Spinal epidural and synovial lipomatosis in a 3‐year‐old Eurasian dog receiving sustained steroid therapy

Signoret, Marion; Gros, Lucile; Dumont, Renaud; Dally, Claire; Boedec, Kevin Le; Cauzinille, Laurent

doi:10.1002/vms3.842

Cited by 4 publications

(10 citation statements)

References 22 publications

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“…Considering the previous case reports and the present case, many characteristics of SEL in dogs seem to be similar to those of human SEL. In a previous case report, cauda equina syndrome occurred because of the accumulation of epidural fat compressing the cauda equina in the lumbosacral spinal canal (11), and ambulatory paraparesis occurred by hypertrophic epidural fat in T8 to L3 vertebral canal segment (16). In this case, the patient's clinical symptoms were caused by hypertrophy of the epidural adipocytes pressing the spinal cord from dorsal to ventral and may be exaggerated by con- current IVDD pressing the spinal cord from ventral to dorsal.…”

Section: Discussionmentioning

confidence: 71%

“…Since then, many studies have reported the clinical characteristics, prevalence, pathophysiology, and treatment of SEL (7,19,21). In veterinary medicine, there have been no related reports except for the studies on idiopathic SEL in a dachshund dog (11) and steroid-induced SEL in a Eurasian dog (16). Thus, little is known regarding this disease.…”

Section: Discussionmentioning

confidence: 99%

“…Spinal epidural lipomatosis (SEL) is a disease in which fat tissue present in the epidural space of the spinal canal proliferates and compresses the surrounding nerve and vascular system (7). In humans, the prevalence of SEL is 1.1% to 2.5% (13,19), and it is extremely rare in veterinary medicine where only two cases have been reported (11,16). Clinical symptoms vary depending on the type, location, severity of nerves pressed by hyperplastic fat, and concurrent spinal canal stenosis, and non-specific symptoms such as back pain, lameness, and ataxia can occur due to SEL (21).…”

Section: Introductionmentioning

confidence: 99%

“…In human medicine, long-term exogenous steroid therapy, Cushing syndrome, hypothyroidism, obesity, and surgery have been suggested as causes of SEL (21). In veterinary medicine, the case of SEL secondary to long-term steroid use has recently been reported (16). SEL can be diagnosed by confirming hyperplasia of fat in the spinal canal, and magnetic resonance imaging (MRI) is the most sensitive and specific diagnostic modality (19).…”

Section: Introductionmentioning

confidence: 99%

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Spinal Epidural Lipomatosis Secondary to Hypothyroidism in a Siberian Husky Dog

et al. 2022

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A 10-year-old neutered male Siberian Husky presented with paraparesis and severe lethargy. On physical examination, the patient was unable to weight-bear and walk and exhibited significant muscle mass loss in both hindlimbs and generalized truncal alopecia with a dull coat of hair. On neurological examination, cranial lumbar vertebral pain, hind limb cross-extensor reflex, delayed hindlimb postural reaction, upper motor neuron bladder dysfunction, and total absence of cutaneous trunci reflex were identified. Computed tomography revealed diffuse idiopathic skeletal hyperostosis and spondylosis deformans of the cervical and thoracolumbar vertebrae. In addition, a generalized decrease in bone mineral density of the vertebrae was identified. Magnetic resonance imaging showed hyperplasia of the epidural fat compressing the spinal cord in the thoracolumbar region and concurrent mild multiple intervertebral disc herniations. No specific findings were observed in cerebrospinal fluid analysis. Blood analysis of thyroid function revealed decreased total T4 and free T4 levels, and increased TSH levels. The patient was tentatively diagnosed with spinal epidural lipomatosis (SEL) secondary to hypothyroidism. The patient was treated with levothyroxine, firocoxib, and gabapentin. Clinical signs gradually improved, and the patient showed normal ambulation 40 days after treatment initiation. SEL is extremely rare in dogs. To the best of our knowledge, this is the first case report of SEL secondary to hypothyroidism that was treated conservatively. Secondary SEL can be sufficiently managed by treating the underlying cause, if possible.

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Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Spinal Epidural Lipomatosis Secondary to Hypothyroidism in a Siberian Husky Dog

et al. 2022

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“…1,15 This entity has been included in some studies of the concept of lipomatosis, understood as a benign process characterized by the overgrowth of unencapsulated adipose tissue in various locations. 11,16,17 In dogs, lipomatosis has been described in the parotid salivary glands, 18 pancreas, 19 and simultaneously in the tarsal joint and epidural space. 11 Therefore, in cases of clinical suspicion, it may be appropriate to evaluate other potential lesions in animals at the time of diagnosis, given the possibility of systemic or multiple-site involvement.…”

Section: Discussionmentioning

confidence: 99%

Adipocytes in synovial fluid cytology: An approach for diagnosing synovial lipomatosis

Agulla,

Vizcaíno,

Velarde

et al. 2024

Veterinary Clinical Pathol

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A 2‐year‐old neutered male bullmastiff dog was presented with chronic left hind limb lameness. Physical examination revealed left stifle effusion and medial buttress without cranial tibial thrust. Radiographs showed joint effusion and new bone formation at the patella apex. Magnetic resonance imaging showed increased synovial fluid, widening of the joint space, abnormal infrapatellar fat body and thinning of the cranial cruciate ligament. Synoviocentesis and cytologic evaluation of synovial fluid revealed marked mononuclear inflammation with abundant fatty tissue, suggesting synovial lipomatosis in conjunction with the imaging findings. The disease was confirmed histologically after sampling the lesion during arthrotomy. Synovial lipomatosis, characterized by extensive synovial adipose tissue proliferation of the synovial membrane, is a rare “tumor‐like” disorder that usually affects the stifle. Although the etiology remains unclear, joint trauma, inflammation, instability, and lipid abnormalities have been proposed as causes. Inflammatory factors may promote synoviocyte and adipocyte hyperplasia that perpetuate the process. Surgical removal may be suggested to eliminate triggers and prevent future recurrences. The report provides the first cytological description of adipocytes in synovial fluid associated with the diagnosis of synovial lipomatosis in dogs. This case report underscores the potential effectiveness of cytologic analysis of synovial fluid smears, in combination with magnetic resonance imaging (MRI), for diagnosing this condition and reducing complications associated with arthrotomy for sampling purposes. Additionally, the case highlights that synovial lipomatosis should be considered as a potential differential diagnosis for synovial masses in dogs. Further cases are needed to validate these observations in veterinary medicine.

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