Spinal Disorders Flashcards
Which spinal lesions are painful?
IVDD Meningitis/meningoencephalitis Diskospondylitis Fracture/luxation Neoplasia bone)
Atlanto-axial Instability
Toy breed dogs
Usually congenital - hypo/aplasia of dens
Medical management: splint
Surgical management: cross pinning or screws/PMMA (better)
Syringomyelia (syrinx)
Fluid containing cavities within parenchyma of spinal cord
Phantom pain, scratching, lameness
Treatment: gabapentin, omeprazole, NSAID, surgery
Caudal Occipital Malformation Syndrome (Chiari-like malformation)
..
Cervical Spondylomyelopathy (Wobblers)
“Two-engine gait”
Two types: disc-associated and osseous-associated
Disc-Associated Spondylomyelopathy
Chronic protrusion of IVD causing ventral spinal compression
Medical management: NSAIDs, pred, acupuncture
Surgical management: ventral slot, distraction-fusion, disc replacement
OLD DOBIES
Osseous-associated Spondylomyelopathy
Dorsal spinal cord compression
Articular process DJD, malformations, or cysts
Medical management: NSAIDs, pred, PT, accupuncture
Surgical management: dorsal laminectomy, fusion
YOUNG DANES
Steroid Responsive Meningitis +/- Arteritis (SRMA)
Boxer, Bernese, Beagle GSP
<2 years
Severe cervical pain
CBC: leukocytosis, CSF: neutrophilic or mixed pleocytosis
Tx: steroids, azathioprine 4-6 mo
Granulomatous Meningoencephomyelitis
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
Contraindications for medical management of IVDD
Non-ambulatory
Absent pain perception
Prognosis for return to function dogs with IVDD post-sx
With pain perception: 90%
Without pain perception (lost within 24 hrs): 50%
Without pain perception (lost >24 hrs): 20%
Young, small breed dog with cervical pain and no other obvious signs
Inflammatory brain disease
Young, large-breed dog with peracute onset of asymmetrical signs
Jumping/playing, screams, goes down
Fibrocartilagenous Embolism (FCE)
What is the only treatment shown to help with FCCE, ANNPE, infarctions?
Physiotherapy
Great prognosis
What percept of dogs that lose DPP develop myelomalacia?
15%
Signs of myelomalacia?
Ascending loss of panniculus
Loss of PL reflexes, anal tone
TL paresis
Loss of ventilatory function
No Tx, need to euthanize
“Screw-tail” breed with progressive ataxia, paresis, not painful
Congenital spinal malformation
Tx: pred + rest or decompressive sx
Degenerative Myelopathy
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
Diskospondylitis
Infection of IVD and adjacent endplates (L7-S1)
Staph, Strep, E.coli, Brucella
Tx: cephalexin, clavamox, baytril, NSAIDs, tramadol
PAINFUL
Lumbosacral Disease
CS: pain, reluctance to jump/climb, decreased withdrawal reflex, proprioceptive deficits, flaccid tail, fecal/urinary incontinence
Can treat medically or surgically depending on cause
What should you do first with a down cat?
Check pulses, doppler flow, then gat paired NOVAs
Feline IVDD
Rare Older cats L4-L5 Mineralized discs on radiographs Extremely painful Good prognosis with sx
Most common spinal cord tumors in cats?
LSA (thoracic and LS)
Glial (cervical)
Fibrosarcoma (thoracic)
Feline Spinal Infections
Crypto* Toxo* FIP Bacterial myelitis Idiopathic
