Stephanie Kube - Academia.edu (original) (raw)

Papers by Stephanie Kube

Physical Rehabilitation for Veterinary Technicians and Nurses

Frontiers in Veterinary Science

The use of cannabidiol (CBD) in childhood refractory seizures has become a common therapeutic app... more The use of cannabidiol (CBD) in childhood refractory seizures has become a common therapeutic approach for specific seizure disorders in human medicine. Similarly, there is an interest in using CBD, cannabidiolic acid (CBDA) or cannabinoid-rich hemp products in the treatment of idiopathic epilepsy in dogs. We aimed to examine a small cohort in a pilot investigation using a CBD and CBDA-rich hemp product for the treatment of refractory epileptic seizures in dogs. Fourteen dogs were examined in a 24-week randomized cross-over study being provided placebo or CBD/CBDA-rich hemp extract treatment at 2 mg/kg orally every 12 h for each 12-week arm of the study. Serum chemistry, complete blood counts, serum anti-seizure medication (ASM) concentrations and epileptic seizure frequency were followed over both arms of the cross-over trial. Results demonstrated that besides a mild increase in alkaline phosphatase, there were no alterations observed on routine bloodwork at 2, 6, and 12 weeks duri...

Compendium (Yardley, PA), 2008

Acute spinal cord injuries commonly seen in veterinary patients include vascular, compressive, an... more Acute spinal cord injuries commonly seen in veterinary patients include vascular, compressive, and concussive injuries. Vascular lesions, or infracts, are usually caused by fibrocartilagenous emboli. Concussive and compressive injuries have a variety of pathologies, including intervertebral disk disease, fractures, and luxations (dislocations) of the vertebral column. Although considerable controversy exists over the most appropriate way to manage acute spinal cord injuries, early surgical intervention or decompression remains the best treatment option in managing acute compressive injuries in veterinary patients. High-dose methylprednisolone sodium succinate, an established treatment in human medicine, is falling out of favor because studies have shown little therapeutuc benefit and severe adverse effects.

Veterinary pathology, 2008

An acute to chronic idiopathic necrotizing meningoencephalitis was diagnosed in 5 Chihuahua dogs ... more An acute to chronic idiopathic necrotizing meningoencephalitis was diagnosed in 5 Chihuahua dogs aged between 1.5 and 10 years. Presenting neurologic signs included seizures, blindness, mentation changes, and postural deficits occurring from 5 days to 5.5 months prior to presentation. Cerebrospinal fluid analyses from 2 of 3 dogs sampled were consistent with an inflammatory disease. Magnetic resonance imaging of the brain of 2 dogs demonstrated multifocal loss or collapse of cortical gray/white matter demarcation hypointense on T1-weighted images, with T2-weighted hyperintensity and slight postcontrast enhancement. Multifocal asymmetrical areas of necrosis or collapse in both gray and white matter of the cerebral hemispheres was seen grossly in 4 brains. Microscopically in all dogs, there was a severe, asymmetrical, intensely cellular, nonsuppurative meningoencephalitis usually with cystic necrosis in subcortical white matter. There were no lesions in the mesencephalon or metencepha...

Journal of the American Animal Hospital Association, 2003

Primary brain tumors are not commonly reported in young dogs; however, they are the second most c... more Primary brain tumors are not commonly reported in young dogs; however, they are the second most common cancer in children. Astrocytomas are the majority of these tumors. This report presents three cases of astrocytomas in young dogs, indicating a possible higher incidence than what is currently held. When suspected, it is recommended that biopsy or surgical excision be performed to further characterize and grade the tumor and, if appropriate, guide treatment.

Journal of the American Animal Hospital Association, 2003

Two dogs presented with acute tetraparesis, hypoventilation, and bradycardia with a second-degree... more Two dogs presented with acute tetraparesis, hypoventilation, and bradycardia with a second-degree atrioventricular heart block. Neurological examination localized both lesions to the cervical spine. Diagnostic imaging revealed a ventral extradural compression at the second to third cervical (C2–C3) region in one dog and at the third to fourth cervical (C3–C4) region in the other. Following surgical correction of the extruded disk, the hypoventilation and bradycardia resolved. Cervical disk extrusions are a common cause of acute tetraparesis in the dog. This report shows that respiratory and cardiac complications may occur concurrently. The authors recommend screening dogs with cervical myelopathies for respiratory and cardiac dysfunctions and treating appropriately. Prompt surgical intervention and supportive care can improve the prognosis.

Veterinary Radiology <html_ent glyph="@amp;" ascii="&"/> Ultrasound, 2004

Veterinary Pathology, 2014

A 13-week-old male intact Poodle mix dog developed an acute onset of vestibular ataxia, tetrapare... more A 13-week-old male intact Poodle mix dog developed an acute onset of vestibular ataxia, tetraparesis, and vomiting. The patient presented ambulatory, tetraparetic, and ataxic with a head tilt to the left and a disconjugate nystagmus (rotary nystagmus with fast phase to the right in right eye and vertical nystagmus in left eye). There were absent postural reactions in the left pelvic and left thoracic limbs and decreased right-sided postural reactions. Magnetic resonance imaging demonstrated an intra-axial mass within the left midcaudal medulla oblongata. On gross dissection, there was a left-sided neoplasm in the medulla oblongata with surrounding hemorrhage. The histologic findings indicated that the mass was a pleomorphic xanthoastrocytoma. This tumor, an uncommon variant of an astrocytoma most often seen in children and young adult humans, has yet to be described in dogs.

Neuromuscular Disorders, 2006

Nemaline myopathy is associated with rod-shaped structures in muscle fibers. At least seven disti... more Nemaline myopathy is associated with rod-shaped structures in muscle fibers. At least seven distinct clinical forms have been described in humans and mutations have been identified in five different thin-filament genes. Only a few cases of spontaneously occurring nemaline myopathy have been reported in animals and include an adult-onset form in a family of cats and an early-onset form in a dog. Here, we describe a 2-year-old male, neutered, domestic shorthaired cat that was referred to the Veterinary Medical Teaching Hospital, University of California-Davis, for evaluation of chronic, progressive weakness, and fine tremors. Neurologic deficits were restricted to the neuromuscular system. Electromyography showed mild to moderate diffuse spontaneous activity. Although rod bodies were prominent on light and electron microscopic evaluation of biopsies from several muscles, sarcoplasmic accumulations of dystrophin, desmin, and spectrin also were identified by immunohistochemistry. These findings may represent the occurrence of rod bodies in conjunction with a protein-aggregate myopathy.

Journal of Veterinary Internal Medicine, 2006

Journal of Veterinary Emergency and Critical Care, 2008

Objective: To examine the impact of stress on veterinarians resulting from both the provision of ... more Objective: To examine the impact of stress on veterinarians resulting from both the provision of cardiopulmonary-cerebral resuscitation (CPCR) and the discussion of CPCR and do not attempt resuscitation (DNAR) with affected clients. Design: Descriptive cross-sectional with survey methodology. Setting: Eight colleges of veterinary medicine in the United States. Subjects: Two hundred and one academic veterinarians. Interventions: The survey was distributed by the authors to small animal faculty, residents, and interns. Demographic variables and Likert-style questions about comfort discussing and performing CPCR and affective impact of CPCR events were included. Multiple linear regression models were constructed to determine the effect of the questions on different target variables of interest. Measurements and Main Results: Ninety-six percent of veterinarians experienced stress when performing CPCR and reported that positive emotions after a successful CPCR were statistically greater than the negative emotions of an unsuccessful CPCR. Veterinarians trained in CPCR reported lower scores for stress and negative emotional impact from a failed CPCR. Conclusions: Veterinarians experience stress during CPCR and when discussing CPCR and DNAR choices with owners. Steps can be taken to reduce the likelihood of having a negative affect from CPCR efforts, such as improved training of CPCR supervisors and increased competence of CPCR supervisors.

Journal of Veterinary Emergency and Critical Care, 2008

Objective: To document the clinical practice of cardiopulmonary-cerebral resuscitation (CPCR) amo... more Objective: To document the clinical practice of cardiopulmonary-cerebral resuscitation (CPCR) among academic veterinarians. Design: Survey. Setting: Eight colleges of veterinary medicine in the United States. Subjects: Two hundred and one academic veterinarians. Interventions: The survey was distributed by hand by the authors into the mailboxes of small animal faculty, residents, and interns. Demographic variables, questions regarding number of cardiopulmonary arrests (CPA) supervised and number successful, do not attempt resuscitation discussions, and Likert-style questions about client presence during CPCR, appropriateness of CPCR, and CPCR decision-making were included. Multiple linear regression models were constructed to determine the effect of multiple questions on different target variables of interest. Measurements and main results: Numerous differences were noted based on institution, gender, specialty, and position. Most institutions did not have a standard resuscitation consent form. Most respondents believed the client, house officer, and senior clinician should determine whether to perform resuscitation or not. Quality of life was the most significant determinant of whether to resuscitate or not, followed by long-term prognosis, then short-term prognosis. Conclusions: Veterinarians differ in many aspects of their approach to CPA and resuscitation. Creating consensus within the veterinary profession would benefit client service and patient care.

Advances in Small Animal Medicine and Surgery, 2007

A 15-month-old neutered male cat was presented for progressive paraparesis of 3 months' duration ... more A 15-month-old neutered male cat was presented for progressive paraparesis of 3 months' duration and suspected cardiomegaly. Neuroanatomical localization was a T3-L3 myelopathy. On abdominal ultrasound, an anomalous vessel with turbulent blood flow was identified arising from the caudal vena cava. Myelography showed a bilateral ventrolateral extradural spinal cord compression from T12 to L4. Nonselective angiography and contrast-enhanced computed tomography clearly indicated a vascular complex and vena caval aneurysm with an engorged internal vertebral venous plexus. Surgical occlusion of the anomalous vessels was unsuccessful.

Physical Rehabilitation for Veterinary Technicians and Nurses

Frontiers in Veterinary Science

The use of cannabidiol (CBD) in childhood refractory seizures has become a common therapeutic app... more The use of cannabidiol (CBD) in childhood refractory seizures has become a common therapeutic approach for specific seizure disorders in human medicine. Similarly, there is an interest in using CBD, cannabidiolic acid (CBDA) or cannabinoid-rich hemp products in the treatment of idiopathic epilepsy in dogs. We aimed to examine a small cohort in a pilot investigation using a CBD and CBDA-rich hemp product for the treatment of refractory epileptic seizures in dogs. Fourteen dogs were examined in a 24-week randomized cross-over study being provided placebo or CBD/CBDA-rich hemp extract treatment at 2 mg/kg orally every 12 h for each 12-week arm of the study. Serum chemistry, complete blood counts, serum anti-seizure medication (ASM) concentrations and epileptic seizure frequency were followed over both arms of the cross-over trial. Results demonstrated that besides a mild increase in alkaline phosphatase, there were no alterations observed on routine bloodwork at 2, 6, and 12 weeks duri...

Compendium (Yardley, PA), 2008

Acute spinal cord injuries commonly seen in veterinary patients include vascular, compressive, an... more Acute spinal cord injuries commonly seen in veterinary patients include vascular, compressive, and concussive injuries. Vascular lesions, or infracts, are usually caused by fibrocartilagenous emboli. Concussive and compressive injuries have a variety of pathologies, including intervertebral disk disease, fractures, and luxations (dislocations) of the vertebral column. Although considerable controversy exists over the most appropriate way to manage acute spinal cord injuries, early surgical intervention or decompression remains the best treatment option in managing acute compressive injuries in veterinary patients. High-dose methylprednisolone sodium succinate, an established treatment in human medicine, is falling out of favor because studies have shown little therapeutuc benefit and severe adverse effects.

Veterinary pathology, 2008

An acute to chronic idiopathic necrotizing meningoencephalitis was diagnosed in 5 Chihuahua dogs ... more An acute to chronic idiopathic necrotizing meningoencephalitis was diagnosed in 5 Chihuahua dogs aged between 1.5 and 10 years. Presenting neurologic signs included seizures, blindness, mentation changes, and postural deficits occurring from 5 days to 5.5 months prior to presentation. Cerebrospinal fluid analyses from 2 of 3 dogs sampled were consistent with an inflammatory disease. Magnetic resonance imaging of the brain of 2 dogs demonstrated multifocal loss or collapse of cortical gray/white matter demarcation hypointense on T1-weighted images, with T2-weighted hyperintensity and slight postcontrast enhancement. Multifocal asymmetrical areas of necrosis or collapse in both gray and white matter of the cerebral hemispheres was seen grossly in 4 brains. Microscopically in all dogs, there was a severe, asymmetrical, intensely cellular, nonsuppurative meningoencephalitis usually with cystic necrosis in subcortical white matter. There were no lesions in the mesencephalon or metencepha...

Journal of the American Animal Hospital Association, 2003

Primary brain tumors are not commonly reported in young dogs; however, they are the second most c... more Primary brain tumors are not commonly reported in young dogs; however, they are the second most common cancer in children. Astrocytomas are the majority of these tumors. This report presents three cases of astrocytomas in young dogs, indicating a possible higher incidence than what is currently held. When suspected, it is recommended that biopsy or surgical excision be performed to further characterize and grade the tumor and, if appropriate, guide treatment.

Journal of the American Animal Hospital Association, 2003

Two dogs presented with acute tetraparesis, hypoventilation, and bradycardia with a second-degree... more Two dogs presented with acute tetraparesis, hypoventilation, and bradycardia with a second-degree atrioventricular heart block. Neurological examination localized both lesions to the cervical spine. Diagnostic imaging revealed a ventral extradural compression at the second to third cervical (C2–C3) region in one dog and at the third to fourth cervical (C3–C4) region in the other. Following surgical correction of the extruded disk, the hypoventilation and bradycardia resolved. Cervical disk extrusions are a common cause of acute tetraparesis in the dog. This report shows that respiratory and cardiac complications may occur concurrently. The authors recommend screening dogs with cervical myelopathies for respiratory and cardiac dysfunctions and treating appropriately. Prompt surgical intervention and supportive care can improve the prognosis.

Veterinary Radiology <html_ent glyph="@amp;" ascii="&"/> Ultrasound, 2004

Veterinary Pathology, 2014

A 13-week-old male intact Poodle mix dog developed an acute onset of vestibular ataxia, tetrapare... more A 13-week-old male intact Poodle mix dog developed an acute onset of vestibular ataxia, tetraparesis, and vomiting. The patient presented ambulatory, tetraparetic, and ataxic with a head tilt to the left and a disconjugate nystagmus (rotary nystagmus with fast phase to the right in right eye and vertical nystagmus in left eye). There were absent postural reactions in the left pelvic and left thoracic limbs and decreased right-sided postural reactions. Magnetic resonance imaging demonstrated an intra-axial mass within the left midcaudal medulla oblongata. On gross dissection, there was a left-sided neoplasm in the medulla oblongata with surrounding hemorrhage. The histologic findings indicated that the mass was a pleomorphic xanthoastrocytoma. This tumor, an uncommon variant of an astrocytoma most often seen in children and young adult humans, has yet to be described in dogs.

Neuromuscular Disorders, 2006

Nemaline myopathy is associated with rod-shaped structures in muscle fibers. At least seven disti... more Nemaline myopathy is associated with rod-shaped structures in muscle fibers. At least seven distinct clinical forms have been described in humans and mutations have been identified in five different thin-filament genes. Only a few cases of spontaneously occurring nemaline myopathy have been reported in animals and include an adult-onset form in a family of cats and an early-onset form in a dog. Here, we describe a 2-year-old male, neutered, domestic shorthaired cat that was referred to the Veterinary Medical Teaching Hospital, University of California-Davis, for evaluation of chronic, progressive weakness, and fine tremors. Neurologic deficits were restricted to the neuromuscular system. Electromyography showed mild to moderate diffuse spontaneous activity. Although rod bodies were prominent on light and electron microscopic evaluation of biopsies from several muscles, sarcoplasmic accumulations of dystrophin, desmin, and spectrin also were identified by immunohistochemistry. These findings may represent the occurrence of rod bodies in conjunction with a protein-aggregate myopathy.

Journal of Veterinary Internal Medicine, 2006

Journal of Veterinary Emergency and Critical Care, 2008

Objective: To examine the impact of stress on veterinarians resulting from both the provision of ... more Objective: To examine the impact of stress on veterinarians resulting from both the provision of cardiopulmonary-cerebral resuscitation (CPCR) and the discussion of CPCR and do not attempt resuscitation (DNAR) with affected clients. Design: Descriptive cross-sectional with survey methodology. Setting: Eight colleges of veterinary medicine in the United States. Subjects: Two hundred and one academic veterinarians. Interventions: The survey was distributed by the authors to small animal faculty, residents, and interns. Demographic variables and Likert-style questions about comfort discussing and performing CPCR and affective impact of CPCR events were included. Multiple linear regression models were constructed to determine the effect of the questions on different target variables of interest. Measurements and Main Results: Ninety-six percent of veterinarians experienced stress when performing CPCR and reported that positive emotions after a successful CPCR were statistically greater than the negative emotions of an unsuccessful CPCR. Veterinarians trained in CPCR reported lower scores for stress and negative emotional impact from a failed CPCR. Conclusions: Veterinarians experience stress during CPCR and when discussing CPCR and DNAR choices with owners. Steps can be taken to reduce the likelihood of having a negative affect from CPCR efforts, such as improved training of CPCR supervisors and increased competence of CPCR supervisors.

Journal of Veterinary Emergency and Critical Care, 2008

Objective: To document the clinical practice of cardiopulmonary-cerebral resuscitation (CPCR) amo... more Objective: To document the clinical practice of cardiopulmonary-cerebral resuscitation (CPCR) among academic veterinarians. Design: Survey. Setting: Eight colleges of veterinary medicine in the United States. Subjects: Two hundred and one academic veterinarians. Interventions: The survey was distributed by hand by the authors into the mailboxes of small animal faculty, residents, and interns. Demographic variables, questions regarding number of cardiopulmonary arrests (CPA) supervised and number successful, do not attempt resuscitation discussions, and Likert-style questions about client presence during CPCR, appropriateness of CPCR, and CPCR decision-making were included. Multiple linear regression models were constructed to determine the effect of multiple questions on different target variables of interest. Measurements and main results: Numerous differences were noted based on institution, gender, specialty, and position. Most institutions did not have a standard resuscitation consent form. Most respondents believed the client, house officer, and senior clinician should determine whether to perform resuscitation or not. Quality of life was the most significant determinant of whether to resuscitate or not, followed by long-term prognosis, then short-term prognosis. Conclusions: Veterinarians differ in many aspects of their approach to CPA and resuscitation. Creating consensus within the veterinary profession would benefit client service and patient care.

Advances in Small Animal Medicine and Surgery, 2007

A 15-month-old neutered male cat was presented for progressive paraparesis of 3 months' duration ... more A 15-month-old neutered male cat was presented for progressive paraparesis of 3 months' duration and suspected cardiomegaly. Neuroanatomical localization was a T3-L3 myelopathy. On abdominal ultrasound, an anomalous vessel with turbulent blood flow was identified arising from the caudal vena cava. Myelography showed a bilateral ventrolateral extradural spinal cord compression from T12 to L4. Nonselective angiography and contrast-enhanced computed tomography clearly indicated a vascular complex and vena caval aneurysm with an engorged internal vertebral venous plexus. Surgical occlusion of the anomalous vessels was unsuccessful.