scholarly journals Conservative treatment of cervical intervertebral disc disease in a dog with the use of a cervical collar: case report

2020 ◽  
Vol 13 (3) ◽  
pp. 57
Author(s):  
G. F. Pessine ◽  
D. Farias Junior

Intervertebral Disc Disease (IVDD) is the main  spinal cord disease in dogs, especially  of chondrodisthrophic breeds, and it’s  characterized  by structural degeneration of discs, following protrusion or extrusion of debris to the medullar canal, compression and variable degrees of pain, paresis and ataxia. Surgical  descompressive intervention   coupled with disc fenestration are the treatment of choice as it promotes faster recovery with higher succes rates, not withou important morbidity and mortality. The conservative management is considered when the pacient has mild clinical signs, doesn’t have severe medullar compression or contusion lesions on imaging tests, as well as when there are restrictions associated with the clinical state of the pacient or the higher costs of surgical treatment.

2020 ◽  
Vol 48 ◽  
Author(s):  
Angel Ripplinger ◽  
Graciane Aiello ◽  
Mathias Reginatto Wrzesinski ◽  
Marcelo Luís Schwab ◽  
Júlia Da Silva Rauber ◽  
...  

Background: Intervertebral disc extrusion is an important cause of spinal cord dysfunction in dogs. Intradural localization of the extruded disc material is rare, and is generally associated with a traumatic event or with recurrence of disc extrusion at a previously affected site. We report the clinical presentation, diagnostic workup, and treatment of a dog with intradural intervertebral disc extrusion not preceded by a traumatic event.Case:  A 6-year-old male Dachshund was referred for neurological evaluation due to acute onset of hind-end paralysis preceded by claudication of the left hindlimb. The patient had been receiving conservative treatment to no effect. Neurological examination revealed asymmetric non-ambulatory paraparesis, absence of postural reactions and decreased muscle tone in both hindlimbs, a bilaterally diminished patellar reflex, and a hindlimb withdrawal reflex which was normal on the right and greatly diminished to absent on the left. The lower back was tender to epaxial palpation. Plain radiographs of the lumbar spine in the lateral projection showed calcified material within the spinal canal between the third and fourth lumbar vertebrae. Myelography was suggestively abnormal at the same level, with epidural leakage of contrast at L3-L4. Considering the clinical history, breed, age, neurological signs, and radiographic findings, intervertebral disc disease was suspected despite the inconclusive myelography findings. A dorsolateral lumbar hemilaminectomy was performed. Intraoperatively, the diagnosis was confirmed by visualization of a discolored spinal cord and absence of extradural material. The intradural space was accessed via durotomy. A firm, straw-yellow material was seen compressing the spinal cord and removed. Subsequent histopathological examination confirmed that this material consisted of extruded intervertebral disc contents. Postoperatively, the patient underwent physiotherapy and achieved a satisfactory recovery.Discussion: The most common cause of paraparesis in chondrodystrophic dog breeds is intervertebral disc extrusion. Intradural extrusion of the intervertebral disc is a rare phenomenon, often associated with vigorous exercise that causes laceration of the dura mater, allowing penetration of disc material into the intradural space. Although there were no classic signs of intervertebral disc disease on plain radiography, radiopaque material was visible within the spinal canal, which can occur in cases of calcified intervertebral disc extrusion. Myelography was inconclusive, but the decision was made to operate nevertheless, considering that the patient had not responded to conservative treatment and that surgicaltreatment is the most suitable approach for dogs with non-ambulatory paraparesis or paraplegia secondary to intervertebral disc extrusion. The surgical technique consisted of a hemilaminectomy and durotomy. Our diagnostic suspicion was confirmed intraoperatively, as in most cases of intradural disc extrusion in humans. Intradural disc extrusion is anuncommon phenomenon in dogs, and the diagnosis is usually only established intraoperatively. This unusual variant of intravertebral disc disease should be included in the differential diagnosis of spinal cord dysfunction in chondrodystrophic breeds, even in the absence of a history of trauma or preexisting intervertebral disc disease. Clinical treatment appears ineffective in these cases. Conversely, surgical treatment can yield good outcomes, and even functional recovery.


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

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.


2014 ◽  
Vol 58 (2) ◽  
pp. 277-281
Author(s):  
Marcin Wrzosek ◽  
Zdzisław Kiełbowicz ◽  
Elżbieta Giza ◽  
Marta Płonek ◽  
Józef Nicpoń

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.


Spine ◽  
2008 ◽  
Vol 33 (13) ◽  
pp. 1397-1402 ◽  
Author(s):  
Wendy I. Baltzer ◽  
Maureen A. McMichael ◽  
Giselle L. Hosgood ◽  
Sharon C. Kerwin ◽  
Jonathan M. Levine ◽  
...  

2016 ◽  
Vol 19 (4) ◽  
pp. 419-423 ◽  
Author(s):  
Steven De Decker ◽  
Anne-Sophie Warner ◽  
Holger A Volk

Objectives The objective was to evaluate the prevalence and possible breed predilections for thoracolumbar intervertebral disc disease (IVDD) in cats. Methods Medical records and imaging studies of cats diagnosed with thoracolumbar IVDD between January 2008 and August 2014 were retrospectively reviewed and compared with the general hospital population. The association between type of IVDD (ie, intervertebral disc extrusion [IVDE] or intervertebral disc protrusion [IVDP]) and breed, age, sex, and duration and severity of clinical signs was also evaluated. Results Of 12,900 cats presented during the study period, 31 (0.24%) were diagnosed with IVDD, including 17 purebred and 14 non-purebred cats. Of all presented purebred cats, 0.52% were diagnosed with thoracolumbar IVDD. More specifically, 1.29% of all British Shorthairs and 1.83% of all presented Persians were diagnosed with IVDD. Compared with the general hospital population, purebred cats ( P = 0.0001), British Shorthairs ( P <0.0001) and Persians ( P = 0.0006) were significantly overrepresented with thoracolumbar IVDD. Affected purebred cats were younger than affected non-purebred cats ( P = 0.02). Of 31 cats with IVDD, 19 were diagnosed with IVDE and 12 with IVDP. Cats with IVDE had a significantly shorter duration of clinical signs ( P = 0.0002) and demonstrated more severe neurological deficits ( P = 0.04) than cats with IVDP. Conclusions and relevance Although thoracolumbar IVDD is an uncommon condition in cats, purebred cats, British Shorthairs and Persians, were overrepresented. It is currently unclear if this represents a true breed predisposition or a higher likelihood of owners of purebred cats seeking referral for advanced diagnostic imaging procedures.


2012 ◽  
Vol 1 (2) ◽  
Author(s):  
Jude T. Bordelon ◽  
Kenneth E. Bartels

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.


2016 ◽  
Vol 44 (1) ◽  
pp. 4
Author(s):  
Rafael Oliveira Chaves ◽  
Bruna Copat ◽  
Diego Vilibaldo Beckmann ◽  
João Pedro Scusssel Feranti ◽  
Marília Teresa De Oliveira ◽  
...  

Background: Intervertebral disc disease is a usual neurological disorder in dogs, which the spinal cord is compressed by intervertebral disc extrusion or protrusion. Fibrocartilaginous embolic myelopathy isan acute infarction disease of spinal cord caused by fibrocartilaginous emboli histologically identical to the nucleus pulposus of intervertebral discs. The aim of this report is present two cases of fibrocartilaginous embolic myelopathy in dogs with intervertebral disc disease.Cases: Two dogs - dachshund breed - were referred to the Veterinary Medical Teaching Hospital of the UFSM. In the first case, the dog was three years old and the owner described complete inability to move the pelvic limbs. The neurological examination revealed paraplegia, postural reactions deficits, normal spinal reflexes and muscle tonus in the hind limbs, pain on palpation in T12-T11 region and loss of deep pain in hind limbs. In the other case, the dog was seven years old and the owner described partial inability to move four limbs. The neurological examination revealed non-ambulatory tetraparesis, postural reactions deficit, normal spinal reflexes in four limbs and pain on palpation in cervical spine. In both cases, the presumptive diagnosis was intervertebral disc disease and surgical treatment was indicated. The dog with thoracolumbar injury died during the anesthesia and the dog with cervical injury was euthanized, after decision of owner. During the necropsy was observed intervertebral disc extrusion between L1-L2 vertebrae in a dog and between C3-C4 vertebrae in the other case with cartilaginous fragments in the spinal canal. Histopathology revealed marked diffuse necrosis with multifocal hemorrhage and cartilaginous emboli.Discussion: Fibrocartilaginous embolic myelopathy is commonly reported in large and giant breed dogs, though also occur in small and medium-sized breeds of dogs. One hypothesis is the pulpous nucleus remains soft for a longer period in large breed dogs, empowering to infiltration in the spinal cord vessels. The intervertebral disc extrusion occurs predominantly in dogs with age between three and six years old, in the cervical, thoracolumbar (T11-L3) and lumbar regions. Chondroid or fibroid degeneration of the intervertebral disc is the most common cause of spinal cord compression in small animals. In chondrodistrophic breed dogs is frequently chondroid degeneration, which the nucleus pulposus moves into the spinal canal through rupture of the annulus fibrosus (extrusion or Hansen type I), causing acute spinal cord compression. The prevalence of fibrocartilaginous embolism in adult and old dogs increase the possibility of predisposing factors, facilitating the injection intravascular of nucleus pulposus material. One of the most accepted theories about the mechanism of fibrocartilaginous emboli into the vessels is due to increase of inside discal pressure and liberation of fibrocartilaginous emboli from nucleus pulposus into the vertebral artery for retrograde flow, reaching the spinal cord by blood flow. The simultaneous occurrence of intervertebral disc disease and the infarction of spinal cord in the proximate region accentuate the hypothesis that the etiology of fibrocartilaginous embolic myelopathy is mechanical into the vessels of the spinal cord.Keywords: neurology, spinal cord, intervertebral disc disease, dogs.


2020 ◽  
Vol 49 (5) ◽  
pp. 905-913
Author(s):  
Philipp A. Schmierer ◽  
Julia Tünsmeyer ◽  
Andrea Tipold ◽  
Sonja Hartnack‐Wilhelm ◽  
Piotr Lesczuk ◽  
...  

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