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.

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.

scholarly journals Diagnostic Imaging in Intervertebral Disc Disease

2020 ◽  
Vol 7 ◽  
Author(s):  
Ronaldo C. da Costa ◽  
Steven De Decker ◽  
Melissa J. Lewis ◽  
Holger Volk ◽  
Keyword(s):  
Computed Tomography ◽  
Intervertebral Disc ◽  
Nucleus Pulposus ◽  
Imaging Modality ◽  
Imaging Techniques ◽  
Intervertebral Disc Herniation ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Disc Protrusion ◽  
Disc Extrusion

Imaging is integral in the diagnosis of canine intervertebral disc disease (IVDD) and in differentiating subtypes of intervertebral disc herniation (IVDH). These include intervertebral disc extrusion (IVDE), intervertebral disc protrusion (IVDP) and more recently recognized forms such as acute non-compressive nucleus pulposus extrusion (ANNPE), hydrated nucleus pulposus extrusion (HNPE), and intradural/intramedullary intervertebral disc extrusion (IIVDE). Many imaging techniques have been described in dogs with roles for survey radiographs, myelography, computed tomography (CT), and magnetic resonance imaging (MRI). Given how common IVDH is in dogs, a thorough understanding of the indications and limitations for each imaging modality to aid in diagnosis, treatment planning and prognosis is essential to successful case management. While radiographs can provide useful information, especially for identifying intervertebral disc degeneration or calcification, there are notable limitations. Myelography addresses some of the constraints of survey radiographs but has largely been supplanted by cross-sectional imaging. Computed tomography with or without myelography and MRI is currently utilized most widely and have become the focus of most contemporary studies on this subject. Novel advanced imaging applications are being explored in dogs but are not yet routinely performed in clinical patients. The following review will provide a comprehensive overview on common imaging modalities reported to aid in the diagnosis of IVDH including IVDE, IVDP, ANNPE, HNPE, and IIVDE. The review focuses primarily on canine IVDH due to its frequency and vast literature as opposed to feline IVDH.

scholarly journals Classification of Intervertebral Disc Disease

2020 ◽  
Vol 7 ◽  
Author(s):  
Joe Fenn ◽  
Natasha J. Olby ◽  
Keyword(s):  
Intervertebral Disc ◽  
Intervertebral Disc Degeneration ◽  
Clinical Findings ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Clinical Presentations ◽  
Disc Material ◽  
Definition Of ◽  
Current Systems

Intervertebral disc disease (IVDD) has been recognized in dogs since the 1800s, when the first descriptions of extruded disc material within the vertebral canal were published. In the intervening time our understanding of intervertebral disc pathology in dogs and cats has increased dramatically, with many variations of IVDD described. Whilst the volume of literature and collective understanding of IVDD has expanded, there has also been scope for confusion as the definition of intervertebral disc disease, with its myriad different manifestations, becomes more complicated. A large volume of literature has aimed to combine the use of histopathology, diagnostic imaging and clinical findings to better understand the various ways in which IVDD can be classified. Much of this research has focused on the classification of mechanisms of intervertebral disc degeneration, centering around the differences between, and overlaps in, IVDD in chondrodystrophic and non-chondrodystrophic dog breeds. However, with the increasing availability of advanced imaging modalities allowing more accurate antemortem diagnosis, the concept of IVDD has expanded to include other clinical presentations that may not fit into traditional models of classification of IVDD. This review aims to provide an up to date overview of both historical and current systems of IVDD classification, highlighting the important findings and controversies underpinning them.

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.

scholarly journals Evaluating the reliability of computed tomography for the diagnosis of intervertebral disc extrusion in dogs

2021 ◽  
Vol 6 (4) ◽  
Author(s):  
Chloe Smith
Keyword(s):  
Computed Tomography ◽  
Intervertebral Disc ◽  
Surgical Planning ◽  
Imaging Modality ◽  
Research Question ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Bottom Line ◽  
Disc Extrusion ◽  
Lesion Characterisation

PICO question In dogs with an acute thoracolumbar myelopathy, is non-contrast computed tomography (CT) a reliable method for the diagnosis of intervertebral disc extrusion, compared to magnetic resonance imaging (MRI)?   Clinical bottom line Category of research question Diagnosis The number and type of study designs reviewed Four papers were critically reviewed. Two were retrospective, cross-sectional studies, and two were prospective, observational cohort studies Strength of evidence Moderate Outcomes reported The current literature suggests that CT is often sufficient for the diagnosis of thoracolumbar intervertebral disc extrusion, with MRI superior to CT for lesion characterisation. Non-contrast CT is likely sufficient for the diagnosis and surgical planning for intervertebral disc disease in Dachshunds. However, MRI is recommended for diagnosis and surgical planning of thoracolumbar intervertebral disc disease in non-Dachshund breeds Conclusion Computed tomography is often sufficient for the diagnosis of thoracolumbar intervertebral disc extrusion. However, MRI is superior to CT for lesion characterisation and it is therefore recommended to use MRI for cases requiring surgical planning. Computed tomography is likely sufficient for the diagnosis and surgical planning of intervertebral disc disease in Dachshunds Regard for the reason of diagnostics performed (e.g. surgical planning) and the likelihood of other differential diagnoses (e.g. spinal neoplasms) should be taken before deciding to use one imaging modality over the other. Consideration into the risks associated with anaesthetising an animal with a spinal cord lesion, the ability of the practitioner to accurately localise the myelopathy and interpret the results, should be taken before pursuing diagnostics in these cases   How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.  

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.

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