Sa Spinal 3 Flashcards
CSM
Two major forms - osseous or disc associated
Both have a dynamic form
Signalment for CSM - disc associated
Middle age large breed - Doberman, Weimaraner
Symmetric or asymmetric
Acute or chronic - painful
Caudal cervical region (c5-6, 6-7)
CSM osseous associated
Young, giant breeds - Great Danes, mastiffs
Often symmetric
Acute or chronic - painful
More likely congenital, absolute stenosis
CSM-DA diagnosis
3 facts
- relative vertebral canal stenosis
- torsion in caudal cervical vertebral column
- protrusion of larger volume of disc compared to normal dogs
Treatment for both form of CSM medial management
Mildly affected, non progressive
- rest, chest harness, taper course to steroids
50% improve 30% static
Treatment for CSM surgical
More severe cases, progressive
Ventral slot, dorsal surgery, various procedures
70% improve, 20% static
Atlantoaxial instability - congenital
Generally young, small or toy breed
May be acute or chronic onset
Dens hypoplasia or fracture, ligament malformations, avulsion
Atlantoaxial instability signalment for traumatic
Could be any
AAI diagnosis
C1-5 myelopathy - episodic pain
Radiographs +/- fluoroscopy, CT, MRI
Cervical ventroflexion can cause death or make signs worse
Medical management of AAI
Mild clinical signs, young animals, traumatic form
High recurrence rate for congenital form
External coaptation (8-12wk) worry abt atrophy
Analgesics/anti inflammatory
Surgical management of AAI
Moderate to severe clinical signs
Mature bone
70-90% success, approx 5% risk of mortality, approx 25% complication rate
Ventral approach : pins or screws & bone cement, plating
Vertebral malformations
Numerous anomalies
Block, hemi, butterfly vertebrae
Spina bifida
Caudal articular facet hypoplasia
Cause for vertebral malformations
Often caused by a failure of formation or ossification or neural tube closure
Signalment for vertebral anomalies
Most common in screw tail breeds or pugs
Common T7-12
May present with no clinical signs
Spina bifida
Neural tube closure deficiency
Young animals - inability to walk, English bulldogs
Caudal articular process dysplasia
Common in pugs, English & French bulldogs
May cause no clinical signs
Insidious onset T3-L3 myelopathy
Often with fecal & urinary in continent
CAP dysplasia Pathophys
T10-13 commonly affected
Articulations may be hypoplasia or aplastic
May be incidental finding
CAP dysplasia diagnosis
Radiographs
CT is ideal ***
MRI could evaluate for other disease
CAP dysplasia associated disease
Most present T3-L3 myelopathy - gait abnormalities, 50% incontinence
IVDP - 50% of patients
Subarachnoid diverticulum - 20%
Pia-arachnoid fibrosis - 15%
Vertebral instability - 5%
CAP dysplasia treatment/prognosis
No treatment but possible to treat secondary diseases
Prognosis is variable
Spinal arachnoid diverticulum
Large breeds - Rottweiler
Small breeds - pugs
Chronic progressive myelopathy +/- fecal/urinary incontinence
Pathophys for SAD
Cervical - common in large breeds
Thoracolumbar - common in small breeds
Usually non painful
Developmental or aquired
Diagnosing SAD
Myelogram or CT Myelogram MRI
Dilation of subarachnoid space often appears teardrop shaped
Medial management of SAD
Corticosteroids or NSAIDS
Approximately 30% stable, 30% improve, 40% worsen
