Changes in the creatine kinase and lactate dehydrogenase activities in cerebrospinal fluid of dogs with thoracolumbar disc disease

Abstract

Ninety-seven dogs (49 males and 48 females) with thoracolumbar (TL) disc disease which were treated at the Clinic of Surgery and Orthopedics at University of Veterinary and Pharmaceutical Sciences in Brno from October 1997 till the end of December 1998 were included in this study. A total of 142 cerebrospinal fluid (CSF) samples were evaluated. CSF from the cisterna magna (cisterna cerebellomedularis) was collected successfully in all 97 animals. Only 45 samples were obtained from lumbar subarachnoid space in the same patients. The purpose of our study was to determine whether transverse myelopathy due to TL disc protrusion/extrusion may cause elevation of CSF creatine kinase (CK) and lactate dehydrogenase (LDH) activities in dogs. Normal values of CSF CK (0.41 ± 0.43 μkat/l) and LDH (0.40 ± 0.28 μkat/l) activities were determined in 23 healthy dogs. The highest normal enzyme activity was assessed as σΔ0.95 (mean + 2 SD). Activity of CSF CK ≥ 1.27 μkat/l, and activity of CSF LDH ≥ 0.96 μkat/l were considered to be abnormal. Significant differences (Mann-Whitney U-test; p < 0.01) between activities of the two enzymes in the cerebrospinal fluid of healthy dogs and dogs with TL disc extrusion (the mean CSF CK = 2.47 ± 3.22 μkat/l; the mean CSF LDH = 1.45 ± 1.98 μkat/l) were found. CSF from lumbar and atlantooccipital punctures in 45 patients, in which both the samples were successfuly collected, were analyzed and compared statistically. The mean CK activity of the lumbar CSF samples was 2.47 ± 3.22 μkat/l; the mean CK concentration of atlantooccipital CSF was 0.50 ± 0.47 μkat/l. The mean of lumbar CSF LDH activities was 1.45 ± 1.98 μkat/l; the mean of atlantooccipital CSF LDH values was 0.34 ± 0.32 μkat/l. Statistical analysis (Wilcoxon matched-pairs signed-ranks test) indicated that differences in the CK and LDH concentrations between CSF samples obtained from the cisterna magna, and from lumbar subarachnoid space were significant (p < 0.01). The dynamics of CSF CK and LDH activities in dogs with disc disease was assessed, as well. The mean of CSF CK activity taken on the first day of paraparesis/paraplegia was 1.47 ± 1.22 μkat/l. Creatine kinase in the cerebrospinal fluid had peaked at 48 hours after onset of clinical signs (3.84 ± 4.95 μkat/l). On the third and fourth days its activity had significantly decreased (p < 0.01) to 1.76 ± 2.71 μkat/l. A second peak was identified (p < 0.05) between day seven and seventeen (3.80 ±3.23 μkat/l). The mean LDH concentration in the CSF on day one was 1.32 ± 1.28 μkat/l, but its concentration increased significantly (p < 0.01) during the second day of clinical signs (2.36 ± 3.38 μkat/l). Mean LDH concentration decreased significantly (p < 0.01) on the third and the fourth days (0.80 ± 0.33 μkat/l) without a second peak of activity.