Cranial thoracic myelopathies (T1-T6 vertebrae): Retrospective evaluation of the signalment, clinical presentation, and, presumptive or final diagnoses in 84 dogs

The aim of the study was to describe the signalment, clinical presentation and presumptive or final diagnoses of dogs with cranial thoracic spinal cord lesions identified on advanced imaging. Retrospective evaluation of the databases of three veterinary specialty centres, between 2009 and 2021, was performed to identify dogs with a lesion affecting the cranial thoracic vertebral column (T1-T6 vertebrae) as the primary cause for presenting signs of myelopathy and/or spinal pain. Eighty-four dogs were included in the study, with the majority (n = 76) presenting with a progressive history of over 4-weeks' duration. On neurologic examination, most dogs were ambulatory (n = 64), and the most common neuroanatomic localisation was the T3-L3 spinal cord segments (n = 63). Twelve dogs (14%) showed a short-strided thoracic limb gait on clinical examination. The most common diagnosis was neoplasia (n = 33), followed by anomalies (n = 22, including vertebral body malformations in 14 dogs) and degenerative disorders (n = 16, with intervertebral disc protrusion diagnosed in 9 dogs). The most common vertebrae affected were T3 and T5. Most dogs with degenerative conditions showed asymmetric clinical signs, and the majority of dogs with neoplasia showed signs of spinal hyperaesthesia on examination. The findings of this study describe the clinical signs and presumptive or final diagnoses associated with lesions affecting the cranial thoracic spinal cord. When combined with the signalment and clinical history, this information can assist in both the recognition of and problem-based approach to these cases.

Thoracic Vertebral Canal Stenosis Associated with Vertebral Arch Anomalies in Small Brachycephalic Screw-Tail Dog Breeds

OBJECTIVE

 The aim of this study was to describe clinical and imaging features of thoracic vertebral canal stenosis secondary to the hypertrophy of the vertebral lamina and articular processes in screw-tail brachycephalic dog breeds, to evaluate the prevalence of the malformation in a large group of screw-tail dog breeds and to determine if degree of stenosis is associated with presence of neurological signs.

STUDY DESIGN

 This is a retrospective multicentric study.

MATERIALS AND METHODS

 Clinical records of 185 screw-tail brachycephalic dogs (French Bulldogs, English Bulldogs, Boston Terriers) and Pugs were reviewed. Ten dogs with neurological deficits secondary to thoracic vertebral canal stenosis diagnosed on magnetic resonance imaging were identified (Group 1). Neurologically normal dogs (n = 175) of the same breeds underwent computed tomographic imaging of the thoracic vertebral column for other medical reasons (Group 2). Cross-sectional measurements were used to calculate a stenotic ratio.

RESULTS

 Group 1 consisted of three French Bulldogs, six English Bulldogs and one Pug. Eight were males. Most dogs presented with progressive non-painful pelvic limbs ataxia and paresis. Twenty stenotic sites were identified with the most common being T4-T5. Three of ten dogs were treated surgically and all had a good long-term outcome. In Group 2, 33 of 175 dogs had one or more stenotic sites with the most common being T2-T3. The degree of the stenosis was significantly higher in Group 1 (p = 0.019). A stenotic ratio of 0.56 had sensitivity and specificity of 67% to differentiate between dogs with and without neurological signs.

CONCLUSION

 Cranial thoracic vertebral canal stenosis is observed predominantly in young male Bulldogs, but not all stenoses are clinically relevant.

Thoracic vertebral canal stenosis in cats: clinical features, diagnostic imaging findings, treatment and outcome

OBJECTIVES

The aim of this study was to describe the clinical features, diagnostic imaging findings, treatment and outcome in cats with thoracic vertebral canal stenosis (TVCS).

METHODS

Medical records and imaging studies of cats with TVCS were retrospectively reviewed. Outcome was acquired from patient records and from owners or referring veterinary surgeons via a telephone questionnaire. For each case, breed-, age- and sex-matched controls were identified with CT imaging of the thoracic vertebral column. For each cat, vertebral canal height was determined at three levels for each thoracic vertebra. Vertebral canal heights were compared between control cats of different breeds and between affected and control cats of the same breed.

RESULTS

Nine TVCS cases were included. British Shorthairs and male neutered cats were over-represented (P <0.05). Median age at presentation was 9 years. All cats were presented for a chronic, progressive, painful, ambulatory, T3-L3 myelopathy. Five cats were treated conservatively, three surgically and one was euthanased. Two cats treated surgically demonstrated improvement of clinical signs and one demonstrated initial improvement followed by deterioration. Of the conservatively treated cats, three deteriorated and two improved. Compared with controls, affected cats had a lower vertebral canal height at multiple thoracic vertebral levels, being most prominent for British Shorthairs and domestic shorthairs (P <0.05). Unaffected British Shorthairs had a lower thoracic vertebral canal height at multiple levels than control domestic shorthairs (P <0.05).

CONCLUSIONS AND RELEVANCE

TVCS should be considered a differential diagnosis in middle-aged to older cats presenting with a chronic, progressive, painful, T3-L3 myelopathy. The predisposition of British Shorthairs could be explained by a narrower vertebral canal in this breed.

Assessment of the medium- to long-term radiographically confirmed outcome for juvenile dogs with hip dysplasia treated with double pelvic osteotomy

OBJECTIVE

To assess the medium- to long-term radiographically confirmed outcomes in juvenile dogs with hip dysplasia (HD) that did and did not undergo double pelvic osteotomy (DPO).

STUDY DESIGN

Retrospective case-controlled.

ANIMALS

Twenty-six dogs with HD that were candidates for DPO; 22 dogs underwent DPO (16 bilateral, six unilateral); four dogs did not.

METHODS

Initial and follow-up radiographs of DPO candidates (2011-2017) that did and did not undergo surgery were reviewed, and the British Veterinary Association and Kennel Club Hip Dysplasia Scheme score (BVA-HD), osteoarthritis score (OAS) and laxity index score (LI) were determined. Baseline and follow-up BVA-HD, OAS, and change in radiographically confirmed scores were compared by using analysis of variance for correlated samples.

RESULTS

There was no significant difference in BVA-HD or OAS between surgically treated and nonsurgically treated cohorts at baseline. Follow-up radiographs (median, 49 months) revealed that most (34/38) hips had a BVA-HD ≤10 after DPO, while four of eight hips from the nonsurgical cohort had BVA-HD >10. Follow-up BVA-HD and OAS were lower in hips after surgery (BVA-HD median 2.15, interquartile range [Q1-Q3] 1.3-4.1; OAS median 1.9, Q1-Q3 1.1-4.1) compared with the nonsurgically treated cohort (BVA-HD median 11.4, Q1-Q3 8.1-17.5, P < .01; OAS median 7.0, Q1-Q3 5.1-13.4, P < .01). Seven hips with an LI >1 had no radiographically confirmed progression of osteoarthritis after DPO.

CONCLUSION

Double pelvic osteotomy prevented radiographically confirmed progression of osteoarthritis in the medium- to long-term. Laxity index score > 1 was not a contraindication for DPO in this study.

CLINICAL SIGNIFICANCE

Double pelvic osteotomy prevents progression of radiographically confirmed features of osteoarthritis in juvenile dogs with HD.

Thoracic vertebral canal stenosis due to articular process hypertrophy in two cats treated by hemilaminectomy with partial osteotomy of the spinous process

Case summary

A 9-year-old neutered female British Shorthair cat (case 1) and a 13-year-old neutered male domestic shorthair cat (case 2) showed signs of chronic T3-L3 myelopathy, which progressed over 6 and 12 months, respectively. On presentation, case 1 had moderate pelvic limb proprioceptive ataxia and ambulatory paraparesis, and case 2 was non-ambulatory paraparetic and had urinary incontinence. Bilateral enlargement of the articular process joints at T11-T12 in case 1 and T3-T4 in case 2 causing dorsolateral extradural spinal cord compression was shown on MRI. Surgical decompression by a unilateral approach through hemilaminectomy with partial osteotomy of the spinous process was performed in both cases. The side of the approach was chosen based on the severity of the cord compression. Surgery resulted in a satisfactory outcome with short hospitalisation times. On discharge, case 1 showed mild postural reaction deficits on both pelvic limbs. Case 2 had regained urinary continence and could ambulate unassisted, although it remained severely ataxic. The 6 month follow-up showed very mild paraparesis and proprioceptive ataxia in both cats. No chronic medical treatment was required.

Relevance and novel information

This is the first report to describe clinical presentation, imaging features, surgical treatment and outcomes of thoracic vertebral canal stenosis owing to bilateral articular process hypertrophy in cats with no adjacent spinal diseases. Thoracic articular process hypertrophy should be included in the differential diagnosis of adult cats with chronic progressive myelopathy. Hemilaminectomy with partial osteotomy of the spinous process might be an appropriate surgical technique in these cases.