Conditions Involving Both Hind Limbs

Question 1

Spinal cord lesions caudal to what specific vertebra cause paraparesis or paraplegia (both pelvic limbs) unless the lesion is strictly unilateral ?

Answer 1

T2

Question 2

Degenerative Myelopathy generally demonstrates what signs to the hind limbs?

Answer 2

UMN; hyperreflexia, CPdeficits, normal/clinic flexor withdrawal reflexes

Question 3

How is DM diagnosed?

Answer 3

Only definitively by histopathology:

Axonal and myelin degeneration with astrogliosis

Question 4

What breeds are suspected to have a genetic basis for Degenerative Myelopathy?

Answer 4

GSDs, corgis, boxers, huskies, Chesapeake bay retrievers, Rhodesian Ridgebacks

Question 5

What disc area is associated with Cauda Equina Syndrome (aka Lumbosacral degenerative stenosis)?

Answer 5

L7/S1

Question 6

The compressive forces associated with Cauda Equina Syndrome result in pain and LMN signs to what nerves?

Answer 6

Sciatic and Pudendal nn.

Question 7

Where do most disc protrusions occur in Thoracolumbar IVDD and what signs result in the hind limbs?

Answer 7

Between T11 and L2; UMN

Question 8

For grades 1, 2, and 3 TIVDD, what is the best treatment for the first couple of weeks while the patients’ status and prognosis is evaluated?

Answer 8

Cage rest! - 80-100% success!!

Question 9

In Thoracolumbar IVDD, what medicinal therapy can be included with cage rest to relieve pain?

Answer 9

NSAIDS, but even better: Prednisone, (0.5-1mg/kg for 2-3days)

Question 10

Degenerative Myelopathy (DM) is characterized by what signs (UMN/LMN) to the hind limbs? What is spared?

Answer 10

UMN; urinary and fecal continence and pain usu. spared til late in progression of dz

Question 11

The degenerative processes of Cauda Equina Syndrome, the ____ nerve is spared, while the _____ nerves are usually painful/elicit LMN signs.

Answer 11

Femoral; sciatic and pudendal

Question 12

T or F: There is disc degeneration in Lumbosacral Degenerative Stenosis/ Lumbosacral malarticulation (Cauda Equina Syndrome).

Answer 12

FALSE: no disc degeneration, but there are changes in ligaments and articulation facets

Question 13

T or F: Corticosteroids, NSAIDS, and B-vitamins are an appropriate treatment for DM

Answer 13

FALSE; there is no effective treatment for DM

Question 14

How do we differentiate L7/S1 abnormalities on plain radiographs from Cauda Equina compression?

Answer 14

Contrast radiography (Dx) and pain as a result of hyperextension of the tail head (tail jack) (Sx)

Question 15

In TIVDD, disc protrusions mostly occur in what area? What signs result?

Answer 15

In the thoracolumbar area between T11 and L2; UMN signs to hind limbs and UMN bladder

Question 16

What is the appropriate treatment for Grade 1-3 TIVDD?

Answer 16

Strict cage rest for 2 weeks; continuing for another 2 weeks after complete resolution of clinical signs. If no improvement, consider surgery.

Question 17

What is the appropriate Tx for Grade 4 TIVDD?

Answer 17

Cage rest—>surgery; dorsolateral hemilaminectomy—>
physiotherapy regimen*:
1. Flexion/extension of limbs for at least 5min q 8h
2. Massaging the limbs for 5min q 8h
3. Assisted standing and walking when animals taken outside to urinate/defecate.
physiotherapy regimen w Grade 5 patients also
Prazosin/Phenoxybenzamine can be given to treat the UMN bladder

Question 18

What are the 3 most common agents involved in Diskospondylitis?

Answer 18

S. Intermedius,
Brucella canis,
And Strep.spp.

Question 19

In diskospondylitis, what is the prognosis?

Answer 19

Generally favorable, EXCEPT for fungal infections