Neurology: spinal pain/paresis/plegia Flashcards
Causes of spinal pain
- discospondilitis
- steroid responsive meningitis
- atlanto-axial subluxation
- canine chiari malformation
- syringohyrdomyelia
- lumbosacral stenosis
Discospondylitis
- definition
- how
- predisposition
- CS
- common sites
- Dx
- Tx
infection of the inter vertebral disc and adjacent endplates
haematogenopus/ FB migration/ direct extension
large intact, males young-middle aged
usually just pain
common sites: LS junction, TL junction, caudal cervical
Dx:
- radiographay (takes 2-4 weeks to see changes
- blood and urine culture (75% sensitivity)
Tx: ABs, analgesics and strict rest
steroid responsive meningitis
immune-mediated condition
young dogs (8-18 months)
CS:
- fluxating
- pyrexia
- inappetence
- spinal pain (cervical!)
Dx:
- normal radiographs
- neutrophilic pleocytosis on CSF analysis
- increase in APP (CRP)
Tx: prednisilon: self limiting after 18-24 months
atlanto-axial subluxation
cervical pain that can progress to neurological deficits
Dx: extension and flexion radiographs
Tx: conservative/arthrodesis
canine chiari malformation
- AKA
- what
- CS
AKA: caudal occipital malformation syndrome
congenital hypoplasia of supra-occipital bone –> decrease in caudal fossa volume –> cerebellar herniation
CS: phantom scratching
Syringohydromyelia
definitiosn (2) why it occurs (3) CS (4) Dx Tx
syringomyelia: fluid filled cavitations within the spinal canal
hydromyelia: dilation of the central canal of the spinal cord
occurs secondary to abnormal CSF movement, associated with canine chiari malformation: fluid can’t move properly an gathers
CS:
- cervical/spinal pain
- persistent scratching
- torticolis
- may progress to neurological deficits
Dx: MRI
Tx: NSAIDs and gabapentin, decrease in CSF (furosemide)
Lumbosacral Stenosis
- predisposition
- CS (6)
- Dx
- Tx
large, middle aged, males
CS
- pain over lumbosacral region (particularly hyperextension)
- difficulty jumping
- intermittent lameness (foraminal stenosis)
L1-S1: -instability -chronic inter vertebral disc herniation -foraminal stenosis transitional vertebrae predispose
Dx: MRI/CT
Tx: strict rest, NSAIDs, gabapentin, epidural steroid injcetion
Acute paresis/plegia
Hansens type I
traumatic disc extrusion
fibrocartilagenous embolism
spinal trauma
Hansens type 1
- what
- predisposition
- CS
chondroid degenration of the nucleus pulpous (hardens and pops out)
chondrodystophic breeds predisposed, 3-7 years
acute and painful
traumatic disc extrusion
trauma causes rupture of normal disc
minimal compression and minimal/no pain due to it still being like jelly
Tx: physiotherapy
fibrocartilaginous embolism
- what
- Dx
- Tx
spinal cord ischaemia due to acute emboli (emboli are disc derived fibrocartilage)
may yelp at onset but then pain free
dx: normal radiographs, MRI changes
Tx: physiotherapy
Progressive paresis/plegia
Hansens II neoplasia degenrative myelopathy myelitis congenital vertebral malformations cervical spondylomyelopathy
Hansens II
Large breeds
fibroid degeneration of the annulus fibrosis that protrudes slowly to compress the spinal canal
chronic and progressive
painful
Neoplasia
extradural (outwith spinal canal)
intradural, extramedullary (outwith spinal cord)
indramedullary (inside spinal canal)
just pain tends to be a neoplasia of the veretbal column
Degenerative myelopathy
gradual progression of pelvic limb ataxia with no spinal pain
> 6yo, large breeds (GSD!)
differentiate from hansens II
