The effect of prior thecal puncture on cerebrospinal fluid analytes in normal adult horses.
Authors: Chidlow Hayley, Giguère Steeve, Camus Melinda, Wells Bridgette, Berghaus Roy, McConachie Beasley Erin
Journal: Journal of veterinary internal medicine
Summary
# The Effect of Prior Thecal Puncture on Cerebrospinal Fluid Analytes in Normal Adult Horses When horses present with neurological disease, clinicians may need to collect cerebrospinal fluid (CSF) on multiple occasions to monitor disease progression or treatment response, yet the impact of an initial puncture on subsequent analyses remained unknown. Researchers collected CSF samples from ten healthy adult horses at two sites (lumbosacral and cervical C1-C2) separated by 14 days, with a 4-month washout period between sites, and analysed protein concentration, nucleated cell counts and equine protozoal myeloencephalitis (EPM) titres using mixed-effects statistical modelling. Crucially, no significant differences emerged between day 0 and day 14 samples at either collection site for any measured analyte: cervical protein remained stable (45 versus 49 mg/dL), lumbosacral protein showed no significant change (64 versus 83 mg/dL), and nucleated cell counts similarly showed no statistical effect of the initial puncture. These findings provide reassurance that serial CSF sampling for diagnostic and monitoring purposes does not confound subsequent results, allowing veterinarians to repeat collections with confidence when clinical neurological cases warrant longitudinal assessment without concern that prior puncture will artificially alter protein levels, cell counts or antibody titre ratios.
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Practical Takeaways
- •Serial CSF collections from the same or different sites 2 weeks apart can be reliably compared without concern that the first puncture site affects subsequent results
- •Clinicians can confidently perform repeat CSF taps to monitor neurologic disease progression or treatment response without analyte contamination from prior puncture sites
- •Both cervical and lumbosacral sites are equally suitable for repeat CSF sampling in the same patient when clinical circumstances require sequential analysis
Key Findings
- •No significant effect of collection day (day 0 vs day 14) on protein concentration in C1-C2 (P = 0.12) or lumbosacral (P = 0.37) CSF collections
- •No significant difference in nucleated cell counts between day 0 and day 14 at either collection site (C1-C2: P = 0.65; LS: P = 0.10)
- •No significant difference in EPM titers or serum:CSF ratios between sequential collections 14 days apart
- •Repeat thecal puncture from either lumbosacral or C1-C2 space does not impact CSF analyte values when performed 2 weeks apart