelia (SM), a spinal cord disorder, characterised by fluid-filled cavitation. SM is a complex trait with a moderately high heritability. Selective breeding against SM is confounded by its complex inheritance, its late onset nature and high prevalence in some breeds. This study investigated the early outcome of existing SM breeding guidelines. Six hundred and forty-three dogs, 550 Cavalier King Charles spaniels (CKCS) and 93 Griffon Bruxellois (GB), were identified as having either one (454 dogs) or both parents (189 dogs) with MRI-determined SM status. Offspring without SM were more common when the parents were both clear of SM (SM-free; CKCS 70 per cent, GB 73 per cent). Conversely, offspring with SM were more likely when both parents had SM (SM-affected; CKCS 92 per cent, GB 100 per cent). A mating of one SM-free parent with an SM-affected parent was risky for SM affectedness with 77 per cent of CKCS and 46 per cent of GB offspring being SM-affected. It is recommended that all breeding dogs from breeds susceptible to SM be MRI screened; that the SM status at five years old is established; and all results submitted to a central database that can be used by dog breeders to better enable mate selection based on estimated breeding values.

  • Loderstedt S, Benigni L, Chandler K, Cardwell JM, Lamb CR, Volk HA, Rusbridge C. (2011) 'Distribution of syringomyelia along the entire spinal cord in clinically affected Cavalier King Charles Spaniels'. Veterinary Journal, 190 (3), pp. 359-363.

    Abstract

    Chiari-like malformation (CM) and syringomyelia (SM) is an important disease complex in the Cavalier King Charles Spaniel (CKCS) but data about the anatomical distribution of SM along the spinal cord are lacking in veterinary medicine. The objective of this study was to define the anatomic distribution of SM in CKCS clinically affected by CM/SM. Magnetic resonance imaging (MRI) of the brain and the entire spinal cord of 49 dogs was performed and different morphological parameters compared.Syrinx formation was present in the C1-C4 region and in other parts of the spinal cord. The maximal dorsoventral syrinx size can occur in any region of the spinal cord and the total syrinx size was positively correlated with age. Seventy-six per cent of CKCS with a cranial cervical syrinx also have a syrinx affecting more caudal spinal cord regions. MRI restricted to the cervical region may underestimate the extent of SM and the severity of the disease process in the majority of dogs. © 2010 Elsevier Ltd.

  • Costanzo C, Garosi LS, Glass EN, Rusbridge C, Stalin CE, Volk HA. (2011) 'Brain abscess in seven cats due to a bite wound: MRI findings, surgical management and outcome'. Journal of Feline Medicine and Surgery, 13 (9), pp. 672-680.

    Abstract

    Presentation and lesion localisation: Seven adult domestic shorthair cats were presented with a 1- to 6-day history of progressive neurological signs. A focal skin puncture and subcutaneous swelling over the dorsal part of the head were detected on physical examination. Neurological examination indicated lesion(s) in the right forebrain in four cats, multifocal forebrain in one cat, left forebrain in one cat, and multifocal forebrain and brainstem in the remaining cat. In all cats, magnetic resonance imaging revealed a space-occupying forebrain lesion causing a severe mass effect on adjacent brain parenchyma. Clinical approach and outcome: All cats were managed with a combination of medical and surgical treatment. At surgery a small penetrating calvarial fracture was detected in all cats, and a tooth fragment was found within the content of the abscess in two cats. The combination of surgical intervention, intensive care and intravenous antimicrobials led to a return to normal neurological function in five cats. Practical relevance: As this series of cases indicates, successful resolution of a brain abscess due to a bite injury depends on early recognition and combined used of antimicrobials and surgical intervention. A particular aim of surgery is to remove any skull and foreign body (tooth) fragments that may represent a continuing focus of infection. © 2011 ISFM and AAFP.

  • Bhatti SF, Vanhaesebrouck AE, Van Soens I, Martlé VA, Polis IE, Van Ham LM, Rusbridge C. (2011) 'Myokymia and neuromyotonia in 37 Jack Russell terriers'. Veterinary Journal, 189 (3), pp. 284-288.

    Abstract

    The clinical and clinicopathological characteristics, treatment and outcome of vermicular muscle contractions (myokymia) and generalized muscle stiffness (neuromyotonia) in 37 Jack Russell terriers were evaluated retrospectively. Thirty dogs were affected by both disorders, whereas seven were presented with myokymia and never developed neuromyotonia. Clinical signs started at the mean age of 8. months. Except for signs of myokymia and neuromyotonia, clinical and neurological examination was normal in all dogs. Thirty dogs demonstrated typical signs of hereditary ataxia.Changes in serum chemistry included increased creatine kinase, aspartate aminotransferase and alanine aminotransferase concentrations. Electromyographic abnormalities, especially in muscles showing macroscopically visible myokymia, consisted of semirhythmic bursts of doublet, triplet, or multiplet discharges of a single motor unit. The amplitudes varied between 80 μV and 1. mV and occurred with an interburst frequency between 10 and 40. Hz and an intraburst frequency between 150 and 280. Hz.Most dogs were treated with a sodium channel blocker with variable results. Seven dogs died (most likely because of hyperthermia) or were euthanased during a neuromyotonic attack; 15 dogs were euthanased due to worsening of clinical signs, or lack of or no long-lasting effect of medication, and three were euthanased for unknown or unrelated reasons. Nine dogs were lost to follow-up and three were still alive 5-10.5. years after the start of clinical signs. In conclusion, young Jack Russell terriers with myokymia and neuromyotonia should undergo a complete blood and electrophysiological examination. Long-term prognosis is not favourable. © 2010 Elsevier Ltd.

  • Parker JE, Jeffery ND, Knowler SP, Rusbridge C, Noorman E. (2011) 'Prevalence of asymptomatic syringomyelia in Cavalier King Charles spaniels'. Veterinary Record, 168 (25), pp. 667-667.

    Abstract

    The prevalence of syringomyelia was investigated in a sample population of 555 Cavalier King Charles spaniels. All dogs, which were declared by their owners to be showing no clinical signs of syringomyelia, underwent MRI to determine the presence or absence of the condition. Data were analysed by logistic regression to determine the effects of sex and age on the prevalence of syringomyelia. Only increased age was found to have a significant effect. The prevalence of syringomyelia was 25 per cent in dogs aged 12 months, increasing to a peak of 70 per cent in dogs aged 72 months or more.

  • Rusbridge C, Nicholas N, Addicott D. (2011) 'Breed-specific diseases: Polymyositis and DNA collection in the Hungarian vizsla dog'. Veterinary Record, 168 (3), pp. 85-86.
  • Driver CJ, McGonnell IM, Volk HA, Rusbridge C. (2010) 'Morphometric assessment of cranial volumes in age-matched Cavalier King Charles spaniels with and without syringomyelia'. Veterinary Record, 167 (25), pp. 978-979.
  • Driver CJ, Cross HR, Volk HA, Rusbridge C, McGonnell I. (2010) 'Relationship of brain parenchyma within the caudal cranial fossa and ventricle size to syringomyelia in cavalier King Charles spaniels'. Journal of Small Animal Practice, 51 (7), pp. 382-386.

    Abstract

    Objectives: To assess if the volumes of the caudal cranial fossa (CCF), parenchyma within the caudal cranial fossa (CCFP) or ventricles (V) are associated with syringomyelia (SM) in cavalier King Charles spaniels (CKCS) with Chiari-like malformation (CM). To evaluate if volumes are associated with transverse syrinx width.Methods: Magnetic resonance images of 59 CKCS with CM were retrospectively reviewed and grouped with or without SM. Three-dimensional images were created and volumes of the fossae, brain parenchyma and ventricular system were calculated from which percentages of CCF, CCFP and V were created. If present, syrinx size was measured from its maximal transverse width. The percentages were statistically compared between groups, and correlation between percentages and syrinx dimensions was made.Results: CKCS with SM had significantly higher CCFP (P=0·0001) and V (P=0·0002) to those without but no significant difference in CCF (P=0·925). There was a positive correlation between CCFP and syrinx width (Pearson r=0·437) and ventricle size to syrinx width (Spearman r=0·627).Clinical Significance: A more marked overcrowding of the CCF is associated with SM, which may explain the high incidence of SM in CKCS with CM. The association between ventricle and syrinx dimensions supports the theory that SM development is the result of altered cerebrospinal fluid dynamics. © 2010 British Small Animal Veterinary Association.

  • Rusbridge C, Knowler SP, Heath S, Gunn-Moore DA, Johnston N, McFadyen AK. (2010) 'Feline orofacial pain syndrome (FOPS): A retrospective study of 113 cases'. Journal of Feline Medicine and Surgery, 12 (6), pp. 498-508.

    Abstract

    Feline orofacial pain syndrome (FOPS) is a pain disorder of cats with behavioural signs of oral discomfort and tongue mutilation. This report describes the findings from a case series of 113 cats including 100 Burmese. FOPS is suspected to be a neuropathic pain disorder and the predominance within the Burmese cat breed suggests an inherited disorder, possibly involving central and/or ganglion processing of sensory trigeminal information. The disease is characterised by an episodic, typically unilateral, discomfort with pain-free intervals. The discomfort is triggered, in many cases, by mouth movements. The disease is often recurrent and with time may become unremitting - 12% of cases in this series were euthanased as a consequence of the condition. Sensitisation of trigeminal nerve endings as a consequence of oral disease or tooth eruption appears to be an important factor in the aetiology - 63% of cases had a history of oral lesions and at least 16% experienced their first sign of discomfort during eruption of permanent teeth. External factors can also influence the disease as FOPS events could be directly linked to a situation causing anxiety in 20% of cats. FOPS can be resistant to traditional analgesics and in some cases successful management required anti-convulsants with an analgesic effect. © 2010 ISFM and AAFP.

  • Lewis T, Blott S, Rusbridge C, Knowler P, Woolliams JA. (2010) 'Heritability of syringomyelia in Cavalier King Charles spaniels'. Veterinary Journal, 183 (3), pp. 345-347.

    Abstract

    Mixed model analysis of 384 Cavalier King Charles spaniels (CKCS), with a magnetic resonance imaging diagnosis for the presence or absence of a syrinx, in conjunction with the Kennel Club pedigree records of all dogs registered from the mid 1980s to September 2007, revealed a moderately high estimate of heritability of syringomyelia (h = 0.37 ± 0.15 standard error) when analysed as a binary trait. Inspection of cases where the disease segregated within families pointed to genes at more than one locus influencing syringomyelia. The availability of estimated breeding values for Kennel Club registered CKCS is a significant step in being able to select against syringomyelia, particularly given the difficulty of ascertaining the disease phenotype. © 2009 Elsevier Ltd. All rights reserved.

  • Mandigers P, Rusbridge C. (2009) 'Op Chiari lijkende malformatieSyringomyelie bij de Cavalier King Charles Spaniel'. Tijdschrift voor Diergeneeskunde, 134 (18), pp. 746-750.

    Abstract

    This article, which is based on the PhD thesis of Clare Rusbridge, is a review of chiari-like malformation and syringomyelia in the Cavalier King Charles Spaniel. The abnormality is becoming more common among dwarf breeds and brachychepalic breeds. The nature, prevalence, and treatment of the disease are described, as is current knowledge on its heritability in the Cavalier King Charles Spaniel.

  • Mandigers P, Rusbridge C. (2009) '[Chiari-like malformation--syringomyelia in the Cavalier King Charles Spaniel].'. Tijdschr Diergeneeskd, Netherlands: 134 (18), pp. 746-750.

    Abstract

    This article, which is based on the PhD thesis of Clare Rusbridge, is a review of chiari-like malformation and syringomyelia in the Cavalier King Charles Spaniel. The abnormality is becoming more common among dwarf breeds and brachychepalic breeds. The nature, prevalence, and treatment of the disease are described, as is current knowledge on its heritability in the Cavalier King Charles Spaniel.

  • Cross HR, Cappello R, Rusbridge C. (2009) 'Comparison of cerebral cranium volumes between cavalier king charles spaniels with chiari-like malformation, small breed dogs and labradors'. Journal of Small Animal Practice, 50 (8), pp. 399-405.

    Abstract

    Objectives: To ascertain whether cavalier King Charles spaniels (CKCSs) have a proportionately smaller caudal fossa compared with other small dogs and with Labradors. To evaluate if cerebellar herniation in CKCS correlates with caudal fossa volume. Methods: In this retrospective study, three-dimensional images were created from magnetic resonance imaging brain series of 117 dogs (split into three groups: CKCS, Labradors and small breeds) from which the volumes of the fossae and brain parenchyma were calculated. These volumes were transformed into percentages of total cranial cavity and parenchyma volumes, respectively. The percentages were statistically compared among the groups. The percentage of herniated cerebellum in the CKCS was compared using linear regression with the caudal fossa and parenchyma percentages. Results: Cavalier King Charles spaniels had a proportionately smaller caudal fossa compared with Labradors (P=0·002) but not to small breeds (P=0·103). Their caudal fossa parenchyma was proportionately the same volume as Labradors (P=0·976) but greater than small breeds (P=0·005). No relationship was found for the per cent of cerebellum herniated. Clinical Significance: The results support mesoderm insufficiency or craniosynostosis as the pathogenesis of Chiari-like malformation (CM) in CKCS. It presents evidence for overcrowding of the caudal fossa due to a mismatch of brain parenchyma and fossa volumes as to why CKCS and not other small dogs are affected. © 2009 British Small Animal Veterinary Association.

  • Rusbridge C, Knowler SP, Pieterse L, McFadyen AK. (2009) 'Chiari-like malformation in the griffon bruxellois'. Journal of Small Animal Practice, 50 (8), pp. 386-393.

    Abstract

    Objectives: This study describes Chiari-like malformation and syringomyelia in the Griffon Bruxellois and establishes if skull radiographs are useful for disease prediction. Methods: Magnetic resonance imaging from 56 Griffon Bruxellois dogs was assessed for Chiari-like malformation and cerebrospinal fluid pathway abnormalities. Skull radiographs were obtained in 33 dogs. Two rostrocaudal and two ventrodorsal measurements were made, and ratios of one length to another were compared. Results: In this selected sample, 60·7 per cent had Chiari-like malformation. Syringomyelia occurred with and without Chiari-like malformation (37·5 and 8·9 per cent study population, respectively). The radiographic study demonstrated that one measurement ratio could be used to predict Chiari-like malformation (sensitivity of 87 per cent and specificity of 78 per cent) and that there were significant interaction factors between sex and syringomyelia for two measurement ratios. Clinical Significance: The study suggests that Chiari-like malformation is characterised by a shortening of the basicranium and supra-occipital bone with a compensatory lengthening of the cranial vault, especially the parietal bone. We described a simple radiographic technique, which may be useful as a screening test until a more definite genetic test for Chiari-like malformation is available. © 2009 British Small Animal Veterinary Association.

  • Carruthers H, Rusbridge C, Dubé M-P, Holmes M, Jeffery N. (2009) 'Association between cervical and intracranial dimensions and syringomyelia in the cavalier king charles spaniel'. Journal of Small Animal Practice, 50 (8), pp. 394-398.

    Abstract

    Objectives: To investigate the possible association between caudal fossa area and cervical vertebral dimensions and the presence of syringomyelia in cavalier King Charles spaniels. Methods: From magnetic resonance imaging scans of 78 cavalier King Charles spaniels, measurements were made of the widest vertical spinal width at C1/C2, C2, C2/C3 and C3; angulation of the C2/C3 spine; and estimated caudal fossa area. A correlation between these measurements and syringomyelia was sought. Results: A total of 59 dogs with and 19 without syringomyelia were compared. Older dogs had a significantly higher incidence of syringo-myelia. No difference in incidence was noted between genders. There was no significant difference in vertebral canal width at C1/C2 and C2, or angulation of C2/C3 between syringomyelia and non-syringomyelia groups. The width of the canal at C2/C3 and C3 was significantly increased in syringomyelia dogs. There was no significant difference in the caudal fossa area between groups. Clinical Significance: Although syringomyelia was shown to be more prevalent in older dogs, the age beyond which dogs were considered at greater risk was not deducible from the dataset. The association identified between wider spinal canal at C3, and C2/C3 and syringomyelia presence is of questionable clinical significance, as the difference between syringomyelia and non-syringomyelia groups is too small to be measured in a clinical setting. © 2009 British Small Animal Veterinary Association.

  • Chandler K, Volk H, Rusbridge C, Jeffery N. (2008) 'Syringomyelia in cavalier King Charles spaniels.'. Vet Rec, England: 162 (10)
  • Rusbridge C, Jeffery ND. (2008) 'Pathophysiology and treatment of neuropathic pain associated with syringomyelia.'. Vet J, England: 175 (2), pp. 164-172.

    Abstract

    The pain behaviour expressed by dogs with syringomyelia suggests that they experience neuropathic pain, probably due to disordered neural processing in the damaged dorsal horn. As such it is likely that conventional analgesic medication will be ineffective. In this review, physiological and pathological pain processing through the dorsal horn is summarised and mechanisms by which syringomyelia could result in a persistent pain state are discussed. Finally, current knowledge regarding treatment of Chiari malformation and syringomyelia is reviewed and possible drugs which may give improved pain relief in affected dogs are discussed.

  • Stalin CE, Rusbridge C, Granger N, Jeffery ND. (2008) 'Radiographic morphology of the cranial portion of the cervical vertebral column in Cavalier King Charles Spaniels and its relationship to syringomyelia.'. Am J Vet Res, United States: 69 (1), pp. 89-93.

    Abstract

    To compare radiographic morphology of the atlantoaxial region between Cavalier King Charles Spaniels (CKCSs) and dogs of other breeds and determine whether there was an association between radiographic morphology of the atlantoaxial region and syringomyelia in CKCSs.

  • Rusbridge C, Carruthers H, Dubé MP, Holmes M, Jeffery ND. (2007) 'Syringomyelia in cavalier King Charles spaniels: the relationship between syrinx dimensions and pain.'. J Small Anim Pract, England: 48 (8), pp. 432-436.

    Abstract

    This study was designed to test the hypothesis that pain associated with syringomyelia in dogs is dependent upon size and involvement of the dorsal part of the spinal cord.

  • Jokinen TS, Rusbridge C, Steffen F, Viitmaa R, Syrjä P, De Lahunta A, Snellman M, Cizinauskas S. (2007) 'Cerebellar cortical abiotrophy in Lagotto Romagnolo dogs.'. J Small Anim Pract, England: 48 (8), pp. 470-473.

    Abstract

    This case report documents two pathological variations of potentially inherited, cerebellar cortical abiotrophy in two unrelated Lagotto Romagnolo breed dogs. The first dog had an atypical lesion in the cerebellar cortex with depletion of cerebellar granular cell layer and sparing of the Purkinje cell layer. The second case had degenerative changes in both Purkinje and granular cell layers. The clinical picture was similar in both cases presented, although the severity of the signs of cerebellar dysfunction varied.

  • Cappello R, Rusbridge C, Chiari-Like Malformation and Syringomyelia Working Group . (2007) 'Report from the Chiari-Like Malformation and Syringomyelia Working Group round table.'. Vet Surg, United States: 36 (5), pp. 509-512.
  • Rusbridge C. (2007) 'Chiari-like malformation with syringomyelia in the Cavalier King Charles spaniel: long-term outcome after surgical management.'. Vet Surg, United States: 36 (5), pp. 396-405.

    Abstract

    To evaluate long-term success of cranial cervical decompression for management of canine Chiari-like malformation with syringomyelia (CM/SM).

  • Cherubini GB, Rusbridge C, Singh BP, Schoeniger S, Mahoney P. (2007) 'Rostral cerebellar arterial infarct in two cats.'. J Feline Med Surg, England: 9 (3), pp. 246-253.

    Abstract

    A 10-year-old female neutered domestic shorthair (DSH) cat and a 6-year-old female neutered Siamese cat were presented following a peracute onset of decerebellate rigidity and a cerebellar vestibular syndrome, respectively. In both cats, physical examination and routine blood tests were unremarkable, as was routine analysis of cerebrospinal fluid obtained from the DSH cat. Based on the magnetic resonance imaging (MRI) features - focal wedge-shaped lesion in the cerebellum characterised by hyperintensity in T2-weighted, T2( *)-gradient echo and fluid attenuated inversion recovery (FLAIR) images - a presumptive diagnosis of cerebellar infarct was made in both cases. In the DSH cat, the post-mortem examination confirmed the diagnosis of cerebellar infarct and additionally found acute renal infarcts and a pulmonary neoplasia. In the Siamese cat, ultrasonographic evaluation of the heart revealed a probable low-grade chronic valvular endocarditis which was thought to be a potential source of thromboembolism. This paper describes the first two cases - one confirmed and the other suspected - of cerebellar infarct in the cat. The in vivo potential diagnostic value of the MRI study is highlighted. Cerebellar infarcts should be included in the differential diagnosis of cat with a peracute onset of cerebellar signs regardless of the severity of neurological deficits.

  • Rusbridge C, Knowler SP. (2006) 'Coexistence of occipital dysplasia and occipital hypoplasia/syringomyelia in the cavalier King Charles spaniel.'. J Small Anim Pract, England: 47 (10), pp. 603-606.

    Abstract

    Concurrent occurrence of occipital dysplasia and occipital hypoplasia in two dogs is described in this report. Occipital hypoplasia results in reduced volume of the caudal fossa, leading to overcrowding of the neural structures and, in severe cases, development of syringomyelia. In occipital dysplasia, there is a failure of complete ossification of the supraoccipital bone. When the two conditions occur concurrently, it is possible that syringomyelia may develop more slowly, resulting in presentation with clinical signs in middle to old age. This has implications for screening tests for early detection of syringomyelia, with a view to using the dog for breeding purposes, as dogs with an apparently mild phenotype for occipital hypoplasia/syringomyelia may actually have a more severe genotype.

  • Cherubini GB, Platt SR, Anderson TJ, Rusbridge C, Lorenzo V, Mantis P, Cappello R. (2006) 'Characteristics of magnetic resonance images of granulomatous meningoencephalomyelitis in 11 dogs.'. Vet Rec, England: 159 (4), pp. 110-115.

    Abstract

    The characteristics of magnetic resonance imaging (mri) of the brains and spinal cords of 11 dogs with histologically confirmed granulomatous meningoencephalomyelitis (gme) were determined. The lesions were in the brain of eight of the dogs, in the brain and spinal cord of two, and in the spinal cord alone in one dog. A single lesion was present in four of the dogs and multiple lesions were found in six. In one dog with intracranial signs, no visible lesions could be detected on mri. No meningeal enhancement was detected in T1-weighted images post-contrast, or in fluid attenuation inversion recovery (flair) images, but there were histological lesions in the meninges in nine of the dogs. The T2-weighted images and flair sequences were characterised in all cases by hyperintensity, whereas the signal intensity of the lesions on T1-weighted images was variable. After the administration of paramagnetic contrast, some of the lesions showed no enhancement, but others showed marked patterns of enhancement. The lesions in 10 of the dogs were easily identifiable by mri and the images had several unifying characteristics, but they could not be considered disease-specific.

  • Kennedy LJ, Quarmby S, Happ GM, Barnes A, Ramsey IK, Dixon RM, Catchpole B, Rusbridge C, Graham PA, Hillbertz NS, Roethel C, Dodds WJ, Carmichael NG, Ollier WE. (2006) 'Association of canine hypothyroidism with a common major histocompatibility complex DLA class II allele.'. Tissue Antigens, Denmark: 68 (1), pp. 82-86.

    Abstract

    Dogs exhibit a range of immune-mediated conditions including a lymphocytic thyroiditis which has many similarities to Hashimoto's thyroiditis in man. We have recently reported an association in Doberman Pinschers between canine hypothyroidism and a rare DLA class II haplotype that contains the DLA-DQA1*00101 allele. We now report a further series of 173 hypothyroid dogs in a range of breeds where a significant association with DLA-DQA1*00101 is shown.

  • Lujan Feliu-Pascual A, Shelton GD, Targett MP, Long SN, Comerford EJ, McMillan C, Davies D, Rusbridge C, Mellor D, Chang KC, Anderson TJ. (2006) 'Erratum: Inherited myopathy of great Danes (Journal of Small Animal Practice (2006) 47, (249-254))'. Journal of Small Animal Practice, 47 (6), pp. 355-355.
  • Lujan Feliu-Pascual A, Shelton GD, Targett MP, Long SN, Comerford EJ, McMillan C, Davies D, Rusbridge C, Mellor D, Chang KC, Anderson TJ. (2006) 'Inherited myopathy of great Danes.'. J Small Anim Pract, England: 47 (5), pp. 249-254.

    Abstract

    A hereditary, non-inflammatory myopathy occurring in young great Danes with distinctive histological features in muscle biopsy specimens is reviewed. Onset of clinical signs is usually before one year of age and both sexes are affected. Clinical signs are characterised by exercise intolerance, muscle wasting, and an exercise-induced tremor. Although most affected dogs have a severe form of the disease, occasional dogs may have a less pronounced form and survive into adulthood with an acceptable quality of life. Litters containing affected puppies are born to clinically unaffected parents, and an autosomal recessive pattern of inheritance is likely. All recorded cases have had fawn or brindle coat coloration. Elevated serum creatinine kinase concentrations and spontaneous electrical activity in skeletal muscles are frequently found. While originally reported (Targett and others 1994) as a central core myopathy in this breed, the histochemical characteristics of the distinct cytoarchitectural structures differ from those of the well-characterised central core myopathy in human beings. In fact, these structures differ from any known myopathy in human beings and likely represents a unique non-inflammatory myopathy affecting dogs. Until this myopathy is characterised further, the name inherited myopathy in great Danes is suggested.

  • Rusbridge C, Greitz D, Iskandar BJ. (2006) 'Syringomyelia: current concepts in pathogenesis, diagnosis, and treatment.'. J Vet Intern Med, United States: 20 (3), pp. 469-479.

    Abstract

    Syringomyelia is a condition that results in fluid-containing cavities within the parenchyma of the spinal cord as a consequence of altered cerebrospinal fluid dynamics. This review discusses the history and the classification of the disorder, the current theories of pathogenesis, and the advanced imaging modalities used in the diagnosis. The intramedullary pulse pressure theory (a new pathophysiologic concept of syringomyelia) also is presented. In addition, the current understanding of the painful nature of this condition is discussed and the current trends in medical and surgical management are reviewed.

Affiliations

OTHER PROFESSIONAL AND ACADEMIC ACTIVITIES
1. The Advisory Council for Welfare Breeding Pedigree Dogs –The role of the Council is to encourage and facilitate significant improvements in the welfare issues associated with dog breeding by providing independent, expert advice to governments and other stakeholders. Clare was appointed to this panel in 2010 from its inception

2. Scrutineer British Veterinary Association/ Kennel Club CMSM MRI screening scheme Clare played a pivotal role in establishing this scheme and has been a scruitneer since its inception.

3. International League Against Epilepsy in Small Animals. Clare is part of a multicenter task force 1. To suggest consensus statements and provide definitions for canine and feline epilepsy and 2. To advance the field by doing collaborative research and exchanging ideas.

4. The Ann Conroy Trust - Clare was Made a Honorary Friend of the Society in 2006 and appointed to “Syringomyelia 2007” Scientific Faculty and organized the veterinary part of this International conference held in Rugby, UK October 2007.  Clare is a member of the British Syringomyelia Group- a group of neurosurgeons involved in treatment of syringomyelia.

5. Phyllis Croft Foundation for Canine Epilepsy - Clare is the veterinary advisory for this charity.

SCIENTIFIC JOURNALS
4. Clare is on the Editorial Board for Canine Genetics and Epidemiology a peer-reviewed open access journal published by BioMed Central in affiliation with the UK Kennel Club.

5. Clare is a regular reviewer of scientific articles for Veterinary Comparative Orthopedics and Traumatology, Journal of Small Animal Practice, Veterinary Record, Veterinary Radiology and Ultrasound, American Journal of Veterinary Research, Journal of Veterinary Internal Medicine and occasionally other journals.

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