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Doeven L, Cardy T, Crawford AH. Investigation of neutering status and age of neutering in female Dachshunds with thoracolumbar intervertebral disc extrusion. J Small Anim Pract 2024. [PMID: 38622029 DOI: 10.1111/jsap.13733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 03/13/2024] [Accepted: 03/27/2024] [Indexed: 04/17/2024]
Abstract
OBJECTIVES To evaluate neutering status and age of neutering in female Dachshunds with thoracolumbar intervertebral disc extrusion. We hypothesised that neutered Dachshunds presented with intervertebral disc extrusion at an earlier age, with a higher grade of neurological deficits and with more extensive extrusion of disc material compared with intact females. MATERIALS AND METHODS Retrospective multi-centre study of client-owned female Dachshunds with surgically confirmed thoracolumbar intervertebral disc extrusion. Dogs were classified as early, late or not neutered (intact). Age, body condition score, duration of clinical signs before presentation, modified Frankel score at presentation, length of extruded disc material, maximum spinal cord compression and whether dogs presented for a subsequent intervertebral disc extrusion were recorded. RESULTS One hundred and fifty-four dogs were included: 36 early neutered, 69 late neutered and 49 intact. No significant difference was found between early neutered, late neutered and entire female Dachshunds in any of the variables studied. CLINICAL SIGNIFICANCE In this cohort of female dogs, neuter status and age of neutering were not found to affect age at onset nor severity of thoracolumbar intervertebral disc extrusion.
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Affiliation(s)
- L Doeven
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, AL9 7TA, UK
| | - T Cardy
- Neurology and Neurosurgery, Cave Veterinary Specialists, West Buckland, Somerset, TA21 9LE, UK
| | - A H Crawford
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, AL9 7TA, UK
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Schachar J, Bocage A, Nelson NC, Early PJ, Mariani CL, Olby NJ, Muñana KR. Clinical and imaging findings in dogs with nerve root signature associated with cervical intervertebral disc herniation. J Vet Intern Med 2024; 38:1111-1119. [PMID: 38216520 PMCID: PMC10937489 DOI: 10.1111/jvim.16982] [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: 08/17/2023] [Accepted: 12/15/2023] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND Intervertebral disc herniation (IVDH) is the most common spinal cord disease in dogs. Little information is available regarding the clinical presentation of nerve root signature (NRS) associated with cervical IVDH. HYPOTHESIS/OBJECTIVE To detail the clinical and magnetic resonance imaging (MRI) findings in dogs with NRS associated with cervical IVDH. ANIMALS Forty-seven client-owned dogs presenting with thoracic limb NRS and MRI confirmed IVDH. METHODS Medical records from 2010 to 2020 were retrospectively reviewed for dogs that met inclusion criteria. Imaging studies were evaluated by 2 individuals to characterize location and severity of neural tissue compression. RESULTS Chondrodystrophoid dogs comprised the majority of the study cohort, with dachshund the most common breed (n = 10). Three-quarters of dogs were ≥7 years of age. Interobserver agreement was moderate or good for all of the imaging variables evaluated. The C6-C7 intervertebral disc space was significantly overrepresented (P = .01), comprising 32% (15/47) of the affected discs. However, 42% (20/47) of cases involved C2-C3 though C4-C5 disc sites. Disc material was more frequently located laterally compared to medially within the vertebral canal (P = .0005), and to be associated with compression of the nerve root at the level of the intervertebral foramen (P = .012). CONCLUSION/CLINICAL IMPORTANCE NRS is most commonly associated with lateralized or foraminal cervical disc herniations. It is most prevalent with C6-C7 intervertebral disc involvement, suggesting that there might be unique anatomic factors that contribute to development of NRS at this site, but can be a clinical manifestation of IVDH occurring anywhere along the cervical spine.
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Affiliation(s)
- Jordan Schachar
- Department of Clinical SciencesCollege of Veterinary Medicine, NC State UniversityRaleigh, North Carolina 27606USA
- Present address:
Garden State Veterinary SpecialistsTintonNew JerseyUSA
| | - Alan Bocage
- Department of Molecular and Biomedical SciencesCollege of Veterinary Medicine, NC State UniversityRaleigh, North Carolina 27606USA
- Present address:
Mount Laurel Animal HospitalMount LaurelNew JerseyUSA
| | - Nathan C. Nelson
- Department of Molecular and Biomedical SciencesCollege of Veterinary Medicine, NC State UniversityRaleigh, North Carolina 27606USA
| | - Peter J. Early
- Department of Clinical SciencesCollege of Veterinary Medicine, NC State UniversityRaleigh, North Carolina 27606USA
| | - Christopher L. Mariani
- Department of Clinical SciencesCollege of Veterinary Medicine, NC State UniversityRaleigh, North Carolina 27606USA
| | - Natasha J. Olby
- Department of Clinical SciencesCollege of Veterinary Medicine, NC State UniversityRaleigh, North Carolina 27606USA
| | - Karen R. Muñana
- Department of Clinical SciencesCollege of Veterinary Medicine, NC State UniversityRaleigh, North Carolina 27606USA
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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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Shing H, Caine A, Cherubini GB, Sparks T, Housley D. Accuracy of low-field magnetic resonance imaging for differentiating intervertebral disc extrusions and protrusions at the lumbosacral disc space in dogs. Front Vet Sci 2023; 10:1279378. [PMID: 38026646 PMCID: PMC10657993 DOI: 10.3389/fvets.2023.1279378] [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: 08/17/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction/Purpose MRI features differentiating extrusion from protrusion in thoracolumbar discs have been published, however little specifically evaluates the lumbosacral disc. The high prevalence of degenerative changes in apparently normal animals complicates assessment of this region and features relevant elsewhere in the spine may not apply. The aims of this study were to determine the accuracy of MRI in differentiating IVDE and IVDP at the lumbosacral disc space in dogs and determine which MRI characteristics discriminate between IVDE and IVDP. Method MRI examinations from dogs with surgically confirmed IVDE or IVDP at the lumbosacral disc space were collected retrospectively (2011-2019). Two radiologists independently recorded a diagnosis of IVDE or IVDP, gave a confidence rating, and evaluated specific MRI features. Univariable statistical analysis was performed to identify which MRI characteristics might help distinguish IVDE from IVDP. Results 117 dogs with lumbosacral IVDE (n = 16) or IVDP (n = 101) were included. Features associated with IVDE were in concordance with previous studies and included interruption of the dorsal annulus, suspected epidural hemorrhage, dispersed (rather than confined) intervertebral disc herniation on T2W sagittal images, lateralized intervertebral disc herniation and displacement of the cauda equina. Overall diagnostic accuracy was 68.8% and interobserver agreement was fair (κ = 0.37), which is lower than has been reported in thoracolumbar disc herniation, but accuracy increased to 85.3% with substantially improved agreement (κ = 0.87) in "confident" diagnoses. Discussion/Conclusion MRI characteristics used in differentiating thoracolumbar IVDE and IVDP can be extrapolated to the lumbosacral intervertebral disc space, but diagnostic accuracy in low-field MRI is lower than previously reported in herniations involving the thoracolumbar spine.
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Affiliation(s)
- Hannah Shing
- Dick White Referrals, Part of Linnaeus Veterinary Limited, Cambridgeshire, United Kingdom
| | - Abby Caine
- Dick White Referrals, Part of Linnaeus Veterinary Limited, Cambridgeshire, United Kingdom
| | | | - Tim Sparks
- Waltham Petcare Science Institute, Leicestershire, United Kingdom
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Chang YP, Huang WH, Lua WZ, Wong W, Liu IH, Liu CH. Outcomes in Dogs with Multiple Sites of Cervical Intervertebral Disc Disease Treated with Single Ventral Slot Decompression. Vet Sci 2023; 10:377. [PMID: 37368763 DOI: 10.3390/vetsci10060377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/16/2023] [Accepted: 05/26/2023] [Indexed: 06/29/2023] Open
Abstract
In dogs with acute myelopathy but showing multiple sites of spinal compression from intervertebral disc disease (IVDD) on imaging, one approach is surgical decompression of the single acute disc extrusion while ignoring other previously extruded or protruded discs. However, little is known regarding the outcomes of this approach. This study described the outcomes and investigated prognostic factors in 40 dogs with multiple sites of cervical disc extrusion or protrusion on MRI who underwent ventral slot decompression for the single acute disc. The overall recovery rate was 97.5%. The median recovery time was seven days. The number of affected discs (including disc extrusion and protrusion) and the presence and number of the affected discs causing severe spinal compression did not influence the 30-day outcome. Compared with 23 dogs with single disc extrusion treated surgically, the recovery time and outcomes were similar between the two groups. The total number of affected discs was not associated with recovery time or outcomes. In conclusion, if an acute disc could be identified, ventral slot decompression targeting the single acute disc is a viable management approach for dogs with an acute presentation but diagnosed with multiple sites of spinal cord compression from IVDD.
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Affiliation(s)
- Ya-Pei Chang
- Department and Graduate Institute of Veterinary Medicine, School of Veterinary Medicine, National Taiwan University, Taipei 106319, Taiwan
- Graduate Institute of Veterinary Clinical Science, School of Veterinary Medicine, National Taiwan University, Taipei 106319, Taiwan
- National Taiwan University Veterinary Hospital, National Taiwan University, Taipei 106328, Taiwan
| | - Wei-Hsiang Huang
- Graduate Institute of Molecular and Comparative Pathobiology, School of Veterinary Medicine, National Taiwan University, Taipei 106319, Taiwan
| | - Wan-Zhen Lua
- Department and Graduate Institute of Veterinary Medicine, School of Veterinary Medicine, National Taiwan University, Taipei 106319, Taiwan
| | - Wenyi Wong
- Graduate Institute of Veterinary Clinical Science, School of Veterinary Medicine, National Taiwan University, Taipei 106319, Taiwan
| | - I-Hsuan Liu
- Department of Animal Science and Technology, National Taiwan University, Taipei 106073, Taiwan
- Research Center for Developmental Biology and Regenerative Medicine, National Taiwan University, Taipei 106038, Taiwan
| | - Chen-Hsuan Liu
- Department and Graduate Institute of Veterinary Medicine, School of Veterinary Medicine, National Taiwan University, Taipei 106319, Taiwan
- Graduate Institute of Molecular and Comparative Pathobiology, School of Veterinary Medicine, National Taiwan University, Taipei 106319, Taiwan
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Bibbiani L, Gelendi S, Bernardini M, Balducci F, Contiero B, Canal S. Prevalence, clinical presentation and MRI of intervertebral disc herniations in cats. J Feline Med Surg 2022; 24:e443-e452. [PMID: 36172921 PMCID: PMC10812338 DOI: 10.1177/1098612x221121893] [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: 12/31/2022]
Abstract
OBJECTIVES The aims of this study were to evaluate the prevalence and to describe the clinical and diagnostic imaging features of the different types of feline intervertebral disc herniation (IVDH). METHODS Medical records and imaging studies were retrospectively reviewed for cats diagnosed with IVDH between January 2008 and October 2020. Information obtained from the clinical records included signalment, clinical presentation, the presence of spinal hyperaesthesia and neurolocalisation. Diagnostic imaging findings, including type (ie, intervertebral disc extrusion [IVDE], intervertebral disc protrusion [IVDP] or acute non-compressive nucleus pulposus extrusion (ANNPE), site and number of IVDHs, were recorded. The association between breed, age, sex, duration and severity of neurological signs, the presence of spinal pain and MRI features was evaluated. RESULTS Forty-three cats were included. A total of 50 IVDHs were identified: 39 cats were diagnosed with a single IVDH and four with multiple IVDHs. The most common type of IVDH was ANNPE (n = 22), followed by IVDP (n = 19) and IVDE (n = 9). Neuroanatomical localisation included L4-S3 (n = 19/43), T3-L3 (n = 18/43) and C1-C5 (n = 6/43). Cats with a single IVDH were statistically significantly associated with a diagnosis of ANNPE (P = 0.023) compared with cats with multiple IVDHs affected by IVDP (P = 0.004). Males were more commonly affected by IVDE (P = 0.020) and females by ANNPE (P = 0.020). Cats with IVDP had a longer duration of clinical signs (P <0.001) than cats with ANNPE and demonstrated milder neurological deficits (P = 0.005). IVDEs were statistically significantly associated with spinal hyperaesthesia (P = 0.013), while ANNPEs were not (P = 0.014). CONCLUSIONS AND RELEVANCE ANNPE, IVDP and IVDE are each associated with distinctive clinical scenarios. Thoracolumbar and mid-to-caudal lumbar regions are the most affected, followed by the cranial cervical spine segment.
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Affiliation(s)
- Leonardo Bibbiani
- Neurology/Neurosurgery Unit, Anicura Portoni Rossi Veterinary Hospital, Zola Predosa, Italy
| | - Stefania Gelendi
- Department of Animal Medicine, Production and Health, University of Padua, Legnaro, Italy
| | - Marco Bernardini
- Neurology/Neurosurgery Unit, Anicura Portoni Rossi Veterinary Hospital, Zola Predosa, Italy
- Department of Animal Medicine, Production and Health, University of Padua, Legnaro, Italy
| | - Federica Balducci
- Neurology/Neurosurgery Unit, Anicura Portoni Rossi Veterinary Hospital, Zola Predosa, Italy
| | - Barbara Contiero
- Department of Animal Medicine, Production and Health, University of Padua, Legnaro, Italy
| | - Sara Canal
- Neurology/Neurosurgery Unit, Anicura Portoni Rossi Veterinary Hospital, Zola Predosa, Italy
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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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Craciun I, Khan S, Hughes J, Freeman P. Contrast-Enhanced Low-Field MRI Occasionally Alters the Surgical Approach for Canine Intervertebral Disc Extrusions. Vet Comp Orthop Traumatol 2022; 35:347-350. [PMID: 35732181 DOI: 10.1055/s-0042-1748877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVES The aim of this study was to describe how the addition of contrast-enhanced low-field magnetic resonance imaging sequences can confirm or change the initially planned surgical approach for canine intervertebral disc extrusions. STUDY DESIGN Magnetic resonance imagings of 20 dogs diagnosed with intervertebral disc extrusions were retrospectively reviewed by a board-certified neurologist for the location of extradural disc material, contrast enhancement, and whether enhancement reinforced or changed the initially planned surgical approach. RESULTS Extradural compressive material contrast-enhanced in 17/20 dogs. In 14/20 dogs, enhancement was considered to increase the confidence level of the location for surgery including two cases where the surgical approach was altered. CONCLUSION Gadolinium-based contrast agents in low-field magnetic resonance imaging can aid the surgical planning of intervertebral disc extrusions in dogs by improving the confidence level of location and extent of extradural material and occasionally altering the surgical approach.
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Affiliation(s)
- Ioana Craciun
- Queen's Veterinary School Hospital, Veterinary Medicine, Madingley Rd, Cambridge, United Kingdom.,Department of Clinical Sciences, University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca, Cluj-Napoca, Romania
| | - Sam Khan
- Queen's Veterinary School Hospital, Veterinary Medicine, Madingley Rd, Cambridge, United Kingdom
| | - Jonathan Hughes
- Queen's Veterinary School Hospital, Veterinary Medicine, Madingley Rd, Cambridge, United Kingdom
| | - Paul Freeman
- Queen's Veterinary School Hospital, Veterinary Medicine, Madingley Rd, Cambridge, United Kingdom
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Pfund R, Forward AK, Fentem R, Nagendran A, Fraser AR, Crawford AH. Postoperative outcome of ambulatory dogs with intervertebral disc extrusion causing incontinence and/or tail dysfunction: 18 cases (2010-2020). J Small Anim Pract 2022; 63:550-558. [PMID: 35322412 PMCID: PMC9544895 DOI: 10.1111/jsap.13497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 02/14/2022] [Accepted: 03/01/2022] [Indexed: 11/29/2022]
Abstract
Objectives To assess the recovery of urinary continence, faecal continence and tail function in ambulatory dogs with caudal lumbar intervertebral disc extrusion and to explore clinical factors that may be associated with recovery. Materials and Methods Medical records from January 2010 to December 2020 were searched to identify ambulatory dogs undergoing surgical treatment for a caudal lumbar intervertebral disc extrusion causing urinary incontinence, faecal incontinence and/or tail dysfunction. Signalment, history, presenting clinical signs, neurological examination findings, diagnostic test results, treatment and outcome were recorded for all dogs. Results Eighteen dogs with caudal lumbar intervertebral disc extrusion causing tail dysfunction, urinary and/or faecal incontinence were included. Urinary continence was recovered in 12 (86%) of 14 affected dogs, faecal continence recovered in nine (90%) of 10 affected dogs and tail function recovered in 13 (87%) of 15 affected dogs. Loss of tail nociception was recorded in three dogs on presentation; two made a full recovery and one showed mild persistent tail paresis. Clinical Significance The prognosis for functional recovery of urinary continence, faecal continence and tail function in ambulatory dogs with caudal lumbar intervertebral disc extrusion following surgical treatment is good. Larger studies are needed to identify prognostic factors associated with failure of recovery.
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Affiliation(s)
- R Pfund
- Department of Veterinary Clinical Science and Services, Royal Veterinary College, University of London, Hawkshead Lane, North Mymms, Herts, AL9 7TA, UK
| | - A K Forward
- Department of Neurology and Neurosurgery, Davies Veterinary Specialists, Manor Farm Business Park, Higham Gobion, Hitchin, SG5 3HR, UK
| | - R Fentem
- Department of Veterinary Science, Small Animal Teaching Hospital, University of Liverpool, Neston, Cheshire, CH64 7TE, UK
| | - A Nagendran
- Department of Veterinary Science, Small Animal Teaching Hospital, University of Liverpool, Neston, Cheshire, CH64 7TE, UK
| | - A R Fraser
- Department of Neurology and Neurosurgery, Anderson Moores Veterinary Specialists, Hursley, Winchester, SO21 2LL, UK
| | - A H Crawford
- Department of Veterinary Clinical Science and Services, Royal Veterinary College, University of London, Hawkshead Lane, North Mymms, Herts, AL9 7TA, UK
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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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Biercher A, Meller S, Wendt J, Caspari N, Schmidt-Mosig J, De Decker S, Volk HA. Using Deep Learning to Detect Spinal Cord Diseases on Thoracolumbar Magnetic Resonance Images of Dogs. Front Vet Sci 2021; 8:721167. [PMID: 34796224 PMCID: PMC8593183 DOI: 10.3389/fvets.2021.721167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 10/08/2021] [Indexed: 12/12/2022] Open
Abstract
Deep Learning based Convolutional Neural Networks (CNNs) are the state-of-the-art machine learning technique with medical image data. They have the ability to process large amounts of data and learn image features directly from the raw data. Based on their training, these networks are ultimately able to classify unknown data and make predictions. Magnetic resonance imaging (MRI) is the imaging modality of choice for many spinal cord disorders. Proper interpretation requires time and expertise from radiologists, so there is great interest in using artificial intelligence to more quickly interpret and diagnose medical imaging data. In this study, a CNN was trained and tested using thoracolumbar MR images from 500 dogs. T1- and T2-weighted MR images in sagittal and transverse planes were used. The network was trained with unremarkable images as well as with images showing the following spinal cord pathologies: intervertebral disc extrusion (IVDE), intervertebral disc protrusion (IVDP), fibrocartilaginous embolism (FCE)/acute non-compressive nucleus pulposus extrusion (ANNPE), syringomyelia and neoplasia. 2,693 MR images from 375 dogs were used for network training. The network was tested using 7,695 MR images from 125 dogs. The network performed best in detecting IVDPs on sagittal T1-weighted images, with a sensitivity of 100% and specificity of 95.1%. The network also performed very well in detecting IVDEs, especially on sagittal T2-weighted images, with a sensitivity of 90.8% and specificity of 98.98%. The network detected FCEs and ANNPEs with a sensitivity of 62.22% and a specificity of 97.90% on sagittal T2-weighted images and with a sensitivity of 91% and a specificity of 90% on transverse T2-weighted images. In detecting neoplasms and syringomyelia, the CNN did not perform well because of insufficient training data or because the network had problems differentiating different hyperintensities on T2-weighted images and thus made incorrect predictions. This study has shown that it is possible to train a CNN in terms of recognizing and differentiating various spinal cord pathologies on canine MR images. CNNs therefore have great potential to act as a “second eye” for imagers in the future, providing a faster focus on the altered image area and thus increasing workflow in radiology.
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Affiliation(s)
- Anika Biercher
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine, Hannover, Germany
| | - Sebastian Meller
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine, Hannover, Germany
| | - Jakob Wendt
- Caspari, Schmidt-Mosig u. Wendt-vetvise GbR, Hannover, Germany
| | - Norman Caspari
- Caspari, Schmidt-Mosig u. Wendt-vetvise GbR, Hannover, Germany
| | | | - Steven De Decker
- Department of Clinical Science and Services, Royal Veterinary College, London, United Kingdom
| | - Holger Andreas Volk
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine, Hannover, Germany
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12
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Santifort K, Pijnenburg J, Beukers M, Bergmann W, Bergknut N. An unusual case of intervertebral disc extrusion in a dog. VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.97] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Koen Santifort
- Evidensia Small Animal Hospital Arnhem Arnhem The Netherlands
- Evidensia Small Animal Hospital ‘Hart van Brabant’ Waalwijk The Netherlands
| | | | | | - Wilhelmina Bergmann
- Division of Pathology Faculty of Veterinary Medicine, Utrecht University Utrecht The Netherlands
| | - Niklas Bergknut
- Evidensia Small Animal Hospital ‘Hart van Brabant’ Waalwijk The Netherlands
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13
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Bonelli MDA, da Costa LBDSBC, da Costa RC. Magnetic resonance imaging and neurological findings in dogs with disc-associated cervical spondylomyelopathy: a case series. BMC Vet Res 2021; 17:145. [PMID: 33827551 PMCID: PMC8025371 DOI: 10.1186/s12917-021-02846-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 03/22/2021] [Indexed: 11/10/2022] Open
Abstract
Background Canine cervical spondylomyelopathy can be separated into osseous and disc-associated (DA-CSM) forms. Our aim was to describe the magnetic resonance imaging (using a high-field scanner) and neurological findings in dogs with DA-CSM and investigate a relationship between these findings. Results Sixty-three dogs were included: 60/63 (95 %) were large breeds, with Doberman Pinschers and males over-represented (70 %). Mean and median age at the time of diagnosis was 7.25 and 7.2 years (range 0.41–12 years). Chronic signs were noted in 52/63 (83 %) dogs, with proprioceptive ataxia the most common. Main site of spinal cord compression was commonly C6-7 or C5-6. Thirty-six (57 %) dogs had various sites of spinal cord compression. Most dogs younger than 6 years of age had a single affected site. Foraminal stenosis was present in 51/63 dogs (81 %). T2-weighted hyperintensity was present in 40/63 dogs (63 %). 88 % of the articular processes showed degenerative changes, which correlated strongly with intervertebral disc degeneration. Ligamentum flavum hypertrophy was seen in 38 % of dogs. No correlation was observed between neurologic signs and number of affected sites. A moderate positive correlation was observed between severity of spinal cord compression and neurologic grade (r 0.48; p < 0.001). Conclusions DA-CSM was predominantly observed in older, male Dobermans, with lesions located in the caudal cervical vertebral region. It was also seen in dogs 3 years of age or even younger (8 %). Single compressive lesions were more common in dogs younger than 6 years of age. Many dogs had concomitant changes (e.g.: ligamentum flavum hypertrophy and foraminal stenosis). Most dogs with ligamentum flavum hypertrophy were 6 years or older. A positive correlation was observed between severity of spinal cord compression and neurologic grade, but multilevel compression was not associated with more severe neurologic signs. A very high percentage of dogs had articular process degenerative changes. Possible biomechanical or genetic relationships between degenerative changes in articular processes, ligamentum flavum, and intervertebral discs warrants further investigation.
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Affiliation(s)
- Marília de Albuquerque Bonelli
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon Tharp St, OH, 43210, Columbus, USA
| | | | - Ronaldo Casimiro da Costa
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon Tharp St, OH, 43210, Columbus, USA.
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14
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Bresciani L, Trevail R, Clarke S, Gutierrez-Quintana R, Behr S, Lazzerini K, Brocal J, Oxley B, Pink J, José-López R. Lumbosacral intervertebral disk extrusions in 13 dogs. Vet Surg 2021; 50:823-832. [PMID: 33749866 DOI: 10.1111/vsu.13624] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 06/13/2020] [Accepted: 08/31/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To describe the clinical presentation, magnetic resonance imaging (MRI) findings, and outcome of dogs treated surgically for lumbosacral intervertebral disk extrusion (IVDE). STUDY DESIGN Retrospective study. ANIMALS Thirteen dogs. METHODS Records and MRI studies of dogs with intraoperatively confirmed lumbosacral IVDE were reviewed. MRI features of thoracolumbar IVDE were applied to all cases. Postoperative outcome was subjectively assessed as excellent, good, or poor. RESULTS All dogs had an acute or subacute onset of lumbosacral pain and nerve root signature. Seven dogs had neurological deficits. MRI revealed lateralized herniated disk material and partial to complete disk degeneration in all cases; the extradural material extended cranial and/or caudally from the disk space in 10 cases. All dogs underwent L7-S1 dorsal laminectomy and removal of extruded disk material. In six dogs, surgery was complicated by inflammatory changes, including one case of epidural steatitis. On reexamination 4-6 weeks postsurgery, outcome was judged as excellent in 11 dogs and poor in the remaining 2 due to contralateral nerve root signature in one case and nonambulatory paraparesis and urinary incontinence in the case with steatitis. CONCLUSION Lumbosacral IVDE in dogs was characterized by acute/subacute onset of lumbosacral pain and nerve root signature and lateralized and often dispersed extradural material over a degenerated L7-S1 intervertebral disk on MRI. Early decompressive dorsal laminectomy generally resulted in excellent clinical outcome. CLINICAL SIGNIFICANCE Observation of these clinical and imaging features in dogs should prompt clinical suspicion of lumbosacral IVDE.
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Affiliation(s)
- Luca Bresciani
- Small Animal Hospital, School of Veterinary Medicine, University of Glasgow, Glasgow, UK
| | | | | | | | | | - Kali Lazzerini
- Small Animal Hospital, School of Veterinary Medicine, University of Glasgow, Glasgow, UK
| | - Josep Brocal
- Small Animal Hospital, School of Veterinary Medicine, University of Glasgow, Glasgow, UK
| | | | | | - Roberto José-López
- Small Animal Hospital, School of Veterinary Medicine, University of Glasgow, Glasgow, UK
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15
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Longo S, Gomes SA, Briola C, Duffy K, Targett M, Jeffery ND, Freeman P. Association of magnetic resonance assessed disc degeneration and late clinical recurrence in dogs treated surgically for thoracolumbar intervertebral disc extrusions. J Vet Intern Med 2021; 35:378-387. [PMID: 33283382 PMCID: PMC7848362 DOI: 10.1111/jvim.15989] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 11/16/2020] [Accepted: 11/20/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Radiographic signs of intervertebral disc mineralization are thought to indicate sites of future recurrence of disc extrusion (Hansen type I) but the relationship between evidence of disc degeneration on magnetic resonance imaging (MRI) and future disc extrusion with recurrence of clinical signs has not been examined. OBJECTIVES To examine the relationship between MRI-assessed degeneration of thoracolumbar intervertebral discs and late recurrence of clinical signs in dogs presented with acute thoracolumbar intervertebral disc extrusion and treated by hemilaminectomy alone. ANIMALS Ninety-two client-owned dogs presented to 2 referral hospitals between 2009 and 2014. METHODS Retrospective analysis of association between clinical signs consistent with recurrent thoracolumbar intervertebral disc extrusion and MRI evidence of disc degeneration in dogs undergoing hemilaminectomy for acute thoracolumbar intervertebral disc extrusion. Univariable and multivariable Cox regression analyses were used to explore associations between recurrence of clinical signs and several characteristics of T10-L3 discs at initial diagnosis. RESULTS Ninety-two cases were included, of which 42 (46%) were Dachshunds and median age was 5.3 years. Clinical signs recurred in 33/92 (36%) dogs. Finding a completely degenerate disc in the T10 to L3 region (in addition to the operated site) at the time of surgery was associated with a hazard ratio of 2.92 (95% confidence interval: 1.37-6.20) for recurrence of clinical signs. CONCLUSIONS AND CLINICAL IMPORTANCE Our results suggest that in cases of thoracolumbar intervertebral disc extrusion in dogs, recurrence of signs is likely if at least 1 completely degenerate disc in addition to the currently symptomatic disc is visible on MRI.
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Affiliation(s)
| | | | - Chiara Briola
- The Queen's Veterinary School Hospital, Department of Clinical Veterinary MedicineUniversity of CambridgeCambridgeUK
| | - Katherine Duffy
- School of Veterinary Medicine and Science, University of NottinghamLeicestershireUK
| | - Mike Targett
- School of Veterinary Medicine and Science, University of NottinghamLeicestershireUK
| | - Nick D. Jeffery
- Department of Small Animal Clinical SciencesTexas A&M UniversityCollege StationTexasUSA
| | - Paul Freeman
- The Queen's Veterinary School Hospital, Department of Clinical Veterinary MedicineUniversity of CambridgeCambridgeUK
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16
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DiVita MM, Bray KY, Williams LM, Traslavina RP. What Is Your Neurologic Diagnosis? J Am Vet Med Assoc 2020; 256:981-983. [PMID: 32301659 DOI: 10.2460/javma.256.9.981] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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17
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da Costa RC, De Decker S, Lewis MJ, Volk H. Diagnostic Imaging in Intervertebral Disc Disease. Front Vet Sci 2020; 7:588338. [PMID: 33195623 PMCID: PMC7642913 DOI: 10.3389/fvets.2020.588338] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 09/09/2020] [Indexed: 12/27/2022] Open
Abstract
Imaging is integral in the diagnosis of canine intervertebral disc disease (IVDD) and in differentiating subtypes of intervertebral disc herniation (IVDH). These include intervertebral disc extrusion (IVDE), intervertebral disc protrusion (IVDP) and more recently recognized forms such as acute non-compressive nucleus pulposus extrusion (ANNPE), hydrated nucleus pulposus extrusion (HNPE), and intradural/intramedullary intervertebral disc extrusion (IIVDE). Many imaging techniques have been described in dogs with roles for survey radiographs, myelography, computed tomography (CT), and magnetic resonance imaging (MRI). Given how common IVDH is in dogs, a thorough understanding of the indications and limitations for each imaging modality to aid in diagnosis, treatment planning and prognosis is essential to successful case management. While radiographs can provide useful information, especially for identifying intervertebral disc degeneration or calcification, there are notable limitations. Myelography addresses some of the constraints of survey radiographs but has largely been supplanted by cross-sectional imaging. Computed tomography with or without myelography and MRI is currently utilized most widely and have become the focus of most contemporary studies on this subject. Novel advanced imaging applications are being explored in dogs but are not yet routinely performed in clinical patients. The following review will provide a comprehensive overview on common imaging modalities reported to aid in the diagnosis of IVDH including IVDE, IVDP, ANNPE, HNPE, and IIVDE. The review focuses primarily on canine IVDH due to its frequency and vast literature as opposed to feline IVDH.
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Affiliation(s)
- Ronaldo C da Costa
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH, United States
| | - Steven De Decker
- Department of Clinical Sciences and Services, Royal Veterinary College, London, United Kingdom
| | - Melissa J Lewis
- Department of Veterinary Clinical Sciences, Purdue University College of Veterinary Medicine, West Lafayette, IN, United States
| | - Holger Volk
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hanover, Hanover, Germany
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18
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Fenn J, Olby NJ. Classification of Intervertebral Disc Disease. Front Vet Sci 2020; 7:579025. [PMID: 33134360 PMCID: PMC7572860 DOI: 10.3389/fvets.2020.579025] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 08/24/2020] [Indexed: 12/24/2022] Open
Abstract
Intervertebral disc disease (IVDD) has been recognized in dogs since the 1800s, when the first descriptions of extruded disc material within the vertebral canal were published. In the intervening time our understanding of intervertebral disc pathology in dogs and cats has increased dramatically, with many variations of IVDD described. Whilst the volume of literature and collective understanding of IVDD has expanded, there has also been scope for confusion as the definition of intervertebral disc disease, with its myriad different manifestations, becomes more complicated. A large volume of literature has aimed to combine the use of histopathology, diagnostic imaging and clinical findings to better understand the various ways in which IVDD can be classified. Much of this research has focused on the classification of mechanisms of intervertebral disc degeneration, centering around the differences between, and overlaps in, IVDD in chondrodystrophic and non-chondrodystrophic dog breeds. However, with the increasing availability of advanced imaging modalities allowing more accurate antemortem diagnosis, the concept of IVDD has expanded to include other clinical presentations that may not fit into traditional models of classification of IVDD. This review aims to provide an up to date overview of both historical and current systems of IVDD classification, highlighting the important findings and controversies underpinning them.
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Affiliation(s)
- Joe Fenn
- Department of Clinical Science and Services, Royal Veterinary College, London, United Kingdom
| | - Natasha J Olby
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
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19
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Lourinho F, Holdsworth A, McConnell JF, Gonçalves R, Gutierrez-Quintana R, Morales C, Lowrie M, Trevail R, Carrera I. Clinical features and MRI characteristics of presumptive constrictive myelopathy in 27 pugs. Vet Radiol Ultrasound 2020; 61:545-554. [PMID: 32583954 DOI: 10.1111/vru.12890] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 01/30/2020] [Accepted: 04/02/2020] [Indexed: 02/05/2023] Open
Abstract
Constrictive myelopathy has been described in pugs with paraparesis and is characterized by fibrous connective and granulation tissue within the dura mater causing spinal cord compression and focal gliosis. An association between constrictive myelopathy and caudal articular process (CAP) dysplasia is suspected; however, some studies have reported CAP dysplasia as an incidental finding. The imaging appearance of constrictive myelopathy is currently limited to a small number of cases. The aim of this multicenter, retrospective, descriptive study was to detail the magnetic resonance imaging (MRI) characteristics and to correlate these with clinical signs of presumptive constrictive myelopathy in pugs. Medical databases from five veterinary referral hospitals were reviewed to identify pugs with pelvic limb ataxia and paresis, that had a complete record of signalment, neurological examination, and MRI of the thoracolumbar spinal cord. The exclusion criteria were pugs with other conditions, such as unequivocal subarachnoid diverticula, hemivertebrae causing vertebral canal stenosis, intervertebral disc extrusions/protrusions, and multifocal/diffuse lesions. Twenty-seven pugs met the inclusion criteria. All cases were ambulatory with paraparesis and ataxia. Nearly 60% were incontinent. Magnetic resonance imaging revealed a focal myelopathy in all cases showing one or more of the following lesions: CAP dysplasia (25/27), focal subarachnoid space irregular margination (26/27) with circumferential or dorsal contrast enhancement (10/12), and a symmetric V-shaped ventral extradural lesion (23/27). This study describes specific MRI features of pugs with presumptive constrictive myelopathy, which authors hypothesize to be a consequence of chronic micro-motion. Our results may help in diagnosing and subsequently treating this condition, which may warrant vertebral stabilization.
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Affiliation(s)
| | | | - J Fraser McConnell
- Department of Veterinary Science, Small Animal Teaching Hospital, University of Liverpool, Liverpool, UK
| | - Rita Gonçalves
- Department of Veterinary Science, Small Animal Teaching Hospital, University of Liverpool, Liverpool, UK
| | | | - Carles Morales
- Department of Neurology and Neurosurgery, Ars Veterinary Hospital, Barcelona, Spain
| | - Mark Lowrie
- Department of Neurology and Neurosurgery, Dovecote Veterinary Hospital, Derby, UK
| | | | - Ines Carrera
- Radiology Department, Willows Referral Centre, Solihull, UK
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20
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Lampe R, Foss KD, Hague DW, Oliveira CR, Smith R. Dynamic MRI is reliable for evaluation of the lumbosacral spine in healthy dogs. Vet Radiol Ultrasound 2020; 61:555-565. [PMID: 32574428 DOI: 10.1111/vru.12891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 03/31/2020] [Accepted: 04/02/2020] [Indexed: 11/29/2022] Open
Abstract
Magnetic resonance imaging (MRI) is commonly used to diagnose degenerative lumbosacral stenosis; however, studies show limited correlation between imaging and clinical signs. The purpose of this prospective observer agreement study was to use dynamic MRI of the lumbosacral (LS) spine of healthy dogs to determine reliable reference ranges. Twenty-two healthy large breed dogs were prospectively enrolled. MRI of the LS spine was performed in T2-weighted, T1-weighted, and T2-weighted SPACE sequences in neutral, flexed, and extended positions. Four observers performed image analyses. Measurements included LS angle, vertebral canal height and area, and LS foraminal areas. Ordinal categorical assessment of loss of fat signal in the foramina, LS compression, intervertebral disc (IVD) degeneration, spondylosis, and IVD protrusion was also performed. The majority of values were significantly larger in flexion versus neutral position, and significantly smaller in extension versus neutral position (P < .05). Subclinical compression and IVD protrusion was noted in a neutral position in 45% and 55% of dogs and in an extended position in 85% and 73% of dogs, respectively. Interobserver agreement was strong (intracluster correlation coefficient [ICC] > .5) except for the L7:LS vertebral canal area ratio (ICC ≤ .03). Intraobserver agreement was high (rho > .5) for all measurements except for the mid-L6:LS vertebral canal height ratio (rho = .38). There was poor interobserver agreement for loss of fat signal in the foramina and evidence of compression. This study provides the groundwork for future studies using dynamic MRI to evaluate dogs with signs of clinical LS disease.
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Affiliation(s)
- Rachel Lampe
- Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Kari D Foss
- Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Devon W Hague
- Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Cintia R Oliveira
- Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Rebecca Smith
- Department of Veterinary, Pathobiology, University of Illinois at Urbana-Champaign, Urbana, Illinois
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21
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Crowe YC, Child G, Lam R, McGregor R. Congenital block vertebrae and intervertebral disc protrusion in a young cat. JFMS Open Rep 2019; 5:2055116919868037. [PMID: 31448128 PMCID: PMC6693030 DOI: 10.1177/2055116919868037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Case summary A 6-month-old domestic shorthair cat was evaluated for proprioceptive ataxia of the pelvic limbs. Over 2 months, the cat became poorly ambulatory, paraparetic with proprioceptive ataxia and developed a firm, distended bladder with intermittent overflow urinary incontinence. Block vertebrae (T1-3, T4-5 and T10-11) and lordosis were identified on radiographs of the vertebral column. MRI revealed T3/4 intervertebral disc protrusion with severe extradural compression, secondary syringohydromyelia caudal to the protrusion and generalised intervertebral disc disease throughout the cervical and thoracic vertebrae. Dorsal laminectomy at T3/4 resulted in resolution of paraparesis and marked improvement in coordination and strength. Block vertebrae are usually considered an incidental finding. In this patient, angular deformation (lordosis) and adjacent segment disease probably contributed to clinically significant intervertebral disc degeneration and protrusion. Relevance and novel information There are few case reports in the literature of multiple congenital vertebral malformations causing neurological deficits in cats. This is the first reported case of successful surgical management of intervertebral disc protrusion, possibly secondary to block vertebrae and lordosis in a cat.
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Affiliation(s)
| | | | - Richard Lam
- Small Animal Specialist Hospital, Sydney, Australia
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22
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Guevar J, Olby N. Minimally invasive microsurgical decompression of an intervertebral disc protrusion in a dog. Vet Surg 2019; 49 Suppl 1:O86-O92. [PMID: 31237005 DOI: 10.1111/vsu.13263] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 04/10/2019] [Accepted: 05/19/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To report the successful treatment of intervertebral disc protrusion with minimally invasive microsurgery in a large breed dog. STUDY DESIGN Retrospective case report. ANIMAL A 4-year-old, neutered male, German shepherd dog presented with chronic progressive ambulatory paraparesis and thoracolumbar pain; lumbar intervertebral disc protrusion and severe spinal cord compression at L2-L3 were diagnosed. METHODS A minimally invasive approach was used to access the target surgical area by using a muscle splitting technique and retractors. Intraoperative fluoroscopy confirmed correct placement. Magnification and illumination through a surgical microscope were used (microsurgery) to perform the spinal cord decompression by means of a foraminotomy and lateral corpectomy. RESULTS Technically, the combination of fluoroscopy and muscle splitting approach offered adequate minimally invasive access. Microsurgery allowed for precise and efficient spinal cord decompression. Clinically, no immediate postoperative neurological deterioration was observed. Opioid usage was limited to 24 hours postoperatively. Focal muscle swelling was observed postoperatively for 2 days, and hospital stay was 3 days. At 7 weeks postoperatively, neurological examination results were normal, and postoperative MRI confirmed spinal cord decompression. No complications were reported. CONCLUSION The procedure was associated with a small incision, limited muscle trauma, early improvement of the neurological status, a short hospital stay, and limited postoperative pain. CLINICAL SIGNIFICANCE This case provides evidence that minimally invasive microsurgery is an effective treatment for intervertebral disc protrusion in large breed dogs and may offer benefits regarding postoperative pain and functional recovery.
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Affiliation(s)
- Julien Guevar
- University of Wisconsin-Madison, School of Veterinary Medicine, Madison, Wisconsin
| | - Natasha Olby
- North Carolina State University, College of Veterinary Medicine, Raleigh, North Carolina
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23
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Wyatt S, De Risio L, Driver C, José-López R, Pivetta M, Beltran E. Neurological signs and MRI findings in 12 dogs with multiple myeloma. Vet Radiol Ultrasound 2019; 60:409-415. [PMID: 31056799 DOI: 10.1111/vru.12759] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 03/03/2019] [Accepted: 03/03/2019] [Indexed: 12/18/2022] Open
Abstract
Vertebral lesions and associated neurological signs occur in dogs with multiple myeloma, however, veterinary literature describing MRI findings is currently lacking. The objective of this multicenter, retrospective, case series study was to describe neurological signs and MRI findings in a group of dogs that presented for spinal pain or other neurological deficits and had multiple myeloma. Electronic records of four veterinary referral hospitals were reviewed. Dogs were included if they had a pathologically confirmed diagnosis of multiple myeloma, had presented for spinal pain or other neurological signs, and had undergone MRI of the vertebral column. The MRI studies were evaluated and the anatomical location of lesion(s), signal intensity, presence of extra-dural material, degree of spinal cord compression, extent of vertebral lesions, and contrast enhancement were recorded. Twelve dogs met inclusion criteria. Most dogs (n = 8) had a chronic progressive history, with varying degrees of proprioceptive ataxia and paresis (n = 11), and spinal pain was a feature in all dogs. The MRI findings were variable but more consistent features included the presence of multiple expansile vertebral lesions without extension beyond the outer cortical limits of affected vertebrae, and associated extradural material causing spinal cord compression. The majority of lesions were hyper- to isointense on T2 (n = 12) and T1-weighted (n = 8) sequences, with variable but homogeneous contrast-enhancement (n = 12). These described MRI characteristics of multiple myeloma may be used to aid early identification and guide subsequent confirmatory diagnostic steps, to ultimately improve therapeutic approach and long-term outcome.
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Affiliation(s)
- Sophie Wyatt
- Department of Veterinary Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, UK
| | - Luisa De Risio
- Department of Neurology and Neurosurgery, Animal Health Trust, Newmarket, UK
| | | | | | - Mauro Pivetta
- Department of Veterinary Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, UK
| | - Elsa Beltran
- Department of Veterinary Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, UK
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24
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Mateo I, Vet L, Paniagua R, Vet G, Cloquell A, Vet L, Vazquez F, Vet L. Intervertebral T3-T4 Disc Extrusions in Two German Shepherd Dogs. J Am Anim Hosp Assoc 2019; 55:e55303. [PMID: 30870609 DOI: 10.5326/jaaha-ms-6883] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Although intervertebral disc extrusions are extremely frequent in dogs, those affecting the cranial thoracic spine in large-breed dogs have not been reported. In this case report, the clinical, radiological, surgical, and histopathological findings in two German shepherd dogs with T3-T4 disc extrusions are reported. Clinical and imaging findings (acute onset and radiological evidence of lateralized disc material dispersed beyond the margins of the intervertebral disc space) allowed proper diagnosis of disc extrusion. Decompressive surgery via hemilaminectomy was performed in both patients with favorable outcomes. Intervertebral disc extrusions should be considered as a differential diagnosis of large-breed dogs with acute onset, upper-thoracic spinal cord disease. Imaging findings can aid in differentiating thoracic intervertebral disc extrusions from protrusions, thus leading to appropriate treatment.
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Affiliation(s)
- Isidro Mateo
- From Hospital Clínico Veterinario, Universidad Alfonso X el Sabio, Madrid, Spain
| | - Lic Vet
- From Hospital Clínico Veterinario, Universidad Alfonso X el Sabio, Madrid, Spain
| | - Rocio Paniagua
- From Hospital Clínico Veterinario, Universidad Alfonso X el Sabio, Madrid, Spain
| | - Grado Vet
- From Hospital Clínico Veterinario, Universidad Alfonso X el Sabio, Madrid, Spain
| | - Ana Cloquell
- From Hospital Clínico Veterinario, Universidad Alfonso X el Sabio, Madrid, Spain
| | - Lic Vet
- From Hospital Clínico Veterinario, Universidad Alfonso X el Sabio, Madrid, Spain
| | - Fernando Vazquez
- From Hospital Clínico Veterinario, Universidad Alfonso X el Sabio, Madrid, Spain
| | - Lic Vet
- From Hospital Clínico Veterinario, Universidad Alfonso X el Sabio, Madrid, Spain
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25
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Hamilton‐Bennett SE, Behr S. Clinical presentation, magnetic resonance imaging features, and outcome in 6 cats with lumbar degenerative intervertebral disc extrusion treated with hemilaminectomy. Vet Surg 2019; 48:556-562. [PMID: 30828827 DOI: 10.1111/vsu.13182] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 05/09/2018] [Accepted: 06/04/2018] [Indexed: 11/27/2022]
Affiliation(s)
| | - Sebastien Behr
- Neurology‐Neurosurgery ServiceWillows Referral Service Solihull West Midlands United Kingdom
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26
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Inglez de Souza MCCM, Ryan R, ter Haar G, Packer RMA, Volk HA, De Decker S. Evaluation of the influence of kyphosis and scoliosis on intervertebral disc extrusion in French bulldogs. BMC Vet Res 2018; 14:5. [PMID: 29304802 PMCID: PMC5756331 DOI: 10.1186/s12917-017-1316-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 12/08/2017] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Although thoracic vertebral malformations with kyphosis and scoliosis are often considered incidental findings on diagnostic imaging studies of screw-tailed brachycephalic breeds, they have been suggested to interfere with spinal biomechanics and intervertebral disc degeneration. It is however unknown if an abnormal spinal curvature also predisposes dogs to develop clinically relevant intervertebral disc herniations. The aim of this study was to evaluate if the occurrence of thoracic vertebral malformations, kyphosis or scoliosis would be associated with a higher prevalence of cervical or thoracolumbar intervertebral disc extrusion in French bulldogs. RESULTS French bulldogs that underwent computed tomography for reasons unrelated to spinal disease (n = 101), and French bulldogs with thoracolumbar (n = 47) or cervical intervertebral disc extrusion (n = 30) that underwent magnetic resonance imaging were included. There was a significant association between the presence of kyphosis and the occurrence of intervertebral disc extrusion, particularly in the thoracolumbar region. Dogs with kyphosis were at nearly a two times increased odds of being affected by intervertebral disc extrusion than those without kyphosis [(OR = 1.98 (95% CI: 1.04-3.78)]. There was also an association between the presence of scoliosis and the anatomical distribution of intervertebral disc extrusions, with dogs with scoliosis more likely to have more caudal lumbar intervertebral disc extrusions. Presence of scoliosis was not associated with an increased odds of being affected by intervertebral disc extrusion. CONCLUSIONS Although thoracic vertebral malformations with kyphosis only rarely cause spinal cord dysfunction in itself, French bulldogs with kyphosis appear to be at higher risk to develop thoracolumbar intervertebral disc extrusion.
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Affiliation(s)
- Maria Claudia C. M. Inglez de Souza
- Department of Surgery, University of São Paulo-School of Veterinary Medicine and Animal Science, Av. Prof. Dr. Orlando Marques de Paiva, 87, São Paulo, Cidade Universitária Brazil
- Department of Clinical Science and Services, Royal Veterinary College, University of London, Hawkshead lane, AL9 7TA North Mymms, Hatfield, UK
| | - Richard Ryan
- Department of Clinical Science and Services, Royal Veterinary College, University of London, Hawkshead lane, AL9 7TA North Mymms, Hatfield, UK
| | - Gert ter Haar
- Department of Clinical Science and Services, Royal Veterinary College, University of London, Hawkshead lane, AL9 7TA North Mymms, Hatfield, UK
| | - Rowena M. A. Packer
- Department of Clinical Science and Services, Royal Veterinary College, University of London, Hawkshead lane, AL9 7TA North Mymms, Hatfield, UK
| | - Holger A. Volk
- Department of Clinical Science and Services, Royal Veterinary College, University of London, Hawkshead lane, AL9 7TA North Mymms, Hatfield, UK
| | - Steven De Decker
- Department of Clinical Science and Services, Royal Veterinary College, University of London, Hawkshead lane, AL9 7TA North Mymms, Hatfield, UK
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Mayousse V, Desquilbet L, Jeandel A, Blot S. Prevalence of neurological disorders in French bulldog: a retrospective study of 343 cases (2002-2016). BMC Vet Res 2017; 13:212. [PMID: 28676057 PMCID: PMC5497356 DOI: 10.1186/s12917-017-1132-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 06/26/2017] [Indexed: 12/18/2022] Open
Abstract
Background French Bulldog (FB) has significantly gained in popularity over the last few years, and seems to be frequently affected by various neurological conditions. The purpose of this retrospective study was to report the prevalences of neurological diseases in a large population of FB, presented with neurological signs between 2002 and 2016, and for which a definitive diagnosis was established. A secondary objective was to identify epidemiological characteristics regarding specific diseases in this singular breed. Results During the study period, 533 FBs were presented for neurological signs, representing 18.7% of all admitted FBs (N = 2846). In total, 343 FBs with definitive diagnosis were included in this descriptive epidemiological study. Hansen type I intervertebral disk herniation (IVDH) was by far the most common neurological disorder (45.5% of all cases). The IVDH location was cervical in 39.8%, and thoracolumbar in 60.2% of cases. The median ages for cervical and thoracolumbar IVDH were 4.2 and 4 years, respectively. C3-C4 was the most commonly affected disk (57.8% of cervical IDVH) all locations combined. Spinal arachnoid diverticulum (SAD) was detected in 25 FBs, representing the second most common myelopathy (11.3%). A concurrent spinal abnormality was identified in 64.0% of SAD cases. Brain tumours represented 36.8% of encephalopathies, with glioma (confirmed or suspected) being the most common. Meningoencephalitis of unknown origin (MUO) represented 25.0% of brain disorders, females less than 5.5 years being more likely to be affected. Aside from central nervous system conditions, otitis interna associated with peripheral vestibular signs and bilateral congenital deafness (associated with white coat) were also common. Conclusions The findings of this study suggest that FB seems to be prone to several neurological diseases. IVDH is clearly predominant in FB and cervical location seems more represented than in other breeds. FBs affected by IVDH tend to be younger than previously described, either for both cervical and thoracolumbar locations. Thoracic SAD was the second most common myelopathy, with a concurrent spinal anomaly identified in two thirds of the cases. MUO was more likely to affect young to middle-aged females. These findings could be of interest for owners, breeders, practicing veterinarians and insurance companies.
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Affiliation(s)
- Vincent Mayousse
- Université Paris-Est, Ecole Nationale Vétérinaire d'Alfort (EnvA), Unité de Neurologie, 7 avenue du général de Gaulle, 94700, Maisons-Alfort, France. .,Inserm, IMRB U955-E10, 8 rue du général Sarrail, 94000, Créteil, France. .,UMR BNMS Neurobiologie, Ecole Nationale Veterinaire d'Alfort, 7 avenue du General de Gaulle, 94700, Maisons Alfort, France.
| | - Loïc Desquilbet
- Université Paris-Est, Ecole Nationale Vétérinaire d'Alfort (EnvA), Unité de Biostatistiques et d'Epidémiologie Clinique, 7 avenue du général de Gaulle, 94700, Maisons-Alfort, France
| | - Aurélien Jeandel
- Université Paris-Est, Ecole Nationale Vétérinaire d'Alfort (EnvA), Unité de Neurologie, 7 avenue du général de Gaulle, 94700, Maisons-Alfort, France.,Present adress: Davies Veterinary Specialists, Manor Farm Buisiness Park, Higham Gobion, Herts, SG5 3HR, United Kingdom
| | - Stéphane Blot
- Université Paris-Est, Ecole Nationale Vétérinaire d'Alfort (EnvA), Unité de Neurologie, 7 avenue du général de Gaulle, 94700, Maisons-Alfort, France.,Inserm, IMRB U955-E10, 8 rue du général Sarrail, 94000, Créteil, France.,UMR BNMS Neurobiologie, Ecole Nationale Veterinaire d'Alfort, 7 avenue du General de Gaulle, 94700, Maisons Alfort, France
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Crawford AH, De Decker S. Clinical presentation and outcome of dogs treated medically or surgically for thoracolumbar intervertebral disc protrusion. Vet Rec 2017; 180:569. [PMID: 28283670 DOI: 10.1136/vr.103871] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2017] [Indexed: 11/04/2022]
Abstract
To date, few studies have investigated the clinical characteristics of thoracolumbar intervertebral disc protrusion (IVDP). The aim of this retrospective study was to evaluate the presentation and outcome of dogs receiving medical or surgical treatment for thoracolumbar IVDP. Eighty-four dogs were included, with a median age of 9.4 years. German shepherd dogs and Staffordshire bull terriers were the most common breeds. Significantly more surgically treated dogs (n=53) had neurological deficits and were non-ambulatory, compared with medically treated (n=31). Outcome data were available for 27 of 31 medically managed dogs; 11 initially improved, 7 remained stable and 9 deteriorated. Of 18 dogs that initially improved or stabilised, 10 (55.6 per cent) demonstrated recurrence of clinical signs within 12 months of diagnosis. Outcome data were available for 45 of 50 surgically treated dogs that survived to hospital discharge; 34 improved, 9 remained stable and 2 deteriorated following surgery. Of 43 dogs that improved or stabilised with surgical treatment, 11 (25.6 per cent) demonstrated recurrence of clinical signs within 12 months of surgery. Overall, significantly more surgically treated dogs (71.1 per cent) had a successful outcome, consisting of sustained clinical improvement of more than 12 months duration, compared with medically treated dogs (29.6 per cent).
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Affiliation(s)
- A H Crawford
- Department of Clinical Science and Services, Queen Mother Hospital for Animals, Royal Veterinary College, University of London, Hatfield, UK
| | - S De Decker
- Department of Clinical Science and Services, Queen Mother Hospital for Animals, Royal Veterinary College, University of London, Hatfield, UK
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De Decker S, Warner AS, Volk HA. Prevalence and breed predisposition for thoracolumbar intervertebral disc disease in cats. J Feline Med Surg 2016; 19:419-423. [DOI: 10.1177/1098612x16630358] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives The objective was to evaluate the prevalence and possible breed predilections for thoracolumbar intervertebral disc disease (IVDD) in cats. Methods Medical records and imaging studies of cats diagnosed with thoracolumbar IVDD between January 2008 and August 2014 were retrospectively reviewed and compared with the general hospital population. The association between type of IVDD (ie, intervertebral disc extrusion [IVDE] or intervertebral disc protrusion [IVDP]) and breed, age, sex, and duration and severity of clinical signs was also evaluated. Results Of 12,900 cats presented during the study period, 31 (0.24%) were diagnosed with IVDD, including 17 purebred and 14 non-purebred cats. Of all presented purebred cats, 0.52% were diagnosed with thoracolumbar IVDD. More specifically, 1.29% of all British Shorthairs and 1.83% of all presented Persians were diagnosed with IVDD. Compared with the general hospital population, purebred cats ( P = 0.0001), British Shorthairs ( P <0.0001) and Persians ( P = 0.0006) were significantly overrepresented with thoracolumbar IVDD. Affected purebred cats were younger than affected non-purebred cats ( P = 0.02). Of 31 cats with IVDD, 19 were diagnosed with IVDE and 12 with IVDP. Cats with IVDE had a significantly shorter duration of clinical signs ( P = 0.0002) and demonstrated more severe neurological deficits ( P = 0.04) than cats with IVDP. Conclusions and relevance Although thoracolumbar IVDD is an uncommon condition in cats, purebred cats, British Shorthairs and Persians, were overrepresented. It is currently unclear if this represents a true breed predisposition or a higher likelihood of owners of purebred cats seeking referral for advanced diagnostic imaging procedures.
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Affiliation(s)
| | - Anne-Sophie Warner
- Current address: Rhodes Veterinary Surgery, Kingsthorpe, Northampton, UK
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De Decker S, Gomes SA, Packer RMA, Kenny PJ, Beltran E, Parzefall B, Fenn J, Nair D, Nye G, Volk HA. EVALUATION OF MAGNETIC RESONANCE IMAGING GUIDELINES FOR DIFFERENTIATION BETWEEN THORACOLUMBAR INTERVERTEBRAL DISK EXTRUSIONS AND INTERVERTEBRAL DISK PROTRUSIONS IN DOGS. Vet Radiol Ultrasound 2016; 57:526-33. [DOI: 10.1111/vru.12394] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 04/04/2016] [Accepted: 05/25/2016] [Indexed: 11/30/2022] Open
Affiliation(s)
- Steven De Decker
- Department of Veterinary Clinical Science and Services; Royal Veterinary College; University of London; Hawkshead lane, AL9 7TA North Mymms Hatfield England
| | - Sergio A. Gomes
- Department of Veterinary Clinical Science and Services; Royal Veterinary College; University of London; Hawkshead lane, AL9 7TA North Mymms Hatfield England
| | - Rowena MA Packer
- Department of Veterinary Clinical Science and Services; Royal Veterinary College; University of London; Hawkshead lane, AL9 7TA North Mymms Hatfield England
| | - Patrick J. Kenny
- Department of Veterinary Clinical Science and Services; Royal Veterinary College; University of London; Hawkshead lane, AL9 7TA North Mymms Hatfield England
| | - Elsa Beltran
- Department of Veterinary Clinical Science and Services; Royal Veterinary College; University of London; Hawkshead lane, AL9 7TA North Mymms Hatfield England
| | - Birgit Parzefall
- Department of Veterinary Clinical Science and Services; Royal Veterinary College; University of London; Hawkshead lane, AL9 7TA North Mymms Hatfield England
| | - Joe Fenn
- Department of Veterinary Clinical Science and Services; Royal Veterinary College; University of London; Hawkshead lane, AL9 7TA North Mymms Hatfield England
| | - Devi Nair
- Department of Veterinary Clinical Science and Services; Royal Veterinary College; University of London; Hawkshead lane, AL9 7TA North Mymms Hatfield England
| | - George Nye
- Department of Veterinary Clinical Science and Services; Royal Veterinary College; University of London; Hawkshead lane, AL9 7TA North Mymms Hatfield England
| | - Holger A. Volk
- Department of Veterinary Clinical Science and Services; Royal Veterinary College; University of London; Hawkshead lane, AL9 7TA North Mymms Hatfield England
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