Pathology Canine

Question 1

Name some dieases of the Thoracolumbar SPine

Answer 1

Bony Malformations 
Trauma
Tumors 
Degenerative disease
  Infections

Question 2

What are some of the Abnormal SPinal Curves in Dogs

Answer 2

-Lordosis -can be congenital or geriatric or obese sogs

Kyphosis- congenital or due to back or abdominal pain

Scoliosis:
-congenital (abnormal ossification) or compensatory.

Sometimes it can be a compensation- doesnt have to be an irreversible abnormal spinal curve.

Question 3

Vertebral Malformation
hemi. Block, Transitionalvertebrae

Clinically seen as?
Diagnosis with?
Treatment?

Answer 3

Clinically of no significance??
 Instability
Changes of biomechanical function
Deformation of vertebral canal

Diagnose
X-Ray, myelography

Treatment
Surgical decompression and stabilization Guarded prognosis
Chiropractic (Management)

Or wedge vertebrae
-vertebrae either side of the wedge will be compensating, shouldnt adjust through as this can be real painful and not neurologically sound or has symptoms.

ie only 10% of french bulldogs are without hemivertebrae

Question 4

Spina Bifida

Answer 4

-Lack of closure of the neural crest leasts to bondy malformations of the spinal canal

can be genetic, malnutrition, toxine
breed disposition: English Bulldogs

Diagnosis:
Xrar/ CT

TreatmentL not effective

Symptomatic possible signs- hair growth in opposite directions or skin infolds down. These areas more prone to degenration later in life, depending on severity.

Question 5

Dermoid Cyst

Answer 5

google it

Can be congenital abnormality
its where fistulous tract from skin to spinal cord,
common breeds: Ridgeback, boxer, chow

Question 6

Vertebral Fractures
whats it look like clinically
how do you diagnose it and manage it

Answer 6

-potentially sever neurological symptoms
-compression (hemi) fracture
transverse fx of vert body or arch

Diagnosis via xray

May or may not cause neurological symptoms
Ie history of acute trauma, not any neurological signs/ symptoms. Refer to their vet for xrays.
Note any acute pain on palpation, muscle spasm and heat

red flags: Acute pain, obvious edema, limp

Insist they visit their vet or give their vet a call.

Question 7

Tumors of the spine

Symptoms and diagnosis, how it may present clinically?

Answer 7

You may treat a dog with a tumor, and it may decrease their pain around the area due to the neurological affect, b ut if the acute pain continues or progresses you need to refer for further diagnostics.

Symptoms:
Neurological deficit
-acute and sever

Diagnosis:
xray, myelography, CT/ MRI

Question 8

Spondylosis Deformans

what is it? 
Etiology and pathogenesis 
Incidence 
Clinical significance 
Diagnosis and Treatment

Answer 8

Degenerative, proliferative disease
Vertebral Enthesiophytes /bony outgrowth at insertion site of ligaments, annulus fibrosus, ventral longitudinal lig.
Bony ankyloses is rare
 Pseudo-joints

Various etiologies have been suggested:
Stress on the ligaments and periosteum (Pommer)
Intervertebral disk softening (Ipolyi)
Disk changes associated with spondylosis deformans (Schick, Hansen)
Instability because of degeneration of the anulus fibrosus, non-inflammatory (Morgan)

Increases with age
Predisposition : larger breeds
Differential Diagnosis DISH (Diffuse Idiopathic Skeletal Hyperostosis) may be difficult

Clinical significance
With or without clinical signs (50%) (Pommer, Ipolyils)
Signs of musculoskeletal or neurological disease
Progressive paresis
Pain as a result of tension on vertebral ligaments (Debard)
Pressure on spinal nerves or spinal cord (Hoerlein)

Diagnosis of spondylosis deformans
X-ray
 Lateral
 Dorsoventral
Computer Tomography (CT)

Treatment
 Painkillers Anti-inflammatory drugs  Nutrition
Exercise program
 Acupuncture
 Chiropractic

Question 9

DISH 
what is it? 
Etiology and pathogenesis 
Incidence 
Clinical significance 
Diagnosis and Treatment

Answer 9

Etiology and Pathogenesis
Unknown etiology
Ossification of the ventral longitudinal ligament
Rare degenerative changes in the vertebra Sometimes coincidence diagnose in X-rays

Incidence 
Increases with age
Breed Predisposition;
Boxer, Flat Coated Retriever, German Shepard,
Bouvier des Flandres

Clinical Significance
From nothing to severe
Spinal hyperesthesia
Decreased mobility
Pathological fractures
Nerve compressions with muscle atrophy and lameness
Can you feel it??

Diagnosis of DISH 
X-ray
CT
for 3D of bony structures
 MRI
Disc changes and differentiation between Spondylosis deformans and DISH

Treatment
 NSAID 
Weight control 
Muscle building 
 Chiropractic
 Acupuncture
 Physiotherapy 
 Surgery?

Question 10

Intervertebral Disc Disease
describe the process

Tell me about Hansen Type II IVDD Disc Protrusion

Describe
Breeds commonly affected
clinical signs

Answer 10

Degeneration of intervertebral disk –> Prolaps of intervertebral disk –> Compression of spinal cord

Chronic Prolapse
Prolapse of dorsal, outer fibroid layer of annulus fibrosus into vertebral canal
Dorsal displacement of nucleus
Progressive demyelination and injury of white substance of spinal cord

Large breeds predisposed:
German Shepherds, Labrador Retrievers, etc.
 Significantly less affected by percentage as opposed to small dogs
 They undergo fibroid metaplasia: A type of disc degeneration
 Nucleus pulposus becomes fibrous, like the annulus fibrosus. Over time, this can begin to slowly bulge inward toward the spinal cord.
 Most common between 8 and 10 years of age
 Usually an insidious onset (weeks to months)
 Often associated with arthritic changes of the facet joints Typically no history of trauma

Clinical signs
 Weakness
Pain
Neurological symptoms Paresis (Extrusion) Ataxia (Protrusion)
Preogressive Neurological Symptoms: Proprioception, paresis, motor control, bladder function, sensibility in order

Degenerative changes
Degenerative changes in discs may be due to chronic subluxations
 Cause wedging of disc
Chronic subluxations causing uneven distribution or pressure on the disc.

Diagnosis
Neurological examination to localize the effected vertebral segment
 Radiographs
 Myelography
Computer Tomography (CT) Magnetic Resonance Imaging (MRI)

Therapy  Surgery:
Severe cases with profound neurological symptoms (loss of deep pain, Paraplegia) within 48 hours
Type I disc extrusion with Paresis/Paralysis Dorsal hemi-laminectomy

Conservative: Cage rest, medication- NSAIDS, corticosteroids, muscle relaxation

Chiro management: Difficult cases with poor prognosis
-A lot of experience

Question 11

Discospondylitis:

How does it happen?
Symptoms?
Diagnosis?
Treatment

Answer 11

Infection of disc and adjacent vertebra:
Origin of infection:
 Skin, urinary system, heart, teeth, genital organs  Debris
 Wounds
 Surgery
Staph. Aureus or Brucella canis

Symptoms 
 Hyperesthesia
Paresis/Paralysis possible
Signs of infection (fever, decreased state of
health, Anorexia) are possible

Diagnosis DIFFICULT!!
Radiography (complete spine) Compression of intervertebral space Lysis of surface of the intervertebral joints Sclerosis of adjacent vertebral cortex
Full blood examination
Needle aspiration cytology of intervertebral
disc
Differential diagnosis:
 Vertebral tumor

Treatment
Antibiotics after testing resistance (if possible) Improvement not later than 2 weeks Possibly surgery