Surgical removal of an intramedullary spinal cord foreign body granuloma in a dog

Meningoencephalomyelitis associated with foreign plant material in a dog: case report and brief literature review

Neurologic disease associated with migration of plant material is reported infrequently in dogs. Here we describe meningoencephalomyelitis associated with foreign plant material in a 2-y-old castrated male West Highland White Terrier dog with acute neck pain. Magnetic resonance imaging revealed spinal meningeal contrast enhancement. Although clinical signs improved after treatment with steroids, the dog was readmitted for further evaluation 3-mo later and was euthanized after generalized epileptic seizures. Autopsy findings consisted of coalescing, pus-filled, neuroparenchymal cavitations surrounded by hemorrhage in the left caudal colliculus and rostral left cerebellar hemisphere. Histologically, lesions consisted of necrosis and suppuration, which surrounded a 1 × 2-mm foreign body morphologically consistent with plant material and clusters of gram-positive bacterial cocci. Affected areas were surrounded by reactive astrocytes, fibrous connective tissue, and mixed inflammatory infiltrates. Areas of hemorrhage and infiltration by neutrophils and foamy macrophages with fibrinoid change of small capillaries were observed in the adjacent neuroparenchyma. The inflammation extended to the perivascular spaces in the leptomeninges (mesencephalon, cerebellum, and brainstem, and spinal cord) and spinal central canal. Anaerobic bacterial culture of frozen samples of cerebellum yielded heavy growth of Bacteroides pyogenes.

Recovery after inadvertent intramedullary microchip implantation at C1–C2 in a kitten

Case summary

A 15-week-old male British Shorthair cat was presented for peracute paralysis immediately after microchip implantation. Neurological examination revealed a non-ambulatory tetraparesis and left thoracic limb plegia localised to C1–C5 spinal cord segments. CT of the cervical spine showed a diagonally orientated metallic foreign body (microchip transponder, 10 mm in length) within the vertebral canal at the level of C1–C2, resulting in a penetrating spinal cord injury. Based on concerns about further iatrogenic spinal cord injury through surgery, medical management was chosen. Despite the severe clinical signs, the kitten returned to ambulation within 6 days of the injury, with controlled urination and defecation. Continuous neurological improvement was seen for up to 6 weeks after the injury at which point a mild-to-moderate ambulatory tetraparesis and ataxia remained, with an overall good quality of life. Follow-up CT at the age of 13 months revealed a relative cranial displacement and rotation of the microchip towards the foramen magnum, while the cat’s neurological status was unchanged.

Relevance and novel information

This case demonstrated a cervical penetrating spinal cord injury in a growing cat caused by a microchip, which was successfully managed with medical treatment, suggesting that this might be an option for patients at risk of severe surgery-related complications or where owners reject surgery.

Atlantoaxial epidural abscess secondary to grass awn migration in a dog

A two-year-old female Lucerne Hound was presented with a one-week history of signs of progressive neck pain, inappetence, apathy, and an elevated rectal temperature. Findings of magnetic resonance imaging (MRI) were consistent with a foreign body abscess in the epidural space at the level of the first and second cervical vertebrae. A leftsided dorso-lateral atlantoaxial approach was performed, revealing an epidural abscess containing a grass awn. The clinical signs resolved within three days of surgery and the dog made a full recovery. This case report shows that grass awns can migrate to the atlantoaxial region in dogs and MRI findings lead to a suspicion of caudo-cranial migration within the spinal canal.

Cervical porcupine quill foreign body involving the spinal cord of a dog: A description of various imaging modality findings

Although porcupine quill injuries are common in dogs, the detailed appearance of the quill on diagnostic ultrasound, computed tomography, and magnetic resonance imaging has not been sufficiently described. A 4-year-old, intact, female Jack Russel terrier presented with severe neck pain and ataxia after an altercation with a porcupine 2 weeks earlier. Radiology, diagnostic ultrasound, computed tomography and magnetic resonance imaging were all utilised to identify a quill imbedded in the cervical vertebral canal and cervical musculature and were compared to each other. Surgical removal of the quill, guided by imaging findings, led to the resolution of the clinical signs in the patient. Previous ultrasound imaging reports have just stated that the quill consists of paralell hyperechoic lines, and do not mention the finer hyperechoic lines inbetween and do not try to provide a reason for the appearance. Previous computed tomography (CT) reports just mention identifying the quill on CT images (whether or not CT could identify the fragments), but do not go into detail about the attenuating appearance of the quill nor try to relate this to the composition of the quill. This is to the authors’ knowledge the first report with detailed imaging descriptions of a case of cranial cervical vertebral canal porcupine quill foreign body in a dog. This is also the first report to allude to a possible difference in imaging findings related to quill structure because of keratin orientation and melanin content. The ideal imaging modality to use remains elusive, but ultrasound, computed tomography and magnetic resonance imaging could all identify the quill.

Bacterial Meningoencephalitis and Ventriculitis Due to Migrating Plant Foreign Bodies in Three Dogs

Regional suppurative meningoencephalitis and ventriculitis of variable chronicity was diagnosed in three young dogs residing in Colorado. Grass awns were grossly identified in the right occipital cortex of one dog and in the right lateral ventricle of another. Intralesional plant material was microscopically evident in the dura mater overlying the right occipital cortex of the third dog. One grass awn was identified as a floret of Hordeum jabatum. In each case, aerobic culture of brain tissue identified multiple isolates of bacteria. The dogs presented with clinically variable, rapidly progressive neurologic dysfunction, including tetraplegia, depressed mentation, and episodic extensor rigidity, ataxia, circling, stupor, vocalization, and head-pressing. Encephalitis due to bacteria introduced from migrating plant foreign material is a potential sequela of intranasal, periocular, or pharyngeal foreign bodies.

Intramedullary spinal cord mass presumptively associated with leishmaniasis in a dog

CASE DESCRIPTION

A 9-year-old male Miniature Poodle was evaluated because of progressive severe right hemiparesis, right forelimb lameness, and signs of cervical pain.

CLINICAL FINDINGS

A low body condition score (2/9) and popliteal lymphadenopathy were detected. Results of a CBC, serum biochemical analyses, urinalysis, cytologic examination of bone marrow and popliteal lymph node aspirates, and serum ELISA were consistent with systemic leishmaniasis. Magnetic resonance imaging of the cervical spinal cord revealed an intramedullary mass extending from the caudal aspect of the C5 vertebral body to the C5-6 intervertebral disk space with a contrast medium-enhanced pattern that had 3 zones (central contrast medium-enhanced core, intermediate isointense zone, and peripheral contrast medium-enhanced ring). Surgical biopsy of the mass was performed by means of a right C5-6 dorsal hemilaminectomy. Results of PCR assays for detection of Leishmania DNA in CSF and tissue biopsy samples were positive.

TREATMENT AND OUTCOME

Treatment for systemic leishmaniasis was initiated. Two months later, body condition, neurologic signs, and gait of the dog had substantially improved; the dog had mild right forelimb paresis at that time. Results of follow-up MRI indicated resolution of the cervical spinal cord lesion. Four months after diagnosis, the dog's neurologic condition was stable.

CLINICAL RELEVANCE

To the authors' knowledge, this report is the first in which clinical findings, clinicopathologic data, and MRI characteristics of an intramedullary inflammatory spinal cord lesion presumptively attributable to leishmaniasis in a dog have been reported, and the first report of CNS leishmaniasis in a dog with MRI resolution and a successful clinical response to treatment.

Parotid Duct Foreign Body in a Dog Diagnosed with CT

A 12 mo old castrated male German shorthaired pointer was referred with a 3 mo history of a recurrent left-sided facial swelling. Contrast-enhanced computed tomography (CT) combined with a positive contrast sialogram revealed the presence of a thick-walled dilated region of the left parotid duct and a normal appearance of the parotid gland. The affected parotid duct, complete with grass seed foreign body, was surgically removed under general anesthesia, and the parotid duct was ligated leaving the parotid gland in situ. Twelve mo later, the dog was doing well with no reported complications.

Use of magnetic resonance imaging in the diagnosis of spinal empyema caused by a migrating grass awn in a dog

Abstract

CASE HISTORY

A 13 kg 3.5-year-old male neutered Cocker Spaniel presented with a 6-day history of deteriorating hindlimb paresis. Approximately 10 weeks previously the owner reported removing a large number of barley grass seeds from the dog's coat and ears. Eight weeks later the dog was treated for pneumonia, based on clinical findings and thoracic radiographs. In the 4 days prior to referral the dog had a decreased appetite, was lethargic and appeared unable to urinate voluntarily.

CLINICAL FINDINGS

The dog was bright and alert but unable to walk. Upper motor neuron signs were indicative of T3-L3 spinal lesion. Using magnetic resonance imaging (MRI), an abnormal low signal linear structure within the left T12-T13 neural foramen extending to the left lateral aspects of the thoracic spinal cord was detected, consistent with a foreign body. A left T12-T13 lateral hemilaminectomy was performed and a grass seed removed from a tract extending caudally from the T12-13 space, dorsal to the lumbar transverse processes and the rib head. The dog made a rapid recovery after surgery with full resolution of clinical signs.

DIAGNOSIS

Spinal empyema caused by a migrating barley grass awn (Hordeum spp.).

CLINICAL RELEVANCE

Advanced imaging using MRI can bea valuable method for localising foreign bodies prior to exploratory surgery. Animals presenting with neurological signs should have foreign body reactions included as a differential diagnosis.

Metallic foreign body in the liver of a dog

A 4-year-old beagle had intermittent vomiting and weight loss for 1 month. On plain radiography, an approximately 3.5-cm, radiopaque, linear foreign body was identified in the region of the liver. On ultrasonography, a hyperechoic linear structure with reverberation was identified in the left lobe or quadrate lobe. On computed tomography(CT), a thin hyperattenuating material consistent with a metallic foreign body was identified just medial to the gall bladder. Removal of the foreign body was performed without complications. We present a rare case in which a metallic foreign body was embedded in the liver asymptomatically and found incidentally during a clinical examination performed to ascertain the cause of clinical signs.

Computed tomographic diagnosis of nongastrointestinal foreign bodies in dogs

Clinical data and computed tomography (CT) studies were reviewed for 13 dogs with confirmed nongastrointestinal foreign bodies. Locations of foreign bodies were the nasal cavity, thoracic wall, retropharyngeal region, and cerebellum. Types of foreign bodies included small plant components, blades of grass, wooden sticks, cloth fibers, and a needle. Foreign bodies in five dogs were not identified on CT, and secondary reactions resembled neoplastic or fungal disease. In eight dogs, foreign bodies were recognized by their shape and/or internal architecture. In two dogs, three-dimensional reformatting helped demonstrate foreign bodies in relation to palpable bony landmarks.

Successful treatment of cervical spinal epidural empyema secondary to grass awn migration in a cat

Spinal epidural empyema (SEE) represents a severe pyogenic infection of the epidural space. Clinical signs of the disease are non-specific--increased body temperature, intense neck pain, neurological signs of a transverse myelopathy--and can lead to severe and permanent neurological deficits. This report describes the diagnosis and successful surgical treatment of cervical SEE secondary to grass awn migration in a cat. Although it is uncommon, this disease should be suspected in cats with progressive myelopathy. Early diagnosis and emergency surgery combined with antibiotic therapy are required to allow a complete recovery.