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Sparks CR, Woelfel C, Robertson I, Olby NJ. Association between filum terminale internum length and pain in Cavalier King Charles spaniels with and without syringomyelia. J Vet Intern Med 2021; 35:363-371. [PMID: 33426675 PMCID: PMC7848331 DOI: 10.1111/jvim.16023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 12/12/2020] [Accepted: 12/16/2020] [Indexed: 11/30/2022] Open
Abstract
Background Lumbar syringomyelia (SM), lumbosacral pain, and more caudal spinal cord termination are reported in Cavalier King Charles spaniels (CKCS). Data are lacking on the clinical relevance of alterations in their spinal cord terminal structures. Objectives To compare spinal cord termination level and filum terminale internum length (FTIL) with presence of lumbar SM and clinical signs in CKCS. Animals Forty‐eight CKCS. Methods In this prospective study, pain was quantified using owner and clinician assessments. Vertebral level of spinal cord and dural sac termination, presence of SM, and FTIL were determined from sagittal magnetic resonance imaging (MRI) sequences. Kappa and intraclass correlation (ICC) analyses determined interobserver reliability. The MRI findings were compared to owner and clinician‐reported pain quantification. Results Interobserver reliability was good for spinal cord and dural sac termination (kappa = 0.61 and 0.64, respectively) and excellent for FTIL (ICC: 92% agreement). The spinal cord terminated at 6th lumbar vertebra in 1, 7th lumbar vertebra in 31, and the sacrum in 15 dogs, and termination level was associated with lumbar SM (P = .002) but not clinical signs. Mean FTIL was 2.9 ± 1.08 mm; it was associated with owner‐reported pain (P = .033) and spinal palpation scores (P = .023). Painful CKCS without SM had shorter FTIL compared to normal CKCS and painful CKCS with SM (P = .02). Conclusions Painful CKCS without SM have decreased distance between the termination of the spinal cord and dural sac, suggesting a shorter FTIL. More caudal spinal cord termination is associated with development of lumbar SM.
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Affiliation(s)
- Courtney R Sparks
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Christian Woelfel
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Ian Robertson
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - Natasha J Olby
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA.,Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, USA
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2
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Zarzycki A, Thomas ZM, Mazrier H. Comparison of inherited neural tube defects in companion animals and livestock. Birth Defects Res 2020; 113:319-348. [PMID: 33615733 DOI: 10.1002/bdr2.1848] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 11/19/2020] [Accepted: 11/20/2020] [Indexed: 11/10/2022]
Abstract
Neural tube defects (NTDs) are congenital malformations resulting from the improper or incomplete closure of the neural tube during embryonic development. A number of similar malformations of the protective coverings surrounding the central nervous system are also often included under this umbrella term, which may not strictly fit this definition. A range of NTD phenotypes exist and have been reported in humans and a wide range of domestic and livestock species. In the veterinary literature, these include cases of anencephaly, encephalocele, dermoid sinus, spina bifida, and craniorachischisis. While environmental factors have a role, genetic predisposition may account for a significant part of the risk of NTDs in these animal cases. Studies of laboratory model species (fish, birds, amphibians, and rodents) have been instrumental in improving our understanding of the neurulation process. In mice, over 200 genes that may be involved in this process have been identified and variant phenotypes investigated. Like laboratory mouse models, domestic animals and livestock species display a wide range of NTD phenotypes. They remain, however, a largely underutilized population and could complement already established laboratory models. Here we review reports of NTDs in companion animals and livestock, and compare these to other animal species and human cases. We aim to highlight the potential of nonlaboratory animal models for mutation discovery as well as general insights into the mechanisms of neurulation and the development of NTDs.
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Affiliation(s)
- Alexandra Zarzycki
- Faculty of Science, School of Life and Environmental Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Zoe M Thomas
- Faculty of Science, Sydney School of Veterinary Science, The University of Sydney, Sydney, New South Wales, Australia
| | - Hamutal Mazrier
- Faculty of Science, School of Life and Environmental Sciences, The University of Sydney, Sydney, New South Wales, Australia.,Faculty of Science, Sydney School of Veterinary Science, The University of Sydney, Sydney, New South Wales, Australia
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3
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Occult tethered cord syndrome in the canine: Microsurgical resection of the filum terminale. INTERDISCIPLINARY NEUROSURGERY 2020. [DOI: 10.1016/j.inat.2020.100744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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4
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Martín Muñiz L, Del Magno S, Gandini G, Pisoni L, Menchetti M, Foglia A, Ródenas S. Surgical outcomes of six bulldogs with spinal lumbosacral meningomyelocele or meningocele. Vet Surg 2019; 49:200-206. [PMID: 31758707 DOI: 10.1111/vsu.13342] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 11/02/2018] [Accepted: 12/15/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To report the surgical treatment and outcome of six bulldogs with spina bifida (SB) and meningocele (MC) or meningomyelocele (MMC). STUDY DESIGN Case series. ANIMALS Five French bulldogs and one English bulldog with MC or MMC. METHODS Medical records of dogs with spinal MC or MMC diagnosed by MRI at two institutions between 2013 and 2016 were reviewed for surgical treatment and outcomes. RESULTS Meningocele was diagnosed in two dogs, and MMC was diagnosed in four dogs. A lumbosacral dimple was noted in all dogs along with neurological deficits most commonly consisting of urinary and fecal incontinence (n = 6) and mild/moderate paraparesis (n = 3). Dorsal laminectomy was performed in all dogs to allow dissection of the meningeal sac to the vertebral column defect. In dogs with MMC, nerves were repositioned and protruded meninges were removed prior to suturing remaining meninges. Adhesions and filum terminale were resected in two dogs with suspected tethered cord syndrome. Urinary and fecal incontinence improved in two dogs and remained unchanged in four. Paraparesis improved in two dogs. CONCLUSION Surgical treatment resulted in partial improvement of the urinary and fecal incontinence (2/6 dogs) and paraparesis (2/3 dogs) or stable neurological condition (3/6 dogs), with only minor temporary complications. CLINICAL SIGNIFICANCE In the absence of published data comparing surgical and conservative treatment of puppies affected by SB and MC or MMC, early surgical treatment can be considered to prevent deterioration of neurological signs and, eventually, facilitate improvement of neurological signs.
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Affiliation(s)
- Laura Martín Muñiz
- Fundació Hospital Clínic Veterinari, Autonomous University of Barcelona, Bellaterra, Spain
| | - Sara Del Magno
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, Italy
| | - Gualtiero Gandini
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, Italy
| | - Luciano Pisoni
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, Italy
| | - Marika Menchetti
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, Italy
| | - Armando Foglia
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, Italy
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5
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Worth A, Meij B, Jeffery N. Canine Degenerative Lumbosacral Stenosis: Prevalence, Impact And Management Strategies. VETERINARY MEDICINE (AUCKLAND, N.Z.) 2019; 10:169-183. [PMID: 31819860 PMCID: PMC6875490 DOI: 10.2147/vmrr.s180448] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 10/10/2019] [Indexed: 01/22/2023]
Abstract
Canine degenerative lumbosacral stenosis (DLSS) is a syndrome of low back pain with or without neurologic dysfunction associated with compression of the cauda equina. Most commonly occurring in medium- to large-breed dogs of middle to older age, German shepherd and working dogs are predisposed. Diagnosis is based on a combination of clinical signs, advanced imaging and ruling out other differential diagnoses. The volume of the intervertebral foramina at the lumbosacral junction is naturally reduced on extension but degenerative changes lead to a more marked reduction that can impinge the L7 nerve roots. Evidence is lacking on which to base decision-making for treatment of dogs with DLSS. However, surgical intervention may be indicated in dogs that do not respond to conservative management, or for dogs in which there is a requirement to work that prevents lifestyle adjustments. Improvements in electrodiagnosis and novel intra-discal treatments may improve the management of DLSS in the future.
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Affiliation(s)
- Andrew Worth
- Massey University Veterinary Teaching Hospital, School of Veterinary Science, Massey University, Palmerston North4442, New Zealand
| | - Björn Meij
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht3508 TD, The Netherlands
| | - Nicholas Jeffery
- Texas A&M Veterinary Medical Teaching Hospital, College Station, TX77845, USA
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6
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Khan Z, Munro E, Shaw D, Faller KM. Variation in the position of the conus medullaris and dural sac in adult dogs. Vet Rec 2019; 185:20. [PMID: 31092707 DOI: 10.1136/vr.105279] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 04/09/2019] [Accepted: 04/22/2019] [Indexed: 11/03/2022]
Abstract
Although it has long been stated that the level of spinal cord termination varies depending on the size of the dog, the evidence for this remains limited. The aim of this study is to investigate the position of the conus medullaris (CM) and dural sac (DS) in a population of dogs of varying size. MRIs of the thoracolumbosacral spine of 101 dogs were included. The location of CM and DS was determined on sagittal T2-weighted images and T1-weighted images, respectively, by three independent observers. The bodyweight and the back length were used as markers of size. Regression analysis showed that the termination point of the CM had a statistically significant relationship with bodyweight (R2=0.23, P<0.05). Although not statistically significant (P=0.058), a similar relationship was found between CM and back length (R2=0.21). No statistically significant relationship was found between the termination point of the DS and bodyweight (P=0.24) or back length (P=0.19). The study confirms the terminal position of the CM is dependent on size, with a more cranial position with increasing size; however, the termination point of DS remains constant irrespective of dog size.
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Affiliation(s)
- Zohra Khan
- Royal Dick School of Veterinary Studies, University of Edinburgh, Easter Bush, Midlothian, UK
| | - Elizabeth Munro
- Royal Dick School of Veterinary Studies, University of Edinburgh, Easter Bush, Midlothian, UK
| | - Darren Shaw
- Royal Dick School of Veterinary Studies, University of Edinburgh, Easter Bush, Midlothian, UK
| | - Kiterie Me Faller
- Royal Dick School of Veterinary Studies, University of Edinburgh, Easter Bush, Midlothian, UK
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7
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Kopke MA, Jack MW, Baltzer WI, Wightman PF, Gal A. Dermoid sinus type VI associated with spina bifida and tethered cord syndrome in a French Bulldog. J Vet Diagn Invest 2019; 31:294-297. [PMID: 30734666 PMCID: PMC6838840 DOI: 10.1177/1040638719827626] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
A 4-mo-old French bulldog was presented with acute onset pain and reluctance to move. A tubular structure arising in the dorsal thoracic midline and extending from a cutaneous orifice into deeper tissues was palpated on physical examination. Computed tomography with sinography revealed a dermoid sinus associated with spina bifida at the level of T3-T4. On surgical exploration, the dermoid sinus was found to communicate with the dura. Histology confirmed the diagnosis and classification as a type VI dermoid sinus. The pain response and hyperesthesia were suspected to be the result of tethered cord syndrome. Complete resolution of clinical signs was appreciated post-surgery, with the patient still free of clinical signs 3 mo later.
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Affiliation(s)
- Matthew A. Kopke
- School of Veterinary Science, Massey
University, Palmerston North, New Zealand
| | - Malcolm W. Jack
- School of Veterinary Science, Massey
University, Palmerston North, New Zealand
| | - Wendy I. Baltzer
- School of Veterinary Science, Massey
University, Palmerston North, New Zealand
| | - Paul F. Wightman
- School of Veterinary Science, Massey
University, Palmerston North, New Zealand
| | - Arnon Gal
- School of Veterinary Science, Massey
University, Palmerston North, New Zealand
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8
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Sparks CR, Robertson I, Olby NJ. Morphometric analysis of spinal cord termination in Cavalier King Charles Spaniels. J Vet Intern Med 2019; 33:717-725. [PMID: 30758868 PMCID: PMC6430917 DOI: 10.1111/jvim.15437] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 01/18/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND There is an association between Chiari malformations, syringomyelia (CMSM) and tethered cord syndrome (TCS) in people, suggesting Cavalier King Charles Spaniels (CKCS) with CMSM could also have TCS. Currently there are no data on the position of the caudal spinal cord structures in CKCS. OBJECTIVE To describe and compare location of spinal cord termination in CKCS with weight-matched controls and to examine the relationship between SM and spinal cord termination. ANIMALS Thirty-nine CKCS and 33 controls with thoracolumbar MRIs; 34 of 39 CKCS also had cervical MRIs. METHODS Blinded retrospective study. Spinal cord and dural sac termination were determined from T2-weighted sagittal and transverse images and half-Fourier acquisition single-shot turbo spin echo sequences. Intra-observer reliability was determined using kappa analysis. Presence of SM was compared with location of spinal cord and dural sac termination. RESULTS Intra-observer reliability was moderate for identifying spinal cord termination (Kappa = 0.6) and good for dural sac termination (Kappa = 0.8). The spinal cord terminated at lumbar vertebra 6 (L6) in 1, 7 (L7) in 22, and sacrum in 16 CKCS versus 9 at L6, 23 at L7, 1 at sacrum in controls. Spinal cord (P < .001) and dural sac (P = .002) termination were significantly more caudal in CKCS compared to controls. The presence of thoracolumbar SM was associated with more caudal dural sac termination in CKCS (P = .03). CONCLUSIONS AND CLINICAL IMPORTANCE The relationship between TL SM and possible spinal cord tethering because of a more caudal dural sac termination should be investigated.
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Affiliation(s)
- Courtney R Sparks
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Ian Robertson
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, North Carolina
| | - Natasha J Olby
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina.,Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina
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9
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De Decker S, Watts V, Neilson DM. Dynamic Lumbosacral Magnetic Resonance Imaging in a Dog with Tethered Cord Syndrome with a Tight Filum Terminale. Front Vet Sci 2017; 4:134. [PMID: 28868301 PMCID: PMC5563312 DOI: 10.3389/fvets.2017.00134] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Accepted: 08/03/2017] [Indexed: 11/13/2022] Open
Abstract
A 1-year and 11-month- old English Cocker Spaniel was evaluated for clinical signs of progressive right pelvic limb lameness and urinary incontinence. Neurological examination was suggestive of a lesion localized to the L4–S3 spinal cord segments. No abnormalities were seen on magnetic resonance imaging (MRI) performed in the dog in dorsal recumbency and the hips in a neutral position and the conus medullaris ended halfway the vertebral body of L7. An MRI of the hips in extended and flexed positions demonstrated minimal displacement of the conus medullaris in the cranial and caudal directions, respectively. Similar to the images in neutral position, the conus medullaris ended halfway the vertebral body of L7 in both the extended and flexed positions. In comparison, an MRI of the hips in neutral, extended, and flexed positions performed in another English Cocker Spaniel revealed obvious cranial displacement of the conus medullaris with the hips in extension and caudal displacement with hips in flexion. A standard dorsal lumbosacral laminectomy was performed. Visual inspection of the vertebral canal revealed excessive caudal traction on the conus medullaris. After sectioning the distal aspect of the filum terminale, the conus medullaris regained a more cranial position. A neurological examination 4 weeks after surgery revealed clinical improvement. Neurological examinations at 2, 4, 7, and 12 months after surgery did not reveal any abnormalities, and the dog was considered to be clinically normal. Tethered cord syndrome with a tight filum terminale is a very rare congenital anomaly and is characterized by an abnormally short and inelastic filum terminale. Therefore, this disorder is associated with abnormal caudal traction on the spinal cord and decreased physiological craniocaudal movements of the neural structures within the vertebral canal. Although further studies are necessary to evaluate and quantify physiological craniocaudal movement of the spinal cord and conus medullaris in neurologically normal dogs, the results of this report suggest further exploration of dynamic MRI to demonstrate decreased craniocaudal displacement of the conus medullaris in dogs with tethered cord syndrome with a tight filum terminale.
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Affiliation(s)
- Steven De Decker
- Department of Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, United Kingdom
| | - Vicky Watts
- Department of Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, United Kingdom
| | - David M Neilson
- Department of Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, United Kingdom
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10
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Tamura M, Oji T, Une S, Mukaino M, Bekki T, Tado M, Koyama H, Kagawa Y, Kawata M. Tethered cord syndrome with spina bifida aperta in cats: two case reports of different types. JFMS Open Rep 2017; 3:2055116917708060. [PMID: 28546867 PMCID: PMC5431438 DOI: 10.1177/2055116917708060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
CASE SUMMARY Two castrated male cats, aged 8 months old (case 1) and 10 months old (case 2), showed a history of progressive paraparesis, an over-reaching pelvic limb gait, urinary incontinence and a palpable dermoid fistula. In case 1, the fistula was connected to the dural sac on the conus medullaris, and the tethered spinal cord was retracted caudally. In case 2, the tubular structure was connected to the dural sac on the thoracic spinal cord, and the tethered spinal cord was retracted dorsally. Tethered cord syndrome secondary to spina bifida aperta was suspected in both cats. Excision of the fistula and release of the tethered spinal cord was performed. A histopathological examination confirmed the diagnosis of a meningomyelocele in case 1 and a meningocele in case 2. Paraparesis improved postoperatively in both cats. However, urinary incontinence in case 1 remained partially unresolved. RELEVANCE AND NOVEL INFORMATION This is the first report to describe the imaging characteristics, surgical treatments and outcomes of two different types of tethered cord syndrome with spina bifida aperta in cats. Tethered cord syndrome with spina bifida aperta needs to be included in the differential diagnosis of slowly progressive paraparesis in younger cats with or without vesicorectal failure and a palpable dermoid fistula.
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Affiliation(s)
- Masahiro Tamura
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Hokkaido, Japan
| | - Takashi Oji
- Neovets Veterinary Referral Center, Nakamichi, Higashinari-ku, Osaka-shi, Osaka, Japan
| | - Satoshi Une
- Neovets Veterinary Referral Center, Nakamichi, Higashinari-ku, Osaka-shi, Osaka, Japan
| | - Makiko Mukaino
- Neovets Veterinary Referral Center, Nakamichi, Higashinari-ku, Osaka-shi, Osaka, Japan
| | - Tatsuro Bekki
- Neovets Veterinary Referral Center, Nakamichi, Higashinari-ku, Osaka-shi, Osaka, Japan
| | - Masaki Tado
- Neovets Veterinary Referral Center, Nakamichi, Higashinari-ku, Osaka-shi, Osaka, Japan
| | - Hiromi Koyama
- Neovets Veterinary Referral Center, Nakamichi, Higashinari-ku, Osaka-shi, Osaka, Japan
| | - Yumiko Kagawa
- Department of Veterinary Pathology, Graduate School of Veterinary Medicine, Hokkaido University, Hokkaido, Japan
| | - Mutsumi Kawata
- Neovets Veterinary Referral Center, Nakamichi, Higashinari-ku, Osaka-shi, Osaka, Japan
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11
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Abstract
Spina bifida with or without meningocele or meningomyelocele is encountered infrequently in small animal practice. The English bulldog and Manx cat are breeds predisposed. Although often silent clinically, in those animals with clinical signs, it is important to recognize the signs early and to understand the appropriate imaging modalities employed in establishing a diagnosis. In a select population of affected animals, proposed surgical intervention may be considered to prevent neurologic decline, prevent secondary complications, and potentially improve outcomes.
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Affiliation(s)
- Rachel B Song
- Department of Neurology and Neurosurgery, Red Bank Veterinary Hospital, 197 Hance Avenue, Tinton Falls, NJ 07724, USA
| | - Eric N Glass
- Department of Neurology and Neurosurgery, Red Bank Veterinary Hospital, 197 Hance Avenue, Tinton Falls, NJ 07724, USA
| | - Marc Kent
- Department of Small Animal Medicine & Surgery, College of Veterinary Medicine, University of Georgia, 2200 College Station Road, Athens, GA 30602, USA.
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