Thoracic Vertebral Canal Stenosis and Vertebral Instability in a Young Minuet Cat

This report describes a unique case of thoracic vertebral canal stenosis and vertebral instability in a 1 yr old Minuet cat. The cat presented with a history of chronic progressive nonambulatory paraparesis. Myelography with neutral and stress positions revealed dynamic compression at T1-4. Computed tomography and MRI revealed multiple sites of vertebral endplate osteolysis, adjacent bone sclerosis, intervertebral disk space narrowing, and spondylotic bridging within the cervical and cranial thoracic vertebral bodies and pedicles, particularly at C6-T4. The cat underwent a right-sided T1-4 hemilaminectomy and C7-T4 vertebral stabilization using positively threaded profile pins and polymethylmethacrylate. The cat fully recovered without any complication. The case highlights the potential for young cats, especially those with a chondrodysplastic condition, to develop vertebral canal stenosis and vertebral instability. The surgical treatment described herein resulted in an excellent outcome.

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.

Clinical and histopathological features in horses with neuroaxonal degeneration: 100 cases (2017-2021)

BACKGROUND

Adult horses with proprioceptive ataxia and behavior changes that have histologic lesions consistent with neurodegenerative disease have been increasingly recognized.

HYPOTHESIS/OBJECTIVES

Describe the history, clinical findings and histopathologic features of horses presented to a referral institution with neuroaxonal degeneration.

ANIMALS

One hundred horses with a necropsy diagnosis of neuroaxonal degeneration compatible with neuroaxonal dystrophy/degenerative myeloencephalopathy (eNAD/EDM).

METHODS

Retrospective study of horses presented to the University of Pennsylvania, New Bolton Center, between 2017 and 2021 with a necropsy diagnosis of eNAD/EDM.

RESULTS

Affected horses had a median age of 8 years (range, 1-22), and the majority were Warmbloods (72). Sixty-eight horses had behavioral changes, and all 100 had proprioceptive ataxia (median grade, 2/5). Fifty-seven horses had abnormal findings on cervical vertebral radiographs, and 14 had myelographic findings consistent with compressive myelopathy. No antemortem diagnostic test results were consistently associated with necropsy diagnosis of neurodegenerative disease. All 100 horses had degenerative lesions characteristic of eNAD in the brainstem gray matter, and 24 had concurrent degenerative features of EDM in the spinal cord white matter.

CONCLUSIONS AND CLINICAL IMPORTANCE

Clinical and histopathologic findings in this large group of horses with neurodegenerative disease were most consistent with eNAD/EDM, but with a different signalment and clinical presentation from earlier descriptions. The increasing occurrence of neurodegenerative disease in horses and the safety risk posed emphasize the importance of focused research in affected horses.

Vertebral Angiomatosis in a Dog

A 3 yr old spayed female Cavalier King Charles spaniel was referred for insidious ataxia and paraparesis. A thoracolumbar lesion was suspected. Computed tomography showed focal osteolysis of the vertebral body and pedicles of T5. In addition, a hyperdense, extradural material within the vertebral canal, causing spinal cord compression on the right side, was present. The lesion was confirmed with magnetic resonance imaging. A T4-T5 hemi-dorsal laminectomy was performed to decompress the spinal cord. Histopathological examination was consistent with vertebral angiomatosis. After the surgery, the dog rapidly improved; however, 5 mo later the clinical signs relapsed. Vertebral angiomatosis is a vasoproliferative disorder, rarely reported as a cause of myelopathy in cats. This condition has not previously been reported in dogs. This case report describes the clinical features, the diagnostic findings, and the follow-up of a young dog with vertebral angiomatosis.

MRI and CT features of a disc herniation through a fractured lumbar vertebra causing lumbar spinal cord compression in a dog

A 5-year-old intact male Saint Bernard was presented for paraparesis following a fall down the stairs. Magnetic resonance imaging revealed a chronic fragmentation of the dorsocaudal aspect of the second lumbar vertebral body (L2). Material migrated from the L2 to L3 intervertebral space through the fractured caudal vertebral endplate into the vertebral body and reached the vertebral canal, resulting in a severe extradural compressive myelopathy. Computed tomography confirmed the vertebral fragmentation. Histology of surgically removed compressive material revealed fibrocartilaginous material. The uncommon route of the extruded disc material through a fractured vertebral body makes this case of traumatic disc extrusion unusual.

Decompressive laminectomy with vertebral stabilization allows neurologic improvement of most Pekingese dogs with thoracolumbar vertebral instability

OBJECTIVE

To describe the diagnostic findings, surgical techniques, and outcomes of thoracolumbar vertebral instability associated with or without articular process (AP) anomalies in Pekingese dogs.

ANIMALS

11 client-owned Pekingese dogs.

PROCEDURES

Medical records (2007 to 2022) were reviewed. Inclusion criteria were Pekingese dogs with thoracolumbar vertebral instability that underwent decompressive laminectomy and vertebral stabilization. Dynamic myelographic study and/or intraoperative spinal manipulation were used to diagnose vertebral instability. Data on preoperative and postoperative neurologic status, diagnostic findings, surgical techniques, and outcomes were retrieved.

RESULTS

The dogs presented with paraparesis (n = 9) or paraplegia (2). Five dogs had caudal AP anomalies. Dynamic myelographic study demonstrated single (n = 7) or multiple (4) dynamic compressions with poststress spinal cord height reduction (median, 12.5%; IQR, 6.8% to 21.2%). Of the 17 dynamic compression lesions, 5 lesions were at the disc spaces with caudal AP abnormalities. All dogs had vertebral instability confirmed by intraoperative spinal manipulation and underwent hemilaminectomy and unilateral vertebral stabilization. One dog had adjacent segment vertebral instability and underwent vertebral stabilization 3 months after the initial operation. All but 1 dog showed successful outcomes at the last follow-up (median, 16 months; IQR, 3 to 32 months).

CLINICAL RELEVANCE

Vertebral instability associated with or without AP abnormalities is a potential cause of thoracolumbar spinal cord injury in Pekingese dogs. Dynamic myelographic studies and/or intraoperative spinal manipulation demonstrated vertebral instability. Spinal cord decompression and vertebral stabilization are effective, resulting in neurologic improvements in most dogs.

Magnetic resonance imaging characteristics of atlanto-axial subluxation in 42 dogs: Analysis of joint cavity size, subluxation distance, and craniocervical junction anomalies

Background

Atlanto-axial (AA) subluxation can be a complex syndrome in dogs. Accurate identification and assessment of this condition are key to providing treatment and resolution.

Aim

The purpose of this retrospective study was to describe the magnetic resonance imaging (MRI) characteristics of AA subluxation and associated neurologic deficits.

Methods

A multicenter review of dogs with a diagnosis of AA subluxation was conducted, evaluating signalment, neurologic grade, duration of signs, and MRI characteristics. MRI characteristics included degree of spinal cord compression and joint subluxation, integrity of odontoid ligaments, presence of a dens, spinal cord signal intensity, and presence of syringohydromyelia, hydrocephalus, and Chiari-like malformation. A control population with normal AA joints was also evaluated. MR images of 42 dogs with AA subluxation were compared to 26 age and breed-matched control dogs.

Results

Affected dogs had a median age of 27 months and a median weight of 2.7 kg, and the most commonly affected breed was the Yorkshire terrier (47.5%). Spinal cord signal hyperintensity, increased AA joint size, and cross-sectional cord compression at the level of the dens and mid-body C2 were associated with AA subluxation. No associations were found between cord compression, the appearance of the dens, or cord signal intensity and neurologic grade. Affected dogs did not have a higher incidence of Chiari-like malformation, syringohydromyelia, or hydrocephalus than control dogs, and their neurologic grade was not associated with MRI findings. Lack of dens and/or odontoid ligaments was associated with larger subluxations.

Conclusion

Dogs with clinical signs of AA subluxation were significantly more likely to have intramedullary hyperintensity at the level of compression ( p = 0.0004), an increased AA joint cavity size ( p = 0.0005), and increased spinal cord compression at the level of dens and mid-body C2 (p ≤ 0.05). The authors suggest an AA joint cavity size >1.4 mm and a subluxation distance >2.5 mm as cutoffs for MRI diagnosis of AA subluxation in dogs. No differences were noted between dogs with AA subluxation and control dogs regarding syringohydromyelia, hydrocephalus, and Chiari-like malformation.

Lumbar vertebral canal stenosis due to marked bone overgrowth after routine hemilaminectomy in a dog

BACKGROUND

Bone overgrowth after decompressive surgery for lumbar stenosis resulting in recurrence of neurological signs has not been reported in veterinary literature. However, there are few cases described in human medicine.

CASE PRESENTATION

A 13-month-old entire female dog, a crossbreed between a Springer Spaniel and a Border Collie, weighing 24 kg, was referred with a 5-day history of progressive spastic paraplegia, indicative of a T3-L3 myelopathy. Magnetic resonance (MR) imaging revealed a right-sided L2-L3 compressive extradural lesion, compatible with epidural haemorrhage, which was confirmed by histopathology. The lesion was approached via right-sided L2-L3 hemilaminectomy and was successfully removed. One-year postoperatively the dog re-presented with pelvic limb ataxia. MR and computed tomography (CT) images demonstrated excessive vertebral bone formation affecting the right articular processes, ventral aspect of the spinous process of L2-L3, and contiguous vertebral laminae, causing spinal cord compression. Revision surgery was performed, and histopathology revealed normal or reactive osseous tissue with a possible chondroid metaplasia and endochondral ossification, failing to identify a definitive reason for the bone overgrowth. Nine-month postoperatively, imaging studies showed a similar vertebral overgrowth, resulting in minimal spinal cord compression. The patient remained stable with mild proprioceptive ataxia up until the last follow-up 18 months post-revision surgery.

CONCLUSION

This is the first report in the veterinary literature of bone overgrowth after lumbar hemilaminectomy which resulted in neurological deficits and required a revision decompressive surgery.

Magnetic resonance imaging and neurologic characterization of combined osseous- and disc-associated cervical spondylomyelopathy in dogs

BACKGROUND

Although both disc- or osseous-associated forms of cervical spondylomyelopathy (CSM) are observed in the same dogs, this combined form has not been thoroughly evaluated.

OBJECTIVES

To describe imaging characteristics of dogs with concurrent disc- and osseous CSM and investigate an association between findings on neurological examination and imaging.

ANIMALS

Sixty dogs with disc and osseous-associated CSM from 232 CSM-affected dogs.

METHODS

Retrospective study. Dogs diagnosed via high-field MRI with a combination of intervertebral disc (IVD) protrusion and osseous proliferation of articular processes, dorsal lamina, or both were identified. Large and giant breed dogs were grouped according to whether combined compressions were at the same site or different sites. Statistical methods were used to investigate the association and relationship between variables.

RESULTS

Thirty-five out of 60 (58%) were large breeds and 22/60 (37%) were giant breeds. Mean and median age was 6.6 and 7 years respectively (range, 0.75-11 years). Forty of the 60 dogs (67%) had concurrent osseous and disc-associated spinal cord compression in the same location. This was considered the main compression site in 32/40 (80%) dogs. Dogs with osseous- and disc-associated compressions at the same site were more likely to have a higher neurologic grade (P = .04).

CONCLUSIONS AND CLINICAL IMPORTANCE

A substantial percentage of dogs with CSM present with concomitant IVD protrusion and osseous proliferations, most at the same site. Characterizing this combined form is important in the management of dogs with CSM because it could affect treatment choices.

A novel surgical technique for treatment of cervical vertebral stenotic myelopathy (wobbler syndrome) in a filly

Cervical vertebral stenotic myelopathy (CVSM), also known as equine wobbler syndrome or cervical ataxia, is a devastating neurological syndrome resulting from compression of the spinal cord at the cervical region. This report describes a novel surgical technique for treatment of 16-month-old Arabian filly with CVSM. The filly showed grade 4 ataxia, hypermetria, weakness of the hind limbs, stumbling during walking, and abnormal gait. Case history, clinical signs and myelography revealed spinal cord compression between the C3 and C4 and C4-C5. The filly underwent a novel surgical interference for decompression and stabilization of the point of stenosis using specially designed titanium plate and intervertebral spacer. Evidence of arthrodesis with absence of complications was confirmed by periodic radiography over eight months of postoperative care. The new technique applied in this cervical surgery was efficient for the decompression and stabilization of the vertebrae, allowing arthrodesis development and remission of the clinical signs. The obtained results encourage further assessment of this novel procedure in horses clinically affected by CVSM.

Use of computed tomography and magnetic resonance imaging to assess a case of spinal injury in a Showa koi Cyprinus carpio

OBJECTIVE

A privately owned, 4-year-old female Showa koi (ornamental variant of Common Carp Cyprinus carpio) was presented for erratic swimming, air gasping, water spitting, and abnormal orientation in the water column. Initial physical examination revealed an obese patient with no external abnormalities except a small plaque localized to filaments on a right gill hemibranch.

METHODS

The fish was anesthetized using AQUI-S 20E (10% eugenol solution) at 50 mg/L to facilitate diagnostic evaluation. Biopsy of the gill lesion yielded no significant findings. Whole-body computed tomography confirmed an excess of adipose tissue and mild scoliosis, with narrowing of the 10th-11th intervertebral space. A weight loss plan and need for repeat assessment were recommended.

RESULT

The patient's original abnormal behaviors resolved over the following weeks, but it subsequently became hyporexic and depressed. Full-body magnetic resonance imaging (MRI) showed extensive alteration of vertebral centra, with multifocal compression of the spinal cord. Due to the patient's declining clinical condition and the grave prognosis based on MRI findings, the patient was humanely euthanized.

CONCLUSION

Postmortem examination showed severe transmural myelomalacia associated with a vertebral subluxation. This case demonstrates the practical application of advanced cross-sectional imaging that has not been commonly afforded to fish or other lower vertebrates.

Computed tomographic myelography for assessment of the cervical spinal cord in ataxic warmblood horses: 26 cases (2015-2017)

OBJECTIVE

To quantify the degree of dural compression and assess the association between site and direction of compression and articular process (AP) size and degree of dural compression with CT myelography.

ANIMALS

26 client-oriented horses with ataxia.

PROCEDURES

Spinal cord-to-dura and AP-to-cross-sectional area of the C6 body ratios (APBRs) were calculated for each noncompressive site and site that had > 50% compression of the subarachnoid space. Site of maximum compression had the largest spinal cord-to-dura ratio. Fisher exact test and linear regression analyses were used to assess the association between site and direction of compression and mean or maximum APBR and spinal cord-todura ratio, respectively.

RESULTS

Mean ± SD spinal cord-to-dura ratio was 0.31 ± 0.044 (range, 0.20 to 0.41) for noncompressive sites and 0.44 ± 0.078 (0.29 to 0.60) for sites of maximum compression. Sites of maximum compression were intervertebral and extra-dural, most frequently at C6 through 7 (n = 10), followed by C3 through 4 (6). Thirteen horses had dorsolateral and lateral compression at the AP joints, secondary to AP (n = 7) or soft tissue proliferation (6). Site significantly affected direction of compression, and directions of compression from occiput through C4 were primarily ventral and lateral, whereas from C6 through T1 were primarily dorsal and dorsolateral. No linear relationship was identified between mean or maximum APBR and spinal cord-to-dura ratio.

CONCLUSIONS AND CLINICAL RELEVANCE

CT myelography may be useful for examination of horses with suspected cervical compressive myelopathy. Degree of compression can be assessed quantitatively, and site of compression significantly affected direction of compression.

Postmortem diagnoses of spinal ataxia in 316 horses in California

OBJECTIVE

To determine period prevalences of postmortem diagnoses for spinal cord or vertebral column lesions as underlying causes of ataxia (spinal ataxia) in horses.

ANIMALS

2,861 client-owned horses (316 with ataxia [ataxic group] and 2,545 without ataxia [control group]).

PROCEDURES

The medical records database of the University of California-Davis Veterinary Medical Teaching Hospital was searched to identify horses necropsied between January 1, 2005, and December 31, 2017. Results were compared between the ataxic and control groups and between various groups of horses in the ataxic group. Period prevalences were determined for the most common causes of ataxia.

RESULTS

2,861 horses underwent full necropsy, and the period prevalences for the most common definitive diagnoses for ataxia were 2.7% (77/2,861) for cervical vertebral compressive myelopathy (CVCM), 1.3% (38/2,861) for equine neuroaxonal dystrophy or equine degenerative myeloencephalopathy (eNAD-EDM), and 0.9% (25/2,861) for trauma; the period prevalence of ataxia of unknown origin was 2.0% (56/2,861). Horses in the ataxic group (vs the control group) were more likely to have been warmblood horses (OR, 2.70) and less likely to have been Arabian horses (OR, 0.53). In the ataxic group, horses < 5 (vs ≥ 5) years of age had greater odds of CVCM (OR, 2.82) or eNAD-EDM (OR, 6.17) versus trauma or ataxia of unknown origin. Horses in the ataxic group with CVCM were more likely Thoroughbreds (OR, 2.54), whereas horses with eNAD-EDM were more likely American Quarter Horses (OR, 2.95) and less likely Thoroughbreds (OR, 0.11).

CONCLUSIONS AND CLINICAL RELEVANCE

Results indicated that breed distributions differed for horses with CVCM versus eNAD-EDM; therefore, breed should be considered in the clinical evaluation of spinal ataxia in horses.

Diagnosis and treatment of epidural empyema in a pygmy goat

A mixed-breed pygmy goat was presented for nonambulatory tetraparesis. Neurological examination was consistent with a C6 to T2 myelopathy. Initially, the goat was treated medically. Forty-three days later, magnetic resonance imaging (MRI) revealed an extradural mass compressing the cervical spinal cord. Magnetic resonance attributes of the mass were consistent with a slow-growing, fluid-poor lesion. The spinal cord was surgically decompressed. Epidural empyema secondary to Fusobacterium necrophorum was identified. Postoperative care consisted of anti-inflammatory medication, antimicrobials, and physical therapy. Ability to walk occurred by day 14 after surgery. Despite prolonged recumbency before surgery, the goat was clinically normal, and antimicrobials were discontinued on day 60 after surgery. Key clinical message: Epidural empyema can cause a compressive myelopathy which may result in varying degrees of paresis/paralysis. Clinical resolution and return of normal function occurred following the use of MRI to plan surgical decompression combined with extended use of antimicrobials.

Spinal subarachnoid diverticula in dogs: A review

Spinal subarachnoid diverticula are fluid dilations of the subarachnoid space that can cause a compressive myelopathy in dogs. These diverticula are usually associated with high motion areas in the cervical and caudal thoracic spine. The definitive etiopathogenesis has not been determined but likely involves congenital or acquired causes. Pugs, French bulldogs, and Rottweilers are overrepresented breeds. Clinical signs typically include ataxia, paresis, and upper motor neuron urinary and/or fecal incontinence; pain is a less common feature. Diagnosis is based on advanced imaging, with magnetic resonance imaging now being favored given the additional detail of the spinal cord parenchyma that can be obtained. Outcomes are better with surgical intervention than with medical therapies, though there is a lack of long-term data. No superior surgical technique has been identified, and questions remain on the significance of addressing leptomeningeal adhesions at the time of surgery. Clinical signs can recur, though not always due to recurrence of diverticulum formation, and pugs may be less likely to have a successful long-term outcome.

Neurologic and magnetic resonance imaging features of German Shepherd Dogs with cervical spondylomyelopathy: 10 cases (2006-2018)

OBJECTIVE

To describe the neurologic signs and MRI findings for German Shepherd Dogs (GSDs) with cervical spondylomyelopathy (CSM).

ANIMALS

10 GSDs with confirmed CSM.

PROCEDURES

Medical records from January 2006 through July 2018 were reviewed to identify dogs with CSM. For each CSM-affected dog, information regarding age, duration of clinical signs, presence of neurologic signs, and treatments administered were obtained; the main site and cause of spinal cord compression and other vertebral and spinal cord changes were identified on MRI images.

RESULTS

Data for 9 male and 1 female (mean age, 6.2 years) GSDs with CSM were assessed. Dogs were classified as having chronic (n = 9) or acute (1) CSM. Nine dogs had ataxia; 1 dog had only signs of cervical hyperesthesia. Neurologic examination findings localized the lesion to the cervical portion of the vertebral column in each dog. The main spinal cord compression site was at the C6-7 (n = 5), C5-6 (4), or C4-5 (1) intervertebral spaces; osseous proliferation of the articular processes was the sole or a contributory cause of these compressions for 6 of the 10 dogs. Eight dogs also had dorsal compression of the spinal cord as the result of ligamenta flava hypertrophy.

CONCLUSIONS AND CLINICAL RELEVANCE

The 10 GSDs of the present retrospective case series had CSM that was often characterized by osseous changes and a ligamentous component and were older than dogs of other breeds (eg, Great Dane and Mastiff) with osseous-associated CSM described in previous reports. Cervical spondylomyelopathy should be a differential diagnosis for GSDs with ataxia, paresis, or signs of cervical hyperesthesia.

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

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.

MicroRNA expression in the cerebrospinal fluid of dogs with and without cervical spondylomyelopathy

BACKGROUND

Osseous-associated cervical spondylomyelopathy (OA-CSM) is a common condition of the cervical vertebral column that affects giant dog breeds. MicroRNAs (miRNAs) are small RNAs that regulate gene expression, and recent data suggest that circulating miRNAs present in biological fluids may serve as potential biomarkers for disease. The miRNA profiles of cerebrospinal fluid (CSF) from healthy dogs and dogs clinically affected by OA-CSM have not been described.

OBJECTIVE

To characterize the expression levels of miRNAs present in the CSF of normal Great Danes and identify differentially expressed miRNAs in the CSF of Great Danes clinically affected with OA-CSM.

ANIMALS

Client-owned dogs: 12 control, 12 OA-CSM affected.

METHODS

Cerebrospinal fluid samples were collected prospectively. MicroRNA expression was evaluated using the NanoString nCounter platform and quantitative real-time PCR.

RESULTS

We identified 8 miRNAs with significant differential expression. MiR-299-5p and miR-765 had increased expression levels in the CSF of OA-CSM-affected dogs, whereas miR-494, miR-612, miR-302-d, miR-4531, miR-4455, and miR-6721-5p had decreased expression levels in OA-CSM affected dogs compared to clinically normal dogs. Quantitative real-time PCR was performed to validate the expression levels of 2 miRNAs (miR-494 and miR-612), and we found a 1.5-fold increase in miR-494 expression and a 1.2-fold decrease in miR-612 in the CSF of the OA-CSM affected group (P = .41 and .89, respectively).

CONCLUSIONS AND CLINICAL IMPORTANCE

Data generated from our study represent an initial characterization of the miRNA profile of normal canine CSF and suggest that a distinct CSF miRNA expression profile is associated with OA-CSM.

Comparison of the clinical and radiographic appearance of the cervical vertebrae with histological and anatomical findings in an eight-month old warmblood stallion suffering from cervical vertebral stenotic myelopathy (CVSM)

BACKGROUND

Cervical vertebral stenotic myelopathy (CVSM) remains one of the most important abnormalities of the cervical spine resulting in neurological deficits in horses. The aim of the following study was to compare the results of the clinical and neurological examination, the results of myelography and the post mortem anatomical and histological appearance of the spinal cord and cervical vertebrae in a horse with CVSM.

CASE PRESENTATION

The following study describes a clinical case of an eight-month-old stallion with ataxia. Plain cervical radiographs indicated narrowing of the spinal canal. Conservative therapy using NSAIDs did not result in any improvement in the gait of the horse. Due to economic constraints, surgical intervention was excluded. The owner chose to humanely euthanise the horse. Immediately after euthanasia, post mortem myelography was performed, and measurements of the myelographic dye column were taken. They revealed a 67% DMC reduction and a 64% DD reduction at the C3/C4 level. Afterwards, an anatomical dissection was performed. The cervical vertebrae and vertebral canal were macroscopically inspected and measured and indicated a 44% narrowing of the canal at the C3/C4 level. The spinal cord was removed and underwent histological evaluation after staining. Microscopic lesions were visible at the level of the compression and included axonal degeneration with partial or complete loss of myelin in the white matter of the lateral and dorsal funiculi as well as the formation of dysfunctional so-called "spongy structures". An increase in the number of microglial cells and collagen was also observed. The formation of glial scars was excluded. Immunohistochemical studies revealed a negative transmembrane glycoprotein CD68(-) - monocyte response and a negative tumor necrosis alpha TNFα (-) reaction.

CONCLUSIONS

CVSM may be difficult to diagnose, even for experienced veterinary surgeons. Currently, an ex vivo histopathologic examination of the spinal cord is thought to be the gold standard in the diagnosis of CVSM. Our histological examination revealed no CVSM-specific glial scar formation and a CD68(-) negative and TNF-α negative reaction, which have not been previously reported. Histological lesions in CVSM may vary depending show inter-individual variability and on the treatment, which further hinders ex-vivo diagnostics.

Influence of neck position on commonly performed radiographic measurements of the cervical vertebral region in horses

OBJECTIVE To determine the influence of various neck positions on cervical vertebral radiographic measurements in horses. ANIMALS 18 client-owned horses examined for lameness but free of cervical disease. PROCEDURES Laterolateral radiographs of the cervical vertebrae from C1 through T1 were acquired for each horse in 3 neck positions (low, neutral, and high). Minimum sagittal diameter, intravertebral sagittal diameter (intra-VSD) ratio, inter-VSD ratio, length of the articular processes joint ratio, vertebral alignment angle, and vertebral fossa angle were measured at each segment in each neck position. Values for the high and low positions were compared with those for the neutral position. RESULTS No significant differences from neutral position values were identified for minimum sagittal diameter, intra-VSD ratio, and vertebral fossa angle as measured in low and high neck positions. Compared with results in the neutral position, the high position resulted in a greater vertebral alignment angle at C3-4 and inter-VSD ratio at C4-5 and a lower length of the articular processes joint ratio at C2-3, C3-4, and C4-5; the low position resulted in a lower vertebral alignment angle at C4-5. However, all observed differences were small. CONCLUSIONS AND CLINICAL RELEVANCE Neck position influenced some radiographic measurements of the cervical vertebrae in horses free of cervical disease. However, because several of these measurements were not or were only minimally affected by neck position, some latitude in neck position may be possible without concern about substantially affecting radiographic measurements in this region.

Sacrocaudal (sacrococcygeal) intervertebral disc protrusion in 2 cats

One cat was presented for investigation of urinary retention and constipation and a second cat was presented with decreased appetite, reluctance to jump, reduced level of activity, and constipation. Magnetic resonance imaging revealed dorsal bulging of the hypo-intense intervertebral disc at S3-Cd1 on fast spin echo T2. Dorsal laminectomy was performed and both cats recovered with resolution of neurological signs.

Lumbar hemilaminectomy for treatment of diskospondylitis in an aardvark (Orycteropus afer)

CASE DESCRIPTION A 17-year-old sexually intact male aardvark (Orycteropus afer) was evaluated because of hind limb proprioception deficits and ataxia. CLINICAL FINDINGS Results of examination and CT suggested a diagnosis of intervertebral disk disease and diskospondylitis at the L2-3 intervertebral space. Magnetic resonance imaging of the vertebral column also indicated intervertebral disk rupture with spinal cord compression and inflammation of the adjacent epaxial musculature TREATMENT AND OUTCOME Hemilaminectomy was performed according to the technique described for dogs. Anatomic variations encountered intraoperatively limited the ability to completely remove the affected disk material; however, adequate decompression of the spinal cord was achieved. Microbial culture and susceptibility testing of surgical biopsy specimens yielded a multidrug-resistant Enterococcus faecalis that was treated with a 10-week course of linezolid. Intensive postoperative care required constant rate infusions for adequate sedation, analgesia, and antimicrobial treatment. Dehiscence of the surgical site occurred 3 weeks after surgery and was treated with negative pressure wound therapy. Physical rehabilitation initiated 5 days after surgery progressed from passive range of motion to the use of an underwater treadmill. Despite initial improvement, acute deterioration occurred 5.5 months after surgery. Repeated CT revealed progression of diskospondylitis, which prompted euthanasia. CLINICAL RELEVANCE Postoperative hind limb paresis and paralysis in this species presented considerable challenges for care and rehabilitation. Patient demeanor, size, and anatomy required development of custom mechanical devices. Despite the inability to eliminate the multidrug-resistant bacterial osteomyelitis that resulted in the death of this aardvark, information gained may benefit treatment of subsequent patients.

Development of a finite element model of the ligamentous cervical vertebral column of a Great Dane

Cervical spondylomyelopathy (CSM), also known as wobbler syndrome, affects mainly large and giant-breed dogs, causing compression of the cervical spinal cord and/or nerve roots. Structural and dynamic components seem to play a role in the development of CSM; however, pathogenesis is not yet fully understood. Finite element models have been used for years in human medicine to study the dynamic behavior of structures, but it has been mostly overlooked in veterinary studies. To our knowledge, no specific ligamentous spine models have been developed to investigate naturally occurring canine myelopathies and possible surgical treatments. The goal of this study was to develop a finite element model (FEM) of the C₂-C₇ segment of the ligamentous cervical vertebral column of a neurologically normal Great Dane without imaging changes. The FEM of the intact C₂-C₇ cervical vertebral column had a total of 188,906 elements (175,715 tetra elements and 12,740 hexa elements). The range of motion (in degrees) for the FEM subjected to a moment of 2Nm was approximately 27.94 in flexion, 25.86 in extension, 24.14 in left lateral bending, 25.27 in right lateral bending, 17.44 in left axial rotation, and 16.72 in right axial rotation. We constructed a ligamentous FEM of the C₂-C₇ vertebral column of a Great Dane dog, which can serve as a platform to be modified and adapted for studies related to biomechanics of the cervical vertebral column and to further improve studies on osseous-associated cervical spondylomyelopathy.

Acute Herniation of Nondegenerate Nucleus Pulposus: Acute Noncompressive Nucleus Pulposus Extrusion and Compressive Hydrated Nucleus Pulposus Extrusion

Acute herniation of nondegenerate nucleus pulposus material is an important and relative common cause of acute spinal cord dysfunction in dogs. Two types of herniation of nondegenerate or hydrated nucleus pulposus have been recognized: acute noncompressive nucleus pulposus extrusion (ANNPE) and acute compressive hydrated nucleus pulposus extrusion (HNPE). Spinal cord contusion plays an important role in the pathophysiology of both conditions. Sustained spinal cord compression is not present in ANNPE, whereas varying degrees of compression are present in HNPE. Although affected animals often present with severe neurologic signs, good outcomes can be achieved with appropriate treatment.

Surgical treatment of a paraspinal abscess with osteomyelitis and spinal cord compression in a rabbit

CASE DESCRIPTION A 16-month-old neutered male Continental Giant rabbit (Lepus curpaeums) was referred for evaluation of a 7-day history of acute-onset, progressive, symmetric paraparesis. CLINICAL FINDINGS On initial examination, the rabbit was nonambulatory, and results of neurologic examination were consistent with a lesion affecting the T3-L3 spinal cord segments. Thoracic radiography showed irregular widening of the left T11-12 articular process joint. Marked dorsolateral and lateral extradural spinal cord compression with contrast enhancement of the adjacent epaxial muscles was evident on MRI images of the spine. TREATMENT AND OUTCOME A left-sided T11-T12 hemilaminectomy was performed, which revealed an abnormal and hypertrophic T11-12 articular process joint and an osteolytic lesion communicating with the vertebral canal. Copious purulent material causing marked spinal cord compression was evident, and the surgical site was lavaged extensively with sterile (0.9% NaCl) saline solution. Results of aerobic, anaerobic, and enriched bacteriologic cultures of swab specimens obtained from the surgical site were negative. Histologic analysis of biopsy samples revealed chronic purulent osteomyelitis, myositis, and fasciitis with necrosis, fibrosis, and dystrophic mineralization. The rabbit was discharged 48 hours after surgery. Ten weeks after surgery, the rabbit was ambulatory with mild paraparesis. On telephone follow-up 21 months after surgery, the owners indicated that the rabbit was healthy and expressed satisfaction with the treatment and outcome. CLINICAL RELEVANCE Paraspinal abscess with vertebral canal involvement should be considered as a differential diagnosis for rabbits with clinical signs of progressive T3-L3 myelopathy. Outcome for the patient of the present report suggested that surgical treatment including decompression and debridement can result in a favorable long-term outcome.

Spinal neurenteric cyst in a dog

CASE DESCRIPTION An 11-year-old English Cocker Spaniel was evaluated because of chronic progressive ataxia of the hind limbs. CLINICAL FINDINGS The dog had no history of previous illness, and findings of physical examination and laboratory tests were unremarkable. Neurologic examination revealed that the dog was ambulatory with severe ataxia of the hind limbs. Proprioception was decreased in the right and left hind limbs (right affected more than left), and spinal reflexes were bilaterally unremarkable. Moderate signs of pain were detected during palpation of the lumbar portion of the vertebral column. Findings suggested a lesion within the thoracolumbar or lumbar segments of the spinal cord. Magnetic resonance imaging revealed extradural spinal cord compression attributable to an extradural space-occupying lesion originating from or infiltrating the L4 lamina on the right side. TREATMENT AND OUTCOME Hemilaminectomy was performed to remove the extradural lesion. Histologic findings for tissue samples collected during the procedure were consistent with a neurenteric cyst. The late onset and progression of clinical signs of this rare congenital malformation were suspected to have been the result of enlargement of the neurenteric cyst through continuous production of mucus by goblet cells. The dog responded favorably to surgical decompression and was clinically normal 1 year after surgery. It was euthanized 2 years after surgery for an unrelated reason (end-stage heart disease), and no neurologic deficits were evident before that point. CLINICAL RELEVANCE Congenital neurenteric cysts should be considered as a differential diagnosis for neoplastic disease in dogs in which results of diagnostic imaging indicate the presence of an extradural mass affecting vertebral structures.

Computed tomographic and angiographic assessment of spinal extradural arteriovenous fistulas in a dog

A 6-month-old German shepherd dog was presented for progressive paraparesis. Multiple arteriovenous fistulae and hyperostosis of the thoracic vertebrae with secondary thoraco-lumbar spinal cord compression were diagnosed. Arteriovenous spinal fistula is a rare condition but should be considered as a differential diagnosis in young dogs with progressive paraparesis.

Squamous cell carcinoma causing dorsal atlantoaxial spinal cord compression in a dog

A 12-year-old Chihuahua dog was presented for cervical pain and progressive tetraparesis. Magnetic resonance imaging revealed spinal cord compression due to a mass in the dorsal atlantoaxial region. Surgical treatment was performed. The mass was histopathologically diagnosed as a squamous cell carcinoma. The dog recovered to normal neurologic status after surgery.

Compressive Myelopathy due to Intervertebral Disk Extrusion in a Llama (Lama Glama)

A 12-year-old intact female llama was euthanized following acute onset of spastic tetraparesis and recumbency with inability to rise. Postmortem examination revealed caudal cervical spinal cord compression due to a mass within the ventral spinal canal arising from the C6–C7 intervertebral disk space and attached to an irregularly thickened annulus fibrosis. On histopathologic examination, the mass was composed of amorphous acellular basophilic to amphophilic material admixed with irregularly arranged collagen bundles. The amorphous material was metachromatic and contained multiple small foci of markedly vacuolated round cells, characteristic of origin from the nucleus pulposus. Severe necrosis of all white matter tracts with astrocytic reaction was present in the overlying spinal cord segment. Ascending and descending Wallerian degeneration and dissecting interstitial astrogliosis were present within white matter tracts above and below the lesion, respectively. The diagnosis was compressive myelopathy due to chronic extrusion of the nucleus pulposus of the C6–C7 inter-vertebral disk. To the authors' knowledge, this is the first report of intervertebral disk disease in a camelid.

Spinal dermoid sinus in a Dachshund with vertebral and thoracic limb malformations

BACKGROUND

Dermoid sinus is an uncommon epithelial-lined fistula that may be associated with vertebral malformations. In humans, Klippel-Feil syndrome (KFS) is a rare condition characterized by congenital cervical vertebral fusion and may be associated with other developmental defects, including dermoid sinus. The present case report describes an adult Dachshund with cervical and cranial thoracic vertebral malformations as well as thoracic limb malformations resembling KFS with a concurrent type IV dermoid sinus.

CASE PRESENTATION

A 1.5 year-old Dachshund with congenital thoracic limbs deformities and cervical-thoracic vertebral malformations presented with cervical hyperesthesia, rigidity of the cervical musculature and tetraparesis. Neurologic, radiographic, and computed tomography (CT) (2D, 3D, CT fistulography) examinations revealed skeletal anomalies, a dermoid sinus in the cranial thoracic region and epidural gas within the vertebral canal. Surgical resection and histopathological evaluation of the sinus tract were performed and confirmed a type IV dermoid sinus. The clinical signs progressively recovered postoperatively, and no recurrent signs were observed after 6 months of follow-up.

CONCLUSIONS

Cervical vertebral malformations associated with limbs anomalies have not been reported in dogs and may represent a condition similar to KFS in humans. KFS can occur concurrently with other congenital conditions including dermoid sinus and should be included among the complex congenital anomalies described in dogs.

Clinical and magnetic resonance imaging (MRI) findings in 26 dogs with canine osseous-associated cervical spondylomyelopathy

The potential link between degenerative changes seen on magnetic resonance imaging (MRI) in osseous-associated cervical spondylomyelopathy (OA-CSM) and clinical signs has not been explored. Our goal was to retrospectively evaluate MRI findings, while investigating potential correlations between these changes, signalment, and clinical signs. Twenty-six dogs diagnosed with OA-CSM were included in the study. Clinical signs were converted into a Modified Frankel Score (MFS) and MRI findings were assessed and graded. Giant breeds had multiple compressed sites and presented at a younger age than large breeds, suggesting a different underlying pathophysiology. Spinal cord compression, most commonly bilateral, was present in 36.8% of intervertebral spaces. Synovial fluid loss and articular process sclerosis were the most common degenerative changes. Most dogs showed identical MFS scores, and no significant correlations were found between MFS and MRI changes. More detailed functional scales should be used to investigate this in the future.

Infiltrative lipoma compressing the spinal cord in 2 large-breed dogs

Two cases of infiltrative lipomas compressing the spinal cord and causing nonambulatory paraparesis in 2 large-breed dogs are reported. Magnetic resonance imaging (MRI) revealed severe extradural spinal cord compression by inhomogenous masses that infiltrated the adjacent tissues and the muscles of the spine in both dogs. The presumptive clinical diagnoses were infiltrative lipomas, which were confirmed by histopathology. In rare cases infiltrative lipomas are able to compress the spinal cord by the agressive growth of invasive adipocytes causing neurological deficits.

[Metastatic malignant melanoma with spinal cord compression and resulting recumbency ante partum in a mare. A case report]

The case report describes a narrowing of the spinal canal in the lumbar and sacroiliac regions with entailing acute recumbency in a nearterm 17-year-old Welsh B Pony mare. The reason for recumbency was metastases of a malignant melanoma in the spinal canal of the lumbo-sacral region, where the tumour had invaded the dura mater and applied severe pression on the spinal cord over a length of 10 cm. Clinical findings, laboratory diagnostics, pathological-anatomical and histopathological findings are presented.

Paraparese bei einer Zwergziege: Abklärung mittels Magnetresonanztomographie

A 4-year old pygmy goat with chronic paraparesis of the hindlimbs was referred to the Ruminant Clinic of the University of Berne. The causative lesion was localized to the thoracolumbar spinal cord after a thorough clinical examination. Because a radiographic examination of the spine had not been diagnostic, magnetic resonance imaging (MRI) was performed. A mass compressing the spinal cord in the region of L2-L5 was detected. The goat was euthanized and autopsied, which allowed for the definitive diagnosis of lymphosarcoma. In addition to the changes in the lumbar area, further neoplastic masses were detected in the region of the thoracic vertebrae, near the thoracic aperture, on the lungs and on the pericardium. However, these processes had not yet caused clinical signs. MRI investigation allowed for the ante mortem diagnosis of an infiltrative mass in the spinal canal of this goat.

Early versus late treatment of spinal cord compression with long-term intrathecal enzyme replacement therapy in canine mucopolysaccharidosis type I

Enzyme replacement therapy (ERT) with intravenous recombinant human alpha-l-iduronidase (IV rhIDU) is a treatment for patients with mucopolysaccharidosis I (MPS I). Spinal cord compression develops in MPS I patients due in part to dural and leptomeningeal thickening from accumulated glycosaminoglycans (GAG). We tested long-term and every 3-month intrathecal (IT) and weekly IV rhIDU in MPS I dogs age 12-15months (Adult) and MPS I pups age 2-23days (Early) to determine whether spinal cord compression could be reversed, stabilized, or prevented. Five treatment groups of MPS I dogs were evaluated (n=4 per group): IT+IV Adult, IV Adult, IT + IV Early, 0.58mg/kg IV Early and 1.57mg/kg IV Early. IT + IV rhIDU (Adult and Early) led to very high iduronidase levels in cervical, thoracic, and lumber spinal meninges (3600-29,000% of normal), while IV rhIDU alone (Adult and Early) led to levels that were 8.2-176% of normal. GAG storage was significantly reduced from untreated levels in spinal meninges of IT + IV Early (p<.001), IT+IV Adult (p=.001), 0.58mg/kg IV Early (p=.002) and 1.57mg/kg IV Early (p<.001) treatment groups. Treatment of dogs shortly after birth with IT+IV rhIDU (IT + IV Early) led to normal to near-normal GAG levels in the meninges and histologic absence of storage vacuoles. Lysosomal storage was reduced in spinal anterior horn cells in 1.57mg/kg IV Early and IT + IV Early animals. All dogs in IT + IV Adult and IV Adult groups had compression of their spinal cord at 12-15months of age determined by magnetic resonance imaging and was due to protrusion of spinal disks into the canal. Cord compression developed in 3 of 4 dogs in the 0.58mg/kg IV Early group; 2 of 3 dogs in the IT + IV Early group; and 0 of 4 dogs in the 1.57mg/kg IV Early group by 12-18months of age. IT + IV rhIDU was more effective than IV rhIDU alone for treatment of meningeal storage, and it prevented meningeal GAG accumulation when begun early. High-dose IV rhIDU from birth (1.57mg/kg weekly) appeared to prevent cord compression due to protrusion of spinal disks.

Evaluation of decision criteria for detection of spinal cord compression based on cervical myelography in horses: 38 cases (1981-2001)

REASONS FOR PERFORMING STUDY

Different criteria have been described based on height reduction of the total myelographic contrast column and components of it as tests for compression of the spinal cord due to cervical stenotic myelopathy (CSM). Fifty percent height reduction of the dorsal myelographic column (DMC), <2 mm empiric height of the DMC and a 40% reduction of the ratio of stenosis calculated based on the height reduction of the entire dural diameter (DD) have been described as decision criteria for considering the test result positive. The reasons for selecting these decision criteria or their accuracies have rarely been reported.

OBJECTIVES

To evaluate the accuracy of diagnostic criteria based on reduced height of the total myelographic column and components of it for diagnosing extradural spinal cord compression using different decision criteria, and make recommendations for consistent myelographic interpretation in horses suspected of having CSM.

METHODS

Four measurements were obtained by 2 readers in a retrospective sample population of 38 horses in which both cervical myelography and histopathological examination of the cervical spinal cord were performed. The prevalence of CSM in the sample was 50%. At intervertebral sites, the minimum heights of the DD and DMC were measured. At intravertebral sites, the maximum heights of the entire DD and DMC were obtained. Percent height reductions of the DMC and DD were determined as the ratio of minimum intervertebral height to maximum intravertebral height within the next cranial vertebra. Histological examination was used as the gold standard for determining the actual site of spinal cord compression. Sensitivity and specificity for the diagnostic criteria were estimated at each site in neutral and flexed neck positions using several different decision criteria.

CONCLUSIONS

At C6-C7, in neutral or flexed neck position and using 20% reduction of DD, the test was highly sensitive and specific for CSM. At other sites, reduced height of the myelographic column generally was not accurate for diagnosing extradural spinal cord compression. Using 20% reduction of DD in neutral position at the mid-cervical sites, the test had only low sensitivity and high specificity. Flexion of the neck appeared to increase detection of spinal cord compression in the mid-cervical region, but also substantially increased the frequency of false-positive diagnoses.

POTENTIAL RELEVANCE

By using the reported sensitivity and specificity estimates, readers may decide on a decision criterion for diagnosis of extradural spinal cord compression due to CSM. However, in planning a surgical correction, it is difficult to define a decision criterion that combines acceptable sensitivity and specificity, especially at the mid-cervical sites.

Thoracic stenosis causing lateral compression of the spinal cord in two immature Dogues de Bordeaux

This case report describes a novel developmental vertebral malformation in two young Dogues de Bordeaux, which was diagnosed by magnetic resonance imaging. Both dogs were treated surgically with reasonable success.

Degenerative myelopathy and vitamin A deficiency in a young black-maned lion (Panthera leo)

Degenerative myelopathy and vitamin A deficiency were diagnosed in a 1-year-old, female, black-maned lion (Panthera leo). Diffuse white matter degeneration characterized by dilated myelin sheaths, Wallerian degeneration, and reactive astrocytosis was present at all levels of the spinal cord. With luxol fast blue-resyl echt violet stain, bilaterally symmetrical demyelination was observed in the fasciculus cuneatus of the cervical spinal cord and in peripheral white matter of cervical, thoracic, and lumbar segments. Additionally, the ventral gray columns and brain stem nuclei contained rare chromatolytic neurons with abnormal neurofilament accumulation. Leptomeninges of the cervical spinal cord were focally adhered to the dura and thickened by fibrosis and osseous metaplasia. Vitamin A deficiency was diagnosed based on hepatic vitamin A concentration of 1.71 microg/g dry weight. Adequate hepatic vitamin A concentration for yearling to adult domestic animals ranges between 150 and 1000 microg/g dry weight. Lesions were distinct from those previously described in young captive lions with vitamin A deficiency, which had thickened skull bones and cerebellar herniation. The pathogenesis of vitamin A-associated myelopathy in this lion may be similar to that described in adult cattle, which is believed to result from spinal cord compression secondary to elevated pressure of cerebrospinal fluid.

Partial lateral corpectomy for ventral extradural thoracic spinal cord compression in a cat

A 7-year-old, female spayed, domestic shorthair cat was presented for ambulatory paraparesis. No trauma history was reported. Myelography and subsequent computed tomography revealed multiple ventrally located extradural spinal cord compressive lesions possibly due to intervertebral disc disease. Compression at the level of Th3-Th4 intervertebral disc space was considered responsible for the paraparesis. The lesion was approached via a right-sided lateral partial corpectomy as described for dogs. Complete spinal decompression was achieved, as documented intraoperatively by visual inspection and palpation of the spinal canal. No surgery related complications were encountered and the cat improved gradually within 8 weeks after the procedure. At 1 year follow-up only a slight proprioceptive deficit in the right hind limb could be noted. This is the first report of partial lateral corpectomy in a cat and should encourage the use of this technique even in small patients.

Confirmed and presumptive cervical vertebral compressive myelopathy in older horses: a retrospective study (1992-2004)

BACKGROUND

Cervical vertebral compressive myelopathy (CVCM) is a common cause of myelopathy in horses aged 6 months to 4 years. Little information is available regarding the types of lesions, treatment, and outcomes in horses with CVCM that are > or =4 years old.

ANIMALS

Twenty-two affected horses (10 with a confirmed diagnosis of CVCM and 12 presumptive cases) and 210 contemporaneous control horses.

METHODS

Horses > or =4 years old that were diagnosed with CVCM between January 1992 and January 2004 were identified from medical records at Texas A&M University and the University of Florida. Data analyzed included history, signalment, neurologic examination findings, lesion location, treatment, and outcome. Signalment was also recorded in a population of contemporaneous controls.

RESULTS

Horses identified had a median age of 8.4 years, and there was a greater percentage of male horses among the cases than among the controls. The most common breeds represented were warmblood (n=6) and quarter horse (n=5) types; warmbloods were significantly (P < .05) overrepresented relative to control horses. The caudal cervical vertebral column was the most common site of CVCM lesions, and the C5-C6 (4/9) and C6-C7 (3/9) articulations were most often identified as abnormal via myelography. The most common lesions seen with radiography and myelography were articular process osteophytes. Of the 22 affected horses, 8 were euthanized and a diagnosis of CVCM was confirmed by necropsy for all; 5 of 8 of these horses had spinal cord compression caused, entirely or in part, by articular process osteophytes. Medical management was the therapy chosen in all horses, and administration of corticosteroids and nonsteroidal anti-inflammatory drugs resulted in improvement in the greatest number of horses.

CONCLUSIONS AND CLINICAL IMPORTANCE

CVCM should be a differential diagnosis in older horses with cervical myelopathy. Articular process osteophytes are the most frequently identified cause of spinal cord compression in this group. Male horses and horses of warmblood or Tennessee Walking Horse breeds may be predisposed to this condition.