Canine thoracolumbar intervertebral disk herniation and rehabilitation therapy after surgical decompression: A retrospective study

Surface electromyography: A pilot study in canine spinal muscles

In veterinary practice, rehabilitation modalities are often used to help in the recovery of animals affected by InterVertebral Disc Disease (IVDD), a condition frequently observed in chondrodystrophic dog breeds and can lead to Spinal Cord Injury (SCI), resulting in pain, motor impairments and neurological deficits, but there is a lack of objective assessment tools for patient evolution. In this work, an innovative approach using surface ElectroMyoGraphy (sEMG) is proposed to be applied in the field of veterinary medicine rehabilitation. The observed results are thought to be a direct result of nerve compression, leading to unusual patterns of muscle activation; this phenomenon can be attributed to muscle denervation, where the loss of Motor Units (MU) is the primary cause. This is thought to be responsible for the decrease in recorded sEMG amplitude and the increase in frequency observed in the pathological group.•This study involved rigorous animal preparation and signal acquisition protocols, involving multiple exercises and sub-movements, which were subsequently analysed.•RMSA is most used metric to analyse amplitude in sEMG signals, as it results in a more representative measurement of the signal variability than the Mean amplitude or the Standard Deviation.

Physiotherapy in the Recovery of Paraplegic Dogs without Nociception Due to Thoracolumbar Intervertebral Disc Extrusion Treated Surgically

Several authors have advocated for the role of physiotherapy in canine intervertebral disc extrusion, and it is routinely recommended by various veterinary neurologists. However, veterinary literature does not unanimously support the routine use of physiotherapy to ensure an increase in locomotor return in dogs with IVDE. The aim of the study was to investigate whether physiotherapy can influence the functional recovery of paraplegic dogs with loss of nociception (LN) affected by thoracolumbar IVDE (Hansen type I) and treated surgically. The animals were divided into two groups: the physiotherapy group (PG), which included those that underwent decompressive surgery and postoperative physiotherapy; and the control group (CG), which included dogs that did not undergo any physiotherapy after surgery. A total of 51 dogs were included, with 30 in the PG and 21 in the CG. The number of physiotherapy sessions ranged from 6 to 60. The rate of functional recovery in dogs within 21 days postoperatively (PO) was 10% (3/30) in the PG and 19% (4/21) in the CG. After 21 days PO, the recovery rate was 43.33% (13/30) in the PG and 61.9% (13/21) in the CG, with no significant difference observed between the groups (p = 0.258). Based on the findings of this study, it was concluded that physiotherapy in paraplegic dogs with LN due to thoracolumbar IVDE does not appear to influence functional recovery compared to the group without physiotherapy.

Prevalence of canine cranial cruciate ligament rupture and prognosis depending on tibial plateau angle: A retrospective study

Objective

This study aimed to evaluate the prevalence of cranial cruciate ligament rupture (RCCL) and the efficacy of tibial plateau angle (TPA) as a prognostic indicator in small breed dogs diagnosed with RCCL.

Materials and Methods

For this study, 53 dogs with RCCL were selected based on their medical data. The Tibial plateau angle (TPA) was calculated by analyzing the radiographic images of the stifle joint region. The dogs were categorized based on their body weight, sex, age, breed, and RCCL. Subsequently, clinical outcomes of dogs were evaluated based on their pre- and postoperative TPAs.

Results

The prevalence of RCCL was higher in neutered dogs, especially those neutered before 6 months of age. The preoperative TPAs of all dogs diagnosed with RCCL were lowered with TPLO. Preoperative walking time in the higher pre-operative TPA (>25°) group (13.58 ± 1.53 days) was significantly (p < 0.05) longer than the lower pre-operative TPA (≤25°) group (10.09 ± 0.84). The lower pre-operative TPA (≤ 25°) group showed better prognoses without any more complications than the higher pre-operative TPA (> 25°) group. Furthermore, post-operative walking time in the higher post-operative TPA dogs (>10°) group (18.08 ± 2.22 days) was significantly (p < 0.05) longer than the lower post-operative TPA dogs (≤10°) group (10.20 ± 0.90 days). Likewise, the TPA (≤10°) group showed better prognoses with lowered complications.

Conclusion

Therefore, pre- and post-operative TPA plays an important prognostic factor, and post-operative TPA should be kept at<10° to get better clinical outcomes.

Evaluation of Safe Insertion Angles for Spinal Needles and Safe Intensity of the Holmium:YAG Laser during Percutaneous Laser Disc Ablations in Feline Cadavers

In the context of veterinary medicine, minimally invasive techniques for feline spinal surgery remain underexplored, particularly for percutaneous laser disc ablation (PLDA) when using the Holmium:YAG (Ho:YAG) laser. This study aimed to refine the application of the Ho:YAG laser in PLDA by determining the optimal laser intensity and safe insertion angles for the thoracic and lumbar intervertebral discs (IVDs) in cats. Through utilizing computed tomography (CT) for precise guidance, this research involved a cadaveric study of 10 cats to evaluate the spatial configurations that allow for safe needle insertions and effective laser ablation. Various energy settings of the Ho:YAG laser (20 J, 40 J, and 60 J) were tested to ascertain the balance between adequate disc vaporization and minimal adjacent tissue damage. The results demonstrate that a 40 J setting is the most effective in achieving significant disc decompression without compromising surrounding tissue integrity. Additionally, the CT scans proved crucial in confirming the accuracy of the needle placement and the safety of the laser application angles. This study established that the 40 J setting on the Ho:YAG laser, combined with CT-guided insertion techniques, offers a reliable method for PLDA, thus enhancing the safety and efficacy of feline spinal surgeries.

Residual volume of extruded disc material and residual spinal cord compression measured on postoperative MRI do not predict neurological outcomes in dogs following decompressive surgery for thoracolumbar intervertebral disc extrusion

Published studies on the validity of using quantitative MRI measures of pre- and postoperative spinal cord (SC) compression as prognostic indicators for dogs undergoing surgery for intervertebral disc extrusion (IVDE) are currently limited. The aim of this retrospective analytical study was to describe the volume of postoperative residual extradural material (VREM) and the ratio of the cross-sectional area (CSA) of maximum SC compression to the CSA of SC in a compression-free intervertebral space as MRI measures of preoperative and postoperative compression (residual spinal cord compression, RSCC), and to compare these measures between the neurological outcome in a group of dogs. Inclusion criteria were dogs that underwent surgery for thoracolumbar IVDE, were imaged pre- and immediately postoperatively by MRI, and had a neurological follow-up examination 2 to 5 weeks postoperatively. Two blinded observers independently performed measurements in pre- and postoperative MRI studies. Dogs were classified into positive outcome (PO) and negative outcome (NO) groups based on follow-up neurologic examination scores. Seventeen dogs were included (12 PO, 5 NO). Interobserver agreement for MRI measurements was good to excellent (ICCs: 0.76-0.97). The prevalence of residual extradural material in postoperative MRI studies was 100%. No significant differences in mean preoperative SC compression, mean RSCC, mean SC decompression, or VREM were found between outcome groups (P = .25; P = .28; P = .91, P = .98). In conclusion, neither postoperative VREM nor RSCC could predict successful neurological outcomes.

Adaptation of land treadmill scoring system for underwater treadmill in dogs with thoracolumbar intervertebral disc extrusion

The underwater treadmill (UWTM) is utilized in dogs recovering from thoracolumbar intervertebral disc extrusion (TL-IVDE). Gait scoring is validated for dogs with TL-IVDE walking on the land treadmill (LT) but has not been reported for the UWTM. Our objective was to investigate if LT gait analysis could be applied to the UWTM and if non-ambulatory dogs walking unassisted on the UWTM, at a standardized water level, would be more likely to generate gait scores compared to on the LT. This was a prospective, observational study in dogs with TL-IVDE managed surigcally. At 0, 2, 4, 8 and 12 weeks post-operatively, paired video footage of dogs walking on the LT and UWTM (water level at the greater trochanter) was used to generate 0-100 stepping (SS) and coordination (regularity index, RI) scores. Scores were compared between treadmill type and over time. Twenty dogs were enrolled and seventy-eight paired recordings were available for review. Median gait scores increased over time but did not differ by treadmill type (P = 0.262 for SS, P = 0.533 for RI). Combining SS and RI, more recordings received scores of 0 for the LT (n = 58/156; 37.2 %) compared to the UWTM (n = 44/156; 28.2 %; P = 0.043). Scores of 0, at visits when there was at least movement present at multiple joints, was more common on the LT (n = 11/108; 10.2 %) compared to the UWTM (n = 2/108, 1.9 %; P = 0.026). In dogs recovering from TL-IVDE, LT-based gait scoring was feasible in dogs walking on the UWTM and might complement other gait analysis methods, especially for non-ambulatory dogs.

Conventional fractionated radiotherapy outcomes for young dogs with nephroblastoma of the spinal cord: 5 cases

Published radiotherapy results for spinal nephroblastomas in dogs are limited. In this retrospective longitudinal study (1/2007-1/2022), five dogs with a median age of 2.8 years received post-operative 3D conformal, conventional fractionated radiotherapy (CFRT) with 2-4 fields (parallel-opposed with or without two hinge-angle fields), for an incompletely resected nephroblastoma. Clinical findings prior to surgery included one or more of the following: pelvic limb paresis (5), faecal incontinence (2), flaccid tail (1), non-ambulatory (2) and deep pain loss (1). All masses were located between T11 and L3 and surgically removed via hemilaminectomy. Dogs received 45-50 Gray (Gy) in 18-20 fractions, and no dogs received chemotherapy post-radiation. At analysis, all dogs were deceased, with none lost to follow-up. The median overall survival (OS) from first treatment to death of any cause was 3.4 years (1234 days; 95% CI 68 days-upper limit not reached; range: 68-3607 days). The median planning target volume was 51.3 cc, with a median PTV dose of 51.4 Gy and median D98 = 48.3 Gy. Late complications or recurrence was difficult to fully determine in this small dataset; however, some degree of ataxia persisted throughout life in all dogs. This study provides preliminary evidence that post-operative radiotherapy may result in prolonged survival times dogs with spinal nephroblastomas.

Recovery of Spinal Walking in Paraplegic Dogs Using Physiotherapy and Supportive Devices to Maintain the Standing Position

Paraplegic patients have always been ideal candidates for physiotherapy due to their body's inability to recover on its own. Regardless of the cause that led to the onset of paraplegia (traumatic or degenerative), physiotherapy helps these patients with devices and methods designed to restore the proper functioning of their motility, as well as their quality of life. A total of 60 paraplegic dogs without deep pain in the hindlimbs caused by intervertebral disc extrusion or thoracolumbar fractures underwent physiotherapy sessions: manual therapy (massage), electrostimulation (10-20 min with possible repetition on the same day), ultrasound therapy, laser therapy, hydrotherapy, and assisted gait in supportive devices or on treadmills to stimulate and relearn walking, which was the main focus of the study. To maintain the standing position over time, we developed different devices adapted for each patient depending on the degree of damage and the possible associated pathologies: harnesses, trolleys, straps, exercise rollers, balancing platforms and mattresses, physio balls and rollers for recovery of proprioception. The main objective of our study was to demonstrate that physiotherapy and assisted gait in supportive devices to maintain the standing position may help paraplegic dogs to develop spinal walking. Concurrent pathologies (skin wounds, urinary infections, etc.) were managed concomitantly. Recovery of SW was evaluated by progression in regaining the reflectivity, nociception, gait score, and quality of life. After 125 to 320 physiotherapy sessions (25 to 64 weeks), 35 dogs (58.33%) developed spinal walking and were able to walk without falling or falling only sometimes in the case of a quick look (gait score 11.6 ± 1.57, with 14 considered normal), with a lack of coordination between the thoracic and pelvic limbs or difficulties in turning, especially when changing direction, but with the recovery of the quadrupedal position in less than 30 s. The majority of dogs recovering SW were of small size, with a median weight of 6.83 kg (range: 1.5-15.7), mixed breed (n = 9; 25.71%), Teckel (n = 4; 11.43%), Bichon (n = 5; 14.28%), Pekingese (n = 4; 11.43%), and Caniche (n = 2; 5.71%), while those who did not recover SW were larger in size, 15.59 kg (range: 5.5-45.2), and mixed breed (n = 16; 64%).

Early Locomotor Training in Tetraplegic Post-Surgical Dogs with Cervical Intervertebral Disc Disease

Locomotor training (LT) is task-specific repetitive training, with sensorimotor stimulation and intensive exercises that promote neuromuscular reorganization. This study aimed to observe if LT could be initiated safely in the first 3−15 days after surgery in tetraplegic C1−C5 IVDD—Hansen type I dogs. This prospective blinded clinical study was conducted at two rehabilitation centers in Portugal, with 114 grade 1 (MFS/OFS) dogs, divided by the presence of spinal hyperesthesia into the SHG (spinal hyperesthesia group) (n = 74) and the NSHG (non-spinal hyperesthesia group) (n = 40), evaluated in each time point for two weeks according to a neurorehabilitation checklist by three observers for inter-agreement relation. LT was safely applied with 62.3% of the OFS ≥ 11 within 15 days and of these, 32.4% achieved a OFS ≥ 13. There were no new cases of hyperesthesia in the NSHG and from the SHG all recovered. Comparing groups, a significant difference was observed in their ability to achieve ambulatory status (p < 0.001), between the presence of hyperesthesia and days until ambulation (p < 0.006) and in each time point (p < 0.001; R2 = 0.809). Early LT may be a safe treatment to be applied in the first 3 days on these dogs and spinal hyperesthesia should be important to the rehabilitation team. This study should be continued.

ACVIM consensus statement on diagnosis and management of acute canine thoracolumbar intervertebral disc extrusion

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.

Nonsurgical Rehabilitation in Dachshunds With T3-L3 Myelopathy: Prognosis and Rates of Recurrence

Dachshunds are at significant risk of experiencing thoracolumbar intervertebral disk herniation (IVDH) during their lifetimes. Standard of care includes advanced imaging, surgical intervention, and postoperative rehabilitation. Conservative management is commonly recommended for cases where the standard of care is declined, and little is known about the prognosis of treatment with conservative management and rehabilitation (nonsurgical rehabilitation). This retrospective cohort study assessed 12-week functional outcome and recurrence of clinical signs in 40 dachshunds with T3-L3 myelopathy presumed to be due to Hansen's Type I disc herniation, treated with nonsurgical rehabilitation. The overall prognosis was good with 34 of 40 (85.0%, 95% CI 70.2–94.2) dachshunds achieving functional pet status by 12 weeks postinjury. Modified Frankel Score at presentation was significantly (p < 0.001) higher in dogs with a positive 12-week outcome compared to dogs that did not recover by 12 weeks. All 27 dogs with motor function at presentation had a positive outcome. Of the 9 dogs exhibiting paraplegia with intact deep nociception at presentation, 7 dogs (77.8%) had achieved a positive outcome by 12 weeks. None of the 4 dogs persistently lacking deep nociception had a positive outcome. Among 27 dogs with a positive outcome for whom follow-up records were available, the 1- and 2-year recurrence rates for T3-L3 myelopathy were 5 and 11%, respectively. Nonsurgical rehabilitation should be considered in dachshunds with mild to moderate T3-L3 myelopathy or in severe cases when advanced imaging and surgical intervention are not possible.

Pilot Study on Feasibility of Sensory-Enhanced Rehabilitation in Canine Spinal Cord Injury

Physical rehabilitation is frequently recommended in dogs recovering from acute thoracolumbar intervertebral disc extrusion (TL-IVDE), but protocols vary widely. The objective of this study was to evaluate the feasibility of incorporating sensory-integrated neurorehabilitation strategies into a post-operative rehabilitation protocol in dogs with TL-IVDE. Non-ambulatory dogs with acute TL-IVDE managed surgically were prospectively recruited to this unblinded cross-over feasibility study. Eligible dogs were randomized to start with tactile-enhanced (artificial grass) or auditory-enhanced (floor piano) basic rehabilitation exercises performed twice daily for the first 4 weeks before switching to the opposite surface for the subsequent 4 weeks. Neurologic examination, open field gait scoring, girth measurements and an owner-completed feasibility questionnaire were performed at baseline and 2, 4, 6, and 8 weeks post-operatively. Twenty-four dogs were enrolled, 12 randomized to each order of exercises. Gait scores did not differ between the two groups at baseline, 4 or 8 week visits. All modified exercises could be performed and compliance was high. Adverse events potentially attributable to the study surface were mild, self-limiting and occurred in 2/24 dogs. The most common surface-related limitations were that the piano was slippery and that both surfaces were too short. The artificial grass was preferred by owners and dogs compared to the floor piano surface, but this was influenced by which surface was utilized first. Auditory and tactile modifications were feasible and safe to incorporate into a standardized rehabilitation protocol. This pilot study could prompt larger efficacy studies investigating the benefit of sensory-integrated rehabilitation in dogs with TL-IVDE.

A Controlled Clinical Study of Intensive Neurorehabilitation in Post-Surgical Dogs with Severe Acute Intervertebral Disc Extrusion

Simple Summary

This study explores the potential intensive neurorehabilitation plasticity effects in post-surgical paraplegic dogs with severe acute intervertebral disc extrusion aiming to achieve ambulatory status. The intensive neurorehabilitation protocol translated in 99.4% (167/168) of recovery in deep pain perception-positive dogs and 58.5% (55/94) in deep pain perception-negative dogs. There was 37.3% (22/59) spinal reflex locomotion, obtained within a maximum period of 3 months. Thus, intensive neurorehabilitation may be a useful approach for this population of dogs, avoiding future euthanasia and promoting an estimated time window of 3 months to recover.

Abstract

This retrospective controlled clinical study aimed to verify if intensive neurorehabilitation (INR) could improve ambulation faster than spontaneous recovery or conventional physiotherapy and provide a possible therapeutic approach in post-surgical paraplegic deep pain perception-positive (DPP⁺) (with absent/decreased flexor reflex) and DPP-negative (DDP⁻) dogs, with acute intervertebral disc extrusion. A large cohort of T10-L3 Spinal Cord Injury (SCI) dogs (n = 367) were divided into a study group (SG) (n = 262) and a control group (CG) (n = 105). The SG was based on prospective clinical cases, and the CG was created by retrospective medical records. All SG dogs performed an INR protocol by the hospitalization regime based on locomotor training, electrical stimulation, and, for DPP⁻, a combination with pharmacological management. All were monitored throughout the process, and measuring the outcome for DPP⁺ was performed by OFS and, for the DPP⁻, by the new Functional Neurorehabilitation Scale (FNRS-DPP⁻). In the SG, DPP⁺ dogs had an ambulation rate of 99.4% (n = 167) and, in DPP⁻, of 58.5% (n = 55). Moreover, in DPP⁺, there was a strong statistically significant difference between groups regarding ambulation (p < 0.001). The same significant difference was verified in the DPP^– dogs (p = 0.007). Furthermore, a tendency toward a significant statistical difference (p = 0.058) regarding DPP recovery was demonstrated between groups. Of the 59 dogs that did not recover DPP, 22 dogs achieved spinal reflex locomotion (SRL), 37.2% within a maximum of 3 months. The progressive myelomalacia cases were 14.9% (14/94). Therefore, although it is difficult to assess the contribution of INR for recovery, the results suggested that ambulation success may be improved, mainly regarding time.

A Canine's Behavior and Cognitive State as It Relates to Immobility and the Success of Physical Rehabilitation in the Non-ambulatory Spinal Cord Patient

Physical rehabilitation (PR) is recommended following spinal cord injury to help improve and maintain muscle elasticity, joint mobility, and nerve health. It can also be used to relieve pain and improve cardiopulmonary fitness in an immobile patient. There is evidence, in human medicine, that PR plays a critical role in mental health and the psychological state of the patient. As part of the assessment phase, human physical therapists often identify psychosocial symptoms and barriers at the start of PR that ultimately may affect improvement in human patients suffering from injury and the loss of mobility. Patient psychological state plays an integral role in healing and outcome during treatment and rehabilitation. Specific interventions set to address these symptoms can better outcome. Arguably, one of the most emotionally traumatizing injuries suffered by a canine patient can be immobility secondary to spinal cord injury. Poorly understood is the role the canine cognitive state plays in the success of rehabilitation following spinal cord injury. Should breed, age, sex, physical fitness, personality, previous experiences and history or home lifestyle, affect the PR assessment of these patients? Do these factors affect eventual outcome following PR? The purpose of this manuscript is to explore psychosocial barriers encountered during injury rehabilitation in humans and determine if the similar barriers need to be considered when assessing a canine patient for spinal cord injury rehabilitation.

The Physiology Associated With "Bed Rest" and Inactivity and How It May Relate to the Veterinary Patient With Spinal Cord Injury and Physical Rehabilitation

In the twentieth century, bed rest was commonly prescribed by human healthcare professionals as a treatment for a variety of ailments including spinal cord injury and disease. With time, the negative impact of bed rest was recognized as a source of slow and even reduced patient healing. As treatment paradigms shifted, the utility and importance of physical rehabilitation (PR) as a critical adjunctive treatment for human patients with spinal cord injury became fully recognized. Today, standardized PR protocols exist for humans with the spinal cord disease, but the same cannot be said for our veterinary patients with spinal cord injury. The purpose of this manuscript is to discuss the effects of inactivity on the musculoskeletal system and to explore how and why PR can play a critical role in improved mobility and overall health in the veterinary patient with spinal cord injury. Research with a focus on the effects of inactivity, in the form of cage rest, for the veterinary patient with spinal cord injury is lacking.

Development of a simple method to measure static body weight distribution in neurologically and orthopedically normal mature small breed dogs

Background

Objective outcome measures capable of tracking different aspects of functional recovery in dogs with acute intervertebral disc herniation are needed to optimize physical rehabilitation protocols. Normal, pre-injury distribution of body weight in this population is unknown. The aims of this study were to quantify static weight distribution (SWD) using digital scales and to establish the feasibility of different scale methods in neurologically normal, mature, chondrodystrophic small breed dogs predisposed to intervertebral disc herniation.

Results

Twenty-five healthy, mature dogs were enrolled with a mean age of 4.6 years (SD 2.7) and a mean total body weight of 11.5 kg (SD 3.6). SWD for the thoracic and pelvic limbs and between individual limbs was acquired in triplicate and expressed as a percentage of total body weight using commercially available digital scales in four combinations: two bathroom, two kitchen (with thoracic and pelvic limbs combined), four bathroom and four kitchen (with limbs measured individually). SWD was also obtained using a pressure sensing walkway for comparison to scale data. Feasibility for each method was determined and coefficients of variation were used to calculate inter-trial variability. Mean SWD values were compared between methods using an ANOVA. The two bathroom scales method had the highest feasibility and lowest inter-trial variability and resulted in mean thoracic and pelvic limb SWD of 63 % (SD 3 %) and 37 % (SD 3 %), respectively. Thoracic limb mean SWD was higher for the PSW compared to any of the scale methods (p < 0.0001).

Conclusions

SWD in a population of healthy chondrodystrophic dogs was simple to obtain using inexpensive and readily available digital scales. This study generated SWD data for subsequent comparison to dogs recovering from acute intervertebral disc herniation.

Canine models of spine disorders

Neck and low back pain are common among the adult human population and impose large social and economic burdens on health care and quality of life. Spine-related disorders are also significant health concerns for canine companions with etiopathogeneses, clinical presentations, and diagnostic and therapeutic options that are very similar to their human counterparts. Historically, induced and spontaneous pathology in laboratory rodents, dogs, sheep, goats, pigs, and nonhuman primates have been used for study of human spine disorders. While each of these can serve as useful preclinical models, they all have inherent limitations. Spontaneously occurring spine disorders in dogs provide highly translatable data that overcome many of the limitations of other models and have the added benefit of contributing to veterinary healthcare as well. For this scoping review, peer-reviewed manuscripts were selected from PubMed and Google Scholar searches using keywords: "intervertebral disc," "intervertebral disc degeneration," "biomarkers," "histopathology," "canine," and "mechanism." Additional keywords such as "injury," "induced model," and "nucleus degeneration" were used to further narrow inclusion. The objectives of this review were to (a) outline similarities in key features of spine disorders between dogs and humans; (b) describe relevant canine models; and (c) highlight the applicability of these models for advancing translational research and clinical application for mechanisms of disease, diagnosis, prognosis, prevention, and treatment, with a focus on intervertebral disc degeneration. Best current evidence suggests that dogs share important anatomical, physiological, histological, and molecular components of spinal disorders in humans, such that induced and spontaneous canine models can be very effective for translational research. Taken together, the peer-reviewed literature supports numerous advantages for use of canine models for study of disorders of the spine when the potential limitations and challenges are addressed.

Emerging and Adjunctive Therapies for Spinal Cord Injury Following Acute Canine Intervertebral Disc Herniation

Some dogs do not make a full recovery following medical or surgical management of acute canine intervertebral disc herniation (IVDH), highlighting the limits of currently available treatment options. The multitude of difficulties in treating severe spinal cord injury are well-recognized, and they have spurred intense laboratory research, resulting in a broad range of strategies that might have value in treating spinal cord-injured dogs. These include interventions that aim to directly repair the spinal cord lesion, promote axonal sparing or regeneration, mitigate secondary injury through neuroprotective mechanisms, or facilitate functional compensation. Despite initial promise in experimental models, many of these techniques have failed or shown mild efficacy in clinical trials in humans and dogs, although high quality evidence is lacking for many of these interventions. However, the continued introduction of new options to the veterinary clinic remains important for expanding our understanding of the mechanisms of injury and repair and for development of novel and combined strategies for severely affected dogs. This review outlines adjunctive or emerging therapies that have been proposed as treatment options for dogs with acute IVDH, including discussion of local or lesion-based approaches as well as systemically applied treatments in both acute and subacute-to-chronic settings. These interventions include low-level laser therapy, electromagnetic fields or oscillating electrical fields, adjunctive surgical techniques (myelotomy or durotomy), systemically or locally-applied hypothermia, neuroprotective chemicals, physical rehabilitation, hyperbaric oxygen therapy, electroacupuncture, electrical stimulation of the spinal cord or specific peripheral nerves, nerve grafting strategies, 4-aminopyridine, chondroitinase ABC, and cell transplantation.

Diagnosis and surgical treatment of bilateral ureteral calculi, hydronephrosis, pyometra, pyocolpos, vestibulovaginal stenosis, and imperforate hymen in a dog: A rare critical case report

Objective:

Bilateral ureteral calculi, hydronephrosis, pyometra, pyocolpos, vestibulovaginal stenosis, and imperforate hymen in a dog are uncommon and can be difficult to diagnose. The aim of this article is to report diagnostic challenges and successful surgical treatment of this rare event and the long-term outcomes.

Materials and methods:

A 5-year-old, spayed (partial ovariohysterectomy) female dog was primarily diagnosed with bilateral hydronephrosis and ureter obstruction due to urolithiasis along with pyometra. The urolith was removed carefully by the right-side ureterectomy, an appropriate ureteral stent was inserted from the bladder to the right kidney, and then, a vasectomy and hysterectomy were performed. The dog improved and was discharged. However, 50 days after surgery, pyocolpos due to imperforate hymen and vestibulovaginal stenosis were diagnosed and surgically corrected, and the ureteral stent was removed because the ureter had completely healed.

Results:

During the first admission, serum biochemistry results revealed the increased blood urea nitrogen (5.9 mg/dl), creatinine (116.2 mg/dl), amylase (1,345 U/l), and lipase (141 U/l) values. After surgical correction, all parameters returned to normal. However, 50 days after surgery, the C-reactive protein concentration (143 mg/l) and white blood cell level increased (18.4 × 10⁹/l). After a second surgical correction, the dog recovered fully within 10 days, and no postoperative complications were observed during the follow-up of 6 months.

Conclusion:

This report provides diagnostic assistance and surgical treatment options for a complex urogenital case. Careful examination during puberty is recommended to prevent the associated complications of this disorder.

Current Approaches to the Management of Acute Thoracolumbar Disc Extrusion in Dogs

Intervertebral disc extrusion (IVDE) is one of the most common neurologic problems encountered in veterinary clinical practice. The purpose of this manuscript is to provide an overview of the literature related to treatment of acute canine thoracolumbar IVDE to help construct a framework for standard care of acute canine thoracolumbar IVDE where sufficient evidence exists and to highlight opportunities for future prospective veterinary clinical research useful to strengthen care recommendations in areas where evidence is low or non-existent. While there exist a number of gaps in the veterinary literature with respect to standards of care for dogs with acute thoracolumbar IVDE, recommendations for standard care can be made in some areas, particularly with respect to surgical decompression where the currently available evidence supports that surgery should be recommended for dogs with nonambulatory paraparesis or worse. While additional information is needed about the influence on timing of decompression on outcome in dogs that are deep pain negative for longer than 48 h duration, there is no evidence to support treatment of the 48 h time point as a cut off beyond which it becomes impossible for dogs to achieve locomotor recovery. Surgical decompression is best accomplished by either hemilaminectomy or mini-hemilaminectomy and fenestration of, at a minimum, the acutely ruptured disc. Adjacent discs easily accessed by way of the same approach should be considered for fenestration given the evidence that this substantially reduces future herniation at fenestrated sites. Currently available neuroprotective strategies such as high does MPSS and PEG are not recommended due to lack of demonstrated treatment effect in randomized controlled trials, although the role of anti-inflammatory steroids as a protective strategy against progressive myelomalacia and the question of whether anti-inflammatory steroids or NSAIDs provide superior medical therapy require further evaluation.

Measurement of the tibial plateau angle of normal small-breed dogs and the application of the tibial plateau angle in cranial cruciate ligament rupture

Objective:

In Korea, small dogs are more common than large breeds. This study was performed to measure the influence of body weight, sex, breed, age, and cranial cruciate ligament rupture (RCCL) on the tibial plateau angle (TPA) in small-breed dogs.

Materials and methods:

A total of 274 dogs (221 normal dogs and 53 RCCL dogs) were selected for this study based on medical records. The TPA was measured from stifle joint radiographs. The dogs were divided according to body weight, sex (male and female; normal and neutered), age, breed, and RCCL, and the TPAs of the dogs were compared.

Results:

In general, the TPAs of male dogs were significantly (p < 0.05) higher than those of female dogs, and those of healthy neutered dogs were higher than those of healthy intact dogs. The TPA had a tendency to increase along with the animal’s age but was not significantly different among the four age groups. In general, the TPA of RCCL dogs was 27.12° ± 0.62°, which was significantly higher (p < 0.001) than that of normal dogs (20.21° ± 0.32°), indicating that an increased TPA is associated with a higher risk for RCCL. Similar results were also observed among dogs with similar body weights, breeds, and ages for male and female RCCL dogs.

Conclusion:

This study suggested that the sex and neutering status of dogs could affect the TPA. This study also confirmed the use of TPA in the veterinary clinic as a possible indicator of RCCL, as the TPA is higher in RCCL dogs than in normal dogs.