Intensive Functional Neurorehabilitation and Follow-up of 84 Paraplegic Dogs Affected by Intervertebral Disc Disease

2020 ◽  
Author(s):  
Ângela Rocha Martins ◽  
Débora Gouveia ◽  
Ana Cardoso ◽  
Inês Viegas ◽  
Darryl Millis ◽  
...  
Keyword(s):  
Intervertebral Disc ◽  
Pain Perception ◽  
Spinal Reflex ◽  
Prospective Clinical Study ◽  
Type I ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Expected Time

Abstract BackgroundThe objectives of this study were to verify whether the functionality obtained with functional neurorehabilitation intensive protocols (FNRIP) improve ambulation, promoting a new therapeutic approach, and understand the expected time for functional recovery. Furthermore, to know whether “spinal reflex” locomotion could be a functional locomotory pattern, which may improve the quality of life.A controlled prospective clinical study using a large cohort of 84 dogs comprising mostly chondrodystrophic-breeds. The dogs were diagnosed with T10-L3 Hansen Type I, using computed tomography or magnetic resonance imaging, and treated with hemilaminectomy. All had postsurgical neurological stage 0 or 1, according to the Open Field Score (OFS), and showed either an absent or decreased flexor peripheral reflex. All patients were subjected to FNRIP within a maximum of 3 months, data were recorded on days 1,3,7,15,30,45,60,75, 90 and patients were followed-up after 8-10 days, at 1 and 6 months, and in some cases, after 1 and 2 years. ResultsFifty-one dogs were admitted with an OFS of 1 and were discharged with an OFS of 13 (100% functionality). Of the 29 dogs that were admitted with an OFS 0, 16 were discharged (55%) in an ambulatory state, of which six dogs recovered deep pain perception (DPP) after 4 weeks, and 10 showed functional “spinal reflex” locomotion. 79.3% of these dogs achieved autonomous miction. The results were time-limited, as they were recorded within 2 to 3 months, with follow-up until 6 months. A pattern of sustained functional “spinal reflex” locomotion was observed in 30% of the dogs observed over 2 years.ConclusionsThe FNRIP are viable to regain independence and quality of life in paraplegic dogs with/without DPP, secondary to acute Intervertebral disc disease (IVDD).

Outcome of thoracolumbar surgical feline intervertebral disc disease

2021 ◽  
pp. 1098612X2110280
Author(s):  
Kayla M Fowler ◽  
Theresa E Pancotto ◽  
Stephen R Werre ◽  
Michaela J Beasley ◽  
William Kay ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Intervertebral Disc ◽  
Positive Outcome ◽  
Intervertebral Disc Herniation ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Exact Test ◽  
Imaging Results ◽  
Larger Sample

Objectives The aim of this study was to evaluate the outcome and prognosis of thoracolumbar feline intervertebral disc disease (IVDD) treated by surgical decompression. Methods This was a multi-institutional retrospective study evaluating the age, breed, sex, body weight, presenting complaint, neuroanatomic diagnosis at presentation, diagnostic imaging results, surgery performed and the overall outcome at discharge and at recheck. Bivariable associations between variables were assessed using the Kruskal–Wallis test (age and grade of IVDD at presentation) and Fisher’s exact test (grade of IVDD at presentation and outcome). Results A total of 35 cats met the inclusion criteria for the study. The most frequently reported clinical sign was difficulty walking (54.2%). The majority of cats presented with an L4–S3 localization (57%). The most common site of intervertebral disc herniation (IVDH) was at L6–L7 (34%). The majority of feline patients that received surgery had a positive outcome at the time of discharge (62.5%; n = 20/32) and at the time of the 2-week recheck (91.3%; n = 21/23). No association was identified between the age of the patient and the grade of IVDD. No association was identified between the presenting grade of IVDD and the clinical outcome at the time of discharge or at the time of recheck evaluation. Conclusions and relevance Cats undergoing spinal decompressive surgery for thoracolumbar IVDH appear to have a favorable prognosis independent of the initial presenting grade of IVDD. A larger sample size and a longer length of follow-up is necessary to obtain statistical associations between the presenting grade of IVDD and overall clinical outcome.

Residual herniated disc material following hemilaminectomy in chondrodystrophic dogs with thoracolumbar intervertebral disc disease

2012 ◽  
Vol 25 (02) ◽  
pp. 109-115 ◽  
Author(s):  
M. Thomas ◽  
J. M. Weh ◽  
J. Bleedorn ◽  
K. Wells ◽  
W. J. Roach
Keyword(s):  
Intervertebral Disc ◽  
Herniated Disc ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Vertebral Canal ◽  
Telephone Interviews ◽  
Disc Material ◽  
Long Term Follow Up

SummaryObjective: To evaluate the presence of residual disc material within the vertebral canal following hemilaminectomy in chondrodystrophic dogs with thoracolumbar intervertebral disc disease.Methods: Forty dogs were treated by hemilaminectomy. Computed tomography was performed preoperatively and immediately postoperatively. The vertebral canal height, width, area, and herniated disc material area were measured. Maximum filling percentage (MFP), residual disc percentage (RDP), maximum residual filling percentage (MRFP), and residual filling percentage (RFP) were calculated. Clinical outcome was determined by telephone interviews.Results: Residual disc material was present in 100% of the dogs. Mean MFP = 55.4% (range 25.9–82.3%; median 56.9%). Mean RDP = 50.3% (range 2.6–155.8%; median 47.9%). Mean MRFP = 30.8% (range 4.9–60%; median 30.1%). Mean RFP = 19.8% (range 4.8–45%; median 19.0%). All dogs were ambulatory with voluntary urination at the long-term follow-up (range: 88–735 days).Clinical significance: Residual disc was present in all dogs following hemilaminectomy for intervertebral disc disease. Residual disc was not associated with failure to achieve functional recovery in these cases.

Application of evidence-based medicine to recurrence of Hansen’s type I intervertebral disc disease in dogs: A justification for continuation of study into percutaneous laser disc ablation?

2012 ◽  
Vol 1 (2) ◽  
Author(s):  
Jude T. Bordelon ◽  
Kenneth E. Bartels
Keyword(s):  
Intervertebral Disc ◽  
Clinical Signs ◽  
Controlled Study ◽  
Type I ◽  
Search Term ◽  
Clinical Question ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Level Of Evidence ◽  
Long Term Outcome

AbstractTo review and evaluate the literature reporting results of prophylactic surgical procedures for Hansen’s type I intervertebral disc disease.Systematic literature review.Online bibliographic searches of abstracts through PubMed and the Veterinary Information Network (VIN) were performed using the searchable term “canine intervertebral disc disease and recurrence”. The resources were evaluated in regard to the ability of the retrieved references to directly address the clinical question as follows: which prophylactic technique when considered with or without surgery will consistently reduce or eliminate the recurrence of clinical signs associated with Hansen’s type I intervertebral disc disease. All studies were compared and evaluated with regard to study design, technique utilized, short and long-term outcome, and evidence classification.An online bibliographical search was performed in PubMed using the full search term of “canine intervertebral disc disease and recurrence” resulted in 20 total sources, and of those sources 13 contained information pertaining to the clinical question. The same search term when used in the VIN search engine under the classification of journal abstracts resulted in 43 total results with 18 applicable resources. In review of both searches, 13 resources were listed in both searches. Of the 18 obtained by the VIN search 14 were available in the English language. No resources were included in class I level of evidence, and only one was considered as class II level of evidence. As for the remaining studies, three results were classified as class III studies, and the remaining reports were classified as class IV level of evidence.Although direct extrapolation of the evidence provided by the search to the clinical scenario is not possible, this review will hopefully provide the basis for development of a randomized controlled study to provide for a clear need in evidence for prevention of intervertebral disc extrusion in dogs.

A Prospective Evaluation of CT in Acutely Paraparetic Chondrodystrophic Dogs

2013 ◽  
Vol 49 (6) ◽  
pp. 363-369 ◽  
Author(s):  
Jennifer Deck Bibevski ◽  
R. Mark Daye ◽  
Todd D. Henrickson ◽  
Todd W. Axlund
Keyword(s):  
Imaging Modality ◽  
Clinical Findings ◽  
Type I ◽  
Prospective Evaluation ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Diagnostic Modality ◽  
Spinal Compression ◽  
Lesion Level

The clinical usefulness of computed tomography (CT) as a sole diagnostic modality in identifying disc lesion(s) in chondrodystrophic breeds presenting with acute signs of intervertebral disc disease (IVDD) is incompletely characterized. CT was used prospectively to determine the validity of this tool. Neurologic examinations and CT scans were performed on all dogs at presentation. Surgical decompression was based on those findings. Clinical follow-up examinations were performed on days 1 and 14 postsurgically. CT detected a lesion consistent with clinical findings in 63 of 69 cases (91%). All 63 dogs with Hansen type I IVDD lesions were identified on CT alone. The surgeon and radiologist agreed on lesion level in 72 of 78 lesions (92%) and lateralization in 71 of 78 lesions (91%). Improvement in neurologic grade was documented in 60 of 69 dogs (87%) by 14 days. CT imaging can be used as a single imaging modality in chondrodystrophic dogs presenting with acute paresis. CT used in this manner is a reliable and noninvasive tool for detecting spinal compression secondary to IVDD in chondrodystrophic dogs.

scholarly journals Intervertebral Disc Extrusion between T8 and T9 in a Dachshund

2016 ◽  
Vol 44 (1) ◽  
pp. 4
Author(s):  
Gabriel Antonio Covino Diamante ◽  
Paulo Vinicius Tertuliano Marinho ◽  
Carolina Camargo Zani ◽  
Bruno Cesar Elias ◽  
Mônica Vicky Bahr Arias
Keyword(s):  
Spinal Cord ◽  
Intervertebral Disc ◽  
Spinal Canal ◽  
Clinical Signs ◽  
Type I ◽  
Thoracic Region ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Rib Head ◽  
Disc Extrusion

Background: Intervertebral disc extrusion with consequent spinal compression or intervertebral disc disease (IVDD) is one of the most common causes of compressive myelopathy in dogs, and the thoracolumbar spine discs between T12 and L2 are most affected. Extrusions in cranial thoracic region are rare, and there is few cases in literature reporting this situations, this rarity is attributed to the presence of the intercapital ligament connecting the rib heads between T2 and T10, which strengthens this region both mechanically and anatomically. The aim of this article is report the clinical signs, diagnosis and treatment of a case of Type I Hansen IVDD between T8 and T9 in a Dachshund breed dog.Case: An 8-year-old Dachshund male dog was presented for investigation of pelvic limb incoordination and back pain, which started 10 days prior to the consultation. It had a history of a similar condition 3 months earlier that showed improvement after clinical treatment. On neurological examination was identified in both pelvic limbs proprioceptive ataxia, absence of proprioception, increased muscle tone, presence of interdigital reflex and increased patellar reflex. Cutaneous trunci reflex was absent below T11 on the left side, and pain was noted upon palpation of T7 through the T12 vertebrae. A grade II asymmetric thoracolumbar lesion with hyperesthesia was diagnosed. On suspicion of IVDD, cerebrospinal fluid (CSF) collection and CT scan analysis of the thoracolumbar region were performed. CT scan showed the presence of hyperattenuating and mineralized material, 1 cm long, on the floor of the spinal canal, mainly on the left side, occupying 80% of the diameter of the spinal canal between T8 and T9. The patient was then submitted to decompression surgery through hemilaminectomy and showed a good recovery. As the occurrence of disc extrusion in cranial thoracic region of chondrodystrophic breeds is rare, we report the clinical signs, diagnosis and treatment of a case of Type I Hansen intervertebral disc disease (IVDD) between T8 and T9 in a Dachshund breed dog.Discussion: All spinal discs can undergo a process of degeneration causing IVDD, in which the cervical and thoracolumbar regions are the most affected due to reasons not yet fully understood, however spinal cord compression between the T1 and T9 vertebrae is very rare, probably due to the strengthening provided by the intercapital ligament to the posterior annulus fibrosus. Disc extrusion in unusual locations in chondrodystrophic breeds is mainly reported as extrusion between vertebrae T1 and T2, and T9 and T10, with some cases was attributed to an anatomical abnormality of the intercapital ligament. The evaluation of intervertebral discs of the German shepherd breed dogs using MRI showed disc degeneration processes in thoracic vertebras. Disc extrusions often result in more severe clinical signs than protrusions, and occur acutely or subacutely, which was different from the case described here, maybe because the presence of the intercapital ligament permitted gradual extrusion allowing the spinal cord to adapt to the compression. Despite surgical access to this region being described as more complex due to the presence and proximity of the rib head to the vertebral body and the possibility of injuring the intercostal muscles causing pneumothorax, the hemilaminectomy and rib head excision at T9 could be performed without any complications. Thus, although unusual, the cranial thoracic region should not be overlooked as a possible site of occurrence of IVDD, since the diagnosis, treatment and prognosis are similar to those in patients with extrusions in the most common sites.Keywords: intervertebral disc degeneration, dogs, paresis, ataxia.

Late results of treatment of intervertebral disc disease with chymopapain

1983 ◽  
Vol 59 (6) ◽  
pp. 990-993 ◽  
Author(s):  
Dwight Parkinson
Keyword(s):  
Intervertebral Disc ◽  
First Generation ◽  
Clinical Pathology ◽  
Late Results ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Content Type ◽  
Results Of Treatment ◽  
Fine Print

✓ The authors report a 12-year follow-up review of 33 patients treated with chymopapain (Discase) injection for intervertebral disc disease. This carefully controlled series of patients was treated under local anesthesia in the prone position. Only the single offending disc that correlated with the myelographic and clinical pathology (without the use of discography) was injected with Discase. Anaphylaxis is treated instantly at the first sign of disturbance, and no patients suffered shock. The percentage of patients who were completely cured or improved continues at about 70%. Aside from sensitivity, complications attributable to proper use of the enzyme remain at zero. Follow-up review of those patients over 10 years would indicate that there is no risk of delayed organ toxicity, no risk of carcinogenesis, and no apparent risk of first-generation teratogenesis.

scholarly journals Functional Neurorehabilitation in Dogs with an Incomplete Recovery 3 Months following Intervertebral Disc Surgery: A Case Series

Animals ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 2442
Author(s):  
Ângela Martins ◽  
Débora Gouveia ◽  
Ana Cardoso ◽  
Carla Carvalho ◽  
Cátia Silva ◽  
...  
Keyword(s):  
Pain Perception ◽  
Therapeutic Option ◽  
Case Series ◽  
Spinal Reflex ◽  
Type I ◽  
Locomotor Training ◽  
Pharmacological Management ◽  
Case Series Study ◽  
Flexion Extension

This case series study aimed to evaluate the safety, feasibility, and positive outcome of the neurorehabilitation multimodal protocol (NRMP) in 16 chronic post-surgical IVDD Hansen type I dogs, with OFS 0/DPP− (n = 9) and OFS 1/DPP+ (n = 7). All were enrolled in the NRMP for a maximum of 90 days and were clinically discharged after achieving ambulation. The NRMP was based on locomotor training, functional electrical stimulation, transcutaneous electrical spinal cord stimulation, and 4-aminopyridine (4-AP) pharmacological management. In the Deep Pain Perception (DPP)+ dogs, 100% recovered ambulation within a mean period of 47 days, reaching OFS ≥11, which suggests that a longer period of time is needed for recovery. At follow-up, all dogs presented a positive evolution with voluntary micturition. Of the DPP− dogs admitted, all achieved a flexion/extension locomotor pattern within 30 days, and after starting the 4-AP, two dogs were discharged at outcome day 45, with 78% obtaining Spinal Reflex Locomotion (SRL) and automatic micturition within a mean period of 62 days. At follow-up, all dogs maintained their neurological status. After the NRMP, ambulatory status was achieved in 88% (14/16) of dogs, without concurrent events. Thus, an NRMP may be an important therapeutic option to reduce the need for euthanasia in the clinical setting.

Feline intervertebral disc disease: a review of the literature

2002 ◽  
Vol 15 (03) ◽  
pp. 137-144 ◽  
Author(s):  
R. M. Rayward
Keyword(s):  
Intervertebral Disc ◽  
Surgical Intervention ◽  
Surgical Techniques ◽  
Neurological Dysfunction ◽  
Type I ◽  
Review Of The Literature ◽  
Resonance Imaging ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Clinically Significant

SummaryIntervertebral disc disease should be considered in the differential diagnosis of feline myelopathy. Animals of any age, breed or gender may be affected and onset of neurological dysfunction may be variable. The thoracolumbar junction and to a lesser extent the mid lumbar spine are the most commonly affected sites and Hansen type I disc extrusions predominate. Standard investigations (radiography, myelography, computed tomography, magnetic resonance imaging) and surgical techniques (laminectomy, hemilaminectomy, fenestration, durotomy) may be employed. Although response to conservative treatment is variable, surgically treated cases generally respond favourably but neurological recovery may be incomplete. Following surgical intervention, a recurrence of clinically significant IVDD has not been reported.

scholarly journals Influence of duration of clinical signs on surgical treatment results of 16 dogs with intervertebral disc disease (IVDD)

2014 ◽  
Vol 58 (2) ◽  
pp. 277-281
Author(s):  
Marcin Wrzosek ◽  
Zdzisław Kiełbowicz ◽  
Elżbieta Giza ◽  
Marta Płonek ◽  
Józef Nicpoń
Keyword(s):  
Body Weight ◽  
Surgical Treatment ◽  
Intervertebral Disc ◽  
Success Rate ◽  
Surgical Outcome ◽  
Pain Perception ◽  
Clinical Signs ◽  
Intervertebral Disc Disease ◽  
Treatment Results ◽  
Disc Disease

Abstract The purpose of this study was to evaluate the outcome of surgical treatment in 16 dogs, depending on the animal’s age, body weight, deep pain perception, and time from the onset of neurological symptoms to the consultation with a veterinary neurologist and successive surgery. Sixteen dogs diagnosed with cervical (n = 11) or thoracolumbar (n = 5) disc extrusions underwent spinal surgeries (eleven ventral slots and five hemilaminectomies). The success rate of surgical treatment was 64.3% in dogs with preserved nociception. No association between the animal’s age or body weight and the result of surgical treatment was found. A successful surgical outcome was more likely when the symptom-to-surgery time was shorter.

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