Canine Chiari Institute at Long Island Veterinary Specialists

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Revolutionary Technology at Long Island Veterinary Specialists

  
LOW Field MRI 3 Tesla MRI Parallel Imaging

  3 Tesla MRIhe latest addition to our diagnostic arsenal is a 3.0 Tesla Philips MRI. Custom-made and housed on-site 7 days a week, this ultra-powerful machine is the only one of its kind exclusively for veterinary patients in the United States. Imaging of the brain, spinal cord, limbs, abdomen, and thorax are now available six days a week under the supervision of neurologists, neurosurgeons and radiologists. Imaging requires general anesthesia, and we have invested in the most sophisticated MRI anesthesia monitoring system available in the world, the Invivo Precess 4500.

Our high-field magnet not only produces the highest resolution images possible, but scan times are reduced to a fraction of the time needed for a traditional MRI study.

The “Parallel Imaging” feature permits “whole body” scans, reducing scan time from several hours to only 20 minutes while further improving image quality.



Cavitron Ultrasonic Surgical Aspirator (CUSA)

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CUSA

 

 The Cavitron Ultrasonic Surgical Aspirator (CUSA) is a dissecting device that uses ultrasonic frequencies to fragment tissue.  This highly-specialized instrument is available at only a handful of veterinary universities and human hospitals that focus on neurosurgery. Utilizing a hollow titanium tip that vibrates along its longitudinal axis, fragmentation of susceptible tissue occurs while concurrently lavaging and aspirating material from the surgical site. 

The CUSA selectively ablates tissues with high water content such as liver parenchyma, glandular, and neoplastic tissue.  This instrument is most useful when removing purportedly “non-resectable” brain and spine tumors. With a gentle wand-like motion, the CUSA enables a “layer by layer” surgical excision without affecting vital structures.


Nihon Kohden Neuro Pack S1 Neurodiagnostic Machine

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Long Island Veterinary Specialists has recently acquired a state-of-the-art Nihon Kohden Neuropack MEB9400 electrodiagnostic machine. This unit is able to provide invaluable neurological diagnostic and monitoring information and can only be found at select universities and large specialty practices.  Through the use of electrodes, this computer allows us to compile electrical data from a patient and display this information as waveforms which can then be measured using established values.  Electromyography, Nerve Conduction Studies, and Somatosensory, Auditory, and Visual Evoked Potentials are some of the examinations currently possible.

 



Electromyography (EMG)

Electromyography can aid in the diagnosis of nerve, muscle, and neuromuscular junctional pathologies.  It is a measure of spontaneous electrical activity generated by muscle.  This test usually requires general anesthesia as a needle electrode is repetitively inserted into a muscle (or muscles).  Normal muscle is “electrically silent,” and after a brief burst of activity during needle insertion, normal muscle will generally have a more or less “flat line” of electrical activity.  If there are sharp waveforms that persist for more than a second or two this can be indicative of a neuropathy or myopathy, although not specifically one or the other.  Polymyositis, muscular dystrophy, lower motor neuron disease, and myotonia are a few of the disorders associated with abnormal, persistent electrical discharges.

 


Brainstem Auditory Evoked Response (BAER)

A minimally invasive test that allows us to assess the auditory pathway in order to evaluate a patient’s hearing. 

In patients with intact hearing, the BAER test can also be used to assess the integrity of the brain stem. This test can usually be done without sedation, even though not generally impacted by sedation or anesthesia. 

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Ear plugs that deliver a controlled sound stimulus to one ear at a time (usually at 80 or 100 dB) are placed in the ears, and several small needle electrodes are placed subcutaneously around the scalp.  A tracing of four or five identifiable waveforms confirms the ability to hear on that side.  A flat line is indicative of deafness. Litters of puppies can best be assessed for congenital deafness at 7 to 8 weeks of age.

 


Visual Evoked Potential (VEP)

VEP is a measure of the electrical response of several different cell types in the retina to a light stimulus.  After receiving a mild sedative, a contact lens with attached electrodes or a pair of goggles is placed on the patient’s eyes.  Electrodes are placed on the patient’s head, which will transfer electrical data to the computer.  Identifiable waveforms will help to aid in the diagnosis of optic nerve disorders including optic neuritis.

 


MHF-1 Intraoperative Ultrasound Scanner

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Generation of images based on ultrasound waves is not a new phenomenon in veterinary or human medicine; however, the use of intra-operative ultrasound in facilitating brain and spine surgery is largely limited to major human neurosurgery centers. At LIVS, we have been pioneering the use of this technology in patients referred to us for neurosurgery for several years. With a “probe footprint” of 1cm, specialized high frequency probes allow our neurosurgeons to localize neoplastic masses, granulomas, hematomas, and abscesses within the deepest portions of the nervous system and remove them safely. Ultrasound-guided biopsies of masses deemed non-surgical can safely be harvested to confirm their diagnoses before costly adjunctive therapy like radiation or chemotherapy is recommended. Nowhere in the country is the use of color-flow ultrasound being developed for the quantification of CSF flow except at LIVS.


Medical Infra-red Imaging (Thermography)

THERMOGRAPHY
A non-invasive, diagnostic imaging technique involving the recording of cutaneous thermal patterns generated by the emission of surface heat in the form of a color map. Surface heat measured from the skin is directly related to the local dermal microcirculation, which is under direct control of the sympathetic portion of the autonomic nervous system. Only the local dermal microcirculation is responsible for the surface heat generated. Conduction of heat from deeper portions of the body to the surface does not occur or create changes in the surface temperature. The clinical basis for thermography is the correlation of temperature recordings with various conditions of disease or injury as they relate to autonomic function.  Thermography can be used as a diagnostic screening tool, as an adjunct test to enhance interpretation of physical examination findings, to guide therapeutic management, and to assess long-term response to treatment. Pioneering work in thermographic imaging has been conducted at LIVS by Dr. Catherine Loughin, one of only two veterinarians who are board certified medical thermologists.

Thermography has recently been used in human medicine for breast cancer assessment, cutaneous evaluation of burn patients, rheumatologic assessments, vascular disorders including Raynaud’s phenomenon, scrotal variocele, pulpal blood flow of teeth, pneumothorax, inflammatory conditions, radiculopathies, and intervertebral disk disease, Chiari malformation and syringomyelia, joint disease, and as an adjunct for polygraph testing. In horses, thermography has been used in lameness evaluations, and more specifically to detect ligamentous, osseous, muscular, articular, and neurologic injuries. Because of the recent advances in technology and the lack of sedation needed for imaging, thermography has potential use as a screening test for a variety of conditions in veterinary patients.
To determine the viability of thermography as an imaging modality for clinical disease, we are continuing to conduct research in this area. Our current studies involve Chiari-like malformation (screening normal Cavalier King Charles Spaniels and clinical dogs) and elbow dysplasia. More studies will be ongoing in the near future.


Stereotactic Neurosurgery System-The “Brainsight”

Stereotactic MRI assisted Stereotacic Instruments

  “Brainsight” is our new neuronavigation system which allows the neurosurgeons at LIVS to use the principles of frameless stereotaxy to perform a variety of neurosurgical procedures with accuracy, simplicity and improved subject comfort when compared to the stereotactic frame. Brainsight has been used for a wide variety of applications, including cannula and needle placement and chamber placement for electrophysiology.  It allows LIVS’ neurosurgeons to extend the applicability of the system beyond neuroscience research into more general veterinary applications. Brainsight brings the same benefits of neuronavigation for biopsy guidance and surgery planning and guidance that is commonplace for human treatment. This system has an error rate of 1.2 mm in dogs, meaning that it is very likely to provide diagnostic brain biopsies at minimal risk to the patient. In addition to its potential as a diagnostic tool, the Brainsight system has potential application for gene therapy, in which a specific gene is delivered to a specific location in the brain in order to control or cure a neurologic disorder.


Multislice Helical CT Scanner

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Computed Tomography (CT) is a medical imaging method in which digital processing is used to generate a three-dimensional image of a subject from a large series of two-dimensional X-ray images taken around an axis of rotation. In the U.S., the first CT installation was at the Mayo Clinic while the first veterinary CT on Long Island was opened in 1998 at Long Island Veterinary Specialists in Plainview.

Helical or Spiral CT was introduced in the early 1990s.The major advantage of helical scanning is that a large volume can be covered quickly. Additionally, the data obtained from spiral CT is often well-suited for 3D imaging which led to the rapid rise of helical CT as the most popular type of CT technology.Multislice CT scanners are similar in concept to the helical or spiral CT but there is more than one detector ring.

3D Reconstruction

This allows large volumes to be scanned at the optimal time following intravenous contrast administration, thus minimizing anesthetic time and maximizing patient safety. Because multislice CT scanners offer isotropic, or near isotropic, resolution, display of images does not need to be restricted to the conventional axial images.

Instead, it is possible for a software program to build a volume by 'stacking' the individual slices. From this, a 3-dimensional model can be constructed and displayed on screen.

Clinical advantages of using the Multislice Helical CT at LIVS are numerous and include improved patient safety, enhanced accuracy and most strikingly, the ability to perform 3D image reconstructions with the creation of surgical models to plan surgery for complex cases.


Force Plate

Force Plate

The Force Plate System currently installed at LIVS is a measuring instrument that determines the ground reaction forces generated by a body standing on or moving across plates embedded in the pavement. This system is used to quantify balance, gait and other parameters of biomechanics and load. At LIVS, we are able to measure the three-dimensional components of the single equivalent force applied to the surface and its point of application, usually called the center of pressure, as well as the moment of force. For studies of movements, such as gait analysis, force platforms with at least three pedestals (often four) are used to accommodate forces that migrate across the plate. For example, during walking, ground reaction forces start at the heel and finish near the big toe. The measurements from a force platform can be either studied in isolation or combined with other data, such as limb kinematics, to understand the principles of locomotion. If a patient makes a standing jump from a force plate, the data from the plate alone are sufficient to calculate acceleration, work, power output, jump angle, and jump distance using basic physics. Simultaneous video measurements of leg joint angles and force plate output can allow the determination of torque, work and power at each joint using a method called inverse dynamics.

 

A reference guide for veterinary professionals interested in Chiari -Like Malformation and Syringomyelia. 

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