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Moses WB, Moses IA, Moses EA, Moses PA. Prevalence and classification of congenital thoracic vertebral body abnormalities in neurologically normal brachycephalic 'screw-tail' dog breeds in referral practice in Australia. Aust Vet J 2024; 102:503-509. [PMID: 39032038 DOI: 10.1111/avj.13361] [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: 01/10/2024] [Revised: 05/28/2024] [Accepted: 07/03/2024] [Indexed: 07/22/2024]
Abstract
OBJECTIVE To evaluate the prevalence, type, site and breed predisposition of thoracic congenital vertebral malformations (CVM) in neurologically normal brachycephalic 'screw-tail' dog breeds. STUDY DESIGN Retrospective case series. ANIMALS Neurologically normal French Bulldogs (n = 63), British Bulldogs (n = 42), Boston Terriers (n = 4) and Pugs (n = 86) presenting for brachycephalic obstructive airway syndrome treatment. METHODS Either a plain computer tomography scan of the thorax or lateral and dorso-ventral digital radiographs of the thoracic vertebral column of each dog were assessed for any vertebral malformations and classed according to the Modified McMaster vertebral abnormality classification scheme proposed by Guiterrez et al. RESULTS: The prevalence of dogs with one or more abnormal vertebrae was 96.82% in French Bulldogs, 90.47% in British Bulldogs, and 76.74% in Pugs. Pugs had significantly lower instances of CVMs than French Bulldogs. The four Boston Terriers all had vertebral malformations, but the results were not considered to be statistically significant due to their small sample size. In French Bulldogs and British Bulldogs, ventral hypoplasia (Type 3) occurred at greater rates than all other types, followed by ventral and median hypoplasia (Types 7) and symmetrical hypoplasia (Type 8). In Pugs, symmetrical hypoplasia (Type 8) was the most common and then ventral hypoplasia (Type 3). The most affected vertebrae were T6-T9 in Pugs and T5-T10 in French Bulldogs and British Bulldogs. CONCLUSIONS The majority of neurologically normal brachycephalic 'screw-tail' dogs assessed in this paper possessed one or more congenital thoracic vertebral malformations. Dogs with vertebral malformations were found to be more likely to have more than one affected vertebra. Sex had no effect on the prevalence of CVM. CLINICAL RELEVANCE A substantial number of neurologically normal brachycephalic 'screw-tail' dogs suffer from congenital vertebral malformations. Thus, the need for selective breeding programmes to eliminate this hereditary condition is crucial.
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Affiliation(s)
- W B Moses
- Judhar Veterinary group, Hawthorne, Queensland, Australia
| | - I A Moses
- Ocean State Veterinary Specialists, East Greenwich, Rhode Island, USA
| | - E A Moses
- School of Psychology, University of Queensland, St Lucia, Queensland, Australia
| | - P A Moses
- Veterinary Specialist Services, Jindalee, Queensland, Australia
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Yoshida K, Kobatake Y, Takashima S, Nishii N. Evaluation of muscle mass and intramuscular fatty infiltration in dogs with hypercortisolism and their association with prognosis. J Vet Intern Med 2024; 38:1334-1344. [PMID: 38622799 PMCID: PMC11099730 DOI: 10.1111/jvim.17065] [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: 08/18/2023] [Accepted: 03/22/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Muscle atrophy and intramuscular fatty infiltration, as well as their association with prognosis, have not been quantified in dogs with spontaneous hypercortisolism (HC). OBJECTIVE To quantitatively evaluate muscle atrophy and IM fatty infiltration in dogs with HC and determine their prognostic impact. ANIMALS Fifty-three dogs with HC and 66 control dogs without HC. METHODS Retrospective cohort study. Medical records and computed tomography images obtained between 2014 and 2021 were evaluated. Kaplan-Meier curves and log-rank tests were used to analyze the effect of muscle atrophy and IM fatty infiltration on the prognosis of dogs with HC. RESULTS Dogs with HC showed lower visually measured cross-sectional area (VCSA) and cross-sectional area based on attenuation (HCSA) than control dogs (median [interquartile range {IQR}]: 50.3 mm2/mm [36.2-67.8] vs 66.7 mm2/mm [48.0-85.9]; P < .001; 30.4 mm2/mm [13.7-57.2] vs 54.8 mm2/mm [39.7-71.5]; P < .001, respectively). Dogs with HC had lower epaxial muscle attenuation (L3HU) than control dogs (median [IQR]: 21.2 Hounsfield [HU] [12.4-28.2] vs 33.2 HU [22.6-43.6]; P < .001). Dogs with HC with lower HCSA or L3HU had shorter survival (median [IQR]: 670 days [222-673] vs 949 days [788-1074], P < .01; 523 days [132-670] vs 949 days [756-1074], P < .01, respectively) but not lower VCSA (median [IQR]: 673 days [132-788] vs 949 days [523 to not applicable]; P = .30). CONCLUSION AND CLINICAL IMPORTANCE Hypercortisolism in dogs causes muscle atrophy and IM fatty infiltration and is associated with poor prognosis.
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Affiliation(s)
- Kei Yoshida
- Joint Department of Veterinary MedicineThe United Graduate School of Veterinary Science, Gifu UniversityGifuJapan
| | - Yui Kobatake
- Joint Department of Veterinary MedicineFaculty of Applied Biological Science, Gifu UniversityGifuJapan
| | - Satoshi Takashima
- Joint Department of Veterinary MedicineFaculty of Applied Biological Science, Gifu UniversityGifuJapan
| | - Naohito Nishii
- Joint Department of Veterinary MedicineThe United Graduate School of Veterinary Science, Gifu UniversityGifuJapan
- Joint Department of Veterinary MedicineFaculty of Applied Biological Science, Gifu UniversityGifuJapan
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Scalia B, Freeman P. Outcome of the Use of Clinical Reasoning Alone in Dogs with Acute Thoracolumbar Myelopathy and/or Pain. Animals (Basel) 2024; 14:1017. [PMID: 38612256 PMCID: PMC11010913 DOI: 10.3390/ani14071017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 03/21/2024] [Accepted: 03/25/2024] [Indexed: 04/14/2024] Open
Abstract
Acute thoracolumbar myelopathy is a common neurological presentation in dogs. Although certain spinal conditions present with characteristic clinical pictures, managing such cases with clinical reasoning alone (i.e., without cross-sectional imaging) has never been explored. The aim of this study was to define the outcome of patients with suspected intervertebral disc extrusion (IVDE), ischaemic myelopathy (IM) or acute non-compressive nucleus pulposus extrusion (ANNPE) that were managed with clinical reasoning alone. The database of the Queen's Veterinary School Hospital (Cambridge) was searched for paraparetic or paraplegic dogs with suspected IVDE or IM/ANNPE that were initially managed medically without undergoing imaging. Clinical presentation and outcome were recorded. If cross-sectional imaging was subsequently performed, information about the final diagnosis was collected and compared with the initially suspected diagnosis. A total of 123 IVDE cases were collected: 81% had a successful outcome with no imaging performed; 16% had IVDE confirmed with imaging and successful outcome with surgery or medical management; and just 3% were found to have an alternative diagnosis or were euthanised without imaging. A total of 16 IM/ANNPE cases were collected: 94% had a successful outcome, and one dog was euthanised. Successful outcomes can be obtained by using clinical reasoning alone in most dogs with suspected IVDE or IM/ANNPE.
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Affiliation(s)
- Bruno Scalia
- Queen’s Veterinary School Hospital, University of Cambridge, Madingley Road, Cambridge CB3 0ES, UK;
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Signoret M, Gros L, Musso C, Hahn H, Le Boedec K, Cauzinille L. IV Versus Myelography Computed Tomography for Thoracolumbar Intervertebral Disc Extrusion Surgical Planning in French Bulldogs. J Am Anim Hosp Assoc 2023; 59:207-213. [PMID: 37708472 DOI: 10.5326/jaaha-ms-7318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2023] [Indexed: 09/16/2023]
Abstract
Accurate diagnostic imaging is required for surgical planning of acute thoracolumbar intervertebral disc extrusion. However, data comparing the accuracy of conventional IV contrast-injected computed tomography (CT) and myelography CT for hemilaminectomy localization and size assessment are sparse. In this study, IV contrast-injected CT and myelography CT were performed in 48 French bulldogs presenting with acute disc herniation and compared with postsurgical CT. CT images were evaluated by three raters. IV contrast-injected CT erroneously identified the compressive lesion site significantly more often than myelography CT. The length of the compressive lesion was significantly higher using myelography CT compared with conventional CT, but this did not lead to relevant consequences on the surgical opening site length. Myelography CT should therefore be recommended when thoracolumbar disc disease is suspected and multiple compressive lesions are visualized on IV-injected CT in French bulldogs.
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Affiliation(s)
- Marion Signoret
- From Neurology, Oncovet, Villeneuve D'ascq, Haut de France, France (M.S.)
| | - Lucille Gros
- CHV Frégis, Arcueil, France (L.G., K.L.B., L.C.)
| | - Clément Musso
- Veterinary Clinic Oliolis, Ollioules, France (C.M.); and
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Gouveia D, Correia J, Cardoso A, Carvalho C, Oliveira AC, Almeida A, Gamboa Ó, Ribeiro L, Branquinho M, Sousa A, Lopes B, Sousa P, Moreira A, Coelho A, Rêma A, Alvites R, Ferreira A, Maurício AC, Martins Â. Intensive neurorehabilitation and allogeneic stem cells transplantation in canine degenerative myelopathy. Front Vet Sci 2023; 10:1192744. [PMID: 37520009 PMCID: PMC10374290 DOI: 10.3389/fvets.2023.1192744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/12/2023] [Indexed: 08/01/2023] Open
Abstract
Introduction Degenerative myelopathy (DM) is a neurodegenerative spinal cord disease with upper motor neurons, with progressive and chronic clinical signs, similar to amyotrophic lateral sclerosis (ALS). DM has a complex etiology mainly associated with SOD1 gene mutation and its toxic role, with no specific treatment. Daily intensive rehabilitation showed survival time near 8 months but most animals are euthanized 6-12 months after clinical signs onset. Methods This prospective controlled blinded cohort clinical study aims to evaluate the neural regeneration response ability of DM dogs subjected to an intensive neurorehabilitation protocol with mesenchymal stem cells (MSCs) transplantation. In total, 13 non-ambulatory (OFS 6 or 8) dogs with homozygous genotype DM/DM and diagnosed by exclusion were included. All were allocated to the intensive neurorehabilitation with MSCs protocol (INSCP) group (n = 8) or to the ambulatory rehabilitation protocol (ARP) group (n = 5), which differ in regard to training intensity, modalities frequency, and MSCs transplantation. The INSCP group was hospitalized for 1 month (T0 to T1), followed by MSCs transplantation (T1) and a second month (T2), whereas the ARP group was under ambulatory treatment for the same 2 months. Results Survival mean time of total population was 375 days, with 438 days for the INSCP group and 274 for the ARP group, with a marked difference on the Kaplan-Meier survival analysis. When comparing the literature's results, there was also a clear difference in the one-sample t-test (p = 0.013) with an increase in time of approximately 70%. OFS classifications between groups at each time point were significantly different (p = 0.008) by the one-way ANOVA and the independent sample t-test. Discussion This INSCP showed to be safe, feasible, and a possibility for a long progression of DM dogs with quality of life and functional improvement. This study should be continued.
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Affiliation(s)
- Débora Gouveia
- Arrábida Veterinary Hospital, Arrábida Animal Rehabilitation Center, Setubal, Portugal
- Superior School of Health, Protection and Animal Welfare, Polytechnic Institute of Lusophony, Lisboa, Portugal
- Faculty of Veterinary Medicine, Lusófona University, Lisboa, Portugal
| | - Jéssica Correia
- Arrábida Veterinary Hospital, Arrábida Animal Rehabilitation Center, Setubal, Portugal
- Faculty of Veterinary Medicine, Lusófona University, Lisboa, Portugal
| | - Ana Cardoso
- Arrábida Veterinary Hospital, Arrábida Animal Rehabilitation Center, Setubal, Portugal
- Superior School of Health, Protection and Animal Welfare, Polytechnic Institute of Lusophony, Lisboa, Portugal
| | - Carla Carvalho
- Arrábida Veterinary Hospital, Arrábida Animal Rehabilitation Center, Setubal, Portugal
| | - Ana Catarina Oliveira
- Arrábida Veterinary Hospital, Arrábida Animal Rehabilitation Center, Setubal, Portugal
- Superior School of Health, Protection and Animal Welfare, Polytechnic Institute of Lusophony, Lisboa, Portugal
| | - António Almeida
- Faculty of Veterinary Medicine, University of Lisbon, Lisboa, Portugal
| | - Óscar Gamboa
- Faculty of Veterinary Medicine, University of Lisbon, Lisboa, Portugal
| | - Lénio Ribeiro
- Faculty of Veterinary Medicine, Lusófona University, Lisboa, Portugal
| | - Mariana Branquinho
- Departamento de Clínicas Veterinárias, Instituto de Ciências Biomédicas de Abel Salaza, Universidade do Porto, Porto, Portugal
- Centro de Estudos de Ciência Animal, Instituto de Ciências, Tecnologias e Agroambiente da Universidade do Porto, Porto, Portugal
- Associate Laboratory for Animal and Veterinary Science (AL4AnimalS), Lisboa, Portugal
| | - Ana Sousa
- Departamento de Clínicas Veterinárias, Instituto de Ciências Biomédicas de Abel Salaza, Universidade do Porto, Porto, Portugal
- Centro de Estudos de Ciência Animal, Instituto de Ciências, Tecnologias e Agroambiente da Universidade do Porto, Porto, Portugal
- Associate Laboratory for Animal and Veterinary Science (AL4AnimalS), Lisboa, Portugal
| | - Bruna Lopes
- Departamento de Clínicas Veterinárias, Instituto de Ciências Biomédicas de Abel Salaza, Universidade do Porto, Porto, Portugal
- Centro de Estudos de Ciência Animal, Instituto de Ciências, Tecnologias e Agroambiente da Universidade do Porto, Porto, Portugal
- Associate Laboratory for Animal and Veterinary Science (AL4AnimalS), Lisboa, Portugal
| | - Patrícia Sousa
- Departamento de Clínicas Veterinárias, Instituto de Ciências Biomédicas de Abel Salaza, Universidade do Porto, Porto, Portugal
- Centro de Estudos de Ciência Animal, Instituto de Ciências, Tecnologias e Agroambiente da Universidade do Porto, Porto, Portugal
- Associate Laboratory for Animal and Veterinary Science (AL4AnimalS), Lisboa, Portugal
| | - Alícia Moreira
- Departamento de Clínicas Veterinárias, Instituto de Ciências Biomédicas de Abel Salaza, Universidade do Porto, Porto, Portugal
- Centro de Estudos de Ciência Animal, Instituto de Ciências, Tecnologias e Agroambiente da Universidade do Porto, Porto, Portugal
- Associate Laboratory for Animal and Veterinary Science (AL4AnimalS), Lisboa, Portugal
| | - André Coelho
- Departamento de Clínicas Veterinárias, Instituto de Ciências Biomédicas de Abel Salaza, Universidade do Porto, Porto, Portugal
- Centro de Estudos de Ciência Animal, Instituto de Ciências, Tecnologias e Agroambiente da Universidade do Porto, Porto, Portugal
- Associate Laboratory for Animal and Veterinary Science (AL4AnimalS), Lisboa, Portugal
| | - Alexandra Rêma
- Departamento de Clínicas Veterinárias, Instituto de Ciências Biomédicas de Abel Salaza, Universidade do Porto, Porto, Portugal
- Centro de Estudos de Ciência Animal, Instituto de Ciências, Tecnologias e Agroambiente da Universidade do Porto, Porto, Portugal
- Associate Laboratory for Animal and Veterinary Science (AL4AnimalS), Lisboa, Portugal
| | - Rui Alvites
- Departamento de Clínicas Veterinárias, Instituto de Ciências Biomédicas de Abel Salaza, Universidade do Porto, Porto, Portugal
- Centro de Estudos de Ciência Animal, Instituto de Ciências, Tecnologias e Agroambiente da Universidade do Porto, Porto, Portugal
- Associate Laboratory for Animal and Veterinary Science (AL4AnimalS), Lisboa, Portugal
- Instituto Universitário de Ciências da Saúde (IUCS), Cooperativa de Ensino Superior Politécnico e Universitário (CESPU), Gandra, Portugal
| | - António Ferreira
- Faculty of Veterinary Medicine, University of Lisbon, Lisboa, Portugal
- Associate Laboratory for Animal and Veterinary Science (AL4AnimalS), Lisboa, Portugal
- CIISA - Centro Interdisciplinar-Investigáo em Saúde Animal, Faculdade de Medicina Veterinária, Av. Universi dade Técnica de Lisboa, Lisboa, Portugal
| | - Ana Colette Maurício
- Departamento de Clínicas Veterinárias, Instituto de Ciências Biomédicas de Abel Salaza, Universidade do Porto, Porto, Portugal
- Centro de Estudos de Ciência Animal, Instituto de Ciências, Tecnologias e Agroambiente da Universidade do Porto, Porto, Portugal
- Associate Laboratory for Animal and Veterinary Science (AL4AnimalS), Lisboa, Portugal
| | - Ângela Martins
- Arrábida Veterinary Hospital, Arrábida Animal Rehabilitation Center, Setubal, Portugal
- Superior School of Health, Protection and Animal Welfare, Polytechnic Institute of Lusophony, Lisboa, Portugal
- Faculty of Veterinary Medicine, Lusófona University, Lisboa, Portugal
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Chang YP, Huang WH, Lua WZ, Wong W, Liu IH, Liu CH. Outcomes in Dogs with Multiple Sites of Cervical Intervertebral Disc Disease Treated with Single Ventral Slot Decompression. Vet Sci 2023; 10:377. [PMID: 37368763 DOI: 10.3390/vetsci10060377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/16/2023] [Accepted: 05/26/2023] [Indexed: 06/29/2023] Open
Abstract
In dogs with acute myelopathy but showing multiple sites of spinal compression from intervertebral disc disease (IVDD) on imaging, one approach is surgical decompression of the single acute disc extrusion while ignoring other previously extruded or protruded discs. However, little is known regarding the outcomes of this approach. This study described the outcomes and investigated prognostic factors in 40 dogs with multiple sites of cervical disc extrusion or protrusion on MRI who underwent ventral slot decompression for the single acute disc. The overall recovery rate was 97.5%. The median recovery time was seven days. The number of affected discs (including disc extrusion and protrusion) and the presence and number of the affected discs causing severe spinal compression did not influence the 30-day outcome. Compared with 23 dogs with single disc extrusion treated surgically, the recovery time and outcomes were similar between the two groups. The total number of affected discs was not associated with recovery time or outcomes. In conclusion, if an acute disc could be identified, ventral slot decompression targeting the single acute disc is a viable management approach for dogs with an acute presentation but diagnosed with multiple sites of spinal cord compression from IVDD.
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Affiliation(s)
- Ya-Pei Chang
- Department and Graduate Institute of Veterinary Medicine, School of Veterinary Medicine, National Taiwan University, Taipei 106319, Taiwan
- Graduate Institute of Veterinary Clinical Science, School of Veterinary Medicine, National Taiwan University, Taipei 106319, Taiwan
- National Taiwan University Veterinary Hospital, National Taiwan University, Taipei 106328, Taiwan
| | - Wei-Hsiang Huang
- Graduate Institute of Molecular and Comparative Pathobiology, School of Veterinary Medicine, National Taiwan University, Taipei 106319, Taiwan
| | - Wan-Zhen Lua
- Department and Graduate Institute of Veterinary Medicine, School of Veterinary Medicine, National Taiwan University, Taipei 106319, Taiwan
| | - Wenyi Wong
- Graduate Institute of Veterinary Clinical Science, School of Veterinary Medicine, National Taiwan University, Taipei 106319, Taiwan
| | - I-Hsuan Liu
- Department of Animal Science and Technology, National Taiwan University, Taipei 106073, Taiwan
- Research Center for Developmental Biology and Regenerative Medicine, National Taiwan University, Taipei 106038, Taiwan
| | - Chen-Hsuan Liu
- Department and Graduate Institute of Veterinary Medicine, School of Veterinary Medicine, National Taiwan University, Taipei 106319, Taiwan
- Graduate Institute of Molecular and Comparative Pathobiology, School of Veterinary Medicine, National Taiwan University, Taipei 106319, Taiwan
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Fuchs J, Domaniža M, Kuricová M, Lipták T, Ledecký V. Comparison of Imaging Methods and Population Pattern in Dogs with Spinal Diseases in Three Periods between 2005 and 2022: A Retrospective Study. Vet Sci 2023; 10:vetsci10050359. [PMID: 37235442 DOI: 10.3390/vetsci10050359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 05/10/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023] Open
Abstract
The aim of this study was the long-term comparison of the imaging methods used in dogs with neurologic diseases related to the spine and spinal cord. We also compared the occurrence of neurological diseases according to the localization, gender, age, and breed. As the availability of magnetic resonance imaging (MRI) has increased over the years, resulting in increased diagnostic and therapeutic success rates, the study was divided into three time periods (2005-2014, 2015-2018, and 2019-2022). Our results suggest changes in the population structure of the dogs studied and changes in the use of diagnostic methods that directly or indirectly influence the choice and success rate of therapy. Our results may be of interest to owners, breeders, practicing veterinarians, and insurance companies.
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Affiliation(s)
- Jakub Fuchs
- Small Animal Clinic, Veterinary University Hospital, University of Veterinary Medicine and Pharmacy, Komenskeho 73, 04181 Kosice, Slovakia
| | - Michal Domaniža
- Small Animal Clinic, Veterinary University Hospital, University of Veterinary Medicine and Pharmacy, Komenskeho 73, 04181 Kosice, Slovakia
| | - Mária Kuricová
- Small Animal Clinic, Veterinary University Hospital, University of Veterinary Medicine and Pharmacy, Komenskeho 73, 04181 Kosice, Slovakia
| | - Tomáš Lipták
- Small Animal Clinic, Veterinary University Hospital, University of Veterinary Medicine and Pharmacy, Komenskeho 73, 04181 Kosice, Slovakia
| | - Valent Ledecký
- Small Animal Clinic, Veterinary University Hospital, University of Veterinary Medicine and Pharmacy, Komenskeho 73, 04181 Kosice, Slovakia
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Moore SA, Olby NJ, Brisson B, Fenn J, Flegel T, Kortz G, Lewis M, Tipold A. ACVIM consensus statement on diagnosis and management of acute canine thoracolumbar intervertebral disc extrusion. J Vet Intern Med 2022; 36:1570-1596. [PMID: 35880267 PMCID: PMC9511077 DOI: 10.1111/jvim.16480] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 06/12/2022] [Indexed: 12/16/2022] Open
Abstract
Background Thoracolumbar intervertebral disc extrusion (TL‐IVDE) is the most common cause of acute paraparesis and paraplegia in dogs; however, guidelines on management of the condition are lacking. Objectives To summarize the current literature as it relates to diagnosis and management of acute TL‐IVDE in dogs, and to formulate clinically relevant evidence‐based recommendations. Animals None. Methods A panel of 8 experts was convened to assess and summarize evidence from the peer‐reviewed literature in order to develop consensus clinical recommendations. Level of evidence available to support each recommendation was assessed and reported. Results The majority of available literature described observational studies. Most recommendations made by the panel were supported by a low or moderate level of evidence, and several areas of high need for further study were identified. These include better understanding of the ideal timing for surgical decompression, expected surgical vs medical outcomes for more mildly affected dogs, impact of durotomy on locomotor outcome and development of progressive myelomalacia, and refining of postoperative care, and genetic and preventative care studies. Conclusions and Clinical Importance Future efforts should build on current recommendations by conducting prospective studies and randomized controlled trials, where possible, to address identified gaps in knowledge and to develop cost effectiveness and number needed to treat studies supporting various aspects of diagnosis and treatment of TL‐IVDE.
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Affiliation(s)
- Sarah A Moore
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Natasha J Olby
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | | | - Brigitte Brisson
- Department of Clinical Studies, Ontario Veterinary College, Ontario Veterinary College, Guelph, Ontario, Canada
| | - Joe Fenn
- Department of Clinical Science and Services, Royal Veterinary College, London, United Kingdom
| | - Thomas Flegel
- Department for Small Animals, Leipzig University, Leipzig, Germany
| | - Gregg Kortz
- VCA Sacramento Veterinary Referral Center, Sacramento, California, USA.,VCA Sacramento Veterinary Referral Center, UC Davis, California, USA
| | - Melissa Lewis
- Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, Indiana, USA
| | - Andrea Tipold
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hanover, Hanover, Germany
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Villm J, Windsor R. Diagnosis and Treatment of a Spinal Intraosseous Keratinized Cyst of L1 in a Dog. J Am Anim Hosp Assoc 2022; 58:203-206. [PMID: 35793485 DOI: 10.5326/jaaha-ms-7175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2021] [Indexed: 11/11/2022]
Abstract
An 8 yr old female spayed golden retriever presented for a 3 wk history of progressive pelvic limb ataxia. MRI revealed a well-circumscribed T2-weighted hyperintense, T1-weighted poorly contrast-enhancing extradural mass to the right of the spinal cord at the level of L1 causing severe spinal cord compression. A right-sided hemilaminectomy was performed to remove the mass, and histopathology revealed an intraosseous keratinized cyst. A complete neurologic recovery was made within 2 wk following the surgery. This case illustrates a rare diagnosis and the first case report describing MRI findings and favorable clinical outcome after surgical management of a spinal intraosseous keratinized cyst.
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Affiliation(s)
- Jessica Villm
- From Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, Virginia (J.V.)
| | - Rebecca Windsor
- From Wheat Ridge Animal Hospital, Wheat Ridge, Colorado (R.W.)
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Spence SP, Israel SK. Comparison of magnetic resonance imaging findings in relation to body weight in dogs with thoracolumbar disease. J Am Vet Med Assoc 2021; 258:1222-1228. [PMID: 33978442 DOI: 10.2460/javma.258.11.1222] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare the incidence of MRI lesions between dogs weighing < 15 kg (33 lb) and dogs weighing ≥ 15 kg. ANIMALS 494 dogs with clinical signs of thoracolumbar disease. PROCEDURES Electronic medical records of affected dogs that underwent MRI of the thoracolumbar vertebral column between January 2016 and July 2018 were reviewed. Data extracted included age, body weight, breed, sex, MRI findings, and lesion location. Data were compared between dogs weighing < 15 kg and dogs weighing ≥ 15 kg. RESULTS Of dogs weighing < 15 kg, 94.4% (371/393) were chondrodystrophic breeds. Only 24.8% (25/101) of dogs weighing ≥ 15 kg were chondrodystrophic breeds. Lesions consistent with intervertebral disk disease (IVDD) had an overall incidence of 87.2% (431/494). In dogs weighing < 15 kg, the incidence of IVDD was 94.7% (372/393), compared with 58.4% (59/101) in dogs weighing ≥ 15 kg. Dogs weighing < 15 kg had a significantly higher incidence of IVDD lesions in the T12-13 segment, compared with dogs weighing ≥ 15 kg. Dogs weighing ≥ 15 kg were 11.9 times (95% CI, 5.1 to 27.9) and 7.4 times (95% CI, 2.3 to 23) as likely to have a neoplastic lesion and fibrocartilaginous embolic myelopathy, respectively, compared with dogs weighing < 15 kg. CONCLUSIONS AND CLINICAL RELEVANCE IVDD was the most common MRI finding in the study population. Dogs weighing ≥ 15 kg had a higher incidence of nonintervertebral disk lesions, compared with dogs weighing < 15 kg.
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Elliott RC, Berman CF, Lobetti RG. A comparative study between high-definition volumetric imaging computed tomography and multi-slice computed tomography in the detection of acute thoraco-lumbar disc extrusions in dogs. J S Afr Vet Assoc 2021; 92:e1-e7. [PMID: 33764127 PMCID: PMC8007992 DOI: 10.4102/jsava.v92i0.2010] [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: 08/14/2019] [Revised: 01/15/2021] [Accepted: 01/15/2021] [Indexed: 11/17/2022] Open
Abstract
Computed tomography (CT) is commonly used to image intervertebral disc extrusion (IVDE) in dogs. The current gold standard for CT imaging is the use of multi-slice CT (MS CT) units. Smaller high-definition volumetric imaging (HDVI) mobile CT has been marketed for veterinary practice. This unit is described as an advanced flat panel. The goal of this manuscript was to evaluate the ability of the HDVI CT in detecting IVDE without the need for CT myelography, compared with the detection of acute disc extrusions with a MS CT without the need for MS CT myelogram. Retrospective blinded analyses of 219 dogs presented for thoraco-lumbar IVDE that had a HDVI CT (n = 123) or MS CT (n = 96) were performed at a single referral hospital. A total of 123 cases had HDVI CT scans with surgically confirmed IVDE. The IVDE was identified in 88/123 (72%) dogs on pre-contrast HDVI CT. The remaining 35/128 (28%) cases required a HDVI CT myelogram to identify the IVDE. Ninety-six cases had MS CT scans with surgically confirmed IVDE. The IVDE was identified in 78/96 (81%) dogs on the pre-contrast MS CT. The remaining 18/96 (19%) cases had a MS CT myelogram to identify the IVDE. Multi-slice CT detected IVDE significantly more than HDVI CT (p = 0.032). This study showed that the ability of HDVI CT for detecting IVDE is lower than that of MS CT. The HDVI CT system may be useful in smaller referral practices, with a lower case load where space is limited.
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Affiliation(s)
- Ross C Elliott
- Department of Companion Animal and Clinical Studies, Onderstepoort, South Africa; and, Bryanston Veterinary Hospital, Johannesburg.
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12
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De Freitas MI, Housley D, Caine A, Fauchon E, Baiker K, Corbetta D, Cherubini GB. Myelopathy secondary to an intramedullary arteriovenous malformation in a mature dog. J Vet Intern Med 2021; 35:1098-1104. [PMID: 33527500 PMCID: PMC7995429 DOI: 10.1111/jvim.16045] [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: 10/21/2020] [Revised: 12/27/2020] [Accepted: 01/15/2021] [Indexed: 12/28/2022] Open
Abstract
A 2‐year‐old crossbreed dog was presented for evaluation of a 6‐week history of progressive paraparesis. Magnetic resonance imaging and computed tomography angiography of the thoracic and lumbar spinal cord disclosed multifocal, anomalous, small, vascular structures, distributed throughout the subarachnoid space of the included section of the spinal cord. An additional focal intramedullary lesion was identified extending from T9 to T10 to T12. Histopathological examination confirmed the presence of an intramedullary arteriovenous malformation affecting the thoracic spinal cord and leading to diffuse congestion and focal hemorrhages into the affected spinal cord.
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Affiliation(s)
| | | | - Abby Caine
- Dick White Referrals, Six Mile Bottom, UK
| | | | - Kerstin Baiker
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, UK
| | - Davide Corbetta
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, UK
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13
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da Costa RC, De Decker S, Lewis MJ, Volk H. Diagnostic Imaging in Intervertebral Disc Disease. Front Vet Sci 2020; 7:588338. [PMID: 33195623 PMCID: PMC7642913 DOI: 10.3389/fvets.2020.588338] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 09/09/2020] [Indexed: 12/27/2022] Open
Abstract
Imaging is integral in the diagnosis of canine intervertebral disc disease (IVDD) and in differentiating subtypes of intervertebral disc herniation (IVDH). These include intervertebral disc extrusion (IVDE), intervertebral disc protrusion (IVDP) and more recently recognized forms such as acute non-compressive nucleus pulposus extrusion (ANNPE), hydrated nucleus pulposus extrusion (HNPE), and intradural/intramedullary intervertebral disc extrusion (IIVDE). Many imaging techniques have been described in dogs with roles for survey radiographs, myelography, computed tomography (CT), and magnetic resonance imaging (MRI). Given how common IVDH is in dogs, a thorough understanding of the indications and limitations for each imaging modality to aid in diagnosis, treatment planning and prognosis is essential to successful case management. While radiographs can provide useful information, especially for identifying intervertebral disc degeneration or calcification, there are notable limitations. Myelography addresses some of the constraints of survey radiographs but has largely been supplanted by cross-sectional imaging. Computed tomography with or without myelography and MRI is currently utilized most widely and have become the focus of most contemporary studies on this subject. Novel advanced imaging applications are being explored in dogs but are not yet routinely performed in clinical patients. The following review will provide a comprehensive overview on common imaging modalities reported to aid in the diagnosis of IVDH including IVDE, IVDP, ANNPE, HNPE, and IIVDE. The review focuses primarily on canine IVDH due to its frequency and vast literature as opposed to feline IVDH.
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Affiliation(s)
- Ronaldo C da Costa
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH, United States
| | - Steven De Decker
- Department of Clinical Sciences and Services, Royal Veterinary College, London, United Kingdom
| | - Melissa J Lewis
- Department of Veterinary Clinical Sciences, Purdue University College of Veterinary Medicine, West Lafayette, IN, United States
| | - Holger Volk
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hanover, Hanover, Germany
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14
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Fenn J, Olby NJ. Classification of Intervertebral Disc Disease. Front Vet Sci 2020; 7:579025. [PMID: 33134360 PMCID: PMC7572860 DOI: 10.3389/fvets.2020.579025] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 08/24/2020] [Indexed: 12/24/2022] Open
Abstract
Intervertebral disc disease (IVDD) has been recognized in dogs since the 1800s, when the first descriptions of extruded disc material within the vertebral canal were published. In the intervening time our understanding of intervertebral disc pathology in dogs and cats has increased dramatically, with many variations of IVDD described. Whilst the volume of literature and collective understanding of IVDD has expanded, there has also been scope for confusion as the definition of intervertebral disc disease, with its myriad different manifestations, becomes more complicated. A large volume of literature has aimed to combine the use of histopathology, diagnostic imaging and clinical findings to better understand the various ways in which IVDD can be classified. Much of this research has focused on the classification of mechanisms of intervertebral disc degeneration, centering around the differences between, and overlaps in, IVDD in chondrodystrophic and non-chondrodystrophic dog breeds. However, with the increasing availability of advanced imaging modalities allowing more accurate antemortem diagnosis, the concept of IVDD has expanded to include other clinical presentations that may not fit into traditional models of classification of IVDD. This review aims to provide an up to date overview of both historical and current systems of IVDD classification, highlighting the important findings and controversies underpinning them.
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Affiliation(s)
- Joe Fenn
- Department of Clinical Science and Services, Royal Veterinary College, London, United Kingdom
| | - Natasha J Olby
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
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15
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Tirrito F, Cozzi F, Bonaldi M, Conti S, Lombardo R. Agreement of surgeon's perception of the effectiveness of spinal cord decompression with findings on postoperative magnetic resonance imaging for dogs surgically treated for intervertebral disk extrusion. J Am Vet Med Assoc 2020; 256:210-219. [PMID: 31910078 DOI: 10.2460/javma.256.2.210] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the accuracy of the surgeon's perception versus postoperative MRI findings in assessing the effectiveness of spinal cord decompression achieved in dogs surgically treated for intervertebral disk extrusion (IVDE) and whether postoperative MRI findings were more likely to be associated with various outcomes. ANIMALS 68 dogs surgically treated for cervical or thoracolumbar IVDE. PROCEDURES Data on clinical, neurologic, pre- and postoperative MRI, and intraoperative findings as well as outcomes and recovery times (6-month follow-up period) were prospectively collected and compared between various groups. RESULTS 54 (79%) dogs had thoracolumbar IVDE, and 14 (21%) had cervical IVDE. Median degree of spinal cord compression as assessed on transverse T2-weighted MRI images was 45.6% before surgery and 8.8% after surgery. The correlation between surgeons' perception (n = 3) and postoperative MRI findings for the degree of spinal cord decompression achieved was only fair (κ = 0.40). Unsatisfactory spinal cord decompression as assessed via postoperative MRI was associated with severity of preoperative neurologic grade and preoperative compression, thoracolumbar (vs cervical) IVDE, and ventral (vs ventrolateral or dorsolateral) circumferential distribution of extruded material. Satisfactory (vs unsatisfactory) decompression as assessed via MRI was associated with a lower postoperative neurologic grade, greater likelihood of a successful outcome, and lower mean recovery time. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that for dogs surgically treated for IVDE, the surgeon's perception of adequate spinal cord decompression may be less reliable than postoperative MRI findings. Postoperative MRI appeared particularly useful for dogs with a severe preoperative neurologic status, severe preoperative spinal cord compression, and thoracolumbar IVDE.
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16
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Nishida H, Nakata K, Maeda S, Kamishina H. Prevalence and pattern of thoracolumbar caudal articular process anomalies and intervertebral disk herniations in pugs. J Vet Med Sci 2019; 81:906-910. [PMID: 31092761 PMCID: PMC6612495 DOI: 10.1292/jvms.18-0521] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Thoracolumbar intervertebral disk herniation (TL-IVDH) with caudal articular process anomalies has been reported in Pugs. It currently remains unclear whether congenital caudal articular process aplasia/hypoplasia predisposes to the development of TL-IVDH. However, there are difficulties in proving the causal relationship between caudal articular process anomalies and TL-IVDH. The aim of this study was to describe the prevalence of TL-IVDH at the vertebral space containing anomalous and normal caudal articular processes in Pugs. Fifty-seven pugs were eligible to be included in this study. Caudal articular process aplasia/hypoplasia affected 52/57 (91.2%) dogs. The caudal articular process anomalies were most frequently located between T10 and T13. Colocalization of caudal articular process aplasia/hypoplasia and TL-IVDH was detected in 11 dogs (19.3%). The prevalence of TL-IVDH at vertebral spaces containing abnormal caudal articular processes was 12.3%, whereas the prevalence of TL-IVDH at vertebral spaces containing normal articular processes was 2.4%. With the increase in the number of vertebrae with caudal articular process anomalies, the prevalence of TL-IVDH also increased. The results of this study suggested the prevalence of caudal articular process anomalies was high in Pugs. The caudal articular process anomalies could be associated with TL-IVDH. A large cohort is needed to prove the causal relationship between caudal articular process anomalies and TL-IVDH.
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Affiliation(s)
- Hidetaka Nishida
- Joint Department of Veterinary Medicine, Faculty of Applied Biological Sciences, Gifu University, Gifu 501-1193, Japan.,The United Graduate School of Veterinary Sciences, Gifu University, Gifu 501-1193, Japan
| | - Kohei Nakata
- The United Graduate School of Veterinary Sciences, Gifu University, Gifu 501-1193, Japan
| | - Sadatoshi Maeda
- Joint Department of Veterinary Medicine, Faculty of Applied Biological Sciences, Gifu University, Gifu 501-1193, Japan.,The United Graduate School of Veterinary Sciences, Gifu University, Gifu 501-1193, Japan
| | - Hiroaki Kamishina
- Joint Department of Veterinary Medicine, Faculty of Applied Biological Sciences, Gifu University, Gifu 501-1193, Japan.,The United Graduate School of Veterinary Sciences, Gifu University, Gifu 501-1193, Japan.,Center for Highly Advanced Integration of Nano and Life Sciences, Gifu University, Gifu 501-1193, Japan
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17
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Calcification of extruded intervertebral discs in dachshunds: a radiographic, computed tomographic and histopathological study of 25 cases. Acta Vet Scand 2019; 61:13. [PMID: 30849997 PMCID: PMC6408767 DOI: 10.1186/s13028-019-0448-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 03/03/2019] [Indexed: 11/29/2022] Open
Abstract
Background Three Nordic countries have national breeding programs to reduce the frequency of intervertebral disc disease in dachshunds. The programs include a radiographic examination of the vertebral column and dachshunds with more than four calcified discs visible on radiographs (CDVR) are discouraged from use in breeding. However, disc extrusion is also diagnosed in dachshunds without CDVR. The utility of the breeding programs is therefore questioned. Results A prospective study of 25 dachshunds surgically treated for disc extrusion was conducted. For all the dogs, preoperative radiographs were evaluated for detectable disc calcifications and preoperative computed tomography (CT) scans were evaluated for presence of calcified material in the vertebral canal. Postoperatively, extruded disc material was examined for degeneration and calcification by histology. Diagnostic imaging and histology were done independently. Radiographically visible calcification was identified in 17 (68.0%) of 25 extruded discs. Calcification was seen in the disc space for all these 17 discs, and for eight of the 17, there was also calcified material visible in the vertebral canal. Extruded material from all the 25 discs was found to be calcified, both by CT and histopathology. Conclusions In dachshunds with acute disc extrusion, radiographically visible calcification will frequently be found in the affected disc space, but not all affected disc spaces contain radiographically visible calcification. Using histopathology as the gold standard, a sensitivity of 0.3 (8/25) for radiography and 1.0 (25/25) for CT was found for detecting calcified disc material in the vertebral canal. Further, a sensitivity of 0.7 (17/25) was found for radiography for detecting remaining calcified material in the disc space. Thus, extruded disc material should be considered to be calcified, even in the absence of radiographically visible calcification.
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18
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Hamilton‐Bennett SE, Behr S. Clinical presentation, magnetic resonance imaging features, and outcome in 6 cats with lumbar degenerative intervertebral disc extrusion treated with hemilaminectomy. Vet Surg 2019; 48:556-562. [PMID: 30828827 DOI: 10.1111/vsu.13182] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 05/09/2018] [Accepted: 06/04/2018] [Indexed: 11/27/2022]
Affiliation(s)
| | - Sebastien Behr
- Neurology‐Neurosurgery ServiceWillows Referral Service Solihull West Midlands United Kingdom
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19
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Wang-Leandro A, Hobert MK, Kramer S, Rohn K, Stein VM, Tipold A. The role of diffusion tensor imaging as an objective tool for the assessment of motor function recovery after paraplegia in a naturally-occurring large animal model of spinal cord injury. J Transl Med 2018; 16:258. [PMID: 30223849 PMCID: PMC6142343 DOI: 10.1186/s12967-018-1630-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 09/06/2018] [Indexed: 12/24/2022] Open
Abstract
Background Traumatic spinal cord injury (SCI) results in sensory and motor function impairment and may cause a substantial social and economic burden. For the implementation of novel treatment strategies, parallel development of objective tools evaluating spinal cord (SC) integrity during motor function recovery (MFR) is needed. Diffusion tensor imaging (DTI) enables in vivo microstructural assessment of SCI. Methods In the current study, temporal evolvement of DTI metrics during MFR were examined; therefore, values of fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were measured in a population of 17 paraplegic dogs with naturally-occurring acute SCI showing MFR within 4 weeks after surgical decompression and compared to 6 control dogs. MRI scans were performed preoperatively and 12 weeks after MFR was observed. DTI metrics were obtained at the lesion epicentre and one SC segment cranially and caudally. Variance analyses were performed to compare values between evaluated localizations in affected dogs and controls and between time points. Correlations between DTI metrics and clinical scores at follow-up examinations were assessed. Results Before surgery, FA values at epicentres were higher than caudally (p = 0.0014) and control values (p = 0.0097); ADC values were lower in the epicentre compared to control values (p = 0.0035) and perilesional (p = 0.0448 cranially and p = 0.0433 caudally). In follow-up examinations, no significant differences could be found between DTI values from dogs showing MFR and control dogs. Lower ADC values at epicentres correlated with neurological deficits at follow-up examinations (r = − 0.705; p = 0.0023). Conclusions Findings suggest that a tendency to the return of DTI values to the physiological situation after surgical decompression accompanies MFR after SCI in paraplegic dogs. DTI may represent a useful and objective clinical tool for follow-up studies examining in vivo SC recovery in treatment studies. Electronic supplementary material The online version of this article (10.1186/s12967-018-1630-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Adriano Wang-Leandro
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Lower Saxony, Germany. .,Centre of Systems Neuroscience, Hannover, Lower Saxony, Germany. .,Department of Diagnostics and Clinical Services, Clinic for Diagnostic Imaging, Vetsuisse Faculty, University of Zürich, Zurich, Switzerland.
| | - Marc K Hobert
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Lower Saxony, Germany
| | - Sabine Kramer
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Lower Saxony, Germany
| | - Karl Rohn
- Institute of Biometry, Epidemiology, and Information Processing, University of Veterinary Medicine Hannover, Hannover, Lower Saxony, Germany
| | - Veronika M Stein
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Lower Saxony, Germany.,Division of Clinical Neurology, Department of Clinical Veterinary Sciences, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Andrea Tipold
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Lower Saxony, Germany.,Centre of Systems Neuroscience, Hannover, Lower Saxony, Germany
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20
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Ricciardi M, Campanella A, Grieco G, Zammit R. Usefulness of spinal unenhanced computed tomography and CT-myelography in the age of multidetector CT technology and magnetic resonance imaging - Preliminary considerations. Open Vet J 2018; 8:265-281. [PMID: 30148079 PMCID: PMC6102422 DOI: 10.4314/ovj.v8i3.6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 07/22/2018] [Indexed: 12/14/2022] Open
Abstract
Over the last decade, magnetic resonance imaging (MRI) and multidetector computed tomography (MDCT) have revolutionized diagnostic potential in small animal practice, providing adequate assessment of spinal diseases at levels comparable to that achieved in human radiology. T2-weighted MRI images are extremely sensitive to intramedullary parenchymal disorders, while balanced steady-state free precession sequences provide high-quality myelographic images of the spine without the need of intrathecal contrast medium administration. Multidetector computed tomography, with its near-isotropic spatial resolution and multiplanar reformatting of the acquired datasets, provides sufficient stratigraphic details of the spinal cord and the epidural space, facilitating the detection of compressive pathologies without the need of subarachnoid opacification. Nowadays, MDCT and low-field (LF) MRI have become fairly standard and available in academic institutions and private veterinary facilities, appearing to be valuable, complementary, and non-invasive diagnostic tools for imaging the spine. In this scenario, this clinical communication provides a series of preliminary observations that may help to reconsider the usefulness of CT-myelography in the light of its invasiveness and actual diagnostic advantages compared to MRI and unenhanced MDCT for the assessment of compressive and non-compressive spinal diseases in small animals.
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Affiliation(s)
- Mario Ricciardi
- Pingry Veterinary Hospital, Via Medaglie d'Oro 5, 70126 - Bari, Italy
| | - Angela Campanella
- Ospedale Veterinario Gregorio VII. Piazza di Villa Carpegna 52, 00165 - Roma, Italy
| | - Gloria Grieco
- Clinica Veterinaria Borghesiana, Via di Vermicino 96, 00133 - Roma, Italy
| | - Roberta Zammit
- Clinica Veterinaria Borghesiana, Via di Vermicino 96, 00133 - Roma, Italy
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21
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Siedenburg JS, Wang-Leandro A, Amendt HL, Rohn K, Tipold A, Stein VM. Transcranial magnetic motor evoked potentials and magnetic resonance imaging findings in paraplegic dogs with recovery of motor function. J Vet Intern Med 2018; 32:1116-1125. [PMID: 29566440 PMCID: PMC5980462 DOI: 10.1111/jvim.15058] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 10/27/2017] [Accepted: 01/11/2018] [Indexed: 12/18/2022] Open
Abstract
Background Transcranial magnetic motor evoked potentials (TMMEP) are associated with severity of clinical signs and magnetic resonance imaging (MRI) findings in dogs with spinal cord disease. Hypothesis That in initially paraplegic dogs with thoracolumbar intervertebral disc herniation (IVDH), MRI findings before surgery and TMMEPs obtained after decompressive surgery are associated with long‐term neurological status and correlate with each other. Animals Seventeen client‐owned paraplegic dogs with acute thoracolumbar IVDH. Methods Prospective observational study. TMMEPs were obtained from pelvic limbs and MRI (3T) of the spinal cord was performed at initial clinical presentation. Follow‐up studies were performed ≤ 2 days after reappearance of motor function and 3 months later. Ratios of compression length, intramedullary hyperintensities' length (T2‐weighted hyperintensity length ratio [T2WLR]), and lesion extension (T2‐weighted‐lesion extension ratio) in relation to the length of the 2nd lumbar vertebral body were calculated. Results TMMEPs could be elicited in 10/17 (59%) dogs at 1st and in 16/17 (94%) dogs at 2nd follow‐up. Comparison of TMMEPs of 1st and 2nd follow‐up showed significantly increased amplitudes (median from 0.19 to 0.45 mV) and decreased latencies (from 69.38 to 40.26 ms; P = .01 and .001, respectively). At 2nd follow‐up latencies were significantly associated with ambulatory status (P = .024). T2WLR obtained before surgery correlated with latencies at 2nd follow‐up (P = .04). Conclusions TMMEP reflect motor function recovery after severe spinal cord injury.
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Affiliation(s)
- Johannes S Siedenburg
- Division of Neurology, Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Adriano Wang-Leandro
- Division of Neurology, Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany.,Institute of Biometry, Epidemiology, and Information Processing, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Hanna-Luise Amendt
- Division of Neurology, Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Karl Rohn
- Institute of Biometry, Epidemiology, and Information Processing, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Andrea Tipold
- Division of Neurology, Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany.,Centre of Systems Neuroscience, Hannover, Germany
| | - Veronika M Stein
- Division of Neurology, Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
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22
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Boström AF, Lappalainen AK, Danneels L, Jokinen TS, Laitinen-Vapaavuori O, Hielm-Björkman AK. Cross-sectional area and fat content in dachshund epaxial muscles: an MRI and CT reliability study. Vet Rec Open 2018; 5:e000256. [PMID: 29632671 PMCID: PMC5888436 DOI: 10.1136/vetreco-2017-000256] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 02/07/2018] [Accepted: 02/13/2018] [Indexed: 12/23/2022] Open
Abstract
MRI and CT are frequently used to diagnose spinal diseases in dogs. These modalities have detected epaxial muscle degeneration in dachshunds with intervertebral disc herniation. However, research on the reliability of epaxial muscular measurements is limited in veterinary medicine. The aims of the study were to assess the intrarater and inter-rater reliability of epaxial muscle cross-sectional area (CSA) and fat content measurements on MRI and CT images in dachshunds, and to compare the CSA measurement between the two modalities. MRI and CT images of 10 healthy dachshunds were evaluated. Two blinded observers assessed MRI CSA, MRI fat content, CT CSA and CT muscle attenuation of three thoracolumbar epaxial muscles using OsiriX. The results showed ‘substantial’ to ‘almost perfect’ intrarater reliability (intraclass correlation coefficient (ICC) 0.828–0.998) and inter-rater reliability (ICC 0.685–0.854) for all variables. When individual spinal segments were analysed, the intrarater and inter-rater reliability decreased and the confidence intervals increased. There was positive correlation (r= 0.719–0.841, P=0.001) and high agreement (0.824–0.894) for the measured CSA between MRI and CT. Epaxial muscle CSA and fat content can be reliably measured on MRI and CT, bearing in mind that measurement of certain segments requires adequate training.
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Affiliation(s)
- Anna Fredrika Boström
- Small Animal Surgery, Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Anu K Lappalainen
- Small Animal Surgery, Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Lieven Danneels
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
| | - Tarja S Jokinen
- Small Animal Surgery, Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Outi Laitinen-Vapaavuori
- Small Animal Surgery, Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Anna K Hielm-Björkman
- Small Animal Surgery, Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
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23
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Lewis MJ, Cohen EB, Olby NJ. Magnetic resonance imaging features of dogs with incomplete recovery after acute, severe spinal cord injury. Spinal Cord 2018; 56:133-141. [PMID: 29057987 PMCID: PMC5809200 DOI: 10.1038/s41393-017-0004-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Revised: 08/12/2017] [Accepted: 08/14/2017] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Retrospective case series. OBJECTIVES Describe the magnetic resonance imaging (MRI) features of dogs chronically impaired after severe spinal cord injury (SCI) and investigate associations between imaging variables and residual motor function. SETTING United States of America. METHODS Thoracolumbar MRI from dogs with incomplete recovery months to years after clinically complete (paralysis with loss of pain perception) thoracolumbar SCI were reviewed. Lesion features were described and quantified. Gait was quantified using an ordinal, open field scale (OFS). Associations between imaging features and gait scores, duration of injury (DOI), or SCI treatment were determined. RESULTS Thirty-five dogs were included. Median OFS was 2 (0-6), median DOI was 13 months (3-83), and intervertebral disk herniation was the most common diagnosis (n = 27). Myelomalacia was the most common qualitative feature followed by cystic change; syringomyelia and fibrosis were uncommon. Lesion length corrected to L2 length (LL:L2) was variable (median LL:L2 = 3.5 (1.34-11.54)). Twenty-nine dogs had 100% maximum cross-sectional spinal cord compromise (MSCC) at the lesion epicenter and the length of 100% compromised area varied widely (median length 100% MSCC:L2 = 1.29 (0.39-7.64)). Length 100% MSCC:L2 was associated with OFS (p = 0.012). OFS was not associated with any qualitative features. DOI or treatment type were not associated with imaging features or lesion quantification. CONCLUSIONS Lesion characteristics on MRI in dogs with incomplete recovery after severe SCI were established. Length of 100% MSCC was associated with hind limb motor function. Findings demonstrate a spectrum of injury severity on MRI among severely affected dogs, which is related to functional status.
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Affiliation(s)
- Melissa J Lewis
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC, USA
| | - Eli B Cohen
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Natasha J Olby
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA.
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC, USA.
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Jeffery ND, Harcourt-Brown TR, Barker AK, Levine JM. Choices and Decisions in Decompressive Surgery for Thoracolumbar Intervertebral Disk Herniation. Vet Clin North Am Small Anim Pract 2018; 48:169-186. [DOI: 10.1016/j.cvsm.2017.08.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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25
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Emery L, Hecht S, Sun X. Investigation of parameters predicting the need for diagnostic imaging beyond computed tomography in the evaluation of dogs with thoracolumbar myelopathy: Retrospective evaluation of 555 dogs. Vet Radiol Ultrasound 2017; 59:147-154. [PMID: 29160005 DOI: 10.1111/vru.12576] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 08/08/2017] [Accepted: 09/10/2017] [Indexed: 11/27/2022] Open
Abstract
Thoracolumbar myelopathy encompasses a number of disease processes such as intervertebral disc disease, discospondylitis, trauma, congenital malformations, neoplasia, and intramedullary spinal cord disease. Compressive disc herniations are most common in dogs and require imaging procedures such as myelography, computed tomography (CT), and/or magnetic resonance imaging (MRI) to determine the need and location for decompressive surgery. The purposes of this retrospective, cross-sectional study were to evaluate all dogs undergoing thoracolumbar CT imaging as the initial diagnostic step between 2010 and 2015 and determine whether any of the imaging characteristics could be used to predict the need for additional imaging in the form of myelography, CT myelography, and/or MRI. A total of 555 dogs were identified in this time frame which underwent CT imaging for myelopathy of the thoracolumbar region. Various parameters including age, gender, sexual status, breed, chronicity, site of lesion, time of study, and contrast administration were evaluated. Findings indicated that 7.6% of dogs needed additional imaging after CT. Dachshunds were less likely to need additional imaging (P = 0.0111) as were patients scanned during normal business hours (P = 0.0075). Increasing age of the patient increased the likelihood of additional imaging (P = 0.0107). Dogs which did not have additional imaging performed were 21.89 times more likely to require surgery than those which did have additional imaging (P < 0.0001). Findings supported the use of CT as a first-line imaging modality for dogs presenting with thoracolumbar myelopathy.
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Affiliation(s)
- Lee Emery
- Department of Small Animal Clinical Sciences, University of Tennessee, Knoxville, TN, 37996, USA
| | - Silke Hecht
- Department of Small Animal Clinical Sciences, University of Tennessee, Knoxville, TN, 37996, USA
| | - Xiaocun Sun
- Office of Information Technology, University of Tennessee, Knoxville, TN, 37996, USA
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26
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Noyes JA, Thomovsky SA, Chen AV, Owen TJ, Fransson BA, Carbonneau KJ, Matthew SM. Magnetic resonance imaging versus computed tomography to plan hemilaminectomies in chondrodystrophic dogs with intervertebral disc extrusion. Vet Surg 2017; 46:1025-1031. [PMID: 28834552 DOI: 10.1111/vsu.12700] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Revised: 03/05/2017] [Accepted: 03/21/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine the influence of preoperative computed tomography (CT) versus magnetic resonance (MR) on hemilaminectomies planned to treat thoracolumbar (TL) intervertebral disc (IVD) extrusions in chondrodystrophic dogs. STUDY DESIGN Prospective clinical study. SAMPLE POPULATION Forty chondrodystrophic dogs with TL IVD extrusion and preoperative CT and MR studies. METHODS MR and CT images were randomized and reviewed by 4 observers masked to the dog's identity and corresponding imaging studies. Observers planned the location along the spine, side, and extent (number of articular facets to be removed) based on individual reviews of CT and MR studies. Intra-observer agreement was determined between overall surgical plan, location, side, and size of the hemilaminectomy planned on CT versus MR of the same dog. RESULTS Similar surgical plans were developed based on MR versus CT in 43.5%-66.6% of dogs, depending on the observer. Intra-observer agreement in location, side, and size of the planned hemilaminectomy based on CT versus MR ranged between 48.7%-66.6%, 87%-92%, and 51.2%-71.7% of dogs, respectively. Observers tended to plan larger laminectomy defects based on MR versus CT of the same dog. CONCLUSION Findings from this study indicated considerable differences in hemilaminectomies planned on preoperative MR versus CT imaging. Surgical location and size varied the most; the side of planned hemilaminectomies was most consistent between imaging modalities.
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Affiliation(s)
- Julie A Noyes
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington
| | - Stephanie A Thomovsky
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington
| | - Annie V Chen
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington
| | - Tina J Owen
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington
| | - Boel A Fransson
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington
| | - Kira J Carbonneau
- Department of Educational Leadership, Sports Sciences, and Educational Psychology, College of Education, Washington State University, Pullman, Washington
| | - Susan M Matthew
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington
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27
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Mayousse V, Desquilbet L, Jeandel A, Blot S. Prevalence of neurological disorders in French bulldog: a retrospective study of 343 cases (2002-2016). BMC Vet Res 2017; 13:212. [PMID: 28676057 PMCID: PMC5497356 DOI: 10.1186/s12917-017-1132-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 06/26/2017] [Indexed: 12/18/2022] Open
Abstract
Background French Bulldog (FB) has significantly gained in popularity over the last few years, and seems to be frequently affected by various neurological conditions. The purpose of this retrospective study was to report the prevalences of neurological diseases in a large population of FB, presented with neurological signs between 2002 and 2016, and for which a definitive diagnosis was established. A secondary objective was to identify epidemiological characteristics regarding specific diseases in this singular breed. Results During the study period, 533 FBs were presented for neurological signs, representing 18.7% of all admitted FBs (N = 2846). In total, 343 FBs with definitive diagnosis were included in this descriptive epidemiological study. Hansen type I intervertebral disk herniation (IVDH) was by far the most common neurological disorder (45.5% of all cases). The IVDH location was cervical in 39.8%, and thoracolumbar in 60.2% of cases. The median ages for cervical and thoracolumbar IVDH were 4.2 and 4 years, respectively. C3-C4 was the most commonly affected disk (57.8% of cervical IDVH) all locations combined. Spinal arachnoid diverticulum (SAD) was detected in 25 FBs, representing the second most common myelopathy (11.3%). A concurrent spinal abnormality was identified in 64.0% of SAD cases. Brain tumours represented 36.8% of encephalopathies, with glioma (confirmed or suspected) being the most common. Meningoencephalitis of unknown origin (MUO) represented 25.0% of brain disorders, females less than 5.5 years being more likely to be affected. Aside from central nervous system conditions, otitis interna associated with peripheral vestibular signs and bilateral congenital deafness (associated with white coat) were also common. Conclusions The findings of this study suggest that FB seems to be prone to several neurological diseases. IVDH is clearly predominant in FB and cervical location seems more represented than in other breeds. FBs affected by IVDH tend to be younger than previously described, either for both cervical and thoracolumbar locations. Thoracic SAD was the second most common myelopathy, with a concurrent spinal anomaly identified in two thirds of the cases. MUO was more likely to affect young to middle-aged females. These findings could be of interest for owners, breeders, practicing veterinarians and insurance companies.
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Affiliation(s)
- Vincent Mayousse
- Université Paris-Est, Ecole Nationale Vétérinaire d'Alfort (EnvA), Unité de Neurologie, 7 avenue du général de Gaulle, 94700, Maisons-Alfort, France. .,Inserm, IMRB U955-E10, 8 rue du général Sarrail, 94000, Créteil, France. .,UMR BNMS Neurobiologie, Ecole Nationale Veterinaire d'Alfort, 7 avenue du General de Gaulle, 94700, Maisons Alfort, France.
| | - Loïc Desquilbet
- Université Paris-Est, Ecole Nationale Vétérinaire d'Alfort (EnvA), Unité de Biostatistiques et d'Epidémiologie Clinique, 7 avenue du général de Gaulle, 94700, Maisons-Alfort, France
| | - Aurélien Jeandel
- Université Paris-Est, Ecole Nationale Vétérinaire d'Alfort (EnvA), Unité de Neurologie, 7 avenue du général de Gaulle, 94700, Maisons-Alfort, France.,Present adress: Davies Veterinary Specialists, Manor Farm Buisiness Park, Higham Gobion, Herts, SG5 3HR, United Kingdom
| | - Stéphane Blot
- Université Paris-Est, Ecole Nationale Vétérinaire d'Alfort (EnvA), Unité de Neurologie, 7 avenue du général de Gaulle, 94700, Maisons-Alfort, France.,Inserm, IMRB U955-E10, 8 rue du général Sarrail, 94000, Créteil, France.,UMR BNMS Neurobiologie, Ecole Nationale Veterinaire d'Alfort, 7 avenue du General de Gaulle, 94700, Maisons Alfort, France
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28
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Postoperative pain in dogs undergoing hemilaminectomy: Comparison of the analgesic activity of buprenorphine and tramadol. J Vet Behav 2017. [DOI: 10.1016/j.jveb.2017.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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29
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Housley D, Caine A, Cherubini G, Taeymans O. Evaluation of T2-weighted versus short-tau inversion recovery sagittal sequences in the identification and localization of canine intervertebral disc extrusion with low-field magnetic resonance imaging. Vet Radiol Ultrasound 2017; 58:433-443. [PMID: 28429414 DOI: 10.1111/vru.12500] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 12/23/2016] [Accepted: 01/16/2017] [Indexed: 11/27/2022] Open
Abstract
Sagittal T2-weighted sequences (T2-SAG) are the foundation of spinal protocols when screening for the presence of intervertebral disc extrusion. We often utilize sagittal short-tau inversion recovery sequences (STIR-SAG) as an adjunctive screening series, and experience suggests that this combined approach provides superior detection rates. We hypothesized that STIR-SAG would provide higher sensitivity than T2-SAG in the identification and localization of intervertebral disc extrusion. We further hypothesized that the parallel evaluation of paired T2-SAG and STIR-SAG series would provide a higher sensitivity than could be achieved with either independent sagittal series when viewed in isolation. This retrospective diagnostic accuracy study blindly reviewed T2-SAG and STIR-SAG sequences from dogs (n = 110) with surgically confirmed intervertebral disc extrusion. A consensus between two radiologists found no significant difference in sensitivity between T2-SAG and STIR-SAG during the identification of intervertebral disc extrusion (T2-SAG: 92.7%, STIR-SAG: 94.5%, P = 0.752). Nevertheless, STIR-SAG accurately identified intervertebral disc extrusion in 66.7% of cases where the evaluation of T2-SAG in isolation had provided a false negative diagnosis. Additionally, one radiologist found that the parallel evaluation of paired T2-SAG and STIR-SAG series provided a significantly higher sensitivity than T2-SAG in isolation, during the identification of intervertebral disc extrusion (T2-SAG: 78.2%, paired T2-SAG, and STIR-SAG: 90.9%, P = 0.017). A similar nonsignificant trend was observed when the consensus of both radiologists was taken into consideration (T2-SAG: 92.7%, paired T2-SAG, and STIR-SAG = 97.3%, P = 0.392). We therefore conclude that STIR-SAG is capable of identifying intervertebral disc extrusion that is inconspicuous in T2-SAG, and that STIR-SAG should be considered a useful adjunctive sequence during preliminary sagittal screening for intervertebral disc extrusion in low-field magnetic resonance.
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Affiliation(s)
- Daniel Housley
- Dick White Referrals, Diagnostic Imaging, Newmarket, Cambridgeshire, United Kingdom of Great Britain and Northern Ireland
| | - Abby Caine
- Dick White Referrals, Diagnostic Imaging, Newmarket, Cambridgeshire, United Kingdom of Great Britain and Northern Ireland
| | - Giunio Cherubini
- Dick White Referrals, Diagnostic Imaging, Newmarket, Cambridgeshire, United Kingdom of Great Britain and Northern Ireland
| | - Olivier Taeymans
- Dick White Referrals, Diagnostic Imaging, Newmarket, Cambridgeshire, United Kingdom of Great Britain and Northern Ireland
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30
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Masciarelli AE, Griffin JF, Fosgate GT, Hecht S, Mankin JM, Holmes SP, Platt SR, Kent M, Pancotto TE, Chen AV, Levine JM. Evaluation of magnetic resonance imaging for the differentiation of inflammatory, neoplastic, and vascular intradural spinal cord diseases in the dog. Vet Radiol Ultrasound 2017; 58:444-453. [DOI: 10.1111/vru.12501] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 12/11/2016] [Accepted: 01/16/2017] [Indexed: 11/29/2022] Open
Affiliation(s)
- Amanda E. Masciarelli
- Departments of Large Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences; Texas A&M University; TX 77843
| | - John F. Griffin
- Departments of Large Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences; Texas A&M University; TX 77843
| | - Geoffrey T. Fosgate
- The Department of Production Animal Studies; University of Pretoria; Pretoria South Africa
| | - Silke Hecht
- The Department of Small Animal Clinical Sciences; University of Tennessee College of Veterinary Medicine; Knoxville TN 37996
| | - Joseph M. Mankin
- Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences; Texas A&M University; TX 77843
| | - Shannon P. Holmes
- The Departments of Veterinary Biosciences and Diagnostic Imaging; University of Georgia College of Veterinary Medicine; Athens GA 30602
| | - Simon R. Platt
- Small Animal Medicine and Surgery; University of Georgia College of Veterinary Medicine; Athens GA 30602
| | - Marc Kent
- Small Animal Medicine and Surgery; University of Georgia College of Veterinary Medicine; Athens GA 30602
| | - Theresa E. Pancotto
- The Department of Small Animal Clinical Sciences; Virginia-Maryland College of Veterinary Medicine; Blacksburg VA 24061
| | - Annie V. Chen
- The Department of Veterinary Clinical Sciences, College of Veterinary Medicine; Washington State University; Pullman WA 99164
| | - Jonathan M. Levine
- The Department of Production Animal Studies; University of Pretoria; Pretoria South Africa
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31
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Achard D, Francoz D, Grimes C, Desrochers A, Nichols S, Babkine M, Fecteau G. Cerebrospinal Fluid Analysis in Recumbent Adult Dairy Cows With or Without Spinal Cord Lesions. J Vet Intern Med 2017; 31:940-945. [PMID: 28382682 PMCID: PMC5435069 DOI: 10.1111/jvim.14705] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 02/14/2017] [Accepted: 02/28/2017] [Indexed: 11/28/2022] Open
Abstract
Background Diagnosis of central nervous system (CNS) lesions in recumbent dairy cattle (RDC) is challenging because neurologic examination is limited and medical imaging often is challenging or unrewarding. Cerebrospinal fluid (CSF) analysis is useful in the diagnosis of CNS disorders in cattle. However, its utility in identifying spinal cord lesions in RDC remains to be evaluated. Hypothesis/Objectives We hypothesized that CSF analysis would discriminate between RDC with and without spinal cord lesions. Animals Twenty‐one RDC with spinal cord lesions (RDC+) and 19 without (RDC−) were evaluated. Methods Spinal cord lesions were confirmed at necropsy. Signalment, clinical findings, and CSF results were compared retrospectively. Total nucleated cell count and differential, protein concentration, and red blood cell count in RDC+ and RDC− were compared. Results Neoplasia, trauma, and infectious processes were the most frequent spinal cord lesions identified. Cerebrospinal fluid protein concentrations and TNCC were significantly higher in RDC+ compared to RDC− (P = .0092 and P = .0103, respectively). Additionally, CSF protein concentrations and TNCC in RDC− were lower than previously published reference ranges. Using an interpretation rule based on CSF protein concentration and TNCC, it was possible to accurately identify 13 RDC with spinal cord lesions and 6 RDC without lesions. It was not possible to determine spinal cord status in the remaining 18 RDC. Conclusions and Clinical Importance Cerebrospinal fluid analysis is valuable in the evaluation of spinal cord status in RDC. The prognosis associated with these findings remains to be determined.
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Affiliation(s)
- D Achard
- Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, QC, Canada
| | - D Francoz
- Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, QC, Canada
| | - C Grimes
- Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, QC, Canada
| | - A Desrochers
- Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, QC, Canada
| | - S Nichols
- Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, QC, Canada
| | - M Babkine
- Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, QC, Canada
| | - G Fecteau
- Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, QC, Canada
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Moore SA, Granger N, Olby NJ, Spitzbarth I, Jeffery ND, Tipold A, Nout-Lomas YS, da Costa RC, Stein VM, Noble-Haeusslein LJ, Blight AR, Grossman RG, Basso DM, Levine JM. Targeting Translational Successes through CANSORT-SCI: Using Pet Dogs To Identify Effective Treatments for Spinal Cord Injury. J Neurotrauma 2017; 34:2007-2018. [PMID: 28230415 DOI: 10.1089/neu.2016.4745] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Translation of therapeutic interventions for spinal cord injury (SCI) from laboratory to clinic has been historically challenging, highlighting the need for robust models of injury that more closely mirror the human condition. The high prevalence of acute, naturally occurring SCI in pet dogs provides a unique opportunity to evaluate expeditiously promising interventions in a population of animals that receive diagnoses and treatment clinically in a manner similar to persons with SCI, while adhering to National Institutes of Health guidelines for scientific rigor and transparent reporting. In addition, pet dogs with chronic paralysis are often maintained long-term by their owners, offering a similarly unique population for study of chronic SCI. Despite this, only a small number of studies have used the clinical dog model of SCI. The Canine Spinal Cord Injury Consortium (CANSORT-SCI) was recently established by a group of veterinarians and basic science researchers to promote the value of the canine clinical model of SCI. The CANSORT-SCI group held an inaugural meeting November 20 and 21, 2015 to evaluate opportunities and challenges to the use of pet dogs in SCI research. Key challenges identified included lack of familiarity with the model among nonveterinary scientists and questions about how and where in the translational process the canine clinical model would be most valuable. In light of these, we review the natural history, outcome, and available assessment tools associated with canine clinical SCI with emphasis on their relevance to human SCI and the translational process.
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Affiliation(s)
- Sarah A Moore
- 1 Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine , Columbus Ohio.,2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI)
| | - Nicolas Granger
- 2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,3 Faculty of Health Sciences, University of Bristol , Langford, North Somerset, United Kingdom
| | - Natasha J Olby
- 2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,4 Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University , Raleigh, North Carolina.,5 Comparative Medicine Institute, North Carolina State University , Raleigh, North Carolina
| | - Ingo Spitzbarth
- 2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,6 Department of Pathology, University of Veterinary Medicine , Hannover, Germany .,7 Center for Systems Neuroscience , Hannover, Germany
| | - Nick D Jeffery
- 2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,8 Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University , College Station, Texas
| | - Andrea Tipold
- 2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,7 Center for Systems Neuroscience , Hannover, Germany.,9 Department of Small Animal Medicine and Surgery, University of Veterinary Medicine , Hannover, Germany
| | - Yvette S Nout-Lomas
- 2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,10 College of Veterinary Medicine and Biomedical Sciences, Colorado State University , Fort Collins, Colorado
| | - Ronaldo C da Costa
- 1 Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine , Columbus Ohio.,2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI)
| | - Veronika M Stein
- 2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,11 Department of Clinical Veterinary Sciences, University of Bern , Bern, Switzerland
| | - Linda J Noble-Haeusslein
- 2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,12 Departments of Physical Therapy and Rehabilitation Sciences and Neurological Surgery, University of California , San Francisco, San Francisco, California
| | - Andrew R Blight
- 2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,13 Acorda Therapeutics, Inc. Ardsley, New York
| | - Robert G Grossman
- 2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,14 Department of Neurosurgery, Houston Methodist Neurological Institute , Houston, Texas
| | - D Michele Basso
- 2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,15 School of Health and Rehabilitation Sciences, The Ohio State University , Columbus, Ohio
| | - Jonathan M Levine
- 2 The Canine Spinal Cord Injury Consortium (CANSORT-SCI).,8 Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University , College Station, Texas
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33
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Stout Steele MW, Hodshon AW, Hopkins AL, Tracy GM, Cohen ND, Kerwin SC, Boudreau CE, Thomas WB, Mankin JM, Levine JM. Multi-Center Retrospective Evaluation of Screw and Polymethylmethacrylate Constructs for Atlantoaxial Fixation in Dogs. Vet Surg 2016; 45:909-915. [PMID: 27580972 DOI: 10.1111/vsu.12533] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate outcome and adverse events following ventral stabilization of the atlantoaxial (AA) joint in dogs with clinical AA subluxation using screw/polymethymethacrylate (PMMA) constructs in a retrospective, multi-center cohort study. STUDY DESIGN Historical cohort study. ANIMALS 35 client-owned dogs. METHODS Medical records from 3 institutions were reviewed to identify dogs with AA subluxation treated with ventral screw and PMMA constructs. Data on signalment, pre- and postoperative neurologic status, imaging performed, and adverse events were retrieved. Neurologic examination data were abstracted to generate a modified Frankel score at admission, discharge, and re-examination. Telephone interview of owners >180 days postoperative was conducted. RESULTS Thirty-five dogs with AA subluxation treated with ventral screw/PMMA constructs were included. Most dogs were young (median age 1 year), small breed dogs with acute onset of neurologic signs (median duration 22.5 hours). Most dogs were non-ambulatory at the time of admission (median modified Frankel score 3). Adverse events were identified in 15/35 dogs including 9 dogs with major adverse events. Four dogs required a second surgery due to vertebral canal violation (n = 2) or implant failure (n = 2). Re-examination at 4-6 weeks postoperative reported 15/28 dogs with improved neurologic status and 19/28 dogs were ambulatory. Telephone follow-up was available for 23/35 dogs with 23/23 reported as ambulatory (median follow-up 390 days). CONCLUSIONS Ventral application of screw and PMMA constructs for AA subluxation, as described here, is associated with clinical improvement in the majority of dog. Major adverse events are infrequent and the technique is considered relatively safe.
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Affiliation(s)
- Megan W Stout Steele
- Department of Veterinary Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas
| | - Amy W Hodshon
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee
| | | | | | - Noah D Cohen
- Department of Veterinary Large Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas
| | - Sharon C Kerwin
- Department of Veterinary Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas
| | - C Elizabeth Boudreau
- Department of Veterinary Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas
| | - William B Thomas
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee
| | - Joseph M Mankin
- Department of Veterinary Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas
| | - Jonathan M Levine
- Department of Veterinary Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas
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Royaux E, Martlé V, Kromhout K, Van der Vekens E, Broeckx BJG, Van Ham L, Gielen I. Detection of compressive hydrated nucleus pulposus extrusion in dogs with multislice computed tomography. Vet J 2016; 216:202-6. [PMID: 27687953 DOI: 10.1016/j.tvjl.2016.08.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 07/19/2016] [Accepted: 08/23/2016] [Indexed: 11/28/2022]
Abstract
Compressive hydrated nucleus pulposus extrusion (HNPE) in dogs is defined as acute extradural compression by hydrated nucleus pulposus material at the level of the associated intervertebral disc. Magnetic resonance imaging (MRI) is the imaging modality of choice for diagnosis of HNPE. The aims of this study were to determine the usefulness of unenhanced computed tomography (CT) and contrast enhanced CT (CE-CT), and the sensitivity and specificity of CE-CT, for detection of compressive HNPE. Using CE-CT, HNPE was visualised as a hypodense extradural compressive lesion with rim enhancement immediately dorsal to the intervertebral disc space, with a sensitivity of 91% and a specificity of 100%. CE-CT is a useful technique to detect compressive HNPE in dogs. However, if no clear lesion is identified with CE-CT, or if additional information about intramedullary changes is required, MRI still needs to be performed.
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Affiliation(s)
- E Royaux
- Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, Merelbeke, Belgium.
| | - V Martlé
- Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, Merelbeke, Belgium
| | - K Kromhout
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, Merelbeke, Belgium
| | - E Van der Vekens
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, Merelbeke, Belgium
| | - B J G Broeckx
- Laboratory of Pharmaceutical Biotechnology, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, Ghent, Belgium
| | - L Van Ham
- Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, Merelbeke, Belgium
| | - I Gielen
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, Merelbeke, Belgium
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Moore SA, Early PJ, Hettlich BF. Practice patterns in the management of acute intervertebral disc herniation in dogs. J Small Anim Pract 2016; 57:409-15. [DOI: 10.1111/jsap.12496] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 01/18/2016] [Accepted: 02/29/2016] [Indexed: 11/28/2022]
Affiliation(s)
- S. A. Moore
- Department of Veterinary Clinical Sciences, College of Veterinary MedicineThe Ohio State University Columbus Ohio 43210 USA
| | - P. J. Early
- College of Veterinary MedicineNorth Carolina State University Raleigh North Carolina 27695 USA
| | - B. F. Hettlich
- Department of Veterinary Clinical Sciences, College of Veterinary MedicineThe Ohio State University Columbus Ohio 43210 USA
- Small Animal ClinicVetsuisse Faculty Bern Länggassstrasse 120 3012 Bern Switzerland
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Usefulness of multidetector computed tomography in the evaluation of spinal neuro-musculoskeletal injuries. Vet Comp Orthop Traumatol 2015; 29:1-13. [PMID: 26640838 DOI: 10.3415/vcot-15-05-0082] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 11/06/2015] [Indexed: 11/17/2022]
Abstract
Spinal trauma is commonly diagnosed in small animal practice. Although the first approach to the patient with spinal trauma includes survey spinal radiographs, an accurate evaluation of the injury often requires advanced imaging. Multidetector computed tomography has revolutionized computed tomography technology, providing near-isotropic volumetric representation of the complete body with exquisite anatomical detail in a brief scan time. This review aims to discuss the technical background, indications, and limitations of multidetector computed tomography in the assessment of spinal trauma with particular reference to skeletal, muscular and nervous spinal components.
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Lamb CR. Letter to the editor. Vet Radiol Ultrasound 2014; 55:345. [DOI: 10.1111/vru.12174_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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38
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Martin-Vaquero P, da Costa RC, Drost WT. Comparison of noncontrast computed tomography and high-field magnetic resonance imaging in the evaluation of Great Danes with cervical spondylomyelopathy. Vet Radiol Ultrasound 2014; 55:496-505. [PMID: 24547789 DOI: 10.1111/vru.12148] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2013] [Accepted: 12/08/2013] [Indexed: 11/28/2022] Open
Abstract
Computed tomography (CT) provides excellent bony detail, whereas magnetic resonance (MR) imaging is superior in evaluating the neural structures. The purpose of this prospective study was to assess interobserver and intermethod agreement in the evaluation of cervical vertebral column morphology and lesion severity in Great Danes with cervical spondylomyelopathy by use of noncontrast CT and high-field MR imaging. Fifteen client-owned affected Great Danes were enrolled. All dogs underwent noncontrast CT under sedation and MR imaging under general anesthesia of the cervical vertebral column. Three observers independently evaluated the images to determine the main site of spinal cord compression, direction and cause of the compression, articular process joint characteristics, and presence of foraminal stenosis. Overall intermethod agreement, intermethod agreement for each observer, overall interobserver agreement, and interobserver agreement between pairs of observers were calculated by use of kappa (κ) statistics. The highest overall intermethod agreements were obtained for the main site of compression and direction of compression with substantial agreements (κ = 0.65 and 0.62, respectively), whereas the lowest was obtained for right-sided foraminal stenosis (κ = 0.39, fair agreement). For both imaging techniques, the highest and lowest interobserver agreements were recorded for the main site of compression and degree of articular joint proliferation, respectively. While different observers frequently agree on the main site of compression using both imaging techniques, there is considerable variation between modalities and among observers when assessing articular process characteristics and foraminal stenosis. Caution should be exerted when comparing image interpretations from multiple observers.
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Affiliation(s)
- Paula Martin-Vaquero
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Ohio State University, Columbus, OH, 43210
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