Two dogs and two cats were evaluated for the acute-onset of abnormal mentation, recumbency, and blindness. All cases had systemic hypertension, ranging from 180 mm Hg to 260 mm Hg. MRI of the brain disclosed noncontrast-enhancing, ill-defined, T2-weighted (T2W) hyperintensities in the white matter of the cerebrum in the areas of the frontal, parietal, temporal, and occipital lobes. Lesions were also observed in the caudate nuclei and thalamus (n = 1 in each). Intracranial hemorrhage was observed in one animal. Diffusion-weighted imaging (DWI) was consistent with vasogenic edema in two animals. Retinal lesions were observed in three animals. Hypertension was secondary to renal disease in three animals. A primary underlying disorder was not identified in one animal. Normalization of blood pressure was achieved with amlodipine either alone or in combination with enalapril. In one cat, hypertension spontaneously resolved. In three cases, neurologic improvement occurred within 24–48 hr of normalization of blood pressure. The presumptive diagnosis of hypertensive encephalopathy was supported by the MRI findings and neurologic dysfunction coincident with systemic hypertension in which the neurologic dysfunction improved with treatment of hypertension. The prognosis appears good for the resolution of neurologic deficits with normalization of blood pressure in animals with hypertensive encephalopathy.
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November/December 2013
Case Reports|
November 01 2013
Clinicopathologic and MRI Characteristics of Presumptive Hypertensive Encephalopathy in Two Cats and Two Dogs
Jeremy O'Neill, DVM, DACVIM (Neurology);
Jeremy O'Neill, DVM, DACVIM (Neurology)
Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA (J.O., M.K., S.P.); and the Section of Neurology/Neurosurgery, Red Bank Veterinary Hospital, Tinton Falls, NJ (E.G.).
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Marc Kent, DVM;
Marc Kent, DVM
Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA (J.O., M.K., S.P.); and the Section of Neurology/Neurosurgery, Red Bank Veterinary Hospital, Tinton Falls, NJ (E.G.).
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Eric N. Glass, MS, DVM;
Eric N. Glass, MS, DVM
Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA (J.O., M.K., S.P.); and the Section of Neurology/Neurosurgery, Red Bank Veterinary Hospital, Tinton Falls, NJ (E.G.).
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Simon R. Platt, BVM&S
Simon R. Platt, BVM&S
Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA (J.O., M.K., S.P.); and the Section of Neurology/Neurosurgery, Red Bank Veterinary Hospital, Tinton Falls, NJ (E.G.).
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J Am Anim Hosp Assoc (2013) 49 (6): 412–420.
Citation
Jeremy O'Neill, Marc Kent, Eric N. Glass, Simon R. Platt; Clinicopathologic and MRI Characteristics of Presumptive Hypertensive Encephalopathy in Two Cats and Two Dogs. J Am Anim Hosp Assoc 1 November 2013; 49 (6): 412–420. doi: https://doi.org/10.5326/JAAHA-MS-5942
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