MRI is considered gold standard for the diagnosis of presumptive acute hydrated non-compressive nucleus pulposus extrusions (AHNCNPE). This retrospective study describes the myelographic findings in dogs with AHNCNPE diagnosed by low-field MRI and their association with neurological grade, need of surgical decompression and outcome. Forty-two myelographies (21 dogs with presumptive AHNCNPE, 21 dogs with Hansen type I disc disease herniation) were blindly evaluated. Site of herniation, compression pattern, ratio of length of the lesion to length of the second lumbar vertebra (LL:L2) and degree of spinal cord compression (SCC) were measured on the myelographies of dogs with presumptive AHNCNPE and were compared with the corresponding MRI features. Percentage of extruded volume of nucleus pulposus (VNP) was calculated on MR images. Myelographic interobserver agreement for presumptive diagnosis of AHNCNPE was almost perfect (κ=0.8). Accuracy of myelography to detect site of herniation was 80.9 per cent and to identify extradural compression was 57.1 per cent. Mean SCC was 5.8±2.6 per cent for myelography and 6.6±3 per cent for MRI. Mean LL:L2 ratio was 1.7±0.9 for myelography and 1.2±0.8 for MRI. Mean percentage of extruded VNP was 40±14 per cent, and it was positively associated with neurological grade.
An 18-month-old neutered male Persian cat was referred to the Hospital Clinic Veterinari of the Universitat Aut onoma de Barcelona (HCV-UAB) for an investigation of a 4-week history of progressive paraparesis. Physical examination was considered normal. Neurologic examination was consistent with a T3-L3 myelopathy. Marked thoracolumbar pain was present. Main differential diagnoses included inflammatory/ infectious disease and neoplasia. Hematology and complete serum biochemistry profiles and an abdominal ultrasonographic examination were unremarkable; feline immunodeficiency virus/feline leukemia virus (FeLV) serologic tests were negative. Thoracic radiographs revealed a radiolucent lesion affecting T11-T13 vertebral bodies. Postmyelographic computed tomography revealed a marked thickening of the pedicle, lamina, and vertebral body of T13 and L1 vertebrae causing spinal cord compression on the left side (Figure 1). A T13-L1 left-side hemilaminectomy was performed in order to decompress the spinal cord and obtain a sample for analysis. Excisional biopsy of the proliferative lesion and intraoperative cytologic imprints were submitted for evaluation ( Figure 2). Figure 1. Transverse computed tomographic image at the level of T13 vertebra in a young cat with progressive paraparesis. Note the marked thickening of the pedicle, lamina, and vertebral body on the left side causing spinal cord compression (arrow).Figure 2. Imprint of an extradural vertebral mass from a young cat with progressive paraparesis. Modified Wright stain.
To review the clinical findings and outcome in dogs diagnosed with insulinoma, and to assess which factors are predictors of overall survival. Additionally, to describe the neurological manifestations of this population and their correlation with survival.Materials and MethOds: Retrospective multicentric study of canine insulinoma cases (2009 to 2020). Signalment, clinical history, neurological examination, diagnostic findings, treatment and outcome were obtained from clinical records. Univariate and multivariate analyses were used to compare the overall survival.results: One hundred and sixteen cases were included. Median duration of clinical signs before presentation was 1.5 months. The most common presenting clinical signs were weakness (59.5%), epileptic seizures (33.6%) and changes in consciousness or behaviour (27.6%). Three dogs were suspected to have paroxysmal dyskinesia. Thirty-two dogs had an abnormal neurological examination, most commonly showing obtundation (28.1%), decreased withdrawal reflexes (21.9%) and absent menace response (18.8%). Overall survival for dogs undergoing surgery (20 months) was significantly longer than in medically treated (8 months; adjusted hazard ratio: 0.33; 95% confidence interval: 0.18, 0.59). Presence of metastases was the only other variable associated with prognosis (adjusted hazard ratio 1.72; 95% confidence interval: 1.02, 2.91). clinical significance: Clinical signs of canine insulinoma are vague and non-specific. Weakness, epileptic seizures and changes in mentation or behaviour were the most commonly reported. Obtunded mentation and forebrain neurolocalisation were the main neurological manifestations. Dogs undergoing surgery had a longer overall survival compared to medically treated cases, and dogs with metastasis had a shorter overall survival regardless of treatment modality. Abnormalities in the neurological examination did not correlate with prognosis. D. Ryan et al.
Background: The techniques described for the identification of the lumbosacral (LS) epidural space in dogs do not guarantee the needle position or an accidental subarachnoid puncture, especially in small size dogs.Aim: To determine the relationship between body weight and the location of the dural sac (DS) using myelography in dogs, and to determine the possibility of subarachnoid puncture during LS epidural based on the position of the DS.Methods: Four masked observers evaluated 70 myelographic studies of dogs, annotating the vertebrae where the DS ended, if it was localized before or after the LS space, and if accidental subarachnoid puncture during LS epidural injection was possible (yes/no). Body weight (kg) was categorized into: less than 10 kg, between 10 and 20 kg, and more than 20 kg and was also converted to body surface area (BSA) as a continuous variable.Results: The DS ended at the LS space or caudally in 50% of dogs. There was a statistically significant difference between the position of the DS and the dog’s BSA (p = 0.001). The DS ended caudal to the LS space in 72.7% of dogs weighing <10 kg, in 25% of dogs between 10 and 20 kg and in 15% of dogs in the >20 kg category. The observers considered a possible subarachnoid puncture during LS epidural in 69.7% of patients <10 kg, 16.6% on those between 10 and 20 kg, and in 11.7% of the dogs >20 kg.Conclusion: The DS ended caudal to the LS space in almost 3/4 dogs in the <10 kg category, so accidental subarachnoid puncture during LS epidural is highly possible in this weight range.
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