Holding our nerve – the impact of BSAVA PetSavers’ neurology and pain research (2015-2024)

11 September 2025

BSAVA PetSavers has been funding clinical research into companion animal disease for over 50 years. In the last 10 years alone, we have awarded over £200,000 in funding for research into neurological disease and pain management in pets. But what’s the value of this clinically-based veterinary research? Several of our experienced neurologist researchers have shared their thoughts and helped us examine our impact in this important area. 

“Clinical research is one of the best ways of improving knowledge of disease, understanding how that disease evolves over time and determining the most effective way to diagnose and treat it. For example, canine acute polyradiculoneuritis (like Guillain Barre syndrome) is a challenging diagnosis in veterinary practice involving referral, electrophysiology and nerve and muscle biopsy. The consequence of PetSavers-funded research was the identification of an antibody biomarker [of this disease]. Soon this could be translated into a blood test that general practitioners could use to avoid referral and expense. In addition, this research has improved our understanding of this immune-mediated disease.” Professor Clare Rusbridge, University of Surrey and Wear Referrals

Funding research into acute canine polyradiculoneuritis is a wonderful example of how our funding has a direct impact and benefit on clinical practice. Moreover, the great follow-up news is that Dr Angie Rupp and colleagues at the University of Glasgow are now developing a diagnostic serological assay for the biomarkers they identified.

Advances in understanding disease and investigating potential diagnostic avenues

Autoimmune encephalitis

In 2020 and 2022, we awarded grant funding to Dr Sophie Binks, a medical doctor and Clinical Research Fellow at the University of Oxford, to improve the recognition, diagnosis and treatment of cats with autoimmune encephalitis. Humans have a comparable disease which is better researched than the feline version, and human patients usually respond very well to immunotherapies. In both cats and humans, the condition presents with acute to sub-acute onset of seizures, as well as behavioural and cognitive changes, and both species have autoantibodies against the leucine-rich glioma inactivated 1 (LGI1) protein. Disease presentation in cats is defined as Feline Partial Cluster Seizures with Orofacial Involvement (FEPSO), and involves typically focal seizures with orofacial automatisms (licking, chewing, lip smacking and hypersalivation), altered consciousness, mydriasis and vocalisation.1 Since 2013, when four seizuring cats with LGI1-antibodies were first published,2 this research has helped establish that LGI1 antibody encephalitis is an important cause of feline seizures. Affected cats can now secure a diagnosis leading to targeted treatment and survival, especially critical given the high euthanasia rate of ~20%.

A prize-winning poster deriving from the research and presented at the Association of British Neurologists conference in 2022 concluded that “Many features [of autoimmune encephalitis] are common to humans and cats with LGI1-autoantibodies. Feline patients represent a naturally-occurring disease model and an opportunity to benefit health in both species via a bi-directional translational model, consistent with the ‘One Health’ ideal of a shared world.3 Future work will evaluate the role of immunotherapy in cats, which is especially important given euthanasia may still be an option in severe cases”. 4

To find out more about this condition and the work of the International Feline Encephalitis Group, please visit: https://www.rvc.ac.uk/research/feline-encephalitis

“Research is the foundation of driving advances in medical and veterinary science and is important to me for continuous improvement of the care we can deliver to patients.” Dr Sophie Binks, University of Oxford

Cerebrovascular disease and neurological impairment

Professor Rita Gonçalves and her team from the University of Liverpool used a BSAVA PetSavers grant to research if the protein troponin I (cTnI) might be a useful biomarker for acute ischaemic stroke in dogs. Their published study5 suggested that cTnI is commonly elevated in canine patients diagnosed with acute ischaemic stroke, even more so than in human patients. Cardiac disease was not identified as a common underlying cause for canine ischaemic strokes, confirming this clinical suspicion that had not previously been researched, but no prognostic value was shown for cTnI levels by this small study.

BSAVA PetSavers is also funding an ongoing RVC study to assess hypercoagulability in dogs with ischaemic cerebrovascular infarcts. The research team would welcome referral of any canine cases with suspected ischaemic stroke (i.e., presenting with (per)acute clinical signs localized to the brain and non-progressive beyond 48 hours) to the Queen Mother Hospital for Animals, RVC, via: s.wyatt@rvc.ac.uk.

Robotic cat disease

In 2019, we funded Professor Danielle Gunn-Moore’s investigation into a novel form of feline meningoencephalomyelitis, known as ‘robotic cat disease’. At BSAVA Congress 2025, she explained that the disease appears to be limited to cases in Scotland, and that the cause remains elusive, although a number of viral pathogens have been ruled out. This talk is freely available to BSAVA members here.

The condition has very particular signs, with affected cats demonstrating a stiff walk and tail, with their heads and ears facing forward and chin tucked downwards (Figure 1). They can also be blind and show other altered behaviours. Unfortunately, the disease is progressive and currently untreatable.

Figure 1: Cat showing the stiff gait and head posture characteristic of “robotic” cat syndrome.

Chiari-like malformation associated pain (CM-P) and syringomyelia (SM)

Several undergraduate student projects, under the guidance of Professor Clare Rusbridge at the University of Surrey, have studied aspects of the Cavalier King Charles spaniel (CKCS) anatomy in relation to CM-P and SM. One investigated if CKCS with CM-P or SM are predisposed to oropharynx inflammation, but concluded that though oropharyngeal inflammation is common because of the brachycephalic confirmation and may be a source of pain, it is not seen more often in dogs with CM-P or SM. A separate study undertook 3D quantification and characterization of the spinal cord dorsal horn neuronal population (laminae I to V) in CKCS with SM. The results showed that ‘scratchers’ had significantly larger central cavities than ‘non-scratchers’, and suggested there are differences in the number of inhibitory interneurons in one or more laminae of the left and right dorsal horn between dogs with and without SM (categorised into four different cohorts). The study did not identify in which lamina(e) the differences lie, and it was concluded that further statistical analysis and altered methodology are needed to relate these differences to the development of phantom scratching in dogs with severe syringomyelia.

Myasthenia gravis

Our first Research Fellowship recipient, Dr An Vanhaesebrouck from the University of Cambridge, received a PetSavers grant in 2023 to investigate cell-based assays to detect ‘low-affinity’ antibodies against acetylcholine receptors or antibodies against other neuromuscular junction antigens in canine myasthenia gravis.

Myasthenia gravis is characterised by fatigable skeletal muscle weakness. The common, acquired form of disease is caused by pathogenic autoantibodies targeting nicotinic acetylcholine receptors in the neuromuscular junction, leading to impaired neural transmission. Currently, disease in dogs is confirmed by quantifying AChR autoantibodies using a serological radioimmunoassay (RIA), but a proportion of dogs presenting with suspected myasthenia gravis have no detectable AChR antibodies. Some of these are predicted to have low-affinity antibodies against AChRs or other neuromuscular junction proteins, and Dr Vanhaesebrouck’s study is exploring whether cell-based assays can detect these in dogs with seronegative myasthenia gravis, as in humans. Some canine acquired idiopathic megaoesophagus cases could also be a focal manifestation of myasthenia gravis with no detectable AChR antibodies. An improvement in antibody detection would increase the number of dogs correctly diagnosed that can receive prompt and targeted treatment, resulting in a better outcome for them.

Dr Vanhaesebrouck is keen to obtain more samples from dogs with suspected seronegative myasthenia gravis or acquired idiopathic megaoesophagus. Ideally, excess serum samples are needed from these patients, preferably stored around the time of the first RIA test. Please contact myasthenia@vet.cam.ac.uk for more information or with details of potential samples.

Improved clinical practice and advancement of contextualised care

Several PetSavers-funded studies have focused on improving clinical practices and enhancing treatment options to allow increased contextualisation.

Epilepsy

Dr Laurent Garosi received a PetSavers grant in 2019 to investigate how primary care clinicians in the UK approach initial management of canine generalised epileptic seizures, including factors potentially associated with prescription and choice of anti-seizure drugs. Canine epilepsy is thought to affect 1 in every 130 dogs in the UK, so is a common disorder being managed by clinicians in primary care practice.

The team’s multi-centre research findings showed that “primary care clinicians rarely prescribed anti-seizure drugs following a single epileptic seizure in accordance with International Veterinary Epilepsy Task Force (IVETF) recommendations; despite being significantly more likely to get prescribed [anti-seizure drugs] ASDs at their first consultation, less than half the dogs presenting with cluster seizures received ASD medication or referral to a specialist which is an expectation of IVETF. The reasons for this were generally not recorded in the clinical notes; monotherapy with imepitoin, rather than phenobarbital, was the most frequent choice of intervention for dogs initially presenting with cluster seizures. Imepitoin and phenobarbital have a comparable efficacy to reduce seizure frequency of single recurrent seizures by half. However, imepitoin is not currently recommended or authorised for cluster seizure treatment due to lack of evidence for its use in this situation”. 6

The authors hoped that their findings “may ultimately contribute to improved cohesion in the management of canine epileptic seizures between primary care and referral institutions”.

Intervertebral disc extrusion

Also in 2019, and together with The Debs Foundation, we funded Professor Paul Freeman at the University of Cambridge to investigate the recovery of ambulation in medically-managed non-ambulatory dogs with thoracolumbar intervertebral disc herniation.

Thoracolumbar myelopathy caused by intervertebral disc extrusion (TL IVDE) in dogs is a common presentation in both first opinion and referral practices. Severely affected dogs, particularly those which lose deep pain perception in their hind limbs, are thought to need decompressive surgery to recover ambulation. However, these costs can be prohibitively high, and dogs may be euthanised as a result.

This research study examined whether non-surgical (conservative) management, including analgesia, movement restriction and bladder management, could be successful in enabling small (<15 kg) non-brachycephalic dogs with TL IVDE to regain ambulation. Khan and Freeman (2024)7 concluded that “a high proportion of conservatively treated dogs recovered ambulation after conservative management of acute thoracolumbar disk herniation. Recovery was not dependent on the resolution of compression”.

Another PetSavers-funded investigation, also at the University of Cambridge but led by Dr Chiara Adami, explored the analgesic effect of dry needle acupuncture on 24 dogs undergoing surgical treatment of type I IVDEs (Figure 2). Their results suggested that performing a single dry needle acupuncture treatment before surgery helps to decrease the perioperative opioid consumption and improves the quality of perioperative analgesia in dogs undergoing hemilaminectomy for the treatment of IVDE.

Figure 2: Dachshund undergoing acupuncture before hemilaminectomy for the treatment of IVDE.

Dr Chiari is also leading an on-going, prospective trial investigating the effectiveness of low-level laser therapy to treat osteoarthritis-associated pain in dogs affected with either elbow or shoulder osteoarthritis.

“Clinical research trials are important for informing the diagnosis and management of disorders in clinical practice, and BSAVA PetSavers provides a vital source of funding for anyone hoping to undertake this form of research”. Professor Paul Freeman, University of Cambridge

In conclusion

Ten years of funding clinical research in neurological disease and pain management in companion animals has provided some major wins for pet health. Sometimes the answers are hard to find, but the research still moves us forward. Luckily researchers are generally determined and resilient, as well as curious, and keep looking for the answers.

The researchers we fund are usually clinicians as well; sometimes we fund primary care practitioners, more often we fund specialists and referral clinicians, all undertaking clinical research alongside their work treating sick pets. When asked why they carry out clinical research, the answer is often the same: undertaking research is intellectually stimulating and challenging, but the most important spur for the researcher is alleviating suffering and improving the lives of pets (and their caregivers). Please support us to continue this valuable work: www.bsava.com/petsavers/donate.

“One favourite aspect [of my research work] is following the progress of patients, and hearing of good progress is always so pleasing and motivating.  I am always delighted to hear back from vets about how the LGI1-antibody cats are doing, and finding out that a much-loved family pet is back at home, interacting and affectionate is a great boost.” Dr Sophie Binks, University of Oxford

References

  1. The International Feline Encephalitis Group. Autoimmune encephalitis in cats and humans. https://www.rvc.ac.uk/research/feline-encephalitis, accessed 19th May 2025
  2. Pakozdy A, Halasz P, Klang A, et al (2013) Suspected limbic encephalitis and seizure in cats associated with voltage-gated potassium channel (VGKC) complex antibody. J Vet Intern Med 27(1): 212–21 https://doi.org/10.1111/jvim.12026
  3. Devinsky O, Jordyn M, Boesch, Cerda-Gonzalez S, et al (2018) A cross-species approach to disorders affecting brain and behaviour. Nat Rev Neurol 14: 677– https://doi.org/10.1038/s41582-018-0074-z
  4. Binks S, Crawford A, Woodhall M, et al (2022) One Health: Clinical characteristics of spontaneously-arising feline LGI1- autoantibody limbic encephalitis in a large international cohort. Poster Abstract, Association of British Neurologists annual meeting 2022. https://doi.org/10.1136/jnnp-2022-abn2.111
  5. Gonçalves R, Sanchez-Masian D, Maddox TW, et al (2020) Preliminary investigation of serum cardiac troponin I in dogs with acute ischaemic stroke. J Small Anim Pract 61(2): 93–100. https://doi.org/10.1111/jsap.13097
  6. James M, Lowrie M, Singleton D, et al (2022) Approach to initial management of canine generalised epileptic seizures in primary-care veterinary practices in the UK. J Small Anim Pract 63(11): 801– https://doi.org/10.1111/jsap.13543
  7. Khan S, Jefferies N and Freeman P (2024) Recovery of ambulation in small, non-brachycephalic dogs after conservative management of acute thoracolumbar disk extrusion. J Vet Intern Med 38(5): 2603– https://doi.org/10.1111/jvim.17149