Suspected Paraspinal Abscess and Spinal Epidural Empyema in a Dog

Abstract

Epidural spinal cord compression was visualized myelographically in a dog presented for rapid development of paraparesis. A large, fluid-filled pocket in the epaxial musculature was found at surgery and appeared to communicate with the first lumbar vertebra. Unfortunately, cytopathological evaluation of the fluid was not performed. No etiological agents were isolated on aerobic culture. The dog responded well to decompressive surgery and medical therapy consisting of antibiotics, pain medication, and nursing care. In the veterinary literature, only two studies of spinal epidural empyema in the dog have been reported. Of these dogs, one had successful decompressive surgery performed. The other dogs in these two reports were euthanized. The dog presented in this report fully recovered. Spinal epidural empyema should be considered as a differential diagnosis in dogs presenting with a fever and a rapidly progressing myelopathy.

Medical management of spinal epidural empyema in five dogs

“…Clinical signs and clinicopathologic findings in these dogs were similar to those reported previously for dogs with spinal epidural empyema. 13,14,[20][21][22][23][24][25] Similarly, MRI findings were consistent with those previously reported for dogs with spinal epidural empyema, including hyperintense extradural lesions on T2-weighted images and contrast enhancement in a diffuse or ring-like pattern on T1-weighted images after IV administration of gadolinium-based contrast medium. 5,13,18,19 However, lesions on precontrast T1-weighted images varied from mildly hyperintense (dogs 1, 2, and 3) to hypointense (dogs 4 and 5).…”

“…For instance, even though surgery provides direct access the lesion, in previous reports 13,14,20,21 of dogs with spinal epidural empyema, results of bacterial culture of samples obtained at the time of surgical debridement were positive for only 12. In human patients, positive results for bacterial culture of blood samples in conjunction with consistent clinical signs and MRI findings are considered diagnostic for spinal epidural empyema, 19 and organisms isolated from blood samples closely match those recovered from empyema fluid.…”

“…On the other hand, recovery time may be longer in human patients managed medically. 8 Other than a single conference abstract d describing 3 dogs with spinal epidural empyema that were successfully treated medically, all previous reports 13,17,20,21,23,24 of successful management of spinal epidural empyema in dogs involved surgical management. In human medicine, numerous reports 7-10 describe successful management with antimicrobials alone or in conjunction with percutaneous aspiration of septic fluid.…”

“…13,18-20,d In veterinary medicine, spinal epidural empyema is currently regarded as a surgical emergency, and results of surgical treatment have been reported previously. 14,[20][21][22][23][24][25] However, because a definitive diagnosis is more easily obtained with surgical management, there may be a reporting bias. For human patients, the choice of medical versus surgical management of spinal epidural empyema remains controversial.…”

Dorsal laminectomy for treatment of cervical vertebral stenotic myelopathy in an alpaca

“…22,23 The surgical approach described for this alpaca was similar to that used in dogs and human patients and was associated with similar mild postoperative morbidity. [24][25][26] The dorsal laminectomy technique has been reported in horses but has high morbidity and a low success rate. 27,28 The procedure involves removing the dorsocaudal aspect of the cranial vertebra and the dorsocranial aspect of the caudal vertebra surrounding the area of compression.…”