Atlantoaxial instability in a white-tailed deer fawn (Odocoileus virginianus)

On 14 March 2001, an 8 mo old, male white-tailed deer (Odocoileus virginianus) was found in lateral recumbency exhibiting neurologic signs including inability to rise, opisthotonus, paddling, and respiratory distress. There was evidence of minor cranial trauma. Postmortem examination revealed atlantoaxial instability with ventral deviation of the axis due to malformation of the caudal atlas and cranial axis. Given the age of the fawn, the instability was assumed to be congenital with minor trauma inducing severe, acute neurologic signs.

Spinal compression due to atlantal vertebral malformation in two African lions (Panthera leo)

Two young (14-mo-old and 6-mo-old), unrelated, male African lions (Panthera leo) were presented to the Veterinary Teaching Hospitals of Oklahoma State University and Kansas State University with progressive ambulatory difficulty. In both cases, limited neurologic evaluation demonstrated pelvic limb paresis and ataxia with conscious proprioceptive deficits. Spinal imaging showed nearly identical lesions in both cases. Radiography and myelography demonstrated cervical stenosis secondary to atlantal (C1) malformation producing a dorsoventral deformity of the laminar arch with atlantoaxial spinal cord compression between the ventrally displaced laminar arch of the atlas and the underlying odontoid process of C2. Computed tomography of the atlanto-axial junction confirmed cervical stenosis and cord compression, showing flattening of the spinal cord between the laminar arch of C1 and the dens of C2. Decompressive surgery consisting of dorsal laminectomy of C1 was performed. Each lion demonstrated progressive improvement of neurologic status to recovery of normal ambulation after surgical intervention. Neurologic disease in large captive felids is rare; atlanto-axial spondylomyelopathy has not been reported previously.

Secondary chronic respiratory acidosis in a dog following the cervical cord compression by an intradural glioma

An intradural tumor in the upper cervical region was found in a dog with quadriparesis and chronic respiratory acidosis. Surgical removal of the tumor in the atlas and intraoperative radiotherapy were attempted. The tumor was histologically diagnosed as a neural glioma. A preoperative acid-base disturbance was dramatically improved after surgery. The clinical changes appeared in this case suggest that compression of the spinal cord at this region may cause paralysis of the respiratory muscles and secondarily result in chronic respiratory acidosis following the respiratory insufficiency.

Osteological features in pure-bred dogs predisposing to thoracic or lumbar spinal cord compression

Consistent with those vertebral sites most commonly clinically affected by spinal cord compression, body size normalised midsagittal diameters of the caudal vertebral foramen limits T10-T12 were significantly (P<0.05) lower in Dachshunds relative to other breeds. Minimal midsagittal diameters in Yorkshire Terriers and Maltese were noted at T11cd/12cr. However, these diameters were always larger (P<0.05) in small breeds compared to those in Dachshunds and large breeds suggesting that the small breeds investigated are at lower risk of developing clinical signs if a compressive disease occurs at that site. In large breeds, minimal values were present at L1cd/L2cr and in agreement with clinical findings correlate with those spinal sites most susceptible to spinal cord compression in nonchondrodystrophic large breeds. Caudal displacement of the lumbosacral enlargement of the spinal cord relative to the position previously noted in large breeds was confirmed for the Dachshunds and 50% of small breeds. However, caudal displacement was also noticed in the German Shepherd dogs.

Management of spinal trauma in 69 cats

This study sought to evaluate a series of clinical and radiological findings on spinal trauma in cats and the outcome that emerged from conservative or surgical treatment using 2 types of spinal stapling: stabilization using a Steinmann pin and coated polypropylene. Case records were reviewed for their diagnostic approaches on the basis of physical and neurological conditions, and concurrent disorders in addition to spinal trauma. Radiological examinations of the vertebral column were carried out using survey radiography, myelography and epidurography. All cases were classified according to etiopathogenesis of the disease. Surgical treatment consisted of decompression (laminectomy, hemilaminectomy and durotomy), or decompression with stabilization which was performed by one of two methods. The first one was the employment of translaminar stapling at the base of a spinous process and the other involved spinal stapling at the spinous process. The spinal lesions were identified as cervical (n = 2), thoracic (n = 35), lumbar (n = 22), sacral and caudal (n = 10). While 19 out of 30 conservatively managed cases recovered, the rest had persistent residual paresis and ataxia. Complete recovery was seen in 4 cats that underwent hemilaminectomy and 3 subjected to laminectomy. Partial recovery was observed in 5 cases involving laminectomy; however, there was no improvement observed in another 2 cases. Each animal was followed for at least a 3-month period to evaluate the clinical assessment of the results following treatment. The results of conservative and operative management of spinal trauma indicated that the type and degree of spinal cord degradation strongly influenced any prognosis. The results emerging from decompressive procedures seemed satisfactory for those cases where instability was not an issue. Both stabilization techniques were not ideal in terms of their methodological versatility or regarding weaknesses of bone structure observed in intra- and postoperative periods. However, translaminar stapling at the base of a spinous process was deemed to be the superior technique.

Suspected paraspinal abscess and spinal epidural empyema in a dog

Epidural spinal cord compression was visualized myelographically in a dog presented for rapid development of paraparesis. A large, fluid-filled pocket in the epaxial musculature was found at surgery and appeared to communicate with the first lumbar vertebra. Unfortunately, cytopathological evaluation of the fluid was not performed. No etiological agents were isolated on aerobic culture. The dog responded well to decompressive surgery and medical therapy consisting of antibiotics, pain medication, and nursing care. In the veterinary literature, only two studies of spinal epidural empyema in the dog have been reported. Of these dogs, one had successful decompressive surgery performed. The other dogs in these two reports were euthanized. The dog presented in this report fully recovered. Spinal epidural empyema should be considered as a differential diagnosis in dogs presenting with a fever and a rapidly progressing myelopathy.

Mensuration of cervical vertebral ratios in Doberman pinschers and Great Danes

Canine cervical vertebral instability is a complex syndrome involving cervical spinal cord compressive lesions. Doberman pinschers and Great Danes are the most commonly affected breeds. Measurements of vertebral canal diameter (VCD), vertebral body height (H), and vertebral body length (L) were made from C3-C7 in 24 Doberman pinschers and 8 Great Danes by using digital and analog techniques. Significant differences between affected and unaffected sites were noted for Doberman pinschers at C6 (P = 0.039) and C7 (P = 0.027) using analog measurements of VCD/H, and Great Danes at C6 using analog (P = 0.041) and digital (P = 0.004) measurements of VCD/L. Cervical vertebral ratios have potential as a breed-specific screening tool for cervical vertebral instability and warrant longitudinal studies.

Surgery for disc-associated wobbler syndrome in the dog--an examination of the controversy

Controversy surrounds treatment of disc-associated 'wobbler' syndrome in the dog, centring on the choice of method of surgical decompression used. In this review, details of previously published case series are summarised and critically examined in an attempt to compare success rates and complications of different types of surgery. Unequivocally accurate comparisons were difficult because of differences in methods of case recording between series. Short-term success rates were high (approximately 80 per cent), but there was a high rate of recurrence (around 20 per cent) after any surgical treatment, suggesting the possibility that the syndrome should be considered a multifocal disease of the caudal cervical region. Statistical analysis revealed no significant differences in success rates between the various reported decompressive surgical techniques

Cervical stenotic myelopathy in a horse

A 13-year-old, Thoroughbred gelding presented with a 3-year history of progressive ataxia of all 4 limbs. Physical and neurological examinations indicated a compressive lesion affecting the cervical spinal cord. Radiographs confirmed a lesion, and a myelogram a narrowing of the spinal canal at cervical vertebrae (6-7). Necropsy confirmed cervical stenotic myelopathy.

Osteological features in pure-bred dogs predisposing to cervical spinal cord compression

Relative to body size, midsagittal and interpedicular diameters of the cranial and caudal aspects of cervical vertebral foramina (C3-C7) were found to be significantly (P < 0.05) larger in small breeds than in large breeds and Dachshunds, and also larger in Dachshunds (P < 0.05) than in large breeds. This condition increases the risk for spinal cord compression resulting from relative stenosis of the cervical vertebral foramina, especially in large dogs, and this is also exacerbated by the typical shape of the vertebral foramina (i.e. dorsoventrally flattened cranially and bilaterally narrowed caudally). Within large dogs those breeds highly predisposed to cervical spinal cord compression were Great Danes (the breed with the smallest midsagittal vertebral foramen diameters from cranial C6 to cranial T1) and Doberman Pinschers, because of the most strikingly cranially dorsoventrally narrowed cone-shaped vertebral foramina at C6 and C7. The existence of a small midsagittal diameter in the cranial cervical spine was a high risk factor predisposing to spinal cord compression in small breeds and Dachshunds. Remarkable consistency was noted between the spinal level of the maximum enlargement of the spinal cord which previously was reported to be at C6, and the site of maximum enlargement of the vertebral canal currently stated in Dachshunds and small breeds. In large breeds the maximum enlargement of the vertebral canal tended to be located more caudally at the caudal limit of C7. The average age at which large dogs were most susceptible to noxious factors causing abnormal growth of the pedicles was determined to be 16 wk.

Extradural spinal synovial cysts in nine dogs

Nine dogs presenting for investigation of cervical or thoracolumbar myelopathies were diagnosed with extradural spinal synovial cysts. Degenerative disease affecting the articular facets or intervertebral discs was present on plain spinal radiographs in all cases. Myelography was consistent with dorsolateral, extradural spinal cord compression. Two groups of dogs were identified: (1) young, giant breed dogs with multiple cysts involving one or more levels of the cervical spinal cord; and (2) older, large breed dogs with solitary cysts involving the thoracolumbar spinal cord. The synovial cysts constituted the major compressive lesions in four of the dogs. Analysis of lumbar cerebrospinal fluid demonstrated albuminocytological dissociation, consistent with chronic compressive myelopathy, in six dogs. All dogs underwent decompressive surgery and the diagnosis of synovial cysts was confirmed histologically. The mean follow-up period was 17 months (range four to 36 months). At the time of follow-up, all dogs were fully ambulatory with improved neurological function compared with that at initial presentation.

[Ataxia and pruritus in a pony due to a cervical vertebral fracture]

A mini-Shetland stallion was referred with bilateral pruritus localized to the anterior neck. More detailed clinical examination also revealed ataxia, and diagnostic imaging, including pre- and post-contrast computed tomography, revealed an old fracture of C2. Spinal cord compression was diagnosed. The probable causal relation between the fracture, the ataxia, and the localized pruritus seems comparable to the 'contusio cervicalis posterior' in humans, in which spinal cord trauma may cause pruritus in the associated dermatome.

Radiographic diagnosis: cartilaginous exostoses in a dog

A 6 month-old dog was examined for progressive paraparesis. On physical examination bony malformations were palpated over the cranial lumbar vertebral bodies and on the left metatarsal bone. Neuroanatomic lesion localization for the paraparesis was a T3-L3 spinal cord lesion. Radiographs confirmed bony masses at L1-L2 and on the left 3rd metatarsal bone. Magnetic resonance imaging was performed from T3-L3. Severe spinal cord compression was identified at L1-L2. Surgical decompression and biopsy confirmed the mass to be cartilaginous exostoses. This paper is an example of cartilaginous exostoses imaged with MR.

Suspected latent vertebral metastasis of uveal melanoma in a dog: a case report

A six-year-old intact male Pomeranian was examined because of right eye discomfort. An iris neoplasm was suspected and the eye was enucleated. A uveal melanoma with malignant features was diagnosed. The dog recovered uneventfully from surgery. A general physical examination was performed at 3-month intervals afterwards without any detectable problem, but 18 months after the first presentation the dog suffered a rapid, progressive paraplegia. Radiographic examination and myelography revealed a spinal cord compression at the level of the 8th thoracic (T8) vertebral body. Surgical exploration of the area revealed a potential vertebral neoplasm: histopathology confirmed a melanoma which was suspected to have resulted from metastasis from the previously diagnosed uveal melanoma.

The effects of hypertonic saline on spinal cord blood flow following compression injury

7.5% hypertonic saline was administered following spinal cord injury to test its effect on spinal cord blood flow. Four different groups of rats underwent 10 minutes of spinal cord compression (45 g) at the C3 to C5 levels. A fifth group was not injured, but received hypertonic saline (5 ml/kg) at 5, 15 and 60 minutes following injury. Somatosensory evoked potentials and spinal cord blood flow were measured prior to and for 4 hours following the injury. The administration of hypertonic saline caused a significant increase in flow when administered 5 minutes following injury. Topical nitroprusside administration did not cause any increase in spinal cord blood flow during this time period. Hypertonic saline administration at the later time periods did not increase spinal cord blood flow. The group of animals which were not injured, but received hypertonic saline also showed no significant change in flow. The somatosensory evoked response of the treated animals was maintained for 4 hours after the injury where as the untreated animals began to lose their evoked responses 3 hours after injury.

Atlantoaxial cartilaginous exostosis causing spinal cord compression in a mature Bernese mountain dog

Cartilaginous exostosis developed in the atlantoaxial region of a three-and-a-half-year-old Bernese mountain dog. The dog exhibited ataxia in the hindlimbs and flailing movements in the forelimbs. On survey radiographs of the cervical spine there was a focal calcified mass between the dorsal arch of the atlas and the spinous process of the axis. Lumbar myelography revealed severe dorsal spinal cord compression. The mass was removed surgically and the dog made a complete recovery. Histopathology of the excised mass was consistent with a diagnosis of cartilaginous exostosis.

Magnetic resonance imaging features of cervical stenotic myelopathy in 21 dogs

The cervical spine of 21 dogs with clinical signs of cervical stenotic myelopathy was evaluated using magnetic resonance (MR) imaging. Spin echo T1, T2 and gradient echo T2 weighted images were obtained with a 1.5 Tesla magnet in 12 dogs and a 1.0 Tesla magnet in 9 dogs. Sagittal or parasagittal T1W and T2W images were helpful in determining the presence of spinal cord compression or degenerative disease of the articular processes. Transverse T1W and T2W images were the most useful for the identification of dorsolateral spinal cord compression secondary to soft tissue and ligament hypertrophy, as well as synovial cysts, associated with the articular processes. The MR imaging findings were consistent with the surgical findings in all 14 dogs that underwent surgery. Magnetic resonance imaging provided a safe, non-invasive method of evaluating the cervical spine in dogs suspected of having cervical stenotic myelopathy. Veterinary

Neurological signs in a horse due to metastases of an intestinal adenocarcinoma

A 22-year-old Dutch Warmblood mare was referred to Utrecht University with progressive left hind limb paresis and hyporeflexia. The preliminary clinical diagnosis was the neurological form of equine herpes virus (EHV-1) infection. Within 1 day of admission, the mare became recumbent and deteriorated rapidly. Postmortem examination revealed an adenocarcinoma of the caecum, with metastases in all regional lymph nodes and extending from the lumbar nodes into the vertebral canal, causing spinal cord compression and destruction of the left 4th and 5th lumbar nerves.

Magnetic resonance imaging in the diagnosis and treatment of a canine spinal cord injury

A nine-year-old female crossbred dog was presented with tetraplegia following a fall. No vertebral abnormalities were detectable on plain radiographs of the cervical spine. Magnetic resonance imaging scans revealed absence of extraparenchymal compression and an area of oedema within the cervical spinal cord, suggesting a favourable prognosis. Following nursing care and physiotherapy, the dog recovered the ability to walk, although mild neurological deficits persisted in the left limbs.

Dorsal dens angulation and a Chiari type malformation in a Cavalier King Charles Spaniel

A nineteen month old Cavalier King Charles had clinical signs consistent with a cervical myelopathy. Radiologically there was abnormal angulation of the dens with cervical spinal cord compression and a Chiari type malformation of the atlanto-occipital region. The condition and method of investigation is discussed.

Use of physiatry as the sole treatment for three paretic or paralyzed dogs with chronic compressive conditions of the caudal portion of the cervical spinal cord

Physiatry alone was used to treat 3 large (30- to 40-kg [66 to 88 lb]) mature (6- to 9-year-old) dogs that were tetraparetic or tetraplegic. All 3 dogs had myelographic evidence of multiple chronic compressive extradural lesions of the caudal portion of the cervical spinal cord. All dogs improved substantially after a course of intensive physical treatment. For 2 dogs, an abbreviated treatment regimen was continued by the owners after the dogs were discharged. Both of these dogs regained and retained normal neurologic function. The other dog improved but was treated infrequently at home. That dog's signs recurred, and the dog was euthanatized. Persistent use of physical treatment for paralysis that results from conditions affecting the cervical spinal cord may be useful even without concurrent surgical or pharmacologic treatments.

Treatment of wobbler syndrome in dogs with electroacupuncture

Based on favorable experiences with acupuncture for the treatment of hind limbs paralysis, lumbo-sacral alterations, and other spinal cord problems; a clinical trial, involving 40 dogs affected with wobbler syndrome was carried out. Patients were graded in three categories according to the severity of each case and then randomly divided in two groups. Both groups contained all three grades. Group 1 (20 dogs) was treated using orthodox medical and surgical interventions, while Group 2 (20 dogs) were treated mainly with electroacupuncture, and in few cases with surgical intervention as well. The study was carried out in a three-year period. Acupuncture treatments were given every other day delivering 150 to 300 mVolts at 125 Hz, equivalents to approximately 20 microAmps, in ten acupuncture points per treatment. Deep needle insertion was used. Overall per cent success in Group I was only 20%, while in group II the corresponding value was 85%. The number of acupuncture treatments required to achieve full recovery in Group II was dependent upon the severity of the case, as follows: Grade I: 18.5 +/- 2.5; Grade II: 25 +/- 5.4; and Grade III: 34 +/- 6.7 (r = 0.962). No adverse effects were observed with acupuncture. The use of this technique is proposed for large-scale clinical trials.

Thoracic vertebral chordoma in a domestic ferret (Mustela putorius furo)

A castrated adult male 1.0-kg domestic ferret (Mustela putorius furo) was referred for evaluation of a mass of >5 mo duration that was associated with the thoracic spine. The ferret had motor dysfunction and no conscious proprioception or pain perception in either hind limb. Segmental reflexes were present. Survey radiography, myelography, and magnetic resonance imaging showed a mass involving the ninth and 10 thoracic vertebrae and compressing the spinal cord. Decompressive surgery was performed, but clinical signs persisted. A diagnosis of chordoma was made using histopathology and immunohistochemistry. This is the first reported case of a chordoma involving the thoracic vertebrae in a domestic ferret.

Contrast radiographic findings in canine bacterial discospondylitis: a multicenter, retrospective study of 27 cases

A multicenter, retrospective study was undertaken to evaluate contrast radiographic findings in canine bacterial discospondylitis. Records and myelograms or epidurograms of 27 patients were obtained from five colleges of veterinary medicine. Fifteen cases (56%) were evaluated as having some degree of spinal cord compression. The majority (73.3%) of the cases had only soft tissue as the compressive mass. The median compression for all cases was 5% of the vertebral canal. No difference was noted for compression based on anatomical site (i.e., cervical versus thoracolumbar versus lumbosacral). No significant correlation between degree of lesion compression and clinical outcome was noted, but there was a trend toward increased mortality with greater compression. There was no correlation between the ambulatory status and the ultimate outcome. Three of the 15 (20%) cases showed vertebral subluxation. Results of this study indicate that static spinal cord compression is not a significant component of the neurological dysfunction associated with bacterial discospondylitis. Identification of vertebral subluxation in some patients may indicate a dynamic lesion that should be evaluated with stress radiography.

Spinal cord compression secondary to hemangiosarcoma in a saddlebred stallion

Hemangiosarcoma in the spinal canal was diagnosed in a 25-year-old stallion showing progressive and symmetrical 4-limb ataxia, proprioceptive deficits, and weakness. On necropsy, an extradural mass consisting of spindle-shaped cells and numerous free erythrocytes was found at the level of C7-T1. Immunohistochemical staining confirmed a neoplasm of endothelial origin.

Reoperative neurosurgery in dogs with thoracolumbar disc disease

OBJECTIVE

To characterize the subset of dogs in our neurosurgical practice that underwent spinal surgery for thoracolumbar (TL) disc herniation and subsequently underwent additional decompressive TL surgery.

STUDY DESIGN

A retrospective case series.

SAMPLE POPULATION

Thirty dogs that underwent reoperation for TL disc herniation. A comparison group of Dachshunds that underwent only one decompressive TL disc surgery was also studied.

METHODS

Dogs that underwent reoperation were divided into two groups based on the interval between their first and second surgery. The early reoperation group included those dogs having a second surgery less than 4 weeks after the initial operation. The late reoperation group included those dogs having a second surgery more than 4 weeks after the initial operation. For each Dachshund in the late reoperation group, two Dachshunds that underwent only one decompressive TL disc surgery were selected and formed the comparison group. Dogs in the comparison group were matched with reoperated cases based on the severity of preoperative neurologic deficit and site of disc herniation. These two groups were compared to determine: (1) if age and body weight were risk factors for reoperation, and (2) if dogs had a poorer functional outcome after their second decompressive surgery than did those in the comparison group after their first (and only) decompressive surgery.

RESULTS

A total of 30 of 467 (6.4%) dogs that underwent decompressive TL disc surgery were reoperated. In the early reoperative cases (n = 5 dogs), the inciting cause in all cases was residual compression from disc material at the site of the initial surgery. In the late reoperation group, 22 of 25 (88%) cases had a second disc herniation at a site distinct from the initial lesion. Dachshunds had a significantly higher risk for late reoperation (odds ratio and 95% CI = 3.67, 1.46 to 10.03); other small and medium-sized breeds (<20 kg) were underrepresented. Age and body weight were not significant predictors for reoperation. A total of 21 of 23 (91%) dogs had functional recovery after late reoperation. Complete sensorimotor loss was a significant negative predictor of functional recovery in the late reoperative cases (P = .01). Likelihood of functional recovery in dogs after their second decompressive surgery was identical to the functional recovery of dogs in the comparison group.

CONCLUSIONS AND CLINICAL RELEVANCE

Our results show that a second disc herniation occurring at a site distinct from the initial lesion is the most common cause for reoperation and that Dachshunds have a significantly greater risk than other breeds.

Vertebrectomy, bone allograft fusion, and antitumor vaccination for the treatment of vertebral fibrosarcoma in a dog

OBJECTIVE

To describe the surgical technique of vertebrectomy with bone allograft fusion and the use of antitumor vaccine for the treatment of a primary vertebral neoplasm in a dog.

STUDY DESIGN

Case Report.

ANIMALS OR SAMPLE POPULATION

A 3 year old 32 kg female spayed mixed breed dog with progressive paraplegia.

METHODS

Myelography was performed to identify an L5 lytic lesion with spinal cord compression. A dorsal laminectomy was performed to decompress the spinal cord and obtain biopsies. Pathologic fracture of the vertebral body two days later was treated with L5 vertebrectomy, cortical allograft implantation, and bilateral plating from L4 to L6. Tumor samples were used to create an autologous cytokine-gene-engineered tumor cell vaccine. Recheck radiographs and neurologic examinations were obtained 1, 2, 7, and 13 months after surgery.

RESULTS

The histopathologic diagnosis was fibrosarcoma. Although slight osteopenia of the allograft was noted thirteen months after surgery, the allograft and plate fixation remained stable. The patient tolerated the antitumor vaccination protocol well. Two years after the procedures the dog was able to ambulate normally but remained urinary and fecal incontinent.

CONCLUSIONS AND CLINICAL RELEVANCE

Vertebrectomy and cortical allograft implantation with plating permitted this patient to return to a functional lifestyle with its owners.

Potential central nervous system complications of von Willebrand's disease

Three Doberman pinschers were presented on emergency referral for progressive neurological deficits. All three dogs had a similar onset of clinical signs associated with an apparently minor traumatic event. Each dog progressed to significant neurological dysfunction including paraplegia, tetraplegia, and/or loss of deep pain sensation. None of the animals was apparently affected by cervical vertebral instability ("Wobbler's Syndrome"). All were confirmed to have von Willebrand's disease. In all cases, significant epidural hemorrhage was identified. The etiology of each hemorrhage, however, was different for each animal. The cases presented here demonstrate a potential relationship between neurological deficits and the patient's ability to effectively coagulate blood. Hemostatic abnormalities, such as von Willebrand's disease, should be included as possible differential diagnoses or contributing factors in animals demonstrating neurological deficits. These abnormalities should especially be considered following trauma, intervertebral disk extrusion, or spinal surgery.

Magnetic resonance imaging of the cervical spine in 27 dogs

The cervical spine of 27 dogs with cervical pain or cervical myelopathy was evaluated using magnetic resonance imaging (MRI). Spin echo T1, T2, and post-contrast T1 weighted imaging sequences were obtained with a 0.5 Tesla magnet in 5 dogs and a 1.5 Tesla magnet in the remaining 22 dogs. MRI provided for visualization of the entire cervical spine including the vertebral bodies, intervertebral discs, vertebral canal, and spinal cord. Disorders noted included intervertebral disc degeneration and/or protrusion (12 dogs), intradural extramedullary mass lesions (3 dogs), intradural and extradural nerve root tumors (3 dogs), hydromyelia/syringomyelia (1 dog), intramedullary ring enhancing lesions (1 dog), extradural synovial cysts (1 dog), and extradural compressive lesions (3 dogs). The MRI findings were consistent with surgical findings in 18 dogs that underwent surgery. Magnetic resonance imaging provided a safe, useful non-invasive method of evaluating the cervical spinal cord.

Cervical myelopathy associated with extradural synovial cysts in 4 dogs

Three Mastiffs and 1 Great Dane were presented to the University of Wisconsin Veterinary Medical Teaching Hospital for cervical myelopathy based on history and neurologic examination. All dogs were males and had progressive ataxia and tetraparesis. Degenerative arthritis of the articular facet joints was noted on survey spinal radiographs. Myelography disclosed lateral axial compression of the cervical spinal cord medial to the articular facets. Extradural compressive cystic structures adjacent to articular facets were identified on magnetic resonance imaging (1 dog). High protein concentration was the most important finding on cerebrospinal fluid analysis. Dorsal laminectomies were performed in all dogs for spinal cord decompression and cyst removal. Findings on cytologic examination of the cystic fluid were consistent with synovial fluid, and histopathologic results supported the diagnosis of synovial cysts. All dogs are ambulatory and 3 are asymptomatic after surgery with a follow-up time ranging from 1 to 8 months. This is the 1st report of extradural synovial cysts in dogs, and synovial cysts should be a differential diagnosis for young giant breed dogs with cervical myelopathy.

Hansen type I disk disease at T1-2 in a dachshund

A 7-year-old Dachshund was presented with chronic left thoracic limb lameness and acute neurological deficits to the hind limbs following trauma. A lesion was suspected between C7 and T2 on the basis of neurological examinations. Radiography and myelography identified a calcified intervertebral disk at C7-T1 and an extradural unilateral compressive lesion at T1-2. Computed tomography scans of the cranial thoracic spine revealed extrusion of disk material from the T1-2 intervertebral space resulting in marked spinal cord compression. Intervertebral disk disease is rarely reported at this location. The neurological condition deteriorated after a second myelogram, which was done to examine the thoracolumbar spine. A modified dorsal decompression of T1-2 was performed. The dog was euthanased due to further neurological deterioration 8 days after surgery.

Cervical spinal cord compression caused by cryptococcosis in a dog: successful treatment with surgery and fluconazole

A six-year-old, male Doberman pinscher was presented for acute onset of upper motor neuron tetraparesis. An extradural compressive lesion compatible with intervertebral disk rupture at the sixth to seventh cervical (C6-C7) disk space was evident on myelography. A large, gelatinous mass of pure cryptococcal organisms causing spinal cord compression was identified upon exploratory surgery. Removal of the mass caused relief of clinical signs. No evidence of involvement of other organ systems was found; however, serum and cerebrospinal fluid titers were positive for cryptococcal infection. The dog was treated with fluconazole (5.5 mg/kg body weight, per os sid) until serum titers for cryptococcal infection were negative at seven months postsurgery. To the authors' knowledge, this is the only report of a dog with cryptococcosis treated successfully using fluconazole as a sole agent.

Oxytocin content of the cerebrospinal fluid of dogs and its relationship to pain induced by spinal cord compression

OBJECTIVES

To determine whether oxytocin exists in the cerebrospinal fluid (CSF) of dogs and whether the amount of oxytocin in the CSF of dogs with neck or back pain caused by spinal cord compression is significantly different than that in the CSF of clinically normal dogs.

STUDY DESIGN

Prospective controlled study.

ANIMAL POPULATION

A total of 15 purpose-bred beagles and 17 client-owned dogs.

METHODS

CSF was collected by needle puncture of the cerebellar medullary cistern after induction of general anesthesia. Oxytocin levels within the samples were determined through radioimmunoassay.

RESULTS

Dogs with spinal cord compression had significantly more oxytocin in their CSF than the clinically normal dogs (13.76 +/- 2.0 pg/mL and 3.61 +/- 0.63 pg/mL, respectively; P < .0001). Dogs with chronic signs (>7 days) had significantly more oxytocin in their CSF than dogs with acute signs (<7 days) (21.60 +/- 0.86 pg/mL and 6.80 +/- 0.81 pg/mL, respectively; P < .0001). Both acutely and chronically affected dogs had significantly more oxytocin in their CSF than the controls (P < .005 and P < .0001 respectively).

CONCLUSIONS

Dogs with neck and back pain caused by spinal cord compression have significantly more oxytocin in their CSF than clinically normal dogs. Dogs with chronic clinical signs have significantly more oxytocin in their CSF than dogs with acute clinical signs.

CLINICAL RELEVANCE

In humans, intrathecal injection of oxytocin is effective in treating low back pain for up to 5 hours. Intrathecal oxytocin may be a logical choice for perioperative analgesia in dogs undergoing myelography because the intrathecal space is accessed for injection of contrast agent.

Pheochromocytoma in the vertebral canal of two dogs

Pheochromocytomas are uncommon tumors arising from the adrenal gland, which have potential for aggressive local spread. The diagnosis is extremely challenging, particularly when classical endocrine signs are absent. This paper presents two canine cases of pheochromocytoma in the vertebral canal and illustrates the potential for detection of the tumor by abdominal ultrasonography.

Spinal epidural empyema in two dogs

Extensive, diffuse, epidural spinal cord compression was visualized myelographically in two dogs presented for rapid development of nonambulatory tetraparesis and paraplegia, respectively. Purulent fluid containing bacterial organisms was aspirated percutaneously under fluoroscopic guidance from the epidural space of each dog. One dog responded poorly to aggressive medical therapy, which included installation of an epidural lavage and drainage system. Both dogs were euthanized due to the severe nature of their disorder and the poor prognosis. Spinal epidural empyema (i.e., abscess) is a rare condition in humans and has not been reported previously in the veterinary literature. Spinal epidural empyema should be considered as a differential diagnosis in dogs presenting with painful myelopathies, especially when accompanied by fever.

Management of disc-associated wobbler syndrome with a partial slot fenestration and position screw technique

A previously unpublished surgical technique for the management of disc-associated wobbler syndrome is described. A series of 17 middle-aged dobermanns (mean age 7.4 years) with this condition were managed by a technique of partial slot fenestration and position screw fixation of the affected disc space (C6/7 in all cases). One patient was lost to follow-up and, of the remaining 16 cases, 13 improved following surgery (81 per cent). The three failures were a consequence of incorrect placement of one of the screws. Careful evaluation of immediate postoperative radiographs allows this problem to be identified; the screw can then be correctly repositioned with an immediate return to surgery.

Study of spinal cord evoked injury potential by use of computer modeling and in dogs with naturally acquired thoracolumbar spinal cord compression

OBJECTIVE

To add objective measurements of the characteristics of evoked injury potentials (EIP) and their relations to clinical severity in dogs with thoracolumbar spinal cord damage.

ANIMALS

25 dogs with naturally acquired spinal cord compression attributable to disk extrusion or vertebral fracture at the level of the thoracolumbar junction and with various degrees of paresis/paralysis.

PROCEDURE

Spinal cord potentials evoked by tibial nerve stimulation were recorded every 5 to 10 mm at the lamina level in the vicinity of the cord compression. This allowed an EIP to be recorded even in the least handicapped dogs. A computer model yielded information about the waveform changes of the EIP in the vicinity of conduction blocks.

RESULTS

The EIP waveform changed from biphasic to monophasic a short distance caudad to the location of spinal cord compression. Location of a maximal conduction block was measured in relation to position of the electrodes recording this waveform change. The distance between the assumed conduction block and the actual spinal cord compression was larger in the most affected dogs. The amplitude of the EIP was not related to severity of the clinical picture; however, the proximity of the recording electrode to the spine influenced the amplitude and the waveform of the EIP.

CONCLUSION AND CLINICAL RELEVANCE

Change in the EIP waveform from biphasic to monophasic makes it possible to estimate the conduction block location along the spinal cord. A large distance between the assumed conduction block and site of actual cord compression could be an objective argument to confirm severity of a lesion.

High resolution protein electrophoresis of equine cerebrospinal fluid

OBJECTIVE

To determine normal CSF electrophoresis patterns in horses, and to determine whether the electrophoretic scans from horses with cervical compression differ from those of neurologically normal horses.

ANIMALS

32 horses assigned to 1 of 2 groups: neurologically normal (n = 18) or cervical compression (n = 14).

PROCEDURE

CSF was collected from 18 neurologically normal horses referred to the Marion duPont Scott Equine Medical Center, and protein electrophoresis was performed to describe the normal equine CSF electrophoretogram. Results of CSF electrophoresis from 14 horses with cervical compression were then compared with results for the neurologically normal horses.

RESULTS

Horses with cervical compression had decreased beta-globulin fraction, and 1 or 2 prominent post-beta 2 peak(s). When the presence of post-beta peaks was used as a diagnostic criterion for cervical compression, the test had sensitivity of 71.4% and specificity of 81.8%. The positive and negative predictive values were 83.3 and 69.2%, respectively.

CONCLUSION AND CLINICAL IMPLICATIONS

Electrophoresis of CSF may be a useful diagnostic aid in evaluation of horses with neurologic disease.

Steroid-responsive, cervical, pyogranulomatous pachymeningitis in a dog

Syndromes of steroid-responsive meningitis have been described in the dog and typically are characterized by neutrophilic pleocytosis and an elevated protein concentration of the cerebrospinal fluid. In a minority of cases, histopathology has demonstrated suppurative leptomeningeal (i.e., arachnoid and pia) inflammation. A case of compressive, cervical, pyogranulomatous inflammation of undetermined cause affecting the dura mater (i.e., pachymeningitis), accompanied by fever and hyperpathia, is presented. The pachymeningitis ultimately regressed with long-term immunosuppressive therapy. This case shares features with hypertrophic spinal pachymeningitis of humans, an uncommon, frequently idiopathic, chronic inflammatory disorder causing dural hypertrophy, radiculopathy, and spinal cord compression.

Tetraparesis due to vertebral physeal fracture in an adult dog with congenital hypothyroidism

A four-year-old male affenpinscher was referred for evaluation of hindlimb weakness that had progressed to tetraparesis over a period of four weeks. Neurological examination was suggestive of a cervical spinal cord lesion. Radiographic examination revealed diffuse skeletal immaturity with open physes and epiphyseal dysplasia in long bones and vertebrae, consistent with a diagnosis of congenital hypothyroidism. Total and free serum T4 concentrations were very low, indicative of hypothyroidism. Survey radiographs of the cervical spine revealed a dorsally displaced Salter-Harris type I fracture of the cranial portion of the fourth cervical vertebra with the endplate present in the vertebral canal. Although signs of transverse myelopathy are uncommon in dogs with congenital hypothyroidism, they may be associated with either intervertebral disc protrusion or endplate displacement into the vertebral canal secondary to the epiphyseal abnormalities associated with congenital hypothyroidism.

A myelographic technique for avian species

A post-mortem myelogram was used to diagnose a vertabral fracture in a Red-tailed Hawk (Buteo jamaicensis). This diagnosis led the authors to believe that myelography would be useful in live birds. In a pilot study using live adult female chickens (Gallus domesticus), mammalian myelographic techniques were modified for avian anatomic differences. A thoracolumbar puncture site was used rather than the lumbar or cisternal site which is commonly used in mammals. The volume of contrast medium needed to produce a diagnostic myelogram in birds (0.8-1.2 ml/kg) was found to be approximately four times that needed in mammals. A 25 gauge spinal needle was used rather than a 23 gauge needle. Myelograms of diagnostic quality were obtained with normal subject recovery. Seizures, the most common post-myelographic complication in mammals, were not observed in any of the birds studied. Avian myelography was found to be a cost effective and humane technique with potential application to avian practice.

Subarachnoid cyst in a cat

A five-year-old domestic longhair was presented with hind-limb ataxia and some degree of incontinence of two weeks' duration. An enlarged spinal canal from the twelfth thoracic (T12) vertebra to the third lumbar (L3) vertebra was identified on survey radiographs. An intradural-extramedullary cavity at the twelfth (T12) and thirteenth (T13) thoracic vertebrae, filled with contrast material, was demonstrated on myelography. A left-sided hemilaminectomy was performed over this region, and a subarachnoid cavitation or cyst was found to be the cause of the severe spinal-cord compression. The cyst was drained. The cat showed improvement in the neurological signs during the first three weeks postoperatively. Six months later, no neurological deficits were identified on follow-up examination.