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Thatcher H, Targett M, Alcoverro E, Stee K, Schofield I, Lowrie M, Gomes SA. Incidence and clinical characterisation of thoracolumbar intervertebral disc extrusions in Basset Hounds compared with Dachshunds. Vet Rec 2024; 194:e3212. [PMID: 37455254 DOI: 10.1002/vetr.3212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 05/19/2023] [Accepted: 06/23/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND The Basset Hound is the largest chondrodystrophic breed predisposed to thoracolumbar intervertebral disc extrusion (TL-IVDE). However, literature describing this particular breed in terms of incidence, signalment, anatomical location, clinical severity and short-term outcome of TL-IVDE is lacking. METHODS The medical histories of Dachshunds and Basset Hounds presenting to three neurology departments were retrospectively assessed. Information collected for each dog included signalment, whether it had received a diagnosis of TL-IVDE, duration of clinical signs, affected discs and anatomical region and neurological grading at presentation and discharge. RESULTS A total of 270 Dachshunds and 188 Basset Hounds were included for incidence analysis. Of these, 154 Dachshunds and 68 Basset Hounds with confirmed TL-IVDE were included for signalment, anatomical location, clinical severity and short-term outcome analysis. Statistical analysis indicated a significantly higher incidence of TL-IVDE in Dachshunds than in Basset Hounds (77.4% vs. 36.2%, p < 0.05). Basset Hounds presenting to a neurology department were older (median 87.5 months vs. 66.5 months), had a greater proportion of midlumbar IVDE (L2-L5) and were more frequently ambulatory at discharge than Dachshunds. Only one Basset Hound presented as paraplegic without nociception, compared with 16 Dachshunds (1.5% vs. 10.4%). LIMITATIONS The study had a retrospective design and included multicentric non-standardised cases. CONCLUSION TL-IVDE incidence was higher in Dachshunds than in Basset Hounds. Basset Hounds were older at presentation, frequently affected more caudally in the vertebral column and more frequently ambulatory at discharge than Dachshunds. The differences found in this study could aid in the development of preventive strategies.
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Affiliation(s)
| | - Mike Targett
- School of Veterinary Medicine and Science, University of Nottingham, Loughborough, UK
| | | | - Kimberley Stee
- Department of Small Animal, Faculty of Veterinary Medicine, University of Ghent, Merelbeke, Belgium
| | | | - Mark Lowrie
- Dovecote Veterinary Hospital, Castle Donington, UK
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Freeman P. Recurrence of clinical signs following treatment for intervertebral disc extrusion: what is really going on? Vet Rec 2023; 193:202-204. [PMID: 37681618 DOI: 10.1002/vetr.3436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Affiliation(s)
- Paul Freeman
- Queen's Veterinary School Hospital, University of Cambridge, Cambridge, UK
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Suiter E, Grapes N, Martin-Garcia L, De Decker S, Gutierrez-Quintana R, Wessmann A. MRI and clinical findings in 133 dogs with recurrent deficits following intervertebral disc extrusion surgery. Vet Rec 2023; 193:e2992. [PMID: 37247382 DOI: 10.1002/vetr.2992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 03/01/2023] [Accepted: 04/07/2023] [Indexed: 05/31/2023]
Abstract
BACKGROUND Recurrence of neurological signs following surgery for intervertebral disc herniation (IVDH) is reported, yet many cases lack MRI-confirmed diagnosis. This study describes the MRI and clinical findings in dogs presenting with recurrence of neurological signs following surgical treatment of IVDH. METHODS Medical records of dogs that underwent decompressive surgery for IVDH followed by a subsequent MRI within 12 months were retrospectively reviewed. RESULTS One hundred and thirty-three dogs were identified, all of which initially presented with intervertebral disc extrusion (IVDE). Of these, 109 (81.9%) had a recurrent IVDE, and 24 (18.1%) had an alternative diagnosis that included haemorrhage (n = 10), infection (n = 4), soft tissue encroachment (n = 3), myelomalacia (n = 3) or other (n = 4). Same-site IVDE recurrence or alternative diagnoses were significantly more likely to present within 10 days postoperatively. Thirty-nine percent of dogs presenting with 'early recurrence' had an alternative diagnosis. Type of surgery, fenestration, neurological grade or IVDE site was not significantly associated with the subsequent MRI diagnosis. LIMITATIONS Limitations include the retrospective study design, the exclusion of conservatively managed recurrences, the variable length of follow-up and differences in the clinicians' surgical experience. CONCLUSION The most common cause for the recurrence of neurological signs following decompressive spinal surgery was IVDE. Just over one-third of dogs presenting with early recurrence had an alternative diagnosis.
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Affiliation(s)
- Emma Suiter
- Neurology & Neurosurgery Service, Pride Veterinary Referrals, Derby, UK
| | - Nicholas Grapes
- Clinical Science and Services, Royal Veterinary College, Hatfield, UK
| | - Lucia Martin-Garcia
- Small Animal Hospital, School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, UK
| | - Steven De Decker
- Clinical Science and Services, Royal Veterinary College, Hatfield, UK
| | - Rodrigo Gutierrez-Quintana
- Small Animal Hospital, School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, UK
| | - Annette Wessmann
- Neurology & Neurosurgery Service, Pride Veterinary Referrals, Derby, UK
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Jones GMC, Cherubini GB, Llabres‐Diaz F, Caine A, De Stefani A. A case series of 37 surgically managed, paraplegic, deep pain negative French bulldogs, with thoracolumbar intervertebral disc extrusion, from two English referral centres. Vet Rec Open 2023; 10:e61. [PMID: 37181333 PMCID: PMC10170243 DOI: 10.1002/vro2.61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 02/03/2023] [Accepted: 04/04/2023] [Indexed: 05/16/2023] Open
Abstract
Background Thoracolumbar intervertebral disc extrusions (TL-IVDEs) are a common spinal disorder in dogs, especially within chondrodystrophic breeds. Loss of deep pain perception is a well-documented negative prognostic indicator in dogs with TL-IVDE. The objectives of this study were to report the rate of return of deep pain perception and independent ambulation in surgically treated, paraplegic, deep pain perception negative French bulldogs with TL-IVDEs. Methods A retrospective case series of deep pain perception negative dogs with TL-IVDE presenting to two referral centres between 2015 and 2020 was conducted. Medical and MRI records were reviewed, including the following quantitative MRI changes: lesion length, extent of spinal cord swelling and severity of spinal cord compression. Results Thirty-seven French bulldogs met the inclusion criteria, with 14 of 37 (38%) regaining deep pain perception by the time of discharge (median hospitalisation 10.0 days [interquartile range 7.0-15.5 days]) with two dogs independently ambulatory (6%). Ten of the 37 dogs were euthanased during hospitalisation. Significantly fewer dogs (3/16, 19%) with L4-S3 lesions regained deep pain perception compared to 11 of 21 (52%) of dogs with T3-L3 lesions (p = 0.048). Quantitative MRI changes were not associated with the return of deep pain perception. After discharge, with a median 1-month follow-up period, an additional three dogs regained deep pain perception and five dogs became independently ambulatory (17/37 [46%] and 7/37 [19%], respectively). Conclusions and clinical importance This study adds support to the contention that the recovery of French bulldogs with TL-IVDE from surgery is poor compared with other breeds; further prospective, breed-controlled studies are indicated.
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Affiliation(s)
| | - Giunio Bruto Cherubini
- Dick White ReferralsStation FarmSix Mile BottomCambridgeshireUK
- Veterinary Teaching Hospital “Mario Modenato”Department of Veterinary SciencesUniversity of PisaPisaItaly
| | | | - Abby Caine
- Dick White ReferralsStation FarmSix Mile BottomCambridgeshireUK
| | - Alberta De Stefani
- Department of Clinical Science and ServicesRoyal Veterinary CollegeHertfordshireUK
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Palus V, Stehlik L, Necas A, Srnec R, Urbanova L, Lu D. Cervical intervertebral disc disease in 60 Yorkshire terriers. Front Vet Sci 2023; 10:1148802. [PMID: 37252381 PMCID: PMC10213352 DOI: 10.3389/fvets.2023.1148802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 04/26/2023] [Indexed: 05/31/2023] Open
Abstract
Intervertebral disc extrusion (IVDE) is a common neurological condition in many dog breeds. This study aimed to describe this condition in Yorkshire terriers (YT) and calculate the prevalence of this condition amongst the YTs with neurological diseases. This is a double-centre retrospective study which was conducted in two arms. The first part of the study, describing the clinical features and prognosis of cervical (C) IVDE in YTs, is based on data from 2005 to 2021. The second part of the study calculated the prevalence of C IVDE amongst the YTs with neurological diseases based on data from 2016 to 2021. A retrospective search through the medical records was conducted. YTs with C IVDE diagnosed with MRI and confirmed surgically were eligible for inclusion in this study. Sixty YTs were included in the first part of the study. There were 48 (80%) dogs with acute onset and 12 (20%) with chronic onset with acute deterioration. Ambulation was preserved in 31 (51.7%) dogs on admission, and the remaining 29 (48.3%) dogs were non-ambulatory. No significant association was found between ambulation on admission and recovery status (p = 0.547). Seventy-three intervertebral spaces were treated during the surgical intervention. Relapses were seen in seven (11.7%) dogs. Forty-nine (81.7%) dogs were ambulatory at discharge. A complete recovery was observed in 46 (76.7%) dogs; the remaining dogs (14, 23.3%) were classified as incomplete recovery. A significant difference was found in time to ambulation (p = 0.0238) and time to discharge (p = 0.0139) between the on-admission ambulatory and non-ambulatory dogs. Three hundred and eight YTs were diagnosed with neurological diseases between 2016 and 2021 in one referral centre. C IVDE was diagnosed in 31 (10.06%) dogs. This is the first study explicitly describing the C IVDE in YTs and establishing the prevalence of this condition amongst YTs with other neurological disorders.
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Affiliation(s)
- Viktor Palus
- Neurovet, Trencin, Slovakia
- Faculty of Veterinary Medicine, University of Veterinary Sciences Brno, Brno, Czechia
| | | | - Alois Necas
- Faculty of Veterinary Medicine, University of Veterinary Sciences Brno, Brno, Czechia
| | - Robert Srnec
- Faculty of Veterinary Medicine, University of Veterinary Sciences Brno, Brno, Czechia
| | - Lucie Urbanova
- Faculty of Veterinary Medicine, University of Veterinary Sciences Brno, Brno, Czechia
| | - Diane Lu
- CityU Veterinary Medical Centre, Kowloon, Hong Kong SAR, China
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Recurrence rate of intervertebral disc disease in surgically treated French Bulldogs: a retrospective study (2009-2019). Acta Vet Scand 2023; 65:3. [PMID: 36732796 PMCID: PMC9893528 DOI: 10.1186/s13028-023-00667-0] [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: 05/01/2022] [Accepted: 01/25/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Intervertebral disc disease (IVDD) is a common diagnosis and well-investigated pathological condition in French Bulldogs with neurological deficiencies. However there is currently only one recently published retrospective descriptive study looking for recurrence rates of IVDD in French Bulldogs. Medical reports of French Bulldogs with a first episode of IVDD and surgical treatment were evaluated and reviewed for clinical signs of recurrence. Risk factors for Total-Recurrence, Cervical- and Thoracolumbar-Recurrence were evaluated by means of logistic regression models. The aim of this study was to assess frequency and risk factors associated with the recurrence of IVDD in French Bulldogs. RESULTS One hundred twenty-seven French Bulldogs with a first episode of IVDD and surgical treatment were evaluated. 52.7% (67/127) of these patients showed signs of recurrence. The recurrence rate in the cervical spine was slightly lower (47%) compared to the thoracolumbar spine (56.6%). A significant association with recurrence could be found for the factor age: French Bulldogs with a first episode of IVDD ≤ 3 years seem to be prone for Total-Recurrence (P = 0.002) and Cervical-Recurrence (with ORs ranging from 0.02 to 0.03 for patients older than 3 years). 50% of the recurrences (median) occurred within the first 12 month after the first episode of IVDD. CONCLUSIONS Recurrence of IVDD can be expected in more than half of French Bulldogs affected by IVDD. Especially young French Bulldogs are prone for recurrence in cervical spine. Almost every fourth patient with IVDD suffers from a recurrence within 12 months. Future dog owners should be informed about the risk of IVDD and the early onset of recurrences in French Bulldogs.
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Pontikaki AE, Pavlidou K, Polizopoulou Z, Savvas I, Kazakos G. Prophylactic Effect of Fenestration on the Recurrence of Thoracolumbar Intervertebral Disc Disease in Dogs. Animals (Basel) 2022; 12:ani12192601. [PMID: 36230341 PMCID: PMC9559642 DOI: 10.3390/ani12192601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/22/2022] [Accepted: 09/23/2022] [Indexed: 11/16/2022] Open
Abstract
Simple Summary The prophylactic effect of fenestration on the recurrence of thoracolumbar (TL) intervertebral disc herniation (IVDH) in dogs that have been surgically decompressed has been a topic of ongoing debate in veterinary medicine. The aim of this study was to systematically review the existing literature and critically evaluate the evidence behind the application of prophylactic fenestration on the recurrence of TL IVDH in dogs. PubMed, Web of Science and Scopus electronic databases were searched to collect relevant articles. Twenty-nine articles met the inclusion criteria and were assessed for scientific quality, treatment plan, and recurrence incidence. Five articles were selected for a meta-analysis to test if the recurrence differs in animals treated with or without prophylactic fenestration. In the light of the low scientific quality and the amount of published literature on the topic, further research is needed to robustly support the prophylactic effect of fenestration on the recurrence of TL IVDH in dogs. Abstract This systematic review aimed to assess the effect of prophylactic fenestration (PF) on the recurrence of thoracolumbar (TL) intervertebral disc (IVD) disease in dogs. Three online databases were searched (Web of Science, MEDLINE via PubMed, SCOPUS), 115 relevant studies were thoroughly examined by the authors, 29 of which met the pre-defined inclusion criteria for this systematic review. Data about the initial treatment, the performance of PF, the incidence of recurrence, and the site of recurrence were extracted. Most of the studies were deemed to have serious to moderate risk of bias. Out of 5457 dogs, 1264 underwent prophylactic fenestration. A total of 504 cases of suspected or confirmed recurrence were recorded, in which 164 (32.54% of total recurrences and 11.02% of PF cases) were in dogs treated with PF. In order to perform quantitative analysis for the recurrence odds, we conducted a meta-analysis. Five studies were included that met the inclusion criteria. Despite a large number of relevant publications, the quality of the evidence they provide is low. This prevented us from reaching a definitive conclusion on the prophylactic effect of fenestration on recurrence in dogs surgically treated for TL IVDH.
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Moore SA, Olby NJ, Brisson B, Fenn J, Flegel T, Kortz G, Lewis M, Tipold A. ACVIM consensus statement on diagnosis and management of acute canine thoracolumbar intervertebral disc extrusion. J Vet Intern Med 2022; 36:1570-1596. [PMID: 35880267 PMCID: PMC9511077 DOI: 10.1111/jvim.16480] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 06/12/2022] [Indexed: 12/16/2022] Open
Abstract
Background Thoracolumbar intervertebral disc extrusion (TL‐IVDE) is the most common cause of acute paraparesis and paraplegia in dogs; however, guidelines on management of the condition are lacking. Objectives To summarize the current literature as it relates to diagnosis and management of acute TL‐IVDE in dogs, and to formulate clinically relevant evidence‐based recommendations. Animals None. Methods A panel of 8 experts was convened to assess and summarize evidence from the peer‐reviewed literature in order to develop consensus clinical recommendations. Level of evidence available to support each recommendation was assessed and reported. Results The majority of available literature described observational studies. Most recommendations made by the panel were supported by a low or moderate level of evidence, and several areas of high need for further study were identified. These include better understanding of the ideal timing for surgical decompression, expected surgical vs medical outcomes for more mildly affected dogs, impact of durotomy on locomotor outcome and development of progressive myelomalacia, and refining of postoperative care, and genetic and preventative care studies. Conclusions and Clinical Importance Future efforts should build on current recommendations by conducting prospective studies and randomized controlled trials, where possible, to address identified gaps in knowledge and to develop cost effectiveness and number needed to treat studies supporting various aspects of diagnosis and treatment of TL‐IVDE.
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Affiliation(s)
- Sarah A Moore
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Natasha J Olby
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | | | - Brigitte Brisson
- Department of Clinical Studies, Ontario Veterinary College, Ontario Veterinary College, Guelph, Ontario, Canada
| | - Joe Fenn
- Department of Clinical Science and Services, Royal Veterinary College, London, United Kingdom
| | - Thomas Flegel
- Department for Small Animals, Leipzig University, Leipzig, Germany
| | - Gregg Kortz
- VCA Sacramento Veterinary Referral Center, Sacramento, California, USA.,VCA Sacramento Veterinary Referral Center, UC Davis, California, USA
| | - Melissa Lewis
- Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, Indiana, USA
| | - Andrea Tipold
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hanover, Hanover, Germany
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Argent V, Perillo R, Jeffery N, Freeman P. Recurrence of signs consistent with cervical intervertebral disc extrusion in dogs. J Small Anim Pract 2022; 63:454-459. [PMID: 35146745 PMCID: PMC9303190 DOI: 10.1111/jsap.13480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 11/17/2021] [Accepted: 01/18/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Report the rate of recurrent clinical signs following successful treatment of cervical intervertebral disc extrusion, and explore the association between treatment method and recurrence. MATERIALS AND METHODS Medical records of dogs with MRI- or CT-confirmed cervical intervertebral disc extrusion were reviewed to verify that they recovered. Type of treatment, site of initial extrusion and whether dogs re-presented with recurrent clinical signs were recorded. Recurrence was considered presumed if based on clinical signs or confirmed if based on repeat cross-sectional imaging. RESULTS Complete recovery was documented following medical (36/119, 30.3%) or surgical (83/119, 69.7%) management of initial cervical disc extrusion. There was a recurrence of consistent clinical signs in 40 of 119 (34%) cases, of which 27 of 83 (33%) were initially managed surgically and 13 of 36 (36%) medically. In 24 of 40 (60%) cases, there was imaging confirmation of recurrent extrusion; in medically managed dogs, recurrence mostly occurred at the same site, whereas after surgery, recurrence most commonly involved an adjacent disc. Of the 40 recurrences, 32 (80%) occurred within 2 years of diagnosis. Rate of recurrence was similar between treatment methods in both univariable and multivariable time-to-event analyses (hazard ratio 1.03; 95% confidence interval: 0.67 to 1.53; P=0.87). CLINICAL SIGNIFICANCE Following successful initial medical or surgical treatment, clinical signs consistent with recurrent cervical disc extrusion occurred with similar frequency. Medically treated cases tended to have recurrence at the same site as initial presentation, whereas surgical treatment prevented this. Recurrence usually occurred within 2 years. The retrospective study design, small number of recurrences and lack of imaging confirmation of every recurrence should be considered when interpreting the results.
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Affiliation(s)
- V Argent
- Department of Small Animal Neurology, Davies Veterinary Specialists, Higham Gobion, SG5 3HR, UK
| | - R Perillo
- Department of Small Animal Neurology, Clinica Veterinaria San Marco, Viale dell'Industria, Veggiano, 35030, Italy
| | - N Jeffery
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX, 77843, USA
| | - P Freeman
- Department of Small Animal Neurology, Queen's Veterinary School Hospital, Cambridge, CB3 0ES, UK
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