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Sparks CR, Woelfel C, Robertson I, Olby NJ. Association between filum terminale internum length and pain in Cavalier King Charles spaniels with and without syringomyelia. J Vet Intern Med 2021; 35:363-371. [PMID: 33426675 PMCID: PMC7848331 DOI: 10.1111/jvim.16023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 12/12/2020] [Accepted: 12/16/2020] [Indexed: 11/30/2022] Open
Abstract
Background Lumbar syringomyelia (SM), lumbosacral pain, and more caudal spinal cord termination are reported in Cavalier King Charles spaniels (CKCS). Data are lacking on the clinical relevance of alterations in their spinal cord terminal structures. Objectives To compare spinal cord termination level and filum terminale internum length (FTIL) with presence of lumbar SM and clinical signs in CKCS. Animals Forty‐eight CKCS. Methods In this prospective study, pain was quantified using owner and clinician assessments. Vertebral level of spinal cord and dural sac termination, presence of SM, and FTIL were determined from sagittal magnetic resonance imaging (MRI) sequences. Kappa and intraclass correlation (ICC) analyses determined interobserver reliability. The MRI findings were compared to owner and clinician‐reported pain quantification. Results Interobserver reliability was good for spinal cord and dural sac termination (kappa = 0.61 and 0.64, respectively) and excellent for FTIL (ICC: 92% agreement). The spinal cord terminated at 6th lumbar vertebra in 1, 7th lumbar vertebra in 31, and the sacrum in 15 dogs, and termination level was associated with lumbar SM (P = .002) but not clinical signs. Mean FTIL was 2.9 ± 1.08 mm; it was associated with owner‐reported pain (P = .033) and spinal palpation scores (P = .023). Painful CKCS without SM had shorter FTIL compared to normal CKCS and painful CKCS with SM (P = .02). Conclusions Painful CKCS without SM have decreased distance between the termination of the spinal cord and dural sac, suggesting a shorter FTIL. More caudal spinal cord termination is associated with development of lumbar SM.
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Affiliation(s)
- Courtney R Sparks
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Christian Woelfel
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Ian Robertson
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - Natasha J Olby
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA.,Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, USA
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2
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Zarzycki A, Thomas ZM, Mazrier H. Comparison of inherited neural tube defects in companion animals and livestock. Birth Defects Res 2020; 113:319-348. [PMID: 33615733 DOI: 10.1002/bdr2.1848] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 11/19/2020] [Accepted: 11/20/2020] [Indexed: 11/10/2022]
Abstract
Neural tube defects (NTDs) are congenital malformations resulting from the improper or incomplete closure of the neural tube during embryonic development. A number of similar malformations of the protective coverings surrounding the central nervous system are also often included under this umbrella term, which may not strictly fit this definition. A range of NTD phenotypes exist and have been reported in humans and a wide range of domestic and livestock species. In the veterinary literature, these include cases of anencephaly, encephalocele, dermoid sinus, spina bifida, and craniorachischisis. While environmental factors have a role, genetic predisposition may account for a significant part of the risk of NTDs in these animal cases. Studies of laboratory model species (fish, birds, amphibians, and rodents) have been instrumental in improving our understanding of the neurulation process. In mice, over 200 genes that may be involved in this process have been identified and variant phenotypes investigated. Like laboratory mouse models, domestic animals and livestock species display a wide range of NTD phenotypes. They remain, however, a largely underutilized population and could complement already established laboratory models. Here we review reports of NTDs in companion animals and livestock, and compare these to other animal species and human cases. We aim to highlight the potential of nonlaboratory animal models for mutation discovery as well as general insights into the mechanisms of neurulation and the development of NTDs.
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Affiliation(s)
- Alexandra Zarzycki
- Faculty of Science, School of Life and Environmental Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Zoe M Thomas
- Faculty of Science, Sydney School of Veterinary Science, The University of Sydney, Sydney, New South Wales, Australia
| | - Hamutal Mazrier
- Faculty of Science, School of Life and Environmental Sciences, The University of Sydney, Sydney, New South Wales, Australia.,Faculty of Science, Sydney School of Veterinary Science, The University of Sydney, Sydney, New South Wales, Australia
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3
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Butterfield S, Garcia-Gonzalez B, Driver CJ, Rusbridge C. Limited dorsal myeloschisis in three cats: a distinctive form of neural tube defect. JFMS Open Rep 2020; 6:2055116920924307. [PMID: 32655875 PMCID: PMC7328493 DOI: 10.1177/2055116920924307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Case series summary The aim of this case series was to describe the clinical presentation,
imaging findings and histopathology of three cats with limited dorsal
myeloschisis (LDM). The history, examination and MRI sequences were reviewed
in three cases presented to a single referral hospital. The surgery report
and histopathology were described in two cases. All cats were young (10
weeks old, 5 months old, 4 years old), presenting with varying degrees of
progressive paraparesis. All had a midline skin defect overlying the spinal
column that was either sunken or saccular, containing fluid thought to be
cerebrospinal fluid. MRI sequences demonstrated tissue extending from the
dura through an overlying bifid spinous process and attached to the dermis,
with associated spinal cord tethering, atrophy and syringomyelia. Lesions
were located at L2–L3, T8–T9 and L4. Histopathology described a fibroneural
stalk with a glio-ependymal lining, surrounded by glial nests and nerve
fibres. The youngest and most severely affected was euthanased, while the
other two underwent surgery. Both regained independent ambulation with
persistent paraparesis; however, one required ongoing management of urinary
incontinence. Relevance and novel information LDM is a primary neural tube defect that may result in neurological deficits,
including bladder dysfunction, and is characterised by a fibroneural stalk
between the dermis and the spinal cord. Distinct MRI features, such as a
visible intrathecal tract, dorsally tethered cord and syringomyelia, help
distinguish this condition from the clinically similar dermoid sinus. The
presence of progressive neurological signs, with a palpable midline defect
overlying the affected spinal cord segment, may raise suspicion for this
clinical entity in veterinary patients.
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Affiliation(s)
| | | | - Colin J Driver
- Fitzpatrick Referrals Orthopaedics and Neurology, Eashing, UK
| | - Clare Rusbridge
- Fitzpatrick Referrals Orthopaedics and Neurology, Eashing, UK.,School of Veterinary Medicine, Faculty of Health & Medical Sciences, Vet School Main Building (VSM), University of Surrey, Guildford, UK
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4
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Martín Muñiz L, Del Magno S, Gandini G, Pisoni L, Menchetti M, Foglia A, Ródenas S. Surgical outcomes of six bulldogs with spinal lumbosacral meningomyelocele or meningocele. Vet Surg 2019; 49:200-206. [PMID: 31758707 DOI: 10.1111/vsu.13342] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 11/02/2018] [Accepted: 12/15/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To report the surgical treatment and outcome of six bulldogs with spina bifida (SB) and meningocele (MC) or meningomyelocele (MMC). STUDY DESIGN Case series. ANIMALS Five French bulldogs and one English bulldog with MC or MMC. METHODS Medical records of dogs with spinal MC or MMC diagnosed by MRI at two institutions between 2013 and 2016 were reviewed for surgical treatment and outcomes. RESULTS Meningocele was diagnosed in two dogs, and MMC was diagnosed in four dogs. A lumbosacral dimple was noted in all dogs along with neurological deficits most commonly consisting of urinary and fecal incontinence (n = 6) and mild/moderate paraparesis (n = 3). Dorsal laminectomy was performed in all dogs to allow dissection of the meningeal sac to the vertebral column defect. In dogs with MMC, nerves were repositioned and protruded meninges were removed prior to suturing remaining meninges. Adhesions and filum terminale were resected in two dogs with suspected tethered cord syndrome. Urinary and fecal incontinence improved in two dogs and remained unchanged in four. Paraparesis improved in two dogs. CONCLUSION Surgical treatment resulted in partial improvement of the urinary and fecal incontinence (2/6 dogs) and paraparesis (2/3 dogs) or stable neurological condition (3/6 dogs), with only minor temporary complications. CLINICAL SIGNIFICANCE In the absence of published data comparing surgical and conservative treatment of puppies affected by SB and MC or MMC, early surgical treatment can be considered to prevent deterioration of neurological signs and, eventually, facilitate improvement of neurological signs.
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Affiliation(s)
- Laura Martín Muñiz
- Fundació Hospital Clínic Veterinari, Autonomous University of Barcelona, Bellaterra, Spain
| | - Sara Del Magno
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, Italy
| | - Gualtiero Gandini
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, Italy
| | - Luciano Pisoni
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, Italy
| | - Marika Menchetti
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, Italy
| | - Armando Foglia
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, Italy
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5
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Sparks CR, Robertson I, Olby NJ. Morphometric analysis of spinal cord termination in Cavalier King Charles Spaniels. J Vet Intern Med 2019; 33:717-725. [PMID: 30758868 PMCID: PMC6430917 DOI: 10.1111/jvim.15437] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 01/18/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND There is an association between Chiari malformations, syringomyelia (CMSM) and tethered cord syndrome (TCS) in people, suggesting Cavalier King Charles Spaniels (CKCS) with CMSM could also have TCS. Currently there are no data on the position of the caudal spinal cord structures in CKCS. OBJECTIVE To describe and compare location of spinal cord termination in CKCS with weight-matched controls and to examine the relationship between SM and spinal cord termination. ANIMALS Thirty-nine CKCS and 33 controls with thoracolumbar MRIs; 34 of 39 CKCS also had cervical MRIs. METHODS Blinded retrospective study. Spinal cord and dural sac termination were determined from T2-weighted sagittal and transverse images and half-Fourier acquisition single-shot turbo spin echo sequences. Intra-observer reliability was determined using kappa analysis. Presence of SM was compared with location of spinal cord and dural sac termination. RESULTS Intra-observer reliability was moderate for identifying spinal cord termination (Kappa = 0.6) and good for dural sac termination (Kappa = 0.8). The spinal cord terminated at lumbar vertebra 6 (L6) in 1, 7 (L7) in 22, and sacrum in 16 CKCS versus 9 at L6, 23 at L7, 1 at sacrum in controls. Spinal cord (P < .001) and dural sac (P = .002) termination were significantly more caudal in CKCS compared to controls. The presence of thoracolumbar SM was associated with more caudal dural sac termination in CKCS (P = .03). CONCLUSIONS AND CLINICAL IMPORTANCE The relationship between TL SM and possible spinal cord tethering because of a more caudal dural sac termination should be investigated.
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Affiliation(s)
- Courtney R Sparks
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Ian Robertson
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, North Carolina
| | - Natasha J Olby
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina.,Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina
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6
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Tamura M, Oji T, Une S, Mukaino M, Bekki T, Tado M, Koyama H, Kagawa Y, Kawata M. Tethered cord syndrome with spina bifida aperta in cats: two case reports of different types. JFMS Open Rep 2017; 3:2055116917708060. [PMID: 28546867 PMCID: PMC5431438 DOI: 10.1177/2055116917708060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
CASE SUMMARY Two castrated male cats, aged 8 months old (case 1) and 10 months old (case 2), showed a history of progressive paraparesis, an over-reaching pelvic limb gait, urinary incontinence and a palpable dermoid fistula. In case 1, the fistula was connected to the dural sac on the conus medullaris, and the tethered spinal cord was retracted caudally. In case 2, the tubular structure was connected to the dural sac on the thoracic spinal cord, and the tethered spinal cord was retracted dorsally. Tethered cord syndrome secondary to spina bifida aperta was suspected in both cats. Excision of the fistula and release of the tethered spinal cord was performed. A histopathological examination confirmed the diagnosis of a meningomyelocele in case 1 and a meningocele in case 2. Paraparesis improved postoperatively in both cats. However, urinary incontinence in case 1 remained partially unresolved. RELEVANCE AND NOVEL INFORMATION This is the first report to describe the imaging characteristics, surgical treatments and outcomes of two different types of tethered cord syndrome with spina bifida aperta in cats. Tethered cord syndrome with spina bifida aperta needs to be included in the differential diagnosis of slowly progressive paraparesis in younger cats with or without vesicorectal failure and a palpable dermoid fistula.
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Affiliation(s)
- Masahiro Tamura
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Hokkaido, Japan
| | - Takashi Oji
- Neovets Veterinary Referral Center, Nakamichi, Higashinari-ku, Osaka-shi, Osaka, Japan
| | - Satoshi Une
- Neovets Veterinary Referral Center, Nakamichi, Higashinari-ku, Osaka-shi, Osaka, Japan
| | - Makiko Mukaino
- Neovets Veterinary Referral Center, Nakamichi, Higashinari-ku, Osaka-shi, Osaka, Japan
| | - Tatsuro Bekki
- Neovets Veterinary Referral Center, Nakamichi, Higashinari-ku, Osaka-shi, Osaka, Japan
| | - Masaki Tado
- Neovets Veterinary Referral Center, Nakamichi, Higashinari-ku, Osaka-shi, Osaka, Japan
| | - Hiromi Koyama
- Neovets Veterinary Referral Center, Nakamichi, Higashinari-ku, Osaka-shi, Osaka, Japan
| | - Yumiko Kagawa
- Department of Veterinary Pathology, Graduate School of Veterinary Medicine, Hokkaido University, Hokkaido, Japan
| | - Mutsumi Kawata
- Neovets Veterinary Referral Center, Nakamichi, Higashinari-ku, Osaka-shi, Osaka, Japan
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7
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Abstract
Spina bifida with or without meningocele or meningomyelocele is encountered infrequently in small animal practice. The English bulldog and Manx cat are breeds predisposed. Although often silent clinically, in those animals with clinical signs, it is important to recognize the signs early and to understand the appropriate imaging modalities employed in establishing a diagnosis. In a select population of affected animals, proposed surgical intervention may be considered to prevent neurologic decline, prevent secondary complications, and potentially improve outcomes.
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Affiliation(s)
- Rachel B Song
- Department of Neurology and Neurosurgery, Red Bank Veterinary Hospital, 197 Hance Avenue, Tinton Falls, NJ 07724, USA
| | - Eric N Glass
- Department of Neurology and Neurosurgery, Red Bank Veterinary Hospital, 197 Hance Avenue, Tinton Falls, NJ 07724, USA
| | - Marc Kent
- Department of Small Animal Medicine & Surgery, College of Veterinary Medicine, University of Georgia, 2200 College Station Road, Athens, GA 30602, USA.
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8
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De Decker S, Gregori T, Kenny PJ, Hoy C, Erles K, Volk HA. Tethered cord syndrome associated with a thickened filum terminale in a dog. J Vet Intern Med 2015; 29:405-9. [PMID: 25586550 PMCID: PMC4858091 DOI: 10.1111/jvim.12522] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 10/28/2014] [Accepted: 11/11/2014] [Indexed: 11/28/2022] Open
Affiliation(s)
- S De Decker
- Department of Veterinary Clinical Science and Services, The Royal Veterinary College, University of London, North Mymms, Hertfordshire, England
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