Lead intoxication mimicking idiopathic epilepsy in a young dog
Corresponding Author
Theophanes Liatis
Neurology & Neurosurgery Service, Dick White Referrals, Six Mile Bottom, UK
Correspondence to Dr Theophanes Liatis; [email protected]Search for more papers by this authorPaola Monti
Diagnostic Pathology Laboratory, Dick White Referrals, Six Mile Bottom, United Kingdom
Search for more papers by this authorAriadna Ribas Latre
Internal Medicine Service, Dick White Referrals, Six Mile Bottom, United Kingdom
Search for more papers by this authorPanagiotis Mantis
Diagnostic Imaging Service, Dick White Referrals, Six Mile Bottom, United Kingdom
Search for more papers by this authorGiunio Bruto Cherubini
Neurology & Neurosurgery Service, Dick White Referrals, Six Mile Bottom, UK
Search for more papers by this authorCorresponding Author
Theophanes Liatis
Neurology & Neurosurgery Service, Dick White Referrals, Six Mile Bottom, UK
Correspondence to Dr Theophanes Liatis; [email protected]Search for more papers by this authorPaola Monti
Diagnostic Pathology Laboratory, Dick White Referrals, Six Mile Bottom, United Kingdom
Search for more papers by this authorAriadna Ribas Latre
Internal Medicine Service, Dick White Referrals, Six Mile Bottom, United Kingdom
Search for more papers by this authorPanagiotis Mantis
Diagnostic Imaging Service, Dick White Referrals, Six Mile Bottom, United Kingdom
Search for more papers by this authorGiunio Bruto Cherubini
Neurology & Neurosurgery Service, Dick White Referrals, Six Mile Bottom, UK
Search for more papers by this authorAbstract
An 11-month-old neutered female cocker spaniel was referred for two generalised tonic-clonic epileptic seizures with a one-week interval of mild depression. On admission, physical and neurological examinations were unremarkable. Neurolocalisation was forebrain. Haematology, biochemistry, serology for infectious diseases, urinalysis and urine culture were unremarkable. Cerebral MRI revealed T1-weighted hyperintensity in the lentiform nuclei. Cerebrospinal fluid analysis was unremarkable. Idiopathic epilepsy was mistakenly diagnosed and phenobarbital was started. A delayed blood film examination revealed metarubricytosis, polychromasia and basophilic stippling, raising the suspicion of lead intoxication. Abdominal radiography revealed a metallic lead foreign body (lead curtain weight), which removed endoscopically. Treatment with CaEDTA, thiamine and D-penicillamine was started. This report highlights the importance of including haematology, blood smear examination, biochemistry and urinalysis in the diagnostic workup of acute epileptic seizures particularly in young dogs. Lead intoxication should be included in the differential diagnosis in these patients, as modern lead sources still exist in our environment.
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