Thiamine Deficiency Due to Sulphur Dioxide Preservative in 'Pet Meat' - A Case of Deja vu

摘要

This month's Clinical Section of the Australian Veterinary Journal features an excellent paper concerning thiamine deficiency in canine patients treated by Rita Singh and colleagues at the North Ryde Veterinary Specialist Centre, in Sydney. The seriesof cases is just what you would expect from a state-of-the-art referral hospital in the first decade of the new millennium: a team approach to investigation and treatment, a timely diagnosis in most patients, utilisation of advanced diagnostics and outcomes that were generally favourable, even in dogs that presented late with advanced signs. A range of cases is described, serving to emphasise the spectrum of physical findings that may develop in dogs with this disease. Interestingly, one gets the sensethat the authors' diagnostic acumen was refined by their experience with the index case, as a subtle pattern of suggestive clinical findings emerged, facilitating the "pattern recognition" of subsequent cases. Magnetic resonance imaging (MRI) findings in dogs with thiamine deficiency have been reported on only one occasion previously and the additional data provided from the case so examined suggests that the changes are characteristic, as might be expected from the neuroanatomical distribution of lesions (periventricular brainstem grey matter) in carnivores with this vitamin deficiency. Use of the thiamine pyrophosphate effect test in this case provided unequivocal evidence that thiamine deficiency was the cause of the observed MRI lesions.