Spinal Disorders

Question 1

Which spinal lesions are painful?

Answer 1

IVDD
Meningitis/meningoencephalitis
Diskospondylitis
Fracture/luxation
Neoplasia bone)

Question 2

Atlanto-axial Instability

Answer 2

Toy breed dogs

Usually congenital - hypo/aplasia of dens

Medical management: splint

Surgical management: cross pinning or screws/PMMA (better)

Question 3

Syringomyelia (syrinx)

Answer 3

Fluid containing cavities within parenchyma of spinal cord

Phantom pain, scratching, lameness

Treatment: gabapentin, omeprazole, NSAID, surgery

Question 4

Caudal Occipital Malformation Syndrome (Chiari-like malformation)

Answer 4

..

Question 5

Cervical Spondylomyelopathy (Wobblers)

Answer 5

“Two-engine gait”

Two types: disc-associated and osseous-associated

Question 6

Disc-Associated Spondylomyelopathy

Answer 6

Chronic protrusion of IVD causing ventral spinal compression

Medical management: NSAIDs, pred, acupuncture

Surgical management: ventral slot, distraction-fusion, disc replacement

OLD DOBIES

Question 7

Osseous-associated Spondylomyelopathy

Answer 7

Dorsal spinal cord compression

Articular process DJD, malformations, or cysts

Medical management: NSAIDs, pred, PT, accupuncture

Surgical management: dorsal laminectomy, fusion

YOUNG DANES

Question 8

Steroid Responsive Meningitis +/- Arteritis (SRMA)

Answer 8

Boxer, Bernese, Beagle GSP

<2 years

Severe cervical pain

CBC: leukocytosis, CSF: neutrophilic or mixed pleocytosis

Tx: steroids, azathioprine 4-6 mo

Question 9

Granulomatous Meningoencephomyelitis

Answer 9

Females, toy/terrier breeds

3 forms: ocular, focal, diffuse

Can affect any white matter

CSF: pleocytosis, mononuclear, can be normal

Tx: steroids, cyclosporine

Fatal if untreated

Question 10

Contraindications for medical management of IVDD

Answer 10

Non-ambulatory

Absent pain perception

Question 11

Prognosis for return to function dogs with IVDD post-sx

Answer 11

With pain perception: 90%

Without pain perception (lost within 24 hrs): 50%

Without pain perception (lost >24 hrs): 20%

Question 12

Young, small breed dog with cervical pain and no other obvious signs

Answer 12

Inflammatory brain disease

Question 13

Young, large-breed dog with peracute onset of asymmetrical signs

Jumping/playing, screams, goes down

Answer 13

Fibrocartilagenous Embolism (FCE)

Question 14

What is the only treatment shown to help with FCCE, ANNPE, infarctions?

Answer 14

Physiotherapy

Great prognosis

Question 15

What percept of dogs that lose DPP develop myelomalacia?

Answer 15

15%

Question 16

Signs of myelomalacia?

Answer 16

Ascending loss of panniculus

Loss of PL reflexes, anal tone

TL paresis

Loss of ventilatory function

No Tx, need to euthanize

Question 17

“Screw-tail” breed with progressive ataxia, paresis, not painful

Answer 17

Congenital spinal malformation

Tx: pred + rest or decompressive sx

Question 18

Degenerative Myelopathy

Answer 18

Older dogs; GSD, husky, corgi, boxer

Linked to SOD-1 mutation

Non-painful, slowly-progressive

Diagnosis of exclusion

Physical therapy to maintain QOL, but no tx to stop progression of dz

Question 19

Diskospondylitis

Answer 19

Infection of IVD and adjacent endplates (L7-S1)

Staph, Strep, E.coli, Brucella

Tx: cephalexin, clavamox, baytril, NSAIDs, tramadol

PAINFUL

Question 20

Lumbosacral Disease

Answer 20

CS: pain, reluctance to jump/climb, decreased withdrawal reflex, proprioceptive deficits, flaccid tail, fecal/urinary incontinence

Can treat medically or surgically depending on cause

Question 21

What should you do first with a down cat?

Answer 21

Check pulses, doppler flow, then gat paired NOVAs

Question 22

Feline IVDD

Answer 22

Rare
Older cats
L4-L5
Mineralized discs on radiographs
Extremely painful
Good prognosis with sx

Question 23

Most common spinal cord tumors in cats?

Answer 23

LSA (thoracic and LS)

Glial (cervical)

Fibrosarcoma (thoracic)

Question 24

Feline Spinal Infections

Answer 24

Crypto*
Toxo*
FIP
Bacterial myelitis
Idiopathic