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Capasso M, Canal S, Balducci F. Prevalence of neurological diseases associated with cervical pain and/or signs of cervical myelopathy in French bulldogs: a retrospective analysis of 105 cases. Front Vet Sci 2024; 11:1431358. [PMID: 39021406 PMCID: PMC11252003 DOI: 10.3389/fvets.2024.1431358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Accepted: 06/19/2024] [Indexed: 07/20/2024] Open
Abstract
Introduction French bulldogs can be affected by several neurological diseases, with myelopathies representing the most frequent cause of neurological signs. Studies focusing on the epidemiology of cervical diseases in this breed are lacking. This study aims to describe the prevalence of neurological pathologies responsible for cervical pain and/or signs of cervical myelopathy, assuming that intervertebral disc herniation represents the most common disease; a second aim was to evaluate how often different pathologies coexist in this spinal region in French bulldogs. Materials and methods A retrospective analysis of medical records from the database of a single referral center (AniCura I Portoni Rossi Veterinary Hospital-Zola Predosa, Bologna, Italy) was performed, including French bulldogs presented for neck pain and/or neurological deficits consistent with cervical myelopathy. Clinical and imaging data were reviewed and used as inclusion criteria. Based on the number of MRI-diagnosed diseases, the eligible dogs were divided into three groups. Results One hundred five French bulldogs met the inclusion criteria. The most commonly diagnosed condition was an intervertebral disc herniation (66.9%), followed by C2 idiopathic hypertrophic ganglioneuritis (15.1%), cervical syringomyelia (11.5%), congenital osseous malformations (1.4%), spinal arachnoid diverticula (1.4%), neoplasms (1.4%), steroid-responsive meningitis-arteritis (0.7%), traumatic vertebral fractures (0.7%), and other (0.7%). For the vast majority of dogs (75/105) a single pathology was diagnosed, with intervertebral disc herniations accounting for 86.7% of cases, involving C3-C4 IVD most commonly. In the remaining 30 dogs, two or three different and concurrent diseases were detected. Among these 30 dogs, intervertebral disc herniations still remained the most diagnosed condition, in combination with C2 idiopathic hypertrophic ganglioneuritis and syringomyelia in 19 and seven cases, respectively. Conclusion The results of this study highlight that different pathologies can affect the cervical spinal cord in French bulldogs, with intervertebral disc herniations representing the most frequent condition, as previously described in the veterinary literature. In almost a third of cases, different pathologies can coexist at the cervical level. However, for cases in which different pathologies are present at the same time, it is not always possible to clearly establish their clinical significance.
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Affiliation(s)
- Michele Capasso
- Anicura I Portoni Rossi Veterinary Hospital, Zola Predosa, Bologna, Italy
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Santifort KM, Carrera I, Platt S. Case report: Traumatic hemorrhagic cervical myelopathy in a dog. Front Vet Sci 2023; 10:1260719. [PMID: 37869493 PMCID: PMC10585029 DOI: 10.3389/fvets.2023.1260719] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 09/21/2023] [Indexed: 10/24/2023] Open
Abstract
A 1.5-year-old female entire French bulldog was referred for neurological evaluation, further diagnostic tests, and treatment 24 h after a road traffic accident. Initial emergency treatment, diagnostic tests, and stabilization had been performed by the referring veterinarian. Neurological examination revealed severe spastic non-ambulatory tetraparesis and was consistent with a C1-5 myelopathy. A magnetic resonance imaging (MRI) study revealed an irregular to elongated ovoid intramedullary lesion centered over the body of C2. The lesion showed marked signal heterogeneity with a central T2W and T2* hyperintense region, surrounded by a hypointense rim on both sequences. The lesion appeared heterogeneously T1W hypointense. The lesion was asymmetric (right-sided), affecting both white and gray matter. The C2-3 intervertebral disk appeared moderately degenerate with a Pfirrmann grade of 3. No evidence of vertebral fracture or luxation was found on radiographs or MRI of the vertebral column. Additional soft tissue abnormalities in the area of the right brachial plexus were suggestive of brachial plexus and muscle injury. A diagnosis of traumatic hemorrhagic myelopathy at the level of C2 and concurrent brachial plexus injury was formed. Conservative treatment was elected and consisted of physiotherapy, bladder care with an indwelling urinary catheter, repeated IV methadone based on pain scoring (0.2 mg/kg), oral meloxicam 0.1 mg/kg q24h, and oral gabapentin 10 mg/kg q8h. The dog was discharged after 4 days, with an indwelling urinary catheter and oral medication as described. The catheter was replaced two times by the referring veterinarian and finally removed after 10 days. Thereafter, voluntary urination was seen. During the 2 months after the road traffic accident, slow recovery of motor function was seen. The right thoracic limb recovery progressed more slowly than the left limb, also showing some lower motor neuron signs during follow-up. This was judged to be consistent with a right-sided brachial plexus injury. The dog was reported ambulatory with mild residual ataxia and residual monoparesis of the right thoracic limb at the last follow-up 3 months post-injury. This case report highlights the MRI-based diagnosis of traumatic hemorrhagic myelopathy in a dog. A fair short-term outcome was achieved with conservative treatment in this case.
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Affiliation(s)
- Koen M. Santifort
- IVC Evidensia Small Animal Referral Hospital Arnhem, Neurology, Arnhem, Netherlands
- IVC Evidensia Small Animal Referral Hospital Hart van Brabant, Neurology, Waalwijk, Netherlands
| | - Ines Carrera
- Vet Oracle Teleradiology, Norfolk, United Kingdom
| | - Simon Platt
- Vet Oracle Teleradiology, Norfolk, United Kingdom
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Diagnostic and Treatment of Spinal Fracture and Luxation in Italian Wolves (Canis lupus italicus). Animals (Basel) 2022; 12:ani12213044. [DOI: 10.3390/ani12213044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/24/2022] [Accepted: 11/02/2022] [Indexed: 11/09/2022] Open
Abstract
The medical records of 14 Italian wolves (Canis lupus italicus) with a vertebral fracture or luxation (SFL) between C1 and L7 treated at Ospedale Veterinario San Michele from 2017 and 2022 were reviewed. The most common cause of SFL was “road traffic accident”. Neurological signs were graded from 0 to 6 using a modified Frankel scale. Spinal fractures occurred in C1–C5 in 1 case, in T3–L3 in 11 cases and in L4–L7 in 2 cases. Six wolves were euthanized without treatment because they presented paraplegia without deep pain perception (DPP). Two animals with motor function were treated conservatively, and later on one of them was euthanized because of neurological impairment. Six wolves were surgically treated. Seven wolves had good neurological recovery, and six of them were released into the wild. Our results suggest that wolves with DPP before surgery may have a good functional recovery.
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Lawler PE, Wood JH, Alleva NE, Rishniw M, Porter I, Johnson PJ. Comparison of Surgical Outcomes Associated With Compression Secondary to Hemorrhage and Intervertebral Disk Extrusions in Dogs. Front Vet Sci 2022; 9:889113. [PMID: 35859807 PMCID: PMC9289558 DOI: 10.3389/fvets.2022.889113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 06/01/2022] [Indexed: 11/13/2022] Open
Abstract
Acute intervertebral disk extrusion (IVDE) is one of the most commonly reported neurologic disorders seen in veterinary practice. There is a recognized subset of IVDE cases that have a hemorrhagic inflammatory reaction within the epidural space that causes compression in addition to compression from herniated disk material. Previous reports have been conflicting in the outcomes of these cases. The goals of this retrospective case-control cross-sectional study are to (1) compare the success rate of routine surgical decompression in dogs with DEEH compression compared to Modified Frankel Score (MFS) matched dogs with non-hemorrhagic disk extrusions; (2) evaluate the extent of spinal cord compression on MRI compared to final patient outcomes in DEEH compression and (3) determine the surgical compression to decompression ratio and its relation to patient outcomes in cases of DEEH compression. A total of 143 dogs were included in this study and divided into two groups: DEEH compression dogs (n = 78) and non-hemorrhagic IVDE dogs (n = 65). Outcomes were assigned for each patient [0 = deceased, 1 = alive and non-ambulatory (MFS 0–3), 2 = alive and ambulatory (MFS 4 or 5)] in both groups. Outcomes of DEEH and non-hemorrhagic IVDE did not differ when taken to surgery with comparable success rates when stratified by MFS. Similarly, outcomes did not differ between DEEH and non-hemorrhagic IVDE dogs when assessed by compression to decompression ratio. Dogs with DEEH compression had more compressed sites than dogs with non-hemorrhagic IVDE (P = 0.001) and had more sites decompressed surgically than dogs with non-hemorrhagic IVDE (P < 0.001). Consequently, the compression to decompression ratio did not differ between the two groups (P = 0.52). Our results support the finding that when a similar level of surgical decompression is achieved, dogs with DEEH compression have similar outcomes to dogs with non-hemorrhagic IVDE for similar degrees of neurological dysfunction.
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Affiliation(s)
- Patricia E. Lawler
- Department of Clinical Sciences, Cornell University School of Veterinary Medicine, Ithaca, NY, United States
- *Correspondence: Patricia E. Lawler
| | - Jonathan H. Wood
- Department of Clinical Sciences, Cornell University School of Veterinary Medicine, Ithaca, NY, United States
| | - Nicole E. Alleva
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Mark Rishniw
- Department of Clinical Sciences, Cornell University School of Veterinary Medicine, Ithaca, NY, United States
| | - Ian Porter
- Department of Clinical Sciences, Cornell University School of Veterinary Medicine, Ithaca, NY, United States
| | - Phillipa J. Johnson
- Department of Clinical Sciences, Cornell University School of Veterinary Medicine, Ithaca, NY, United States
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Long-Term Follow-Up of Dogs and Cats after Stabilization of Thoracolumbar Instability Using 2-0 UniLock Implants. Vet Med Int 2022; 2022:5112274. [PMID: 35521052 PMCID: PMC9064500 DOI: 10.1155/2022/5112274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 03/23/2022] [Accepted: 03/29/2022] [Indexed: 11/17/2022] Open
Abstract
Traumatic vertebral fracture or luxation often results in spinal instability requiring surgical stabilization. This study describes the long-term outcome of spinal stabilization using a unilateral 5-hole 2-0 UniLock implant in eight dogs and two cats with trauma-induced thoracolumbar vertebral luxation/subluxation and presumed instability, as assessed by a combination of preoperative radiographs and MRI using a 3-compartment method. The UniLock plate was secured with four monocortical locking screws in adjacent vertebral bodies. Additional pins and facet screws were used in several patients. Postoperative radiographs and MRI studies showed restoration of the main spinal axis in all patients and satisfactory implantation of the screws in the vertebral bodies, with no intrusion in the vertebral canal or in the adjacent intervertebral disc spaces. Neurological status improved in nine patients six weeks postoperatively. Partial implant failure was detected in three patients with no long-term consequences. After 12 months, seven patients reached full recovery with no neurological deficit, two patients were euthanized (including one owing to an unrelated condition), and one remained paraparetic. The results of this study demonstrate that using a 2-0 UniLock implant to stabilize the thoracolumbar spine results in satisfactory long-term recovery in most dogs and cats with traumatic spinal luxation/subluxation and presumed instability. Complications may occur but do not require revision surgery and do not affect clinical outcomes.
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Hanot EM, Cherubini GB, Marçal VC, Caine A. MRI Features of Solitary Vertebral Masses in Dogs: 20 Cases (2010-2019). J Am Anim Hosp Assoc 2021; 57:189-198. [PMID: 34097039 DOI: 10.5326/jaaha-ms-7063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2020] [Indexed: 11/11/2022]
Abstract
The objective of the study was to describe the MRI features of cytologically or histologically diagnosed solitary vertebral masses in dogs and identify potential MRI features enabling differentiation between malignant and benign lesions. Patients were divided into malignant and benign groups according to the final diagnosis. Medical records and MRI studies were retrospectively reviewed, and specific imaging features were compared. The malignant group comprised 15 dogs, with 5 dogs included in the benign group. MRI features of the different histopathologic/cytologic types of masses are described. Involvement of the vertebral body, a hyperintense signal on T2-weighted, short tau inversion recovery, T1-weighted, and T1-weighted gradient echo sequences and evidence of cortical destruction were signifi-cantly associated with malignancy (P < .05). Hypointensity on T1-weighted gradient echo sequence was significantly associated with benign masses (P < .05). The presence of bone sclerosis was significantly associated with osteosarcomas compared with other malignant masses (P < .05). Fractures (5 cases) were only seen in the group of malignant masses. This pilot study identifies some MRI features that may help differentiate between malignant and benign solitary vertebral masses. Greater case numbers are needed in future studies.
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Gallastegui A, Davies E, Zwingenberger AL, Nykamp S, Rishniw M, Johnson PJ. MRI has limited agreement with CT in the evaluation of vertebral fractures of the canine trauma patient. Vet Radiol Ultrasound 2019; 60:533-542. [PMID: 31309654 DOI: 10.1111/vru.12785] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 05/06/2019] [Accepted: 05/13/2019] [Indexed: 11/26/2022] Open
Abstract
Complete assessment of vertebral trauma in dogs currently requires CT and MRI for evaluation of the osseous and soft tissue structures that contribute to vertebral stability. Some studies in people have suggested that MRI may be sensitive and specific at detecting vertebral fractures making this potentially a single modality that could be used in spinal trauma evaluation. This study aimed to assess the ability for observers to evaluate vertebral fractures using MRI when compared to CT, which was used as the reference standard. Twenty-nine dogs with previously diagnosed acute vertebral fractures and four dogs with no vertebral fracture that had undergone sequential CT and MRI were included into the study. One hundred twenty-eight vertebrae were evaluated for the presence of fractures. Imaging studies were read by two observers blinded to the history. While both observers had similarly high sensitivity and specificity for simple detection of any fractured vertebrae, interobserver agreement was only moderate (κ = 0.584). When evaluations were specifically limited to detection of structurally unstable fractured vertebrae both observers showed improved specificity and interobserver agreement became substantial (κ = 0.650). Complete agreement for exact fracture location between MRI and CT results was only achieved in 14.3-32.6% of fractured vertebra with up to 79% of fractures being missed in some vertebral structures. This suggests that although MRI may be able to detect the presence of fractured vertebrae, it is not able to replace CT for the complete evaluation of the traumatized spine and documentation of fracture morphology.
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Affiliation(s)
- Aitor Gallastegui
- College of Veterinary Medicine, University of Florida, Gainesville, Florida
| | - Emma Davies
- Cornell College of Veterinary Medicine, Cornell University, Ithaca, New York
| | | | - Stephanie Nykamp
- The Ontario Veterinary College Health Sciences Center, University of Guelph, Guelph, Ontario, Canada
| | - Mark Rishniw
- Cornell College of Veterinary Medicine, Cornell University, Ithaca, New York
| | - Philippa J Johnson
- Cornell College of Veterinary Medicine, Cornell University, Ithaca, New York
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Wang X, Yao G, Chen Y, Wang W, Zeng J. New reduction technique for the treatment of unilateral locked facet joints of the lower cervical spine : A retrospective analysis of 12 cases. DER ORTHOPADE 2018; 47:212-220. [PMID: 28808751 DOI: 10.1007/s00132-017-3456-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Closed reduction of bilateral locked facet joints of the lower cervical spine is possible, but reduction of unilateral locked facet joints of the lower cervical spine (ULFJLCS) is challenging. We explored a new, simple, safe, and effective closed reduction method for the treatment of ULFJLCS. METHODS A retrospective analysis was done on 12 consecutive cases with traumatic ULFJLCS that underwent closed reduction by Z‑shape elevating-pulling reduction through a halo-vest. After reduction, only anterior cervical decompression and internal fixation were performed. The success of reduction and nerve function was assessed, and follow-up data analyzed. RESULTS All patients using our new reduction technique underwent successful closed reduction; the shortest time of reduction was 40 min and the longest 110 (mean, 65) min. No aggravation of neurological damage was observed, nor were other complications. All patients were followed-up from 28 to 72 (mean, 44) months after surgery. The improvement in Frankel's score (on average) was two levels in most patients. CONCLUSION These data demonstrate that our new reduction technique is a simple, safe, and effective treatment for ULFJLCS.
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Affiliation(s)
- Xinjia Wang
- Department of Spine Surgery, the Second Affiliated Hospital, Shantou University Medical College, The DongXia North Road, 515041, Shantou, Guangdong, China.
| | - Guanfeng Yao
- Department of Spine Surgery, the Second Affiliated Hospital, Shantou University Medical College, The DongXia North Road, 515041, Shantou, Guangdong, China
| | - Yuchun Chen
- Department of Spine Surgery, the Second Affiliated Hospital, Shantou University Medical College, The DongXia North Road, 515041, Shantou, Guangdong, China
| | - Weidong Wang
- Department of Spine Surgery, the Second Affiliated Hospital, Shantou University Medical College, The DongXia North Road, 515041, Shantou, Guangdong, China
| | - Jican Zeng
- Department of Spine Surgery, the Second Affiliated Hospital, Shantou University Medical College, The DongXia North Road, 515041, Shantou, Guangdong, China
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Lewis MJ, Cohen EB, Olby NJ. Magnetic resonance imaging features of dogs with incomplete recovery after acute, severe spinal cord injury. Spinal Cord 2018; 56:133-141. [PMID: 29057987 PMCID: PMC5809200 DOI: 10.1038/s41393-017-0004-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Revised: 08/12/2017] [Accepted: 08/14/2017] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Retrospective case series. OBJECTIVES Describe the magnetic resonance imaging (MRI) features of dogs chronically impaired after severe spinal cord injury (SCI) and investigate associations between imaging variables and residual motor function. SETTING United States of America. METHODS Thoracolumbar MRI from dogs with incomplete recovery months to years after clinically complete (paralysis with loss of pain perception) thoracolumbar SCI were reviewed. Lesion features were described and quantified. Gait was quantified using an ordinal, open field scale (OFS). Associations between imaging features and gait scores, duration of injury (DOI), or SCI treatment were determined. RESULTS Thirty-five dogs were included. Median OFS was 2 (0-6), median DOI was 13 months (3-83), and intervertebral disk herniation was the most common diagnosis (n = 27). Myelomalacia was the most common qualitative feature followed by cystic change; syringomyelia and fibrosis were uncommon. Lesion length corrected to L2 length (LL:L2) was variable (median LL:L2 = 3.5 (1.34-11.54)). Twenty-nine dogs had 100% maximum cross-sectional spinal cord compromise (MSCC) at the lesion epicenter and the length of 100% compromised area varied widely (median length 100% MSCC:L2 = 1.29 (0.39-7.64)). Length 100% MSCC:L2 was associated with OFS (p = 0.012). OFS was not associated with any qualitative features. DOI or treatment type were not associated with imaging features or lesion quantification. CONCLUSIONS Lesion characteristics on MRI in dogs with incomplete recovery after severe SCI were established. Length of 100% MSCC was associated with hind limb motor function. Findings demonstrate a spectrum of injury severity on MRI among severely affected dogs, which is related to functional status.
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Affiliation(s)
- Melissa J Lewis
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC, USA
| | - Eli B Cohen
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Natasha J Olby
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA.
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC, USA.
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Jayson SL, Dennis R, Mateo I, Orioles M, Sanchez‐Masian D. Atlantoaxial subluxation with complex occipitoatlantoaxial malformation in two domestic ferrets (
Mustela putorius furo
). VETERINARY RECORD CASE REPORTS 2018. [DOI: 10.1136/vetreccr-2017-000530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
| | - Ruth Dennis
- Diagnostic Imaging DepartmentAnimal Health TrustNewmarketUK
| | - Isidro Mateo
- Department of NeurologyUniversidad Alfonso X El SabioMadridSpain
| | | | - Daniel Sanchez‐Masian
- Department of Neurology and NeurosurgerySmall Animal Teaching HospitalUniversity of LiverpoolNestonLiverpoolUK
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Posporis C, Grau-Roma L, Travetti O, Oliveira M, Polledo L, Wessmann A. Meningeal carcinomatosis and spinal cord infiltration caused by a locally invasive pulmonary adenocarcinoma in a cat. JFMS Open Rep 2017; 3:2055116917742812. [PMID: 29204290 PMCID: PMC5703112 DOI: 10.1177/2055116917742812] [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: 12/20/2022] Open
Abstract
Case summary A 12-year-old domestic shorthair cat was presented with acute non-painful hindlimb proprioceptive ataxia localising to T3–L3 spinal cord segments. MRI revealed paravertebral muscular hyperintensity on T2-weighted images at the level of T7–T8 vertebrae. The cat improved on conservative management but deteriorated 3 months later. Repeated MRI showed meningeal enhancement at the same level and hyperintensity of the paravertebral musculature extending to the right thoracic wall and pleural space on short tau inversion recovery images. Thoracic CT showed mineralised lesions of the right lung, restricted pleural effusion and expansile bone lesions affecting multiple ribs. The cat had been treated for pyothorax 5 years earlier but manifested no current respiratory signs. Cerebrospinal fluid (CSF) examination showed lymphocytic pleocytosis but no neoplastic cells. Biopsy of the affected muscles and cytology of the lung and pleural lesions suggested a malignant epithelial cell tumour. Post-mortem examination confirmed a pulmonary adenocarcinoma locally infiltrating the thoracic wall, T7–T8 vertebrae and the spinal cord white matter. Meningeal carcinomatosis was detected with neoplastic cells invading the ventral median fissure of the spinal cord. No metastases were observed in other organs, indicating that neoplastic cells reached the spinal cord by direct extension. Relevance and novel information Spinal meningeal carcinomatosis has not been reported in dogs or cats with extraneural tumours but is a well-recognised condition in humans. A metastatic cause of meningeal enhancement should be considered in patients with neurological signs of unknown origin. Imaging findings and CSF results can be non-specific.
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Affiliation(s)
- Christoforos Posporis
- Department of Neurology / Neurosurgery, Pride Veterinary Centre, Derby, UK.,School of Veterinary Medicine and Science, University of Nottingham, UK
| | - Llorenç Grau-Roma
- School of Veterinary Medicine and Science, University of Nottingham, UK
| | - Olga Travetti
- Department of Radiology, Pride Veterinary Centre, Derby, UK
| | - Maria Oliveira
- School of Veterinary Medicine and Science, University of Nottingham, UK
| | - Laura Polledo
- School of Veterinary Medicine and Science, University of Nottingham, UK
| | - Annette Wessmann
- Department of Neurology / Neurosurgery, Pride Veterinary Centre, Derby, UK
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Posporis C, Grau-Roma L, Travetti O, Oliveira M, Polledo L, Wessmann A. Meningeal carcinomatosis and spinal cord infiltration caused by a locally invasive pulmonary adenocarcinoma in a cat. JFMS Open Rep 2017. [PMID: 29204290 DOI: 10.1177/2055116917742812.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Case summary A 12-year-old domestic shorthair cat was presented with acute non-painful hindlimb proprioceptive ataxia localising to T3-L3 spinal cord segments. MRI revealed paravertebral muscular hyperintensity on T2-weighted images at the level of T7-T8 vertebrae. The cat improved on conservative management but deteriorated 3 months later. Repeated MRI showed meningeal enhancement at the same level and hyperintensity of the paravertebral musculature extending to the right thoracic wall and pleural space on short tau inversion recovery images. Thoracic CT showed mineralised lesions of the right lung, restricted pleural effusion and expansile bone lesions affecting multiple ribs. The cat had been treated for pyothorax 5 years earlier but manifested no current respiratory signs. Cerebrospinal fluid (CSF) examination showed lymphocytic pleocytosis but no neoplastic cells. Biopsy of the affected muscles and cytology of the lung and pleural lesions suggested a malignant epithelial cell tumour. Post-mortem examination confirmed a pulmonary adenocarcinoma locally infiltrating the thoracic wall, T7-T8 vertebrae and the spinal cord white matter. Meningeal carcinomatosis was detected with neoplastic cells invading the ventral median fissure of the spinal cord. No metastases were observed in other organs, indicating that neoplastic cells reached the spinal cord by direct extension. Relevance and novel information Spinal meningeal carcinomatosis has not been reported in dogs or cats with extraneural tumours but is a well-recognised condition in humans. A metastatic cause of meningeal enhancement should be considered in patients with neurological signs of unknown origin. Imaging findings and CSF results can be non-specific.
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Affiliation(s)
- Christoforos Posporis
- Department of Neurology / Neurosurgery, Pride Veterinary Centre, Derby, UK.,School of Veterinary Medicine and Science, University of Nottingham, UK
| | - Llorenç Grau-Roma
- School of Veterinary Medicine and Science, University of Nottingham, UK
| | - Olga Travetti
- Department of Radiology, Pride Veterinary Centre, Derby, UK
| | - Maria Oliveira
- School of Veterinary Medicine and Science, University of Nottingham, UK
| | - Laura Polledo
- School of Veterinary Medicine and Science, University of Nottingham, UK
| | - Annette Wessmann
- Department of Neurology / Neurosurgery, Pride Veterinary Centre, Derby, UK
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Hülsmeyer VI, Flatz K, Putschbach K, Bechter MR, Weiler S, Fischer A, Feist M. Traumatic odontoid process synchondrosis fracture with atlantoaxial instability in a calf: clinical presentation and imaging findings. Ir Vet J 2015; 68:6. [PMID: 25937919 PMCID: PMC4416342 DOI: 10.1186/s13620-015-0034-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 02/16/2015] [Indexed: 11/10/2022] Open
Abstract
A 6-week-old female Simmental calf was evaluated for acute non-ambulatory tetraparesis. Physical and laboratory examinations revealed no clinically relevant abnormalities. Neurological findings were consistent with acute, progressive and painful cervical myelopathy. Radiographs displayed a fractured odontoid process (dens axis) and vertebral step misalignment at the fracture site. A traumatic origin was suspected. Advanced diagnostic imaging was considered to allow better planning of potential surgical stabilisation and to exclude any additional lesions of the cervical vertebral column. However, during trailer transportation to the advanced diagnostic imaging and surgery site, the calf deteriorated neurologically and was humanely euthanised. Magnetic resonance imaging (MRI) and computed tomography (CT) were performed immediately post-mortem for scientific reasons. The MRI examination reflected the radiographic findings and confirmed severe spinal cord compression at the fracture site. In addition, a T2W-hyperintense signal change within the paravertebral soft tissue dorsal to the fracture site was indicative of a traumatic event. CT identified the fracture site at the synchondrosis between the odontoid process and the body of the axis, and this finding was confirmed by post-mortem examination. Advanced diagnostic imaging and post-mortem examination did not identify any other cervical lesion. In summary, this calf was diagnosed with a traumatic odontoid process synchondrosis fracture, which has not been reported previously in calves but presents a challenging and well-known fracture type in young children. This case report indicates that the odontoid process synchondrosis is a potential predisposed injury site and that traumatic odontoid process synchondrosis fractures should be considered as a potential differential in calves with acute cervical pain and/or signs of a cervical myelopathy.
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Affiliation(s)
- Velia-Isabel Hülsmeyer
- Section of Neurology, Clinic of Small Animal Medicine at the Centre for Clinical Veterinary Medicine, Ludwig Maximilian University, Veterinärstr.13, 80539 Munich, Germany
| | - Katharina Flatz
- Clinic of Small Animal Surgery and Reproduction at the Centre for Clinical Veterinary Medicine, Ludwig Maximilian University, Munich, Germany
| | - Katrin Putschbach
- Section of Neurology, Clinic of Small Animal Medicine at the Centre for Clinical Veterinary Medicine, Ludwig Maximilian University, Veterinärstr.13, 80539 Munich, Germany
| | - Martina Ramona Bechter
- Clinic for Ruminants with Ambulatory and Herd Health Services at the Centre of Clinical Veterinary Medicine, Ludwig Maximilian University, Munich, Germany
| | - Sebastian Weiler
- Clinic for Ruminants with Ambulatory and Herd Health Services at the Centre of Clinical Veterinary Medicine, Ludwig Maximilian University, Munich, Germany
| | - Andrea Fischer
- Section of Neurology, Clinic of Small Animal Medicine at the Centre for Clinical Veterinary Medicine, Ludwig Maximilian University, Veterinärstr.13, 80539 Munich, Germany
| | - Melanie Feist
- Clinic for Ruminants with Ambulatory and Herd Health Services at the Centre of Clinical Veterinary Medicine, Ludwig Maximilian University, Munich, Germany
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15
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Hodshon AW, Hecht S, Thomas WB. USE OF THE T2*-WEIGHTED GRADIENT RECALLED ECHO SEQUENCE FOR MAGNETIC RESONANCE IMAGING OF THE CANINE AND FELINE BRAIN. Vet Radiol Ultrasound 2014; 55:599-606. [DOI: 10.1111/vru.12164] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Accepted: 01/27/2014] [Indexed: 11/30/2022] Open
Affiliation(s)
- Amy W. Hodshon
- Department of Small Animal Clinical Sciences; College of Veterinary Medicine; University of Tennessee; Knoxville TN 37996-4544
| | - Silke Hecht
- Department of Small Animal Clinical Sciences; College of Veterinary Medicine; University of Tennessee; Knoxville TN 37996-4544
| | - William B. Thomas
- Department of Small Animal Clinical Sciences; College of Veterinary Medicine; University of Tennessee; Knoxville TN 37996-4544
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16
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Cooper JJ, Young BD, Griffin JF, Fosgate GT, Levine JM. Comparison between noncontrast computed tomography and magnetic resonance imaging for detection and characterization of thoracolumbar myelopathy caused by intervertebral disk herniation in dogs. Vet Radiol Ultrasound 2013; 55:182-9. [PMID: 24118546 DOI: 10.1111/vru.12114] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Accepted: 07/27/2013] [Indexed: 11/29/2022] Open
Abstract
Magnetic resonance imaging (MRI) and computed tomography (CT) are commonly used to evaluate dogs with thoracolumbar myelopathy; however, relative diagnostic sensitivities for these two modalities have not been previously reported. The purpose of this prospective study was to compare diagnostic sensitivity and observer agreement for MRI and CT in a group of dogs with thoracolumbar myelopathy due to surgically confirmed intervertebral disk herniation (IVDH). All included dogs had magnetic resonance (MR) imaging followed by noncontrast CT using standardized protocols. Three experienced observers interpreted each imaging study independently without knowledge of clinical or surgical findings. The operating surgeon was aware of MR findings but not CT findings at the time surgical findings were recorded. Forty-four dogs met the inclusion criteria. The sensitivity of CT was 88.6% (79.5%-94.2%) and of MR was 98.5% (95% confidence interval, 94.1%-99.7%) for diagnosis of intervertebral disk herniation. Specificity was not calculated, as all dogs had IVDH at surgery. Magnetic resonance imaging was more accurate than CT for identifying the site of intervertebral disk herniation-associated spinal cord compression and differentiating disk extrusion vs. protrusion. Computed tomography was less accurate for lesion localization in per acute cases, as well as for chondrodystrophic, female, older and smaller (<7 kg) dogs. Inter-rater agreement was good for lesion lateralization for both MR and CT (κ = 0.687, 95% CI = 0.552, 0.822, P = 0.002, and κ = 0.692, 95% CI = 0.542, 0.842, P = 0.003). Findings from the current study indicated that MR imaging was more sensitive and accurate than noncontrast CT for diagnosis and characterization of thoracolumbar myelopathy due to IVDH in dogs.
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Affiliation(s)
- Jocelyn J Cooper
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, 77843
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17
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DiFazio J, Fletcher DJ. Updates in the management of the small animal patient with neurologic trauma. Vet Clin North Am Small Anim Pract 2013; 43:915-40. [PMID: 23747266 DOI: 10.1016/j.cvsm.2013.03.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Neurologic trauma, encompassing traumatic brain injury (TBI) and acute spinal cord injury (SCI), is a cause of significant morbidity and mortality in veterinary patients. Acute SCIs occurring secondary to trauma are also common. Essential to the management of TBI and SCI is a thorough understanding of the pathophysiology of the primary and secondary injury that occurs following trauma. This article reviews the pathophysiology of this primary and secondary injury, as well as recommendations regarding clinical assessment, diagnostics, pharmacologic and nonpharmacologic therapy, and prognosis.
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Affiliation(s)
- Jillian DiFazio
- Section of Emergency and Critical Care, Cornell University Hospital for Animals, Upper Tower Road, Ithaca, NY 14853, USA
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