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Metabolic - miscellaneous

“MRI Findings in a Dog with Kernicterus”

Katie M. Belz, DVM*, Andrew J. Specht, DVM, DACVIM, Victoria S. Johnson, BVSc, DVR, DECVDI, MRCVS, Julia A. Conway, DVM, DACVP

J Am Anim Hosp Assoc 2013; 49:286–292


A severe increase in total bilirubin coincided with a decline in neurologic status to comatose in a 9 yr old spayed female mixed-breed dog being treated for immune-mediated hemolytic anemia. The signs started with head bobbing and generalized ataxia which progressed to coma in 4 hours. 

MRI revealed bilaterally symmetrical hyperintensities within the caudate nuclei, globus pallidus, thalamus, deep cerebellar nuclei, and cortical gray matter on T2 and FLAIR sequences, which coincided with areas of bilirubin deposition and neuronal necrosis (kernicterus) identified on necropsy examination.

This is the second case report of an adult dog exhibiting kernicterus, and the first report to document MRI findings associated with that condition. Kernicterus is an uncommonly reported complication of hyperbilirubinemia in dogs, but is potentially underreported due to difficulties in recognizing subtle lesions and distinguishing kernicterus from other potential causes of neurologic abnormalities with readily available antemortem tests. MRI may be helpful in supporting the diagnosis of kernicterus.

**No CSF analysis in this case