1
|
De Frias JM, De Decker S, De Stefani A, Llabres-Diaz F. Description and clinical relevance of the variable conformation of canine spinal arachnoid diverticula. Vet Radiol Ultrasound 2024; 65:344-351. [PMID: 38572892 DOI: 10.1111/vru.13365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 03/18/2024] [Indexed: 04/05/2024] Open
Abstract
The conformation of spinal arachnoid diverticula (SAD) and their clinical implications are poorly characterized in dogs. This retrospective cross-sectional study describes different SAD conformations in dogs and aims to identify if there is an association between SAD conformation and clinical features, localization, syringomyelia (SM) presence, concurrent vertebral condition, treatment option, and short as well as long-term outcome. Sixty-two dogs were included (12 cervical and 50 thoracolumbar SAD). All dogs with a cervical SAD had a cranial tethered conformation and were not included in the statistical analysis. Half of the dogs with a thoracolumbar SAD were cranial tethered, and the other half were caudal tethered. SM associated with SAD had a moderate prevalence in the cervical region (58.3%) and a high prevalence in the thoracolumbar region (82%). All dogs with the presence of SM and caudal tethered SAD had a cranial positioned SM, and all dogs with SM and a cranial tethered SAD had a caudal positioned SM. The SM absolute length and SM length/L2 ratio were significantly higher (P = .018, respectively) in the caudal tethered SAD compared with the cranial tethered SAD. The short-term outcome was statistically different (P = .045) between caudal and cranial tethered thoracolumbar SAD, but not the long-term outcome (P = .062). Multivariable logistic regression identified thoracolumbar caudal tethered SAD conformation had a better short-term outcome (P = 0.017, OR: 0.043, CI: 0.003-0.563), independently of SM length measurements. SAD conformation in dogs can influence SM formation. A possible link between short-term outcome and SAD conformation was found, but further research is warranted.
Collapse
Affiliation(s)
- Joao Miguel De Frias
- Hospital for Small Animals, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian, UK
- Department of Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, UK
| | - Steven De Decker
- Department of Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, UK
| | - Alberta De Stefani
- Department of Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, UK
| | - Francisco Llabres-Diaz
- Department of Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, UK
| |
Collapse
|
2
|
Pilkington EJ, De Decker S, Skovola E, Cloquell Miro A, Gutierrez Quintana R, Faller KME, Aguilera Padros A, Goncalves R. Prevalence, clinical presentation, and etiology of myelopathies in 224 juvenile dogs. J Vet Intern Med 2024; 38:1598-1607. [PMID: 38483074 PMCID: PMC11099773 DOI: 10.1111/jvim.17045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 03/01/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Intervertebral disc herniation is widely recognized as the most common cause of myelopathy in dogs older than 2 years; however, the prevalence of various causes of myelopathy in younger dogs has not been reported. HYPOTHESIS/OBJECTIVES To describe the prevalence, clinical presentation, and etiology of myelopathy in dogs aged 18 months or less. Secondarily, to investigate which clinical features were associated with each of the most common etiologies. ANIMALS Two hundred twenty-four dogs aged 18 months or less with myelopathy were included in the study. METHODS Retrospective review of clinical records from 4 referral institutions. Multivariable logistic regression analyses assessed which clinical features were associated with each diagnosis. RESULTS French bulldogs (n = 51, 22.8%), pugs (n = 18, 8.0%), crossbreeds (n = 12, 5.4%), and English bulldogs (n = 11, 4.9%) were the most frequently affected breeds. Overall, 31 diagnoses were reached. The 5 most frequent diagnoses were vertebral malformation (VM; n = 42, 18.8%), spinal arachnoid diverticulum (SAD; n = 28, 12.5%), traumatic fracture of the vertebral column (n = 22, 9.8%), atlantoaxial instability (n = 18, 8.0%), and osseous-associated cervical spondylomyelopathy (n = 17, 7.6%). Intervertebral disc extrusion (IVDE) accounted for 4.5% of cases (n = 10). A final diagnosis of VM was associated with younger, screw-tailed, and pug breeds with chronic signs of T3-L3 myelopathy. SAD was associated with screw-tailed and pug breeds with nonpainful clinical signs. Intervertebral disc extrusion was associated with older, screw-tailed, and pug breeds with shorter duration of clinical signs. CONCLUSIONS AND CLINICAL IMPORTANCE Prioritization of differential diagnoses for dogs presenting with signs of myelopathy when aged 18 months or less should differ to those for older dogs, with IVDE not the most common cause in the former.
Collapse
Affiliation(s)
- Ed J. Pilkington
- Small Animal Teaching Hospital, Institute of Veterinary ScienceUniversity of LiverpoolLiverpoolUnited Kingdom
| | - Steven De Decker
- Department of Clinical Science and Services, Royal Veterinary CollegeUniversity of LondonHatfieldUnited Kingdom
| | - Eleftheria Skovola
- Department of Clinical Science and Services, Royal Veterinary CollegeUniversity of LondonHatfieldUnited Kingdom
| | - Ana Cloquell Miro
- Small Animal Hospital, School of Biodiversity, One Health and Veterinary MedicineUniversity of GlasgowGlasgowUnited Kingdom
| | - Rodrigo Gutierrez Quintana
- Small Animal Hospital, School of Biodiversity, One Health and Veterinary MedicineUniversity of GlasgowGlasgowUnited Kingdom
| | - Kiterie M. E. Faller
- The Royal (Dick) School of Veterinary StudiesThe University of EdinburghMidlothianUnited Kingdom
| | - Albert Aguilera Padros
- The Royal (Dick) School of Veterinary StudiesThe University of EdinburghMidlothianUnited Kingdom
| | - Rita Goncalves
- Small Animal Teaching Hospital, Institute of Veterinary ScienceUniversity of LiverpoolLiverpoolUnited Kingdom
| |
Collapse
|
3
|
De Decker S, Rohdin C, Gutierrez-Quintana R. Vertebral and spinal malformations in small brachycephalic dog breeds: Current knowledge and remaining questions. Vet J 2024; 304:106095. [PMID: 38458418 DOI: 10.1016/j.tvjl.2024.106095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 03/04/2024] [Accepted: 03/04/2024] [Indexed: 03/10/2024]
Abstract
Small brachycephalic dog breeds, such as the French bulldog, English bulldog and pug have become increasingly popular. These breeds are predisposed to a variety of vertebral and spinal malformations, including hemivertebra, caudal articular process dysplasia, transitional vertebra, cranial thoracic vertebral canal stenosis, spinal arachnoid diverticulum and meningeal fibrosis. Recent studies have provided new insights into the prevalence, anatomical characteristics, pathophysiology and treatment of these conditions. Thoracic hemivertebra, caudal articular process dysplasia, transitional vertebra, and cranial thoracic vertebral canal stenosis occur commonly in neurologically normal dogs. Although the clinical relevance of these vertebral anomalies has therefore been questioned, severe kyphosis and hemivertebra in pugs have been associated with an increased likelihood of neurological signs. Meningeal fibrosis is characterised by the formation of dense intradural fibrotic adhesions, constricting the spinal cord. This condition has been heavily associated with the pug breed. It is in pugs further common to observe multiple concurrent spinal disorder in association with chronic progressive pelvic limb gait abnormalities. This clinical presentation has been referred to as 'pug dog thoracolumbar myelopathy' and potential genetic risk factors have recently been identified. Despite our increased knowledge, many questions remain currently unanswered. This review discusses our current understanding and controversies surrounding vertebral and spinal malformations in small brachycephalic dog breeds.
Collapse
Affiliation(s)
- Steven De Decker
- Department of Clinical Science and Services, Royal Veterinary College, University of London, Hatfield AL9 7TA, UK.
| | - Cecilia Rohdin
- Swedish University of Agricultural Sciences, University Animal Hospital, Uppsala 75007, Sweden; Anicura Albano Small Animal Hospital, Danderyd 18236, Sweden
| | - Rodrigo Gutierrez-Quintana
- School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G61 1QH, UK
| |
Collapse
|
4
|
Gernone F, Uva A, Cavalera MA, Zatelli A. Neurogenic Bladder in Dogs, Cats and Humans: A Comparative Review of Neurological Diseases. Animals (Basel) 2022; 12:3233. [PMID: 36496754 PMCID: PMC9739254 DOI: 10.3390/ani12233233] [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: 10/09/2022] [Revised: 11/02/2022] [Accepted: 11/17/2022] [Indexed: 11/24/2022] Open
Abstract
Lower urinary tract disease (LUTD) includes abnormalities in the structure and function of the bladder and the urethra. LUTD caused by neurological disease is defined neurogenic bladder (NB). The integrity of the central nervous system (CNS) and peripheral nervous system (PNS) is required to explicate normal micturition, maintaining the proper function of bladder and urethra. The location and type of neurological lesions influence the pattern of clinical manifestations, potential treatment, and prognosis. Though, in dogs and cats, spinal cord injury is considered mainly responsible for bladder and/or urethra incompetence, other disorders, congenital or acquired, involving CNS or PNS, could play a role in NB. In veterinary medicine, the information about the epidemiology, prevalence, etiopathogenesis, diagnosis and treatment of NB are scattered. The aim of this study is to provide an overview of the epidemiology, prevalence, clinical findings, diagnosis and prognosis for NB in dogs and cats compared with humans.
Collapse
Affiliation(s)
- Floriana Gernone
- Department of Veterinary Medicine, University of Bari, 70010 Valenzano, Italy
| | | | | | | |
Collapse
|
5
|
Gutierrez‐Quintana R, Decker S. Tail end of the brachycephalic problem: diagnostic and treatment options for spinal malformations. IN PRACTICE 2021. [DOI: 10.1002/inpr.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
6
|
Spinillo S, Golini L, Mariscoli M, Motta L. Retrospective evaluation of surgical outcomes after closure of durotomy in eight dogs affected by spinal subarachnoid diverticulum. Open Vet J 2020; 10:384-391. [PMID: 33614433 PMCID: PMC7830178 DOI: 10.4314/ovj.v10i4.5] [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: 08/17/2020] [Accepted: 10/27/2020] [Indexed: 11/17/2022] Open
Abstract
Background: Canine spinal subarachnoid diverticulum has been studied since 1968 and a few advancements have been made with regard to the treatment of this disease. Several surgical techniques have been proposed which include durectomy, fenestration, and/or marsupilization with the latter two regarded as the more favorable surgical treatments. Aim: In this retrospective study, we evaluated the closure of the durotomy incision in the treatment of canine spinal subarachnoid diverticulum. Methods: We retrospectively evaluated eight dogs with clinical signs and magnetic resonance imaging findings consistent with spinal subarachnoid diverticulum located in the cervical and thoracolumbar area. This was to determine whether the fenestration with closure of durotomy was superior to the marsupialization technique. In all dogs, fenestration and removal of subarachnoid adherences alongside closure of the durotomy were carried out. Results: Mild post-operative deterioration was observed in all dogs. Follow-up from 7 to 36 months indicated a satisfactory outcome. Conclusion: We conclude that the closure of durotomy has similar short-term and long-term outcomes compared to the previous reported studies. These results suggest that the closure of durotomy is a viable technique for spinal subarachnoid diverticulum.
Collapse
Affiliation(s)
| | - Lorenzo Golini
- Northwest Veterinary Specialists, Runcorn, UK.,Vetsuisse Faculty, University of Zürich, Zürich, Switzerland
| | - Massimo Mariscoli
- Northwest Veterinary Specialists, Runcorn, UK.,Paragon Veterinary Referrals, Wakefield, UK
| | - Luca Motta
- Northwest Veterinary Specialists, Runcorn, UK
| |
Collapse
|
7
|
Tauro A, Rusbridge C. Syringopleural shunt placement in a pug with a cervical spinal diverticulum and associated syringomyelia. Clin Case Rep 2020; 8:1142-1148. [PMID: 32695345 PMCID: PMC7364096 DOI: 10.1002/ccr3.2845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 03/16/2020] [Accepted: 03/19/2020] [Indexed: 01/12/2023] Open
Abstract
We report persistence of associated syringomyelia and formation of newly caudal spinal arachnoid diverticulum, following marsupialization surgery. We describe syringopleural shunt placement as a novel approach to treat both conditions in a Pug dog.
Collapse
Affiliation(s)
- Anna Tauro
- ChesterGates Veterinary SpecialistsChesterUK
| | - Clare Rusbridge
- School of Veterinary MedicineGuildfordUK
- Fitzpatrick ReferralsEashingUK
| |
Collapse
|
8
|
Rohdin C, Ljungvall I, Häggström J, Leijon A, Lindblad-Toh K, Matiasek K, Rosati M, Wohlsein P, Jäderlund KH. Thoracolumbar meningeal fibrosis in pugs. J Vet Intern Med 2020; 34:797-807. [PMID: 32003496 PMCID: PMC7096664 DOI: 10.1111/jvim.15716] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Accepted: 01/20/2020] [Indexed: 12/29/2022] Open
Abstract
Background Thoracolumbar myelopathies associated with spinal cord and vertebral column lesions, with a similar clinical phenotype, but different underlying etiologies, occur in pugs. Objectives To further characterize the clinical and neuropathological characteristics of pugs with longstanding thoracolumbar myelopathy. Animals Thirty client‐owned pure‐bred pugs with a history of more than a month of ataxia and paresis of the pelvic limbs, suggesting a myelopathy localized to the thoracolumbar spinal cord, were included in the study. Methods Prospective clinicopathological study. Included pugs underwent a complete neurological examination and gross and histopathologic postmortem studies with focus on the spinal cord. Computed tomography (n = 18), magnetic resonance imaging (n = 17), and cerebrospinal fluid analysis (n = 27) were performed before or immediately after death. Results Twenty male and 10 female pugs had a median age at clinical onset of 84 months (interquartile range, 66‐96). Affected pugs presented with a progressive clinical course and 80% were incontinent. There was circumferential meningeal fibrosis with concomitant focal, malacic, destruction of the neuroparenchyma in the thoracolumbar spinal cord in 24/30 pugs. Vertebral lesions accompanied the focal spinal cord lesion, and there was lympho‐histiocytic inflammation associated or not to the parenchymal lesion in 43% of the pugs. Conclusions and Clinical Importance Meningeal fibrosis with associated focal spinal cord destruction and neighboring vertebral column lesions were common findings in pugs with long‐standing thoracolumbar myelopathy.
Collapse
Affiliation(s)
- Cecilia Rohdin
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden.,Anicura Albano Small Animal Hospital, Danderyd, Sweden
| | - Ingrid Ljungvall
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Jens Häggström
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Alexandra Leijon
- Department of Biomedical Sciences and Veterinary Public Health (BVF), Section of Pathology, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Kerstin Lindblad-Toh
- Science for Life Laboratory, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden.,Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Kaspar Matiasek
- Section of Clinical and Comparative Neuropathology, Ludwig-Maximilians-Universität, Munich, Germany
| | - Marco Rosati
- Section of Clinical and Comparative Neuropathology, Ludwig-Maximilians-Universität, Munich, Germany
| | - Peter Wohlsein
- Department of Pathology, University of Veterinary Medicine, Hannover, Germany
| | - Karin Hultin Jäderlund
- Department of Companion Animal Clinical Sciences, Norwegian University of Life Sciences, Oslo, Norway
| |
Collapse
|
9
|
Driver CJ, Rose J, Tauro A, Fernandes R, Rusbridge C. Magnetic resonance image findings in pug dogs with thoracolumbar myelopathy and concurrent caudal articular process dysplasia. BMC Vet Res 2019; 15:182. [PMID: 31151444 PMCID: PMC6544997 DOI: 10.1186/s12917-019-1866-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 04/12/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND A retrospective case series study was undertaken to describe the magnetic resonance imaging (MRI) findings in Pug dogs with thoracolumbar myelopathy and concurrent caudal articular process (CAP) dysplasia. Electronic clinical records were searched for Pug dogs who underwent MRI for the investigation of a T3-L3 spinal cord segment disease with subsequent confirmation of CAP dysplasia with computed tomography between January 2013 and June 2017. Clinical parameters age, gender, neuter status, body weight, urinary or faecal incontinence, severity and duration of clinical signs were recorded. MRI abnormalities were described. Univariable non-parametric tests investigated the association between the clinical parameters and evidence of extra- or intra-dural spinal cord compression on MRI. RESULTS 18 Pug dogs were included. The median age was 106 months with median duration of clinical signs 5 months. All presented with variable severity of spastic paraparesis and ataxia; 50% suffered urinary/faecal incontinence. In all cases, MRI revealed a focal increase in T2-weighted signal intensity within the spinal cord at an intervertebral level where bilateral CAP dysplasia was present; this was bilateral aplasia in all but one case, which had one aplastic and one severely hypoplastic CAP. MRI lesions were associated with spinal cord compression in all but one case; intervertebral disc protrusion resulted in extra-dural compression in 10 (56%) cases; intra-dural compression was associated with a suspected arachnoid diverticulum in 4 (22%) cases and suspected pia-arachnoid fibrosis in 3 cases (17%). There was no association between clinical parameters and a diagnosis of intra-dural vs extra-dural compression. CAP dysplasia occurred at multiple levels in the T10-13 region with bilateral aplasia at T11-12 most often associated with corresponding spinal cord lesions on MRI. CONCLUSIONS All Pugs dogs in this study were presented for chronic progressive ambulatory paraparesis; incontinence was commonly reported. Although intervertebral disc disease was the most common radiologic diagnosis, intra-dural compression associated with arachnoid diverticulae/fibrosis was also common. Bilateral CAP aplasia was present in all but one Pug dog at the level of MRI detectable spinal cord lesions. A causal relationship between CAP dysplasia and causes of thoracolumbar myelopathy is speculated but is not confirmed by this study.
Collapse
Affiliation(s)
- Colin J Driver
- Fitzpatrick Referrals Ltd, Eashing, Godalming, Surrey, GU7 2QQ, UK. .,Lumbry Park Veterinary Specialists, Selborne Road, Alton, Hampshire, GU34 3HL, UK.
| | - Jeremy Rose
- Fitzpatrick Referrals Ltd, Eashing, Godalming, Surrey, GU7 2QQ, UK.,Lumbry Park Veterinary Specialists, Selborne Road, Alton, Hampshire, GU34 3HL, UK
| | - Anna Tauro
- Fitzpatrick Referrals Ltd, Eashing, Godalming, Surrey, GU7 2QQ, UK
| | | | - Clare Rusbridge
- Fitzpatrick Referrals Ltd, Eashing, Godalming, Surrey, GU7 2QQ, UK.,Faculty of Health & Medical Sciences, University of Surrey School of Veterinary Medicine, Daphne Jackson Road, Guildford, Surrey, GU2 7AL, UK
| |
Collapse
|
10
|
Alisauskaite N, Cizinauskas S, Jeserevics J, Rakauskas M, Cherubini GB, Anttila M, Steffen F. Short- and long-term outcome and magnetic resonance imaging findings after surgical treatment of thoracolumbar spinal arachnoid diverticula in 25 Pugs. J Vet Intern Med 2019; 33:1376-1383. [PMID: 30844093 PMCID: PMC6524397 DOI: 10.1111/jvim.15470] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 02/20/2019] [Indexed: 12/14/2022] Open
Abstract
Background There is a successful outcome after surgical management of spinal arachnoid diverticula (SAD) in up to 82% of cases. Hypothesis/Objectives We hypothesized that Pugs have favorable short‐term and poor long‐term prognosis after surgical treatment of thoracolumbar SAD. The aim of the present investigation was to describe clinical findings, short‐ and long‐term outcomes, and follow‐up magnetic resonance imaging (MRI) findings in Pugs with thoracolumbar SAD. Animals Twenty‐five client owned Pugs with 12‐month follow‐up information after surgical treatment of thoracolumbar SAD. Methods Multicenter retrospective case series. All medical records were searched for Pugs diagnosed with SAD. Data regarding signalment, history, surgical procedure, outcome, histopathology, and follow‐up MRI results were extracted. Results Mean age at presentation was 7.32 (range 2‐11) years, 80% were males. Short‐term outcome was available in 25 dogs, and improvement was confirmed in 80% of dogs. Long‐term outcome was available in 21 dogs, and deterioration was confirmed in 86% of cases, with late‐onset recurrence of clinical signs after initial postsurgical improvement affecting 85% of Pugs. A moderate correlation (r = 0.50) was found between duration of clinical signs and outcome. In 8 dogs with deteriorating clinical signs, follow‐up MRI revealed regrowth of the SAD in 2 cases, new SAD formation in 2 cases, and intramedullary T2W hyperintensity/syringomyelia in 6 cases. Conclusions and Clinical Importance This study suggests that Pugs with thoracolumbar SAD do not have a favorable long‐term prognosis after surgical treatment for reasons yet to be determined.
Collapse
Affiliation(s)
- Neringa Alisauskaite
- Department of Small Animal Surgery, Neurology Service, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | | | | | | | - Giunio Bruto Cherubini
- Dick White Referrals, Neurology and Neurosurgery Service, Six Mile Bottom, Cambridgeshire, United Kingdom
| | | | - Frank Steffen
- Department of Small Animal Surgery, Neurology Service, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| |
Collapse
|
11
|
Rusbridge C, Stringer F, Knowler SP. Clinical Application of Diagnostic Imaging of Chiari-Like Malformation and Syringomyelia. Front Vet Sci 2018; 5:280. [PMID: 30547039 PMCID: PMC6279941 DOI: 10.3389/fvets.2018.00280] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Accepted: 10/22/2018] [Indexed: 12/18/2022] Open
Abstract
Chiari-like malformation (CM) and syringomyelia (SM) is a frequent diagnosis in predisposed brachycephalic toy breeds since increased availability of MRI. However, the relevance of that MRI diagnosis has been questioned as CM, defined as identification of a cerebellar herniation, is ubiquitous in some breeds and SM can be asymptomatic. This article reviews the current knowledge of neuroanatomical changes in symptomatic CM and SM and diagnostic imaging modalities used for the clinical diagnosis of CM-pain or myelopathy related to SM. Although often compared to Chiari type I malformation in humans, canine CM-pain and SM is more comparable to complex craniosynostosis syndromes (i.e., premature fusion of multiple skull sutures) characterized by a short skull (cranial) base, rostrotentorial crowding with rostral forebrain flattening, small, and ventrally orientated olfactory bulbs, displacement of the neural tissue to give increased height of the cranium and further reduction of the functional caudotentorial space with hindbrain herniation. MRI may further reveal changes suggesting raised intracranial pressure such as loss of sulci definition in conjunction with ventriculomegaly. In addition to these brachycephalic changes, dogs with SM are more likely to have craniocervical junction abnormalities including rostral displacement of the axis and atlas with increased odontoid angulation causing craniospinal junction deformation and medulla oblongata elevation. Symptomatic SM is diagnosed on the basis of signs of myelopathy and presence of a large syrinx that is consistent with the neuro-localization. The imaging protocol should establish the longitudinal and transverse extent of the spinal cord involvement by the syrinx. Phantom scratching and cervicotorticollis are associated with large mid-cervical syringes that extend to the superficial dorsal horn. If the cause of CSF channel disruption and syringomyelia is not revealed by anatomical MRI then other imaging modalities may be appropriate with radiography or CT for any associated vertebral abnormalities.
Collapse
Affiliation(s)
- Clare Rusbridge
- Fitzpatrick Referrals, Godalming, United Kingdom.,School of Veterinary Medicine, Faculty of Health & Medical Sciences, University of Surrey, Guildford, United Kingdom
| | | | - Susan P Knowler
- School of Veterinary Medicine, Faculty of Health & Medical Sciences, University of Surrey, Guildford, United Kingdom
| |
Collapse
|
12
|
Alcoverro E, McConnell JF, Sanchez-Masian D, De Risio L, De Decker S, Gonçalves R. Late-onset recurrence of neurological deficits after surgery for spinal arachnoid diverticula. Vet Rec 2018; 182:380. [DOI: 10.1136/vr.104579] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 11/28/2017] [Accepted: 11/29/2017] [Indexed: 12/20/2022]
Affiliation(s)
- Emili Alcoverro
- Institute of Veterinary Science, Small Animal Teaching Hospital, University of Liverpool; Neston UK
| | - James Fraser McConnell
- Institute of Veterinary Science, Small Animal Teaching Hospital, University of Liverpool; Neston UK
| | - Daniel Sanchez-Masian
- Institute of Veterinary Science, Small Animal Teaching Hospital, University of Liverpool; Neston UK
| | - Luisa De Risio
- Department of Neurology and Neurosurgery; The Animal Health Trust; Suffolk UK
| | - Steven De Decker
- Department of Clinical Science and Services; Royal Veterinary College, University of London; Hatfield UK
| | - Rita Gonçalves
- Institute of Veterinary Science, Small Animal Teaching Hospital, University of Liverpool; Neston UK
| |
Collapse
|
13
|
de Nies KS, Edwards RA, Bergknut N, Beukers M, Meij BP. Caudal lumbar spinal cysts in two French Bulldogs. Acta Vet Scand 2018; 60:14. [PMID: 29490674 PMCID: PMC5831591 DOI: 10.1186/s13028-018-0368-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Accepted: 02/23/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Spinal cysts are rare findings in veterinary medicine, but they are increasingly recognized due to the availability of advanced imaging techniques. Extradural meningeal cysts in French Bulldogs have not been reported previously and arachnoid cysts (diverticula) have not been reported at the caudal lumbar (L6-L7) region in dogs. CASE PRESENTATION Two French Bulldogs, aged 5 and 8 years, were referred for evaluation of lower back pain and bilateral hind limb neurological deficits. Neurologic examination revealed ataxia and postural deficits in both dogs. Magnetic resonance imaging (MRI) showed cauda equina compression due to a cyst-like lesion at the level of L6-L7 in both cases. The dogs underwent dorsal laminectomy and the meningeal cyst was completely removed in one dog and in the other dog the spinal arachnoid diverticula was marsupialized. In Case 1, histopathology of the cysts was performed and MRI was repeated. Both dogs were pain free during follow-up evaluations. CONCLUSIONS Based on radiological, intra-operative and histopathological findings, the first case was diagnosed as a meningocele connected by a pedicle to the caudal tip of the dural sac forming a dural diverticulum categorized as an extradural spinal cyst type Ib, and Case 2 as a type III intradural arachnoid diverticula. It is concluded that spinal cysts should be included in the differential diagnosis of cauda equina syndrome and lower back pain in French Bulldogs. Results of these cases may be useful for diagnostic and treatment management.
Collapse
|
14
|
Rohdin C, Jäderlund KH, Ljungvall I, Lindblad-Toh K, Häggström J. High prevalence of gait abnormalities in pugs. Vet Rec 2018; 182:167. [PMID: 29437993 PMCID: PMC5870464 DOI: 10.1136/vr.104510] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Revised: 09/22/2017] [Accepted: 11/11/2017] [Indexed: 12/11/2022]
Abstract
The objective of this prospective study was to determine the prevalence of gait abnormalities in a cohort of Swedish pugs by using an owner-based questionnaire targeting signs of gait abnormality and video footage showing the dog’s gait. This study also evaluated associated conditions of abnormal gait, including other health disorders prevalent in the breed. Five hundred and fifty (550) pugs registered in the Swedish Kennel Club, of one, five and eight years of age, in 2015 and 2016, were included in the study. Gait abnormalities were reported in 30.7 per cent of the responses. In the majority of cases, the character of the described gait indicated a neurological cause for the gait abnormality. An association was observed between abnormal gait and age, with gait abnormalities being significantly more common in older pugs (P=0.004). An association was also found between abnormal gait and dyspnoea, with dyspnoea being significantly more common in pugs with gait abnormalities (P<0.0001). This study demonstrated that the prevalence of gait abnormalities was high in the Swedish pug breed and increased with age. Future studies on the mechanisms behind these gait abnormalities are warranted.
Collapse
Affiliation(s)
- Cecilia Rohdin
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden.,Anicura, Albano Animal Hospital, Danderyd, Sweden
| | - Karin Hultin Jäderlund
- Department of Companion Animal Clinical Sciences, Norwegian University of Life Sciences, Oslo, Norway
| | - Ingrid Ljungvall
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Kerstin Lindblad-Toh
- Department of Medical Biochemistry and Microbiology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden.,Broad Institute of Harvard and Massachusetts, Institute of Technology, Cambridge, MA, USA
| | - Jens Häggström
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| |
Collapse
|
15
|
Nagendran A, Rzechorzek N, Liuti T, Marioni-Henry K. What Is Your Neurologic Diagnosis? J Am Vet Med Assoc 2017; 250:1235-1238. [PMID: 28509638 DOI: 10.2460/javma.250.11.1235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
16
|
Mauler DA, De Decker S, De Risio L, Volk HA, Dennis R, Gielen I, Van der Vekens E, Goethals K, Van Ham L. Spinal Arachnoid Diverticula: Outcome in 96 Medically or Surgically Treated Dogs. J Vet Intern Med 2017; 31:849-853. [PMID: 28426173 PMCID: PMC5435043 DOI: 10.1111/jvim.14714] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Revised: 02/27/2017] [Accepted: 03/16/2017] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Little is reported about the role of medical management in the treatment of spinal arachnoid diverticula (SAD) in dogs. OBJECTIVES To describe the outcome of 96 dogs treated medically or surgically for SAD. ANIMALS Ninety-six dogs with SAD. METHODS Retrospective case series. Medical records were searched for spinal arachnoid diverticula and all dogs with information on treatment were included. Outcome was assessed with a standardized questionnaire. RESULTS Fifty dogs were managed medically and 46 dogs were treated surgically. Dogs that underwent surgery were significantly younger than dogs that received medical management. No other variables, related to clinical presentation, were significantly different between both groups of dogs. The median follow-up time was 16 months (1-90 months) in the medically treated and 23 months (1-94 months) in the surgically treated group. Of the 38 dogs treated surgically with available long-term follow-up, 82% (n = 31) improved, 3% (n = 1) remained stable and 16% (n = 6) deteriorated after surgery. Of the 37 dogs treated medically with available long-term follow-up, 30% (n = 11) improved, 30% (n = 11) remained stable, and 40% (n = 15) deteriorated. Surgical treatment was more often associated with clinical improvement compared to medical management (P = .0002). CONCLUSIONS AND CLINICAL IMPORTANCE The results of this study suggest that surgical treatment might be superior to medical treatment in the management of SAD in dogs. Further studies with standardized patient care are warranted.
Collapse
Affiliation(s)
- D A Mauler
- Veterinary Medical Teaching Hospital, College of Veterinary Medicine, University of Missouri, Columbia, MO
| | - S De Decker
- Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, Hertfordshire, UK
| | - L De Risio
- Centre for Small Animal Studies, Animal Health Trust, Newmarket, Suffolk, UK
| | - H A Volk
- Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, Hertfordshire, UK
| | - R Dennis
- Centre for Small Animal Studies, Animal Health Trust, Newmarket, Suffolk, UK
| | - I Gielen
- Department of Medical Imaging of Domestic Animals and Orthopedics of Small Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - E Van der Vekens
- Department of Medical Imaging of Domestic Animals and Orthopedics of Small Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - K Goethals
- Department of Comparative Physiology and Biostatistics, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - L Van Ham
- Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| |
Collapse
|
17
|
da Costa RC, Cook LB. Cystic Abnormalities of the Spinal Cord and Vertebral Column. Vet Clin North Am Small Anim Pract 2015; 46:277-93. [PMID: 26706913 DOI: 10.1016/j.cvsm.2015.10.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Cystic lesions of the vertebral column and spinal cord are important differential diagnoses in dogs with signs of spinal cord disease. Synovial cysts are commonly associated with degenerative joint disease and usually affect the cervical and lumbosacral regions. Arachnoid diverticulum (previously known as cyst) is seen in the cervical region of large breed dogs and thoracolumbar region of small breed dogs. This article reviews the causes, diagnosis, and treatment of these and other, less common, cystic lesions.
Collapse
Affiliation(s)
- Ronaldo C da Costa
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210-1089, USA.
| | - Laurie B Cook
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210-1089, USA
| |
Collapse
|
18
|
Lobacz MA, Gutierrez Crespo BT, Philbey AW, Hammond G. Lumbar subarachnoid diverticulum secondary to a sarcoma in the sacral canal of a dog. VETERINARY RECORD CASE REPORTS 2015. [DOI: 10.1136/vetreccr-2015-000205] [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)
- Monika Anna Lobacz
- Department of Diagnostic ImagingSchool of Veterinary MedicineUniversity of GlasgowSmall Animal HospitalGlasgowUK
| | | | - Adrian W Philbey
- Department of Easter Bush PathologyRoyal (Dick) School of Veterinary StudiesEdinburghUK
| | - Gawain Hammond
- Department of Diagnostic ImagingSchool of Veterinary MedicineUniversity of GlasgowSmall Animal HospitalGlasgowUK
| |
Collapse
|