Intramedullary Spinal Cord Neoplasia in 53 Dogs (1990-2010): Distribution, Clinicopathologic Characteristics, and Clinical Behavior

Multivariable Analysis of the Association Between Lumbar and Lumbosacral MRI-Diagnosed Spinal Pathologies and Pain in Dogs

Lumbar and lumbosacral pain in dogs often involves multiple concurrent spinal pathologies, complicating the identification of primary pain generators. This study assessed the associations between MRI-diagnosed spinal pathologies and pain to provide clinically relevant insights for their diagnosis and management. MRI scans and clinical records of 518 client-owned dogs were retrospectively reviewed, documenting demographic data, pain status, and MRI findings. Multivariable logistic regression models evaluated the associations between spinal pathologies and pain, adjusting for age and weight. The intervertebral disc (IVD) extrusion was the primary pathology associated with lumbar pain, while radiculopathy had the strongest association with lumbosacral pain. Additional lumbosacral pathologies, including foraminal stenosis, IVD bulging, and IVD protrusion, were also significantly associated with pain. However, some dogs with MRI-diagnosed abnormalities showed no pain, whereas others with pain had no detectable MRI pathology, underscoring the need to interpret imaging within the clinical context. Pain responses observed during physical examination often overlapped between spinal and hip conditions, complicating diagnostic accuracy. These findings emphasise the importance of integrating imaging, clinical assessment, and targeted diagnostic techniques to improve pain localisation and treatment decisions, providing veterinarians with valuable data to refine the management of lumbar and lumbosacral pain in dogs.

MRI findings in six dogs with ependymoma of the brain and spinal cord

There are few published descriptions of the MRI appearance of canine intracranial or spinal cord ependymoma. In this multicenter, retrospective, secondary analysis, case series study, three veterinary radiologists independently reviewed and recorded imaging characteristics of MRI studies in six dogs with histopathologically confirmed ependymoma (three intracranial and three spinal cord cases). A consensus was reached when there was disagreement on specific features. All intracranial ependymomas had forebrain location, heterogeneous signal intensity in T1-weighted (T1W) and T2-weighted (T2W) images, heterogeneous contrast enhancement, and hyperintensity in T2W images. Two ependymomas had an intraventricular location; one was intra-axial. Other imaging features included intralesional cyst-like structures, intralesional hemorrhage, and perilesional edema. Dogs with spinal cord ependymoma had intramedullary lesions located in the cervical or thoracic spinal cord. Spinal cord ependymomas were isointense and homogeneous in T1W images and hyperintense in T2W images. Lesion location relative to the central canal of the spinal cord was variable. All three spinal cord ependymomas had perilesional T2W hyperintensity and moderate, heterogeneous contrast enhancement. None of the spinal cord ependymomas had intralesional cyst-like structures. One spinal cord ependymoma had evidence of drop metastases (diffuse, leptomeningeal). MRI features of canine ependymomas overlap with those of other diseases of the brain and spinal cord. Ependymoma should be considered a differential diagnosis for dogs with intraventricular, intra-axial forebrain, or intramedullary spinal cord masses.

Clinical presentation and magnetic resonance imaging findings of a spinal cord ganglioglioma in a 7.5-year-old, male, neutered German shepherd dog

A dog presented with a 1-month history of left-sided hemiparesis. MRI showed a focal, 4-cm-long, symmetrical, ovoid, poorly demarcated intramedullary expansion at C6-C7 that was T2-weighted hyperintense, T1-weighted isointense, and noncontrast enhancing. After clinical progression and euthanasia, pathology revealed a neoplasm composed of astrocytes and dysmorphic neurons, consistent with a ganglioglioma. The diagnosis was confirmed with immunohistochemistry and transmission electron microscopy, which demonstrated electron-dense granules in the perikaryon. Gangliogliomas are rare, benign neoplasms that may present as intramedullary spinal cord neoplasia. This is the first report on the clinical presentation, imaging, and pathology of a canine spinal ganglioglioma.

Combined forequarter amputation and hemilaminectomy for treatment of canine peripheral nerve sheath tumors of the brachial plexus invading the spinal canal: Surgical technique and outcome in nine dogs

OBJECTIVE

The aim of the study was to describe the surgical technique and outcome of a combined forequarter amputation and hemilaminectomy (FAHL) for excision of canine peripheral nerve sheath tumors (PNSTs) of the brachial plexus extending into the vertebral canal.

STUDY DESIGN

Retrospective case series.

ANIMALS

Nine client-owned dogs.

METHODS

Dogs which underwent FAHL for resection of a brachial plexus PNST extending into the vertebral canal were included. Data from medical records including signalment, clinical findings, MRI data, histopathology reports, interval between appearance of the clinical signs and surgical intervention, affected spinal nerves and nerve roots, time to ambulate postoperatively, survival time, tumor grade and completeness of surgical margins were collected.

RESULTS

In seven of nine cases the PNST affected the eighth cervical nerve root. Five of the nine cases were ambulatory within the first 3 days postoperatively and in one case unassisted ambulation was delayed and achieved 28 days postoperatively. The median survival time was calculated to be 317 days and the mean 522 days (range 120-1620 days). Four of nine dogs were euthanized 120, 270, 306 and 317 days postoperatively, because of suspected tumor recurrence. In one of those four cases the histological margins were reported as complete.

CONCLUSION

FAHL appeared to be a reliable technique for excision of PNSTs of the brachial plexus invading the spinal canal, with similar outcomes to previously reported for PNSTs not extending into the vertebral canal.

Clinical, magnetic resonance imaging, histopathological features, treatment options and outcome of spinal ependymoma in dogs: 8 cases (2011-2022)

OBJECTIVES

This study aims to report on the clinical magnetic resonance imaging, histological features, treatment options and outcomes of spinal ependymomas in dogs.

MATERIALS AND METHODS

Retrospective evaluation of medical records from dogs histologically confirmed spinal ependymomas with clinical presentations, magnetic resonance imaging findings, histological aspects, treatment options and outcomes.

RESULTS

Eight dogs presented with acute to subacute onset of para- or tetraparesis. Magnetic resonance imaging findings included intramedullary oval-shaped space-occupying lesions that appeared hyperintense on T2-weighted images isointense on T1-weighted images and exhibited marked homogeneous or ring contrast enhancement. A peculiar feature, previously described only in human ependymomas, was observed in three patients - a T2-weighted hypointense rim, termed hemosiderin cap sign. Haematomyelia with necrotic foci was observed in one dog. Surgery, when performed, enabling a definitive intra-vitam diagnosis. Histological examination revealed that rosettes and pseudo-rosettes as disposition of neoplastic cells were the most common features reported. Furthermore, cerebrospinal fluid metastases were identified in one case.

CLINICAL SIGNIFICANCE

Clinical and histopathological findings in our case series were consistent with those previously reported in the literature. Magnetic resonance imaging features were fairly typical and highly suggestive of spinal ependymomas. The hemosiderin cap sign may aid in the presumptive intra-vitam diagnosis of these rare spinal tumours. Additionally, we described cerebrospinal fluid spread of neoplastic cells and subsequent multifocal or metastasis presentations. Surgery offered a dual benefit by facilitating intra-vitam diagnosis and, in some cases, extending survival time.

Malignant transformation of an intraparenchymal hemangioma in the cervical spinal cord of a German shepherd dog

An 8-year-old female spayed German shepherd dog was presented for evaluation of a 1-week history of right thoracic limb monoparesis. Magnetic resonance imaging (MRI) identified an intraparenchymal, T2 hypointense and T1 isointense, strongly heterogeneously contrast-enhancing mass with moderate internal susceptibility artifact on T2* images at the level of the cranial extent of the C5 vertebral body. Euthanasia was elected after a rapid neurologic decline in the 24 hours after MRI. Necropsy and histopathology identified an intraparenchymal hemangiosarcoma arising from a hemangioma in the cervical spinal cord, with no evidence of neoplastic disease in any other examined organs. The spectrum of vasoproliferative disorders in the central nervous system in veterinary species has been codified recently, but hemangiosarcoma is considered metastatic to the central nervous system. Herein we describe the clinical, imaging, and histologic findings in a dog with a novel primary location of hemangiosarcoma in the cervical spinal cord.

Prevalence of neurological diseases associated with cervical pain and/or signs of cervical myelopathy in French bulldogs: a retrospective analysis of 105 cases

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.

Common Neurologic Diseases in Geriatric Dogs

The increase in the canine geriatric population means that veterinarians are more often confronted with diseases that are more prevalent in patients in this age group. As in other organ systems, degenerative, neoplastic, and vascular diseases are the most prevalent neurologic disorders in older dogs. A neurological disease in an older dog poses a challenge for the clinician due to the presence of concomitant diseases and age-related changes that make it difficult to interpret the neurological examination. In addition, given the age of the patients, some owners do not allow advanced imaging tests, and it is necessary to establish the most likely presumptive diagnosis to initiate treatment. Although many of these diseases can cause clinical signs that can be very upsetting, some of them can be managed with symptomatic therapy and have a good prognosis, such as idiopathic vestibular syndrome. Moreover, advances in and the greater availability of therapeutic options such as surgery and radiation therapy may increase survival and quality of life in diseases with a more serious prognosis, such as tumours. The aim of this review is to summarize the clinical presentation, diagnosis, and treatment of the more frequent diseases affecting the central nervous systems of geriatric dogs.

Case report: Magnetic resonance imaging features with postoperative improvement of atypical cervical glioma characterized by predominant extramedullary distribution in a dog

Introduction

Intramedullary cord tumors present diagnostic and therapeutic challenges. Furthermore, spinal cord tumors can move across compartments, making antemortem diagnosis difficult, even with advanced imaging. This report presents a rare case of a cranial cervical spinal glioma, confirmed by surgical histopathology, with postoperative improvement in a dog.

Case description

A 9-year-old female Maltese dog presented with kyphotic posture, progressive left hemiparesis, and decreased appetite. Neurological examination revealed neck pain and decreased proprioception in the left limbs along with intact deep pain perception. Two days later, the patient developed non-ambulatory tetraparesis. Magnetic resonance imaging (MRI) revealed an ovoid, well-defined mass with homogeneously marked contrast enhancement in the second cervical spinal cord that severely compressed the spinal cord. This mass was heterogeneously hyperintense on T2-weighted images and iso-to-hypointense on T1-weighted images, showing an appearance resembling the "golf-tee" and "dural tail" signs. The MRI findings suggested an intradural extramedullary tumor. Intraoperatively, a well-demarcated mass which was locally adherent to the spinal meninges was removed. Both histopathological and genomic tumor tests were indicative of a glioma. Approximately 2 weeks postoperatively, the patient's neurological signs returned to normal.

Conclusion

This case report describes an atypical cervical glioma with complicated MR characteristics in a dog, where MRI helped guide surgical intervention.

Case report: Traumatic hemorrhagic cervical myelopathy in a dog

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.

Spinal cord haemangiosarcoma in one dog - Case report

A 5-year-old intact female Shih Tzu was presented with acute onset of hind leg paralysis. The neurologic examination revealed severe T3-L3 myelopathy. The differential diagnoses included degenerative, anomalous, traumatic, inflammatory, vascular, metabolic, and neoplastic changes. The results of the paraclinical examinations and diagnostic imaging narrowed the list of differential diagnoses and, along with the patient's deteriorating condition, led to the owner's decision to euthanise the dog. The histologic findings of the spinal cord specimens indicated a tumour of the blood vessels formed by the proliferation of endothelial cells, which may present as either capillary or cavernous structures. In this case, the tumour was a capillary-type haemangiosarcoma. The primary site of proliferation could not be determined in this case because no mass formation was noted while performing the necropsy.

Surgical management of a metastatic vertebral tumour originating from a mammary adenocarcinoma in a dog

An 11-year-old spayed female Toy Poodle presented with acute tetraparesis. A small subcutaneous mass was found in the right trunk region, and the magnetic resonance revealed a compressive spinal cord lesion due to an irregular bone proliferation at the third cervical vertebra. After surgical resection of the vertebral lesion, the neurological symptoms improved, and the patient could walk on her own. The excised vertebral and subcutaneous masses were diagnosed as a mammary adenocarcinoma on the histopathological examination, with Ki-67 and HER-2 immunohistochemistry staining. This case report highlights the importance of defining the primary tumours of metastatic vertebral tumours and the necessity of palliative surgery to improve the patient's quality of life.

Presumptive Haematomyelia Secondary to Warfarin Toxicosis in a Dog

A 3-year-old male entire Boxer was presented for a 6-day history of progressive symmetric nonambulatory tetraparesis with diffuse spinal hyperesthesia. Eight days prior to admission, the dog ingested warfarin accidentally, exhibiting systemic clinical signs of intoxication 2 days later. Upon referral, the dog was nonambulatory with paretic thoracic limbs and plegia with absent nociception on pelvic limbs, spinal reflexes were decreased to absent in all four limbs, and urinary and faecal incontinence were noticed. Magnetic resonance imaging (MRI) of the cervical, thoracic, and lumbar regions of the vertebral column revealed intramedullary lesions extending from the first cervical segments to the conus medullaris consistent with extensive intramedullary haemorrhages. Despite management with vitamin K1 and physiotherapy, 6 weeks later, improvement was limited to thoracic limb motor function, and euthanasia was elected. This case reports an extensive presumptive haematomyelia with severe neurological deficits suspected to be secondary to warfarin intoxication in a dog.

Central cord syndrome: clinical features, etiological diagnosis, and outcome in 74 dogs

OBJECTIVE

To describe the clinical and neurologic signs, diagnostic investigations, definitive or presumptive diagnosis, treatment, and outcome of dogs presented with acute onset central cord syndrome (CCS).

ANIMALS

74 client-owned dogs evaluated for CCS at 5 referral hospitals between January 2016 and March 2021.

PROCEDURES

Data were collected from the medical records of each dog, including patient signalment, physical and neurologic examination results, presence of signs of respiratory failure, diagnostic imaging findings, definitive or presumptive diagnosis, treatment and follow-up information. Descriptive statistics were calculated and bivariable analysis was performed to identify associations between selected variables.

RESULTS

2 neuroanatomic locations for the CCS were identified: C1-C5 spinal cord segments in 65 of 74 (88%) dogs and C6-T2 in 9 (12%) dogs. Neurolocalization did not correlate with the imaging findings in 43 (58%) dogs. Different diseases were associated with CCS. The most common condition was Hansen type I disk herniation in 27 (36%) dogs and hydrated nucleus pulposus extrusion in 16 (22%) dogs. Main lesion locations within the vertebral column associated with CCS were C3-C4 and C4-C5 intervertebral disk spaces in 21 (28%) and 18 (24%) dogs, respectively. Outcome was favorable in 69 (93%) dogs. Patients presenting with hypoventilation were 14.7 times more likely to have a poor outcome.

CLINICAL RELEVANCE

CCS in dogs may be seen with lesions in the C1-C5 and C6-T2 spinal cord segments. Etiologies are variable. Total or partial improvement was achieved in most dogs with the appropriate treatment. Hypoventilation was associated with death.

Magnetic resonance imaging findings and antemortem cytologic diagnosis of intramedullary spinal cord ependymoma in a dog

CASE DESCRIPTION

A 3-year-old 31.1-kg castrated male mixed-breed dog was evaluated because of a 1- to 2-week history of paraparesis, knuckling of the hind feet, and difficulty posturing to urinate or defecate.

CLINICAL FINDINGS

The dog was paraparetic but weakly ambulatory with a kyphotic posture, a mildly decreased patellar reflex in the right pelvic limb, increased tone in both pelvic limbs, and marked hyperesthesia on paraspinal palpation of the lumbar region. The urinary bladder was enlarged and firm on palpation. Neuroanatomic findings were primarily consistent with localization to the T3-L3 spinal cord segments. Magenetic resonance imaging of the thoracolumbar spinal column revealed a discrete intramedullary spinal cord mass from the cranial aspect of L4 to the middle of L5. The mass was sampled by fine-needle aspiration, and on cytologic evaluation, the suspected diagnosis was an ependymoma.

TREATMENT AND OUTCOME

Owing to poor prognosis and limited treatment options, the owner elected euthanasia. Postmortem examination of the spinal cord and histologic findings for samples of the mass supported a likely diagnosis of ependymoma.

CLINICAL RELEVANCE

Ependymoma is a rare neoplasm in dogs but should be considered in young patients with evidence of a tumor in the CNS. Fine-needle aspiration of the spinal cord mass was possible in the dog of this report, and the cytologic findings provided useful diagnostic information.

MRI features of canine hemangiosarcoma affecting the central nervous system

Hemangiosarcoma is the most common metastatic tumor involving the brain in dogs but detailed published descriptions of the magnetic resonance imaging (MRI) features are lacking. The objective of this multi-center, retrospective case series study was to describe MRI characteristics of canine hemangiosarcoma affecting the central nervous system (CNS). Medical records of seven referral institutions were retrospectively reviewed. Dogs were included if they had a histopathologically confirmed diagnosis of hemangiosarcoma affecting the CNS and undergone an MRI of the brain and/or vertebral column. Lesions were independently evaluated by two observers. Twenty dogs met the inclusion criteria and one dog had both intracranial and intramedullary hemangiosarcoma. Consistent MRI features included heterogeneous (17/21) lesions in all sequences with mainly mixed signal intensity (12/21), presence of susceptibility artifact on T2*w (15/16), associated moderate to severe perilesional edema (21/21), and moderate to strong (20/21) heterogeneous (14/21) or ring-like (6/21) contrast enhancement. Intracranial hemangiosarcoma was frequently multiple and intra-axial, affecting consistently the telencephalon and no differences in MRI features were found between primary and metastatic hemangiosarcoma. This is the first MRI description of primary intracranial hemangiosarcoma and primary intracranial epithelioid hemangiosarcoma. Vertebral hemangiosarcomas were segmental poorly marginated polyostotic and highly aggressive lesions invading the thoracic vertebral canal and paraspinal tissues. Epidural hemangiosarcomas were single and well-marginated lesions in the thoracolumbar and/or lumbar region. Intramedullary hemangiosarcomas were cervical, metastatic in origin, and frequently (3/4) accompanied by intracranial lesions. These described MRI features will aid early identification of hemangiosarcoma guiding subsequent diagnostics and therapeutics.

Agreement and differentiation of intradural spinal cord lesions in dogs using magnetic resonance imaging

Background

Magnetic resonance imaging is the method of choice for diagnosing spinal cord neoplasia, but the accuracy of designating the relationship of a neoplasm to the meninges and agreement among observers is unknown.

Objectives

To determine agreement among observers and accuracy of diagnosis compared with histology when diagnosing lesion location based on relationship to the meninges.

Animals

Magnetic resonance images from 53 dogs with intradural extramedullary and intramedullary spinal neoplasms and 17 dogs with degenerative myelopathy.

Methods

Six observers were supplied with 2 sets of 35 images at different time points and asked to designate lesion location. Agreement in each set was analyzed using kappa (κ) statistics. We tabulated total correct allocations and calculated sensitivity, specificity, and likelihood ratios for location designation from images compared with known histologic location for lesions confined to 1 location only.

Results

Agreement in the first set of images was moderate (κ = 0.51; 95% confidence interval [CI], 0.43‐0.58) and in the second, substantial (κ = 0.69; 95% CI, 0.66‐0.79). In the accuracy study, 180 (75%) of the 240 diagnostic calls were correct. Sensitivity and specificity were moderate to high for all compartments, except poor sensitivity was found for intradural extramedullary lesions. Positive likelihood ratios were high for intradural extramedullary lesions and degenerative myelopathy.

Conclusions and Clinical Importance

Overall accuracy in diagnosis was reasonable, and positive diagnostic calls for intradural extramedullary lesions and negative calls for intramedullary lesions are likely to be helpful. Observers exhibited considerable disagreement in designation of lesions relationship to the meninges.

Magnetic Resonance Imaging Features of Extradural Spinal Neoplasia in 60 Dogs and Seven Cats

This retrospective study describes the MRI features of extradural spinal neoplasia in 60 dogs and seven cats to identify potential distinguishing features between tumor classes and individual tumor types within each class. In dogs, mesenchymal tumors were most common (48%), with undifferentiated sarcomas being the predominant tumor type. Round cell neoplasms were second most common (35%), with lymphoma and multiple myeloma/plasma cell tumor comprising the majority of cases. Only two benign tumors were identified. In cats, lymphoma was most common (5/7), with one case of mesenchymal neoplasia and one case of metastatic carcinoma. Despite some overlap, certain imaging features were able to help prioritize differential diagnoses. The combined features that predicted round cell neoplasia (84%) included the preservation of vertebral shape, homogeneous contrast enhancement, and lesion centering on bone. The combined features that predicted mesenchymal neoplasia (73%) included altered vertebral shape, heterogeneous contrast enhancement, and lesion centering on paraspinal soft tissues. Round cell neoplasms were more likely to have cortical sparing, preservation of overall shape, lesion centering on bone, small soft tissue tumor size, and homogeneous contrast enhancement. Both epithelial and mesenchymal neoplasms were more likely to have cortical lysis, a cavitary component to the soft tissue mass and medium to large soft tissue mass size. The findings of this study can aid in prioritizing differential diagnoses in cases of extradural spinal neoplasia in cats and dogs, which can impact case management, but tissue sampling remains the gold standard for definitive diagnosis.

Clinical reasoning in canine cervical hyperaesthesia: which presenting features are important?

BACKGROUND

To evaluate whether clinical features from the history, presentation, physical and neurological examination of dogs with cervical hyperaesthesia are statistically predictive of the underlying diagnosis.

METHODS

Two hundred and ninety-eight dogs presenting with cervical hyperaesthesia between January 2010 and October 2018 were investigated. Only neurologically normal dogs with cervical hyperaesthesia on examination were included, while those with concurrent neurological deficits including gait abnormalities and proprioceptive deficits were excluded. Univariate analysis of clinical variables was performed, and those associated with each diagnosis were retained for multivariable binary logistic regression models.

RESULTS

Ninety-five per cent of cervical hyperaesthesia presentations were represented by eight conditions that included steroid-responsive meningitis arteritis (SRMA; n=100), intervertebral disc extrusion (n=78), syringomyelia (SM; n=51), intervertebral disc protrusion (n=30), neoplasia (n=8), cervical spondylomyelopathy (n=7), immune-mediated polyarthritis (n=5) and meningoencephalomyelitis of unknown aetiology (n=5). Younger age (P=0.003), pyrexia (P=0.003) and haematology abnormalities (P=0.03) comprising leucocytosis, neutrophilia or monocytosis were associated with a diagnosis of SRMA.

CONCLUSIONS

Easy-to-recognise clinical features can be used to identify the most likely differential diagnosis in neurologically normal dogs with cervical hyperaesthesia, which may aid the decision making of veterinary surgeons evaluating dogs with this presentation.

Magnetic Resonance Imaging Findings in 13 Neurologic Pot-Bellied Pigs

This study reports the magnetic resonance imaging (MRI) findings in 13 pot-bellied pigs presented to our institution with neurological deficits. Nine pigs had abnormal MRI findings (7 with spinal cord localization and 2 with brain localization), with three of them having histopathological confirmation of the diagnoses. MRI diagnoses included a myopathy suspected to be secondary to Erysipelothrix rhusiopathiae, a round cell neoplasia involving the vertebral canal, myelomalacia, a cervical cyst like extradural lesion, pelvic fracture with secondary cauda equina involvement, two cases of fibrocartilaginous embolism or acute non-compressive nucleus pulposus extrusion, multifocal brain infarcts, and a cystic fourth ventricle dilation resulting in obstructive hydrocephalus and syringomyelia. Four pigs had normal MRI studies, with one of them ultimately diagnosed with idiopathic vestibular disease. This retrospective study illustrates the wide variety of diagnoses achieved with MRI of the head or vertebral column in pigs, several of them having never been described in this species. Some of the conditions identified had a good outcome. This justifies using MRI as an ante-mortem diagnostic tool as it can provide relevant information about the prognosis which can significantly influence treatment recommendations. Our findings suggest that MRI should be considered as a valuable imaging modality, when feasible, in pigs with neurological deficits.

Remission after complete excision of an intramedullary hemangioma with an identifiable tumor plane in a dog

OBJECTIVE

To describe the use of an identifiable tumor plane (ITP) during myelotomy to excise an intramedullary hemangioma in a dog and report the outcome.

STUDY DESIGN

Case report.

ANIMALS

One 5.5-year-old 42.9-kg spayed female Leonberger dog.

METHODS

Clinical signs included progressive proprioceptive deficits of both pelvic limbs. Magnetic resonance imaging was consistent with a dorsal intramedullary mass at L3-L4. A laminectomy of the third and fourth lumbar vertebrae provided access for dorsal myelotomy. A clear surgical ITP was identified between the intramedullary mass and the spinal cord facilitating complete surgical resection.

RESULTS

Histopathological examination was consistent with a hemangioma. Postoperative MRI was consistent with complete excision of the mass. No evidence of recurrence was found by MRI at 3 months and at 22 months after surgery. Mild proprioceptive deficits persisted in the right pelvic limb.

CONCLUSION

A clear ITP was present, and gross-total resection (GTR) was achieved without significant morbidity. Persistent clinical remission resulted from surgery as the sole therapy.

CLINICAL SIGNIFICANCE

For an intramedullary tumor, GTR is the absence of visible tumor on intraoperative inspection combined with the absence of intramedullary contrast enhancement on postoperative MRI. When an ITP is present, GTR and resultant long-term remission may be more likely.

Cervical hyperaesthesia in dogs: an epidemiological retrospective study of 185 cases

OBJECTIVES

To describe the prevalence, clinical findings and predictors of disease in dogs with cervical hyperaesthesia.

MATERIALS AND METHODS

Medical records of dogs referred for neurological investigation of cervical hyperaesthesia between 2009 and 2013 were retrospectively reviewed. Dogs were assigned to one of the following groups according to the final diagnosis: Non-Neurologic, Brain, Cervical Spine, Multifocal, and Chiari-like Malformation/Syringomyelia. Demographic data, clinical and neurological signs and laboratory findings were compared between groups using univariate analysis; predictors of disease location were assessed by multivariate analysis.

RESULTS

Final diagnostic allocations of the 185 records included in the study were as follows: 2.7% Non-Neurologic, 2.2% Brain, 63.2% Cervical Spine, 22.2% Multifocal and 9.7% Chiari Malformation/Syringomyelia. Intervertebral disc extrusion and steroid-responsive meningitis arteritis were the most common diseases. Compared to Multifocal dogs, those allocated a Cervical Spine diagnosis were older, heavier, more frequently ataxic and lame on a thoracic limb; furthermore, they were less frequently depressed or hyperthermic at presentation. Leucocytosis, neutrophilia and monocytosis were more frequent in dogs allocated a Multifocal diagnosis. Dogs with cervical hyperaesthesia older than 36 months and non-hyperthermic at presentation were more likely to have a lesion of the cervical region rather than a multi-focal disease.

CLINICAL SIGNIFICANCE

Although non-specific, these results may be useful to guide clinicians in management of dogs presenting with cervical hyperaesthesia. Animal age and body temperature may support the suspicion of either focal or multi-focal cervical spinal disease.

Feline glioma: a retrospective study and review of the literature

Case series summary This study aimed to evaluate the pathologic and diagnostic features of 13 cases of feline glioma diagnosed at two veterinary diagnostic institutions over 16 years. A retrospective search was conducted using the laboratory information system. Selected cases were reviewed, tumors were classified according to the 2007 World Health Organization Classification of Tumours of the Central Nervous System, and tissue sections were submitted to an immunohistochemistry panel for further characterization. Affected cats were adults (average age 8 years), and male neutered (9/13) domestic shorthair cats (12/13) were over-represented. Clinical signs had acute onset and were progressive, lasting from 1-60 days (average course 20.7 days). Euthanasia was elected in all but one case, owing to a poor prognosis or because of a suspicion of rabies. Tumors occurred in the telencephalon (8/13), spinal cord (3/13) and brainstem (2/13). Gross changes in seven cases consisted of well- or poorly demarcated, gray-to-brown, soft, gelatinous masses that often caused secondary changes to the brain. The final diagnosis and classification were made based on histopathology and immunohistochemistry. Diagnoses consisted of oligodendroglioma (six cases), anaplastic astrocytoma (two cases), oligoastrocytoma, anaplastic ependymoma, gliomatosis cerebri, glioblastoma and anaplastic oligodendroglioma (one case each). Relevance and novel information This article confirms the need for a full neurologic and neuropathologic examination in cats with clinical neurologic disease. In addition, it highlights and proposes a complete routine immunohistochemical panel for diagnostic confirmation and differentiation between glioma and other morphologically similar central nervous system neoplasms in cats.

Imaging and surgical outcomes of spinal tumors in 18 dogs and one cat

Clinical and magnetic resonance imaging (MRI) findings, histological appearances and surgical outcomes of 18 dogs and one cat with spinal tumors are presented. Medical records of the cases admitted for spinal disorders were reviewed, and cases of spinal tumors that were diagnosed by MRI and confirmed by histological examination were included in this study. T1 weighted, T2 weighted and contrast enhanced T1 weighted images were taken and interpreted to evaluate the spinal tumors. The tumors were diagnosed as: meningioma (n = 6), ependymoma (n = 1), nerve sheath tumor (n = 4), metastatic spinal tumor (n = 3), osteosarcoma (n = 2), osteoma (n = 1), rhabdomyosarcoma (n = 1), and nephroblastoma (n = 1). Thirteen cases underwent surgical operation and the remaining six cases were euthanized at the request of the owners. The neurological status of the surgical cases did not deteriorate, except for one dog that showed ependymoma in the early period after the operation. These results indicate the potential for surgical gross total tumor removal of vertebral tumors to provide better quality of life and surgical collection of histological specimens for definitive diagnosis. For effective case management, dedicated MRI examination is important to accurate evaluation of the spinal tumors, and surgical treatment is useful for extradural and intradural-extramedullary spinal tumors.

Canine spinal cord glioma

Spinal cord glioma is uncommonly reported in dogs. We describe the clinicopathologic and diagnostic features of 7 cases of canine spinal cord glioma and briefly review the veterinary literature on this topic. The median age at presentation was 7.2 y. Six females and 1 male were affected and 4 dogs were brachycephalic. The clinical course lasted from 3 d to 12 wk, and clinical signs were progressive and associated with multiple suspected neuroanatomic locations in the spinal cord. Magnetic resonance imaging of 6 cases revealed T2-weighted hyperintense lesions with variable contrast enhancement in the spinal cord. All dogs had a presumptive clinical diagnosis of intraparenchymal neoplasia or myelitis based on history, advanced imaging, and cerebrospinal fluid analysis. Euthanasia was elected in all cases because of poor outcome despite anti-inflammatory or immunosuppressive treatment or because of poor prognosis at the time of diagnosis. Tumor location during autopsy ranged from C1 to L6, with no clear predilection for a specific spinal cord segment. The diagnosis was based on histopathology and the immunohistochemistry expression of glial fibrillary acidic protein, oligodendrocyte lineage transcription factor 2, 2′,3′-cyclic-nucleotide 3′-phosphodiesterase, neuron-specific enolase, synaptophysin, and Ki-67. Diagnoses consisted of 4 cases of oligodendroglioma, 2 cases of gliomatosis cerebri, and 1 astrocytoma. This case series further defines the clinicopathologic features of canine spinal glioma and highlights the need for comprehensive immunohistochemistry in addition to routine histopathology to confirm the diagnosis of these tumors.

Optic nerve astrocytoma in a dog

Intracranial astrocytomas are relatively uncommon in dogs and optic nerve astrocytomas even more so. This neoplasm should be considered as differential in canine patients with vision loss, retinal detachment, ocular mass, and histopathologic findings of infiltrative fusiform to polygonal glial cells possibly associated with glomeruloid vascular proliferation.

IMAGING DIAGNOSIS-MAGNETIC RESONANCE IMAGING FEATURES OF A MULTIFOCAL OLIGODENDROGLIOMA IN THE SPINAL CORD AND BRAIN OF A DOG

An 8-year-old neutered male Toy Poodle was presented with chronic, progressive tetraparesis, and possible seizures. Magnetic resonance images demonstrated an extensive, T1 and T2 hyperintense contrast enhancing mass in the cervical spinal cord. Three nodules were present on the surface of the thalamus, with enhancement most evident on delayed images. A diagnosis of high-grade oligodendroglioma was confirmed with postmortem histopathology and immunohistochemical labeling. Oligodendroglioma should be considered as a differential for T1 hyperintense intraaxial or intramedullary lesions with contrast enhancement. If enhancement is not visualized on postcontrast images, delayed images may be beneficial.

Gemistocytic astrocytoma in the spinal cord in a dog: a case report

ABSTRACT This paper reports a case of a rare variant of the cervical spinal cord astrocytoma diagnosed in a dog with progressive neurological signs, initially asymmetrical, not ambulatory tetraparesis, segmental reflexes and normal muscle tone in all four limbs and absence of pain upon palpation of the cervical spine. Myelography revealed attenuation of the ventral and dorsal contrast line in the third region of the fifth cervical vertebra. At necropsy intramedullary cylindrical mass that stretched from the third to the sixth cervical vertebra, which replaced all the gray matter of the spinal cord was observed. In the histological study, there was the replacement of the substance by neoplastic cells mantle arranged loosely. The cells were large and slightly rounded. The eosinophilic cytoplasm was well defined, sometimes forming processes interconnecting cells. The nucleus was eccentric, round, oval or kidney-shaped, and the nucleolus was evident. Thus, the microscopic changes observed in the cervical spinal cord were consistent with gemistocytic astrocytoma.

The Spinal Ependymal Layer in Health and Disease

Ependymal cells are epithelial support cells that line the central canal and ventricular cavities of the central nervous system, providing the interface between the cerebrospinal fluid and the parenchyma of the brain and spinal cord. The spinal ependymal layer (SEL) is composed of 3 main cell types: tanycytes, ependymocytes, and cerebrospinal fluid-contacting neurons. A fourth cell type, termed the supraependymal cell, is also occasionally described. Cells of the SEL show restricted proliferative capacity in health but display neural stem cell properties both in vitro and in vivo in various disease states. A growing body of literature is devoted to the regenerative roles of the SEL, particularly in the context of spinal cord injury, where mechanical damage to the spinal cord leads to a significant increase in SEL proliferation. SEL-derived cell progeny migrate to sites of injury within the injured spinal cord parenchyma and contribute primarily to glial scar formation. In additional to their role as endogenous neural stem cells, cells of the SEL may be an important source of cytokines and other cell signaling molecules, such as tumor necrosis factor, heat shock proteins, and various growth factors. The SEL has become of recent interest to neuroscience researchers because of its potential to participate in and respond to diseases affecting the spinal cord (eg, traumatic spinal cord injury) and neurodegenerative disease. The intimate association of the SEL with the cerebrospinal fluid makes intrathecal therapies a viable option, and recent studies highlight the potential promise of treatments that augment SEL responses to disease.

Management of transitional cell carcinoma of the urinary bladder in dogs: a review

Transitional cell carcinoma (TCC), also referred to as urothelial carcinoma, is the most common form of urinary bladder cancer in dogs, affecting tens of thousands of dogs worldwide each year. Canine TCC is usually a high grade invasive cancer. Problems associated with TCC include urinary tract obstruction, distant metastases in >50% of affected dogs, and clinical signs that are troubling both to the dogs and to their owners. Risk factors for TCC include exposure to older types of flea control products and lawn chemicals, obesity, female sex, and a very strong breed-associated risk. This knowledge is allowing pet owners to take steps to reduce the risk of TCC in their dog. The diagnosis of TCC is made by histopathology of tissue biopsies obtained by cystoscopy, surgery, or catheter. Percutaneous aspirates and biopsies should be avoided due to the risk of tumor seeding. TCC is most commonly located in the trigone region of the bladder precluding complete surgical resection. Medical treatment is the mainstay for TCC therapy in dogs. Although TCC is not usually curable in dogs, multiple drugs have activity against it. Approximately 75% of dogs respond favorably to TCC treatment and can enjoy several months to a year or more of good quality life. Many promising new therapies for TCC are emerging and with the close similarity between TCC in dogs and high grade invasive bladder cancer in humans, new treatment strategies found to be successful in canine studies are expected to help dogs and to be subsequently translated to humans.