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Proteasa A, Walton MB, Carrera I, Garosi LS, Alcoverro E, Heyes M, Tauro A. Spinal decompression and stabilisation in a cat with lumbar vertebral pathological fracture and subluxation, following discospondylitis and spinal epidural empyema. JFMS Open Rep 2023; 9:20551169231186860. [PMID: 37547626 PMCID: PMC10399260 DOI: 10.1177/20551169231186860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023] Open
Abstract
Case series summary A 1-year-old castrated male Maine Coon cat was referred because of a 1-week history of progressive spastic non-ambulatory paraparesis. An MRI examination of the thoracolumbar spine showed multiple lytic lesions, with the most aggressive one centred on the adjacent endplates of L1-L2 and its associated disc. Ventral new bone formation, L1 vertebral body shortening and mild dorsal displacement of the caudal aspect of L1 were noted. Contrast enhancement of both paravertebral soft tissue and extradural lesion was present. These findings were compatible with L1-L2 discospondylitis (DS), spinal epidural empyema (SEE), with secondary L1 pathological vertebral fracture, subluxation and spinal cord compression. CT of the thoracolumbar spine, abdomen and thorax confirmed these findings. The patient deteriorated to paraplegia with absent nociception, despite initial medical therapy. A right-sided L1-L2 hemilaminectomy and spinal decompression were then performed, followed by application of a unilateral construct comprising four smooth arthrodesis wires and polymethylmethacrylate (PMMA). Staphylococcus aureus was isolated from both epidural material, intraoperatively sampled and blood culture. Antibiotic therapy was continued for 6 weeks, based on susceptibility results. The outcome was excellent, with a gradual improvement and complete neurological recovery at the 8-week postoperative check. Repeated spinal radiographs showed an intact apparatus and marked signs of vertebral fusion. At the 14-month follow-up examination, the cat remained free of clinical signs. Relevance and novel information To the authors' knowledge, this is the first case report of SEE and DS in a cat that required surgical stabilisation. The outcome was still optimal, despite the rapid neurological deterioration.
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Affiliation(s)
| | | | - Ines Carrera
- VetOracle Teleradiology (CVS UK), CVS Limited, Norfolk, UK
| | | | | | - Menai Heyes
- ChesterGates Veterinary Specialists, Chester, UK
| | - Anna Tauro
- ChesterGates Veterinary Specialists, Chester, UK
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González-Martín M, Silva V, Poeta P, Corbera JA, Tejedor-Junco MT. Microbiological aspects of osteomyelitis in veterinary medicine: drawing parallels to the infection in human medicine. Vet Q 2022; 42:1-11. [PMID: 34936853 PMCID: PMC8725753 DOI: 10.1080/01652176.2021.2022244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 11/22/2021] [Accepted: 12/20/2021] [Indexed: 11/29/2022] Open
Abstract
Osteomyelitis is a challenging infectious disease affecting humans and animals. It is difficult to diagnose because, in many cases, symptoms are non-specific and, for example in implant-related cases, can appear long time after surgery. In addition to this, it is also difficult to treat due to the need to find the appropriate antibiotic regime and delivery system to reach the site of infection and to avoid development of bacterial resistance. The central purpose of this review is to compare the microbiological aspects of osteomyelitis in human and veterinary medicine, with the aim of improving the microbiological diagnosis and treatment of this infection in animals. Furthermore, the study of osteomyelitis in animals may help to improve the development of animal models for testing new treatments in humans. Host factors and underlying conditions have been studied mainly in humans, although aspects as immunodeficiency have been described in some veterinary cases. Even when Staphylococcus aureus is still considered the most prevalent causing microorganism, this prevalence should be reviewed using molecular diagnostic techniques, and this could affect treatment options. New approaches to treatment include local delivery of antibiotics using different biomaterials, antimicrobial photodynamic therapy, and new antimicrobial compounds. We would like to remark the need of large, high-quality clinical trials and of the development of guides for the diagnosis and treatment of osteomyelitis in different animal species.
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Affiliation(s)
- Margarita González-Martín
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain
- Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain
| | - Vanessa Silva
- Microbiology and Antibiotic Resistance Team (MicroART), Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal
- Associated Laboratory for Green Chemistry (LAQV-REQUIMTE), University NOVA of Lisboa, Caparica, Portugal
- Veterinary and Animal Research Centre, Associate Laboratory for Animal and Veterinary Science (AL4AnimalS), University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal
| | - Patricia Poeta
- Microbiology and Antibiotic Resistance Team (MicroART), Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal
- Associated Laboratory for Green Chemistry (LAQV-REQUIMTE), University NOVA of Lisboa, Caparica, Portugal
- Veterinary and Animal Research Centre, Associate Laboratory for Animal and Veterinary Science (AL4AnimalS), University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal
| | - Juan Alberto Corbera
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain
- Department of Animal Pathology, Animal Production and Food Science and Technology, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain
| | - María Teresa Tejedor-Junco
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain
- Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain
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Gomes SA, Targett M, Lowrie M. Computed tomography features of discospondylitis in dogs. Vet Med (Auckl) 2022; 36:2123-2131. [PMID: 36208075 DOI: 10.1111/jvim.16551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 09/15/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Computed tomography (CT) findings of dogs with discospondylitis have not been widely described despite increased availability of this imaging modality. OBJECTIVES Describe the CT features of discospondylitis in a population of clinically affected dogs with discospondylitis diagnosed by magnetic resonance imaging (MRI). ANIMALS Forty-one dogs (63 affected discs) with MRI-identified discospondylitis presented to a single referral hospital between 2012 and 2022. METHODS Retrospective, single center, descriptive case series with analysis of MRI-identified discospondylitis sites and concomitant CT imaging. Computed tomographic features of MRI-affected sites including intervertebral disc space (IVDS), endplates, vertebral body, epidural space and paraspinal tissues were described. RESULTS The most frequently found changes were: (1) endplate involvement (87.3%) most frequently bilateral (94.5%), with erosion (61.9%) and multifocal osteolysis (67.3%); (2) periosteal proliferation adjacent to the IVDS (73%) and spondylosis (66.7%); and (3) vertebral body involvement (66.7%) involving one-third of the vertebra (85.7%) with multifocal osteolysis (73.5%). Other less prevalent features included an abnormal IVDS (narrowed or collapsed), sclerosis of the adjacent vertebral body or endplates, presence of disseminated idiopathic skeletal hyperostosis or vacuum artifact. CONCLUSIONS AND CLINICAL IMPORTANCE We determined that bilateral endplate erosion and periosteal proliferation were very common in dogs with discospondylitis. Careful evaluation of CT in all 3 planes (dorsal, sagittal, transverse) is necessary to identify an affected IVDS. These described CT features can aid in the diagnosis of discospondylitis in dogs but equivocal cases might still require MRI.
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Affiliation(s)
| | - Mike Targett
- School of Veterinary Medicine and Science, University of Nottingham, Leicestershire, UK
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Gomes SA, Garosi LS, Behr S, Toni C, Tabanez J, Rusbridge C, Targett M, Lowrie M. Clinical features, treatment and outcome of discospondylitis in cats. J Feline Med Surg 2022; 24:311-321. [PMID: 34100660 PMCID: PMC10812237 DOI: 10.1177/1098612x211020159] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES There is a paucity of information on feline discospondylitis. This study aimed to describe the signalment, clinical and laboratory findings, aetiological agents, treatment and outcome in cats affected by discospondylitis. METHODS This was a retrospective review of the medical records of cats diagnosed with discospondylitis at four referral institutions. RESULTS A total of 17 cats were identified. Most were domestic shorthair cats (76.5%) and male (58.8%), with a median age of 9 years (range 0.9-14) and a median duration of clinical signs of 3 weeks (range 0.3-16). All cats presented with spinal hyperaesthesia; 3/17 had pyrexia. Neurological dysfunction was found in 64.7% of cats, which was indicative of a T3-L3 or L4-S2 spinal segment, associated nerve root or associated nerve neurolocalisation. Haematology, serum biochemistry and urinalysis revealed occasional inconsistent non-specific changes. All cats underwent urine culture; 9/17 cats also had a distinct tissue cultured. Positive bacterial cultures were obtained in two cats (11.8%) for Staphylococcus species (urine, blood and intradiscal fine-needle aspirate) and Escherichia coli (urine); both presented with multifocal discospondylitis. Treatment was non-surgical in all cats, with sustained antibiotic therapy for a median of 3 months (range 1-9). Analgesia provided included non-steroidal anti-inflammatory drugs, alone or in combination with gabapentin. Restricted exercise was advised for a minimum of 4 weeks. Outcome information available in 12 cats was excellent in terms of pain control and neurological function in 10 cats (83.3%) at the time of stopping antibiotics. Recurrence occurred in one case, which had received a single antibiotic for 6 weeks, and relapsed 4 months after presentation. One other case failed to improve and was euthanased during the course of hospitalisation. CONCLUSIONS AND RELEVANCE Feline discospondylitis is uncommon and no obvious signalment predisposition was found in this study. Spinal hyperaesthesia was universally present, with neurological dysfunction also highly prevalent. Bacterial culture was unrewarding in most cases. Amoxicillin-clavulanic acid or cephalosporins are reasonable choices for first-line antibiotics. Prognosis was favourable, with no long-term evidence of recurrence in cats on sustained antibiotic therapy, for a mean duration of 3 months.
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Affiliation(s)
- Sergio A Gomes
- Dovecote Veterinary Hospital, Castle Donington, Derby, UK
| | | | - Sebastien Behr
- Neurology/Neurosurgery Service, Willows Veterinary Centre and Referral Centre, Solihull, West Midlands, UK
| | - Cristina Toni
- Neurology/Neurosurgery Service, Willows Veterinary Centre and Referral Centre, Solihull, West Midlands, UK
| | | | - Clare Rusbridge
- Fitzpatrick Referrals, Godalming, Surrey, UK
- Faculty of Health and Medical Sciences, School of Veterinary Medicine, University of Surrey, Guildford, Surrey, UK
| | - Mike Targett
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, Leicestershire, UK
| | - Mark Lowrie
- Dovecote Veterinary Hospital, Castle Donington, Derby, UK
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Griffeuille E, Seriot P, Baudin-Tréhiou C, Gibert S, Blond L, Poujol L, Dunié-Mérigot A. Comparison of computed tomography and surgical findings and investigation of their associations with outcomes for dogs with sublumbar abscesses. J Am Vet Med Assoc 2021; 259:1300-1308. [PMID: 34727061 DOI: 10.2460/javma.20.07.0403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To describe and compare the results of preoperative CT and surgical findings in dogs with sublumbar abscesses and investigate potential associations between these variables and the outcome of abscess recurrence. ANIMALS 51 client-owned dogs. PROCEDURES A retrospective, records-based study was performed of dogs undergoing surgery for treatment of sublumbar abscesses diagnosed by use of CT between January 2010 and December 2018. Signalment, clinical signs, clinicopathologic data, CT findings, surgical techniques and findings, duration of hospitalization, postoperative treatment, and complications were recorded. Long-term follow-up was performed through telephone interviews. Logistic regression analysis was used to investigate associations between the variables of interest and abscess recurrence. RESULTS 51 dogs met the study inclusion criteria; 48 were included in outcome analysis. The CT findings agreed with surgical findings for identification of a migrating vegetal foreign body for 39 of 51 (77%) dogs. All dogs survived to hospital discharge; 1 dog died of hemoabdomen 3 days after surgery, and 6 had minor (surgical wound) complications reported. Abscess recurrence developed in 12 of 48 (25%) dogs with a median time to recurrence of 6 months. Identification of diskospondylitis on CT examination was the only investigated factor significantly associated with recurrence; odds of recurrence in dogs with this finding were 8.4 times those for dogs without this finding. CONCLUSIONS AND CLINICAL RELEVANCE Our results suggested dogs with sublumbar abscesses have a good prognosis after surgery, although recurrence can develop. Preoperative identification of diskospondylitis was significantly associated with abscess recurrence in this study sample.
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Кемельман Е, Kemel'man E, Корешков А, Koreshkov A, Лапшин М, Lapshin M, Уварова Ю, Uvarova Y. Discospondylitis in a cat. ACTA ACUST UNITED AC 2019. [DOI: 10.32416/article_5d5a9d1c9c32e6.14511299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Discospondylitis is uncommon in cats. We describe a cat with discospondylitis of the L2-3 intervertebral disc. Radiographic, computed tomographic, magnetic resonance and histological findings are presented. Cultures of blood and bone yielded no growth. Urine and spinal fluid cultures were not carried out. Corpectomy was performed, the cat was successfully treated with amoxicillin/clavulanic acid. Clinical signs resolved completely; the patient was observed for one year after the surgery.
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Affiliation(s)
- Евгений Кемельман
- Инновационный Ветеринарный Центр (ИВЦ) Московской ветеринарной академии им. К.И. Скрябина
- Сеть Ветеринарных Клиник «Свой Доктор»
- Клиника ветеринарной медицины «Айболит»
| | - Evgeniy Kemel'man
- Innovation Veterinary Center of Moscow Veterinary Academy named after K.I. Skryabin
- Chain Veterinary Clinic «Swoi doctor»
- Veterinary Clinic «Aibolit»
| | - Артем Корешков
- Инновационный Ветеринарный Цент Московской Ветеринарной Академии
- Ветеринарная клиника «Медвет»
| | - Artem Koreshkov
- Innovation Veterinary Center of Moscow Veterinary Academy
- Veterinary Clinic «Medvet»
| | - Максим Лапшин
- Инновационный Ветеринарный Цент Московской Ветеринарной Академии
| | - Maksim Lapshin
- Innovation Veterinary Center of Moscow Veterinary Academy
| | - Юлия Уварова
- Инновационный Ветеринарный Цент Московской Ветеринарной Академии
| | - Yuliya Uvarova
- Innovation Veterinary Center of Moscow Veterinary Academy
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Gomes SA, Behr S, Garosi LS, Carrera I, Targett M, Lowrie M. Imaging features of discospondylitis in cats. J Feline Med Surg 2019; 22:631-640. [PMID: 31418630 DOI: 10.1177/1098612x19869705] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES This study describes the imaging features of feline discospondylitis on MRI, comparing them with CT and radiographic findings where available. METHODS The medical records of cats diagnosed with discospondylitis, presented to three referring institutions, were reviewed. MRI, CT and radiographic features were assessed by two of the authors independently. RESULTS Fourteen sites of discospondylitis were retrospectively identified in 13 cats. The L7-S1 intervertebral disc space (IVDS) was affected in 7/14 (50%) cases. Characteristic MRI features included a hyperintense nucleus pulposus signal on T2-weighted (T2W) imaging (n = 10/14 [71%]) and short tau inversion recovery (STIR) imaging (n = 11/13 [85%]), with contrast enhancement in all (n = 11/11); involvement of adjacent vertebral endplates (n = 11/14 [79%]) and hyperintense neighbouring soft tissue on T2W (n = 11/14 [79%]) and STIR (n = 10/13 [77%]), with contrast enhancement in all (n = 11/11); and the presence of spondylosis deformans (n = 10/14 [71%]). Other features included narrowed or collapsed IVDS (n = 8/14 [57%]), contrast enhancement of vertebral bodies (n = 5/11 [46%]), epidural space involvement (n = 5/14 [36%]), compression of the spinal cord or nerve roots (n = 5/14 [36%]), paraspinal abscessation (n = 3/14 [21%]) and meningeal signal intensity abnormalities with contrast enhancement (n = 5/6 [83%]). These latter findings may indicate secondary focal meningitis. Radiographs were available covering five sites (in four cats) and CT covering three sites (in two cats). The most common radiological features were collapse or narrowing of the affected IVDS (80%) and endplate erosion (60%). No changes suggestive of discospondylitis were identifiable on radiography or CT in two sites (one cat), despite being identifiable on MRI. Repeated radiography in one case did not reveal complete radiological resolution following 9 months of treatment. CONCLUSIONS AND RELEVANCE The results of this study indicate consistent MRI features of feline discospondylitis that should be considered in the diagnosis of this condition.
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Affiliation(s)
| | - Sebastien Behr
- Neurology/Neurosurgery Service, Willows Veterinary Centre and Referral Centre, Solihull, UK
| | | | - Ines Carrera
- Diagnostic Imaging, Willows Veterinary Centre and Referral Centre, Solihull, UK
| | - Mike Targett
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, UK
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Abstract
Discospondylitis can affect dogs of any age and breed and may be seen in cats. Although radiography remains the gold standard, advanced imaging, such as CT and MRI, has benefits and likely allows earlier diagnosis and identification of concurrent disease. Because discospondylitis may affect multiple disk spaces, imaging of the entire spine should be considered. There is a lengthening list of causative etiologic agents, and successful treatment hinges on correct identification. Image-guided biopsy should be considered in addition to blood and urine cultures and Brucella canis screening and as an alternative to surgical biopsy in some cases.
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Affiliation(s)
- Catherine M Ruoff
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX 77843-4475, USA
| | - Sharon C Kerwin
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX 77843-4474, USA.
| | - Amanda R Taylor
- Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Greene Hall, 1130 Wire Road, Auburn, AL 36849, USA
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Rossanese M, Murgia D. Management of paraureteral pseudocyst and ureteral avulsion using a subcutaneous ureteral bypass (SUB) system in a cat. VETERINARY RECORD CASE REPORTS 2015. [DOI: 10.1136/vetreccr-2015-000173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Matteo Rossanese
- Animal Health TrustNewmarketUK
- Parkside Veterinary SurgeryNew FerryUK
| | - Daniela Murgia
- Animal Health TrustNewmarketUK
- Peace Avenue Veterinary ClinicMongkokKowloonHong Kong
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Rossanese M. Partial ablation of a para‐ureteral pseudocyst without ureteronephrectomy in a cat. VETERINARY RECORD CASE REPORTS 2015. [DOI: 10.1136/vetreccr-2014-000112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Clinical challenge. Diskospondylitis of L6-L7 in a snow leopard cub (Uncia uncia). J Zoo Wildl Med 2011; 42:774-7. [PMID: 22204083 DOI: 10.1638/2011-0073.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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HOLLOWAY ANDREW, DENNIS RUTH, McCONNELL FRASER, HERRTAGE MIKE. MAGNETIC RESONANCE IMAGING FEATURES OF PARASPINAL INFECTION IN THE DOG AND CAT. Vet Radiol Ultrasound 2009; 50:285-91. [DOI: 10.1111/j.1740-8261.2009.01535.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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