Description and repeatability of a newly developed spinal cord injury scale for dogs

Levine, Gwendolyn J.; Levine, Jonathan M.; Budke, Christine M.; Kerwin, Sharon C.; Au, Jennifer; Vinayak, Arathi; Hettlich, Bianca Felicitas; Slater, Margaret R.

doi:10.1016/j.prevetmed.2009.02.016

Cited by 114 publications

(150 citation statements)

References 27 publications

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“…The relatively lower agreement for the moderate to high‐grade ataxia could be explained by the large variation between raters when assessing horses with a median ataxia grade of 2 (Fig 1). We also found a more pronounced disagreement for the assessment of ataxia in horses compared to a new scale applied to assess dogs with spinal cord injury using the Texas Spinal Cord Injury Score (TSCIS) with separate components of gait, proprioceptive positioning and nociception 38. Two blinded raters had excellent agreement (ranging from 0.72 to 1.00) across all criteria when rating 36 dogs 38.…”

Section: Discussionmentioning

confidence: 83%

Rater Agreement on Gait Assessment during Neurologic Examination of Horses

Olsen

Dunkel

Barker

et al. 2014

Veterinary Internal Medicne

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BackgroundReproducible and accurate recognition of presence and severity of ataxia in horses with neurologic disease is important when establishing a diagnosis, assessing response to treatment, and making recommendations that might influence rider safety or a decision for euthanasia.ObjectivesTo determine the reproducibility and validity of the gait assessment component in the neurologic examination of horses.AnimalsTwenty‐five horses referred to the Royal Veterinary College Equine Referral Hospital for neurological assessment (n = 15), purchased (without a history of gait abnormalities) for an unrelated study (n = 5), or donated because of perceived ataxia (n = 5).MethodsUtilizing a prospective study design; a group of board‐certified medicine (n = 2) and surgery (n = 2) clinicians and residents (n = 2) assessed components of the equine neurologic examination (live and video recorded) and assigned individual and overall neurologic gait deficit grades (0–4). Inter‐rater agreement and assessment‐reassessment reliability were quantified using intraclass correlation coefficients (ICC).ResultsThe ICCs of the selected components of the neurologic examination ranged from 0 to 0.69. “Backing up” and “recognition of mistakes over obstacle” were the only components with an ICC > 0.6. Assessment‐reassessment agreement was poor to fair. The agreement on gait grading was good overall (ICC = 0.74), but poor for grades ≤ 1 (ICC = 0.08) and fair for ataxia grades ≥ 2 (ICC = 0.43). Clinicians with prior knowledge of a possible gait abnormality were more likely to assign a grade higher than the median grade.Conclusion and Clinical ImportanceClinicians should be aware of poor agreement even between skilled observers of equine gait abnormalities, especially when the clinical signs are subtle.

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Section: Discussionmentioning

confidence: 83%

Rater Agreement on Gait Assessment during Neurologic Examination of Horses

Olsen

Dunkel

Barker

et al. 2014

Veterinary Internal Medicne

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“…This corresponds to findings in several studies. One study has validated the use of the MFS with high interrater agreement 31. Another study showed that the simpler MFS appears more appropriate for retrospective studies, in which prospectively derived examination information is not available 32…”

Section: Discussionmentioning

confidence: 99%

Clinical, Magnetic Resonance Imaging, and Histopathologic Findings in 6 Dogs with Surgically resected Extraparenchymal Spinal Cord Hematomas

Hague

Joslyn

Bush³

et al. 2015

Veterinary Internal Medicne

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BackgroundExtraparenchymal spinal cord hematoma has been described in veterinary medicine in association with neoplasia, intervertebral disk disease, and snake envenomation. There are rare reports of spontaneous extraparenchymal spinal cord hematoma formation with no known cause in human medicine. Multiple cases of spontaneous extraparenchymal spinal cord hematoma have not been described previously in veterinary medicine.ObjectivesTo describe the signalment, clinical findings, magnetic resonance imaging (MRI) features, and surgical outcomes in histopathologically confirmed extraparenchymal spinal cord hematomas in dogs with no identified underlying etiology.AnimalsSix dogs had MRI of the spinal cord, decompressive spinal surgery, and histopathologic confirmation of extraparenchymal spinal cord hematoma not associated with an underlying cause.MethodsMulti‐institutional retrospective study.ResultsSix patients had spontaneous extraparenchymal spinal cord hematoma formation. MRI showed normal signal within the spinal cord parenchyma in all patients. All hematomas had T2‐weighted hyperintensity and the majority (5/6) had no contrast enhancement. All dogs underwent surgical decompression and most patients (5/6) returned to normal or near normal neurologic function postoperatively. Follow‐up of the patients (ranging between 921 and 1,446 days) showed no progression of neurologic clinical signs or any conditions associated with increased bleeding tendency.Conclusions and Clinical ImportanceBefore surgery and histopathology confirming extraparenchymal hematoma, the primary differential in most cases was neoplasia, based on the MRI findings. This retrospective study reminds clinicians of the importance of the combination of advanced imaging combined with histopathologic diagnosis. The prognosis for spontaneous spinal cord extraparenchymal hematoma with surgical decompression appears to be favorable in most cases.

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“…Dogs were classified as chondrodystrophoid or nonchondrodystrophoid on the basis of previously established criteria. 22 Complete physical and neurologic examinations were performed on all affected dogs on arrival at the hospital. A blood sample (2 mL) was routinely collected into a tube containing lithium heparin.…”

Section: Dogs With Acute Thoracolumbar Ivdh-betweenmentioning

confidence: 99%

“…Neurologic dysfunction was classified according to the MFS as follows: paraspinal hyperesthesia only (grade 5), ambulatory paraparesis and ataxia (grade 4), nonambulatory paraparesis (grade 3), paraplegia with intact nociception (grade 2), paraplegia with no superficial nociception (grade 1), and paraplegia with no deep nociception (grade 0). 22,23 After premedication of each affected dog, anesthesia was induced via IV administration of propofol a and anesthesia was maintained by use of inhalation anesthetic agents (sevoflurane b or isoflurane c ) for diagnostic imaging and collection of a CSF sample from the cerebromedullary cistern. Advanced imaging comprised myelography, computed tomography, or MR imaging; the type of imaging performed depended on access to equipment and clinician preference.…”

Section: Dogs With Acute Thoracolumbar Ivdh-betweenmentioning

confidence: 99%

“…Dogs were classified as chondrodystrophoid or nonchondrodystrophoid on the basis of previously established criteria. 22 During the neurologic examination performed to ensure that dogs met the criteria for inclusion in the control group, dogs were classified according to the MFS. For study analyses, a blood sample (3 to 5 mL) was collected into a tube containing lithium heparin from each dog.…”

Section: Dogs With Acute Thoracolumbar Ivdh-betweenmentioning

confidence: 99%

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Associations between cerebrospinal fluid biomarkers and long-term neurologic outcome in dogs with acute intervertebral disk herniation

Witsberger¹,

Levine²,

Fosgate³

et al. 2012

javma

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Objective—To examine associations between CSF biomarkers, initial neurologic dysfunction, and long-term ambulatory outcome in dogs with acute intervertebral disk herniation (IVDH). Design—Prospective clinical study. Animals—54 dogs with acute thoracolumbar IVDH and 16 clinically normal dogs. Procedures—For each dog, variables, including CSF myelin basic protein (MBP), lactate, calcium, glucose, and total protein concentrations; nucleated cell count; and creatine kinase (CK) and aspartate aminotransferase activities, were measured. For dogs with thoracolumbar IVDH, initial neurologic function was characterized by use of a modified Frankel score (MFS; determined on a scale of 0 to 5, where 0 represented paraplegia with no deep nociception and 5 represented paraspinal hyperesthesia only). Long-term follow-up was assessed. Results—Among dogs with thoracolumbar IVDH, those with CSF CK activity ≤ 38 U/L had a 35-fold increase in the odds of long-term ambulation, compared with the odds in dogs with CSF CK activity > 38 U/L, adjusting for neurologic functioning at the evaluation. The CSF lactate, calcium, and glucose concentrations and aspartate aminotransferase activity were not predictive of long-term ambulatory outcome. Data analysis revealed that long-term functional recovery was > 98% for affected dogs, regardless of their initial MFS, when CSF CK activity was ≤ 38 U/L and MBP concentration was ≤ 3 ng/mL. Conclusions and Clinical Relevance—In dogs with acute thoracolumbar IVDH, CSF CK activity and MBP concentration appeared to be prognostic indicators and, along with initial MFS, can be used to predict long-term ambulatory outcome.

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Description and repeatability of a newly developed spinal cord injury scale for dogs

Cited by 114 publications

References 27 publications

Rater Agreement on Gait Assessment during Neurologic Examination of Horses

Rater Agreement on Gait Assessment during Neurologic Examination of Horses

Clinical, Magnetic Resonance Imaging, and Histopathologic Findings in 6 Dogs with Surgically resected Extraparenchymal Spinal Cord Hematomas

Associations between cerebrospinal fluid biomarkers and long-term neurologic outcome in dogs with acute intervertebral disk herniation

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