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SAM > Conditions Involving Both Hind Limbs > Flashcards

Conditions Involving Both Hind Limbs Flashcards

1
Q

Spinal cord lesions caudal to what vertebrae can cause paraparesis or paraplegia?

A

T2

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2
Q

What is a myelopathy?

A

Any disorder of the spinal cord or of bone marrow.

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3
Q

What condition occurs due to degeneration of axons and their myelin sheaths in the thoracolumbar spinal cord?

A

Degenerative myelopathy

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4
Q

Degenerative myelopathy affects what size dog mainly?

A

Large and giant breeds

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5
Q

Are lesions seen with degenerative myelopathy inflammatory?

How is the response to immunosuppressive therapy?

A
  • No

- Poor

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6
Q

Is the loss of voluntary motor functions and position sense quick or gradual with degenerative myelopathy?

A

Gradual

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7
Q

Knuckling, dragging of the toes, crossing of the legs when walking/turning, dysmetria and ataxia of the pelvic limbs are the most common clinical signs seen with what condition?

A

Degenerative myelopathy

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8
Q

In what age range is degenerative myelopathy seen in dogs?

A

Older than 8 years

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9
Q

With degenerative myelopathy, are LMN or UMN signs generally seen in the hind limbs?

A

UMN

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10
Q

Is spinal hyperesthesia seen with degenerative myelopathy?

A

No

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11
Q

How is pain sensation in the pelvic limbs of a dog with degenerative myelopathy?

A

Usually normal

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12
Q

How do you get a definitive diagnosis for degenerative myelopathy?

A

See axonal and myelin degeneration with astrogliosis on histopathology.

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13
Q

What is astrogliosis?

A

Abnormal increase in number of astrocytes dye to destruction of nearby neurons.

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14
Q

What are two conditions that need to be excluded for a clinical diagnosis of degenerative myelopathy to be made?

A
  • Inflammatory

- Compressive causes

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15
Q

A genetic mutation of what gene has been linked to degenerative myelopathy?

A

Superoxide dismutase 1 protein gene (SOD 1)

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16
Q

What is the treatment for degenerative myelopathy?

A

None

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17
Q

What type of degeneration can be seen at the lumbosacral articulation?

A

Hansen type II degeneration

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18
Q

Instability at L7-S1 causing proliferation of the interarcuate ligaments and formation of osteophytes on articulation facets which further compress the spinal cord and sciatic and pudendal nerve can be seen with what 4 conditions?

A
  • Lumbosacral malarticulation-malformation
  • Cauda equina syndrome
  • Lumbosacral stenosis
  • Spondylolisthesis
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19
Q

Compressive forces in the L7-S1 region can result in pain and LMN signs in what 2 nerves?

A
  • Sciatic

- Pudendal

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20
Q

Is there disc degeneration seen with lumbosacral malarticulation-malformation, cauda equine syndrome, lumbosacral stenosis and spondylolisthesis?
What age range and size dogs are these conditions more common in?
Are these seen in cats?

A
  • No
  • 5-8 years old/large breed dogs
  • Very rarely seen in cats
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21
Q

At what point is rear limb paresis usually seen in dogs with lumbosacral conditions?

A

Usually only in advanced cases.

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22
Q

What are 3 early signs that can be seen with problems in the lumbosacral area?

A
  • Lumbosacral pain
  • Difficulty rising
  • Difficulty negotiating stairs
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23
Q

Decreased extension of the hock indicates what nerve is being affected?

A

Sciatic nerve

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24
Q

In which test for pain are the hips extended and a downward force applied to the lumbosacral region?

A

“Lordosis test”

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25
Q

Pain as a result of what action is more specific for lumbosacral problems vs hip problems?

A

Hyperextension of the tail head (tail jack)

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26
Q

With advanced cases involving the lumbosacral region, which reflex may show pseudohyperreflexia?

A

Patellar reflex

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27
Q

Can urinary and fecal incontinence be seen with lumbosacral conditions?

A

Yes in advanced cases

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28
Q

What is diagnosis of lumbosacral conditions based on?

A

Documentation of nerve compression

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29
Q

What is spondylosis?

A

Immobility and fusion of vertebral joints.

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30
Q

Dogs with what condition are about 8 times more likely to develop a cauda equina syndrome?
Where is the lesion usually located in this case?

A
  • Lumbosacral transitional vertebra (LTV)

- Between the last true lumbar vertebra and the LTV

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31
Q

Cauda equina syndrome must be confirmed by what?

Why?

A
  • Contrast radiography

- Many normal dogs have abnormalities at L7/S1 on plain radiographs

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32
Q

What are 2 diagnostic procedures that enable both lumbosacral compression and nerve entrapment in foramina to be assessed?

A
  • MRI

- CT

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33
Q

Is CSF analysis helpful in diagnosing cauda equina syndrome?
Why?

A
  • No

- Spinal cord proper has usually terminated cranial to level of compression (L7/S1)

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34
Q

What are 5 drugs that can be used in addition to cage rest for the medical management of lumbosacral injuries?

A
  • NSAIDs
  • Gabapentin
  • Muscle relaxants
  • Tramadol
  • Prednisone
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35
Q

What is a laminectomy?

A

Surgical removal of part of the posterior arch of a vertebra to provide access to the spinal canal.

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36
Q

What are 2 surgical options for the treatment of lumbosacral injuries?

A
  • Lumbosacral dorsal laminectomy

- Removal of the ligaments and bone putting pressure on the nerves

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37
Q

Does lumbosacral surgery usually improve incontinence?

A

No

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38
Q

What is a foramenotomy?

A

Surgery that widens the opening in the intervertebral foramina where nerve roots leave the spinal canal.

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39
Q

All vertebrae besides which 2 have discs between them which act as shock absorbers and facilitate movement between vertebrae?

A

C1 and C2

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40
Q

What are the 2 components of a disc?

A
  • Outer fibrous ring (annulus fibrosis)

- Inner gelatinous mass (nucleus pulposus)

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41
Q

How is the nucleus pulposus positioned in the annulus fibrosis?

A

Eccentrically between the middle and dorsal third of the disc.

42
Q

As the dog ages, the gel-like nucleus pulposus degenerates and is replace with what?

A

Cartilage

43
Q

In most breeds, replacement with fibrocartilage is complete by what age?
In chondrodystrophic breeds?

A
  • 7-8 years of age

- 4-18 months of age

44
Q

What is common in the central areas of the discs of chondrodystrophic dogs?

A

Calcification

45
Q

Dorsal displacement of the nucleus pulposus can result in what 2 occurrences as a result of impact injury or mechanical compression?

A
  • Stretching of the dorsal longitudinal ligaments causing pain
  • Spinal cord damage causing neurological dysfunction
46
Q

An explosive extrusion of nuclear pulposus material into the spinal canal through the annulus fibrosis is known as what?

A

Hansen type 1 displacement

47
Q

Hansen type 1 displacement is seen most commonly in what type of dogs?

A

Chondrodystrophic

48
Q

In which form of displacement do small tears appear in the annulus fibrosis leading to slow protrusion of the nucleus pulposus?

A

Hansen type 2 displacement

49
Q

Hansen type 2 displacement occurs more commonly in what type of dogs?

A

Large breed dogs

50
Q

Thoracolumbar intervertebral disc disease is usually seen in what age group?

A

3-7 years of age

51
Q

Is calcification of discs common in cats?

Where is it most often seen?

A
  • Yes

- Upper cervical and mid-lumbar (L4-L5)

52
Q

There are seldom disc protrusion in what area of the spine?

Why?

A
  • T2-T10

- Intercapital ligament

53
Q

Most disc protrusions occur in what area of the spine?

A

T11-L2

54
Q

Disc protrusions between T11 and L2 give what kind of sings to where?

A

UMN signs to the hind limbs

55
Q

What is the sequence of the loss of neurological function typically seen with spinal cord compression?

A
  • Conscious proprioception
  • Voluntary motor function and usually control of urination and defecation
  • Superficial pain sensation
  • Deep pain sensation
56
Q

What is proprioception?

A

Awareness of the position on one’s body.

57
Q

Spinal radiographs showing collapse of disc spaces with calcified disc material in the vertebral canal can be indicative of what condition?
What is needed to definitely locate the lesion?

A
  • Thoracolumbar intervertebral disc disease

- Myelography

58
Q

Medical or surgical therapy for thoracolumbar intervertebral disc disease is chosen depending on what 2 factors?

A
  • Severity of compression

- Clinical signs

59
Q

What are the neurological deficits seen with Grade 1 thoracolumbar intervertebral disc disease?

A

Spinal hyperesthesia without neurological defects

60
Q

What are the neurological deficits seen with Grade 2 thoracolumbar intervertebral disc disease?

A

Paresis but ambulatory

61
Q

What are the neurological deficits seen with Grade 3 thoracolumbar intervertebral disc disease?

A

Paresis but non-ambulatory

62
Q

What are the neurological deficits seen with Grade 4 thoracolumbar intervertebral disc disease?

A

Paralysis with deep pain sensation intact

63
Q

What are the neurological deficits seen with Grade 5 thoracolumbar intervertebral disc disease?

A

Paralysis with loss of deep pain

64
Q

Strict cage rest for 2 weeks is usually successful in 80-100% of which grade patients?

A

Grades 1, 2, 3

65
Q

Which is more effective for pain with dogs on cage rest from thoracolumbar intervertebral disc disease, NSAIDs or prednisone?

A

Prednisone

66
Q

What are 2 drugs that can be given to help with the expression of UMN bladders by reducing the tone in the smooth muscle of the urethral sphincter?

A
  • Prazosin

- Phenozybenzamine

67
Q

What is recommended for all grade 4 patients?

A

Surgery

68
Q

What is the technique of choice for surgery on grade 4 patients?

A

Dorsolateral hemilaminectomy

69
Q

Which grade will most likely not recover regardless of treatment?

A

Grade 5

70
Q

If deep pain sensation has not returned in a grade 5 patient by 2 weeks post surgery, is it likely to return?

A

No

71
Q

Is there a difference in prognosis for a grade 5 patient with LMN signs vs UMN signs?

A

No

72
Q

Which has a worse prognosis, dogs with type 1 or type 2 discs?

A

Type 2

73
Q

Are there any preventative measures for thoracolumbar intervertebral disc disease?

A

No known behavioral risk factors

74
Q

An infection of the cartilaginous endplates with secondary involvement of the intervertebral disc is known as what?

A

Discospondylitis

75
Q

What are the 3 most common agents causing discospondylitis?

A
  • Staphylococcus intermedius
  • Brucella canis
  • Streptococcus spp.
76
Q

What type of dogs are predisposed to discospondylosis?

Is it seen in cats?

A
  • Large middle-aged male dogs

- Rare in cats

77
Q

What are the 3 most common sites affected by discospondylosis?

A
  • Caudal cervical (C6-C7)
  • Mid-thoracic (T4-T6)
  • Lumbosacral (L7-S1)
78
Q

Initially, dogs infected with discospondylitis have what 4 clinical signs?

A
  • Hyperesthesia
  • Pyrexia
  • Depression
  • Weight loss
79
Q

What is pyrexia?

A

Fever

80
Q

If discospondylitis remains untreated, proliferation of what 2 things can cause spinal cord compression and paresis caudal to the lesion?

A
  • Fibrous connective tissue

- New bone

81
Q

Spinal cord lesions with concurrent systemic signs should raise a high level of suspicion of what condition?

A

Discospondylitis

82
Q

A definitive diagnosis of discospondylitis can be made with what?
What are 3 things that can be seen?

A
  • Spinal radiographs

- Vertebral lysis, sclerosis, spondylosis

83
Q

Serology for which bacteria should be performed on affected intact dogs with discospondylitis?

A

Brucella canis

84
Q

What are 3 antibiotics that can be used to treat discospondylitis cause by Staphylococcus intermedius?

A
  • Cephalexin
  • Cephazolin
  • Cloxacillin
85
Q

How long should antibiotic treatment be given for the treatment of discospondylitis?

A

Until there are no radiographic signs of active infection.

86
Q

Discospondylitis dogs with neurological dysfunction are surgical candidates for decompression or stabilization using what technique?

A

Hemi-laminectomy

87
Q

What is the prognosis of discospondylitis?

A

Generally favorable, except for fungal infections.

88
Q

What are 4 possible positions of neoplasms within the spine?

A
  • Intramedullary
  • Metastatic intramedullary
  • Intradural-extramedullary
  • Extradural
89
Q

What are 3 examples of intramedullary neoplasms?

A
  • Astrocytoma
  • Oligodendroglioma
  • Ependymoma
90
Q

What are 3 examples of metastatic intramedullary neoplasms?

A
  • Hemangiosarcoma
  • Melanoma
  • Carcinoma
91
Q

What are 3 examples of intradural-extramedullary neoplasms?

A
  • Meningioma
  • Nephroblastoma
  • MPNSTs
92
Q

Which location of tumor is the most common in cats and dogs?

A

Extradural

93
Q

What is the most common primary spinal cord tumor in the dog?
Where is it most frequently found?

A
  • Meningiomas

- Thoracolumbar area

94
Q

What is the second most common spinal tumor in dogs?

A

Hemangiosarcoma

95
Q

What is the most common spinal cord tumor in cats?

Is it also common in the brain?

A
  • Extradural lymphosarcoma

- No, rare in the brain

96
Q

Where do extradural lymphosarcomas mainly occur in the cat?

A

Thoracolumbar area

97
Q

What are 2 characteristics of cats with extradural lymphosarcoma?

A
  • Young (3.5 years old)

- FeLV positive

98
Q

Where do meningiomas mainly occur in the cat?

A

Brain

99
Q

Are intramedullary tumors common or rare in cats?

A

Rare

100
Q

Partial/complete loss of voluntary motor function in both pelvic limbs is known as what?

A

Paraparesis/paraplegia

SAM (8 decks)

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