Cervical porcupine quill foreign body involving the spinal cord of a dog: A description of various imaging modality findings

Treatment and outcomes of five dogs with intrathoracic migration of porcupine quills

OBJECTIVE

To describe the perioperative findings and outcomes in dogs that underwent exploratory thoracotomy following porcupine quill migration and report (1) the use of traction alone for the removal of superficial quills in the pulmonary parenchyma, and (2) the use of exploratory pericardiotomy for the incidental identification of cardiac quills.

ANIMALS

Five client-owned dogs.

STUDY DESIGN

Short case series.

METHODS

Medical records of dogs with pneumothorax or pericardial effusion secondary to porcupine quill migration from January 2019 to January 2022 were reviewed. Advanced imaging and a median sternotomy were performed in each dog. Demographics, preoperative findings, surgical treatment, and outcome were recorded.

RESULTS

Pulmonary quills were treated with gentle traction or lung lobectomy. The intraoperative palpation or appearance of the pericardium prompted pericardiotomy in three dogs, exposing epicardial and intravascular quills. No evidence of these quills was detected on preoperative advanced imaging or on gross appearance of the pericardium. Quills were removed with a combination of gentle traction, purse-string sutures, and mattress sutures. Pneumothorax and pericardial effusion resolved postoperatively in all dogs. All dogs survived to discharge.

CONCLUSION

Traction allowed removal of quills that were superficially attached to the pulmonary parenchyma without the need for subsequent lobectomy. Epicardial and myocardial quills were detected following pericardiotomy in three dogs despite the absence of quills grossly penetrating the pericardium. Preoperative imaging did not allow consistent detection of quills.

Recovery after inadvertent intramedullary microchip implantation at C1–C2 in a kitten

Case summary

A 15-week-old male British Shorthair cat was presented for peracute paralysis immediately after microchip implantation. Neurological examination revealed a non-ambulatory tetraparesis and left thoracic limb plegia localised to C1–C5 spinal cord segments. CT of the cervical spine showed a diagonally orientated metallic foreign body (microchip transponder, 10 mm in length) within the vertebral canal at the level of C1–C2, resulting in a penetrating spinal cord injury. Based on concerns about further iatrogenic spinal cord injury through surgery, medical management was chosen. Despite the severe clinical signs, the kitten returned to ambulation within 6 days of the injury, with controlled urination and defecation. Continuous neurological improvement was seen for up to 6 weeks after the injury at which point a mild-to-moderate ambulatory tetraparesis and ataxia remained, with an overall good quality of life. Follow-up CT at the age of 13 months revealed a relative cranial displacement and rotation of the microchip towards the foramen magnum, while the cat’s neurological status was unchanged.

Relevance and novel information

This case demonstrated a cervical penetrating spinal cord injury in a growing cat caused by a microchip, which was successfully managed with medical treatment, suggesting that this might be an option for patients at risk of severe surgery-related complications or where owners reject surgery.

Ocular porcupine quilling in dogs: Gross, clinical and histopathologic findings in 17 cases (1986-2018)

The objectives of this retrospective study were to evaluate the histopathologic changes associated with porcupine ocular quill injuries in dogs, to discuss the various methods of quill detection when quills are not grossly visible, and to discuss the pathogenesis of delayed ocular quill injuries in dogs. Seventeen globes sustaining ocular quilling injuries from 17 dogs (1986-2018) were identified in the COPLOW archives and the gross and histologic changes tabulated and compared. All cases were dogs, with one whole globe submitted from each patient. Sixteen of 17 cases had known or suspected porcupine encounters in the weeks or years preceding enucleation. Histopathologic findings included retinal detachment, hyphema, cataract, granulomatous to pyogranulomatous inflammation (uveitis, endophthalmitis, panophthalmitis), lens capsule rupture, suppurative phakitis, scleral perforation, stromal keratitis, breaks in Descemet's membrane, preiridal fibrovascular membrane, anterior and posterior synechia, Schnabel's cavernous atrophy, and periorbital fibrosis. Quill-associated ocular trauma can have a significant deleterious effect on vision and result in enucleation. The time from initial quilling to the manifestation of ocular signs may be prolonged (weeks to years). Any dog presenting for ocular signs with a history of a previous porcupine encounter should be carefully checked for quill migration into the globe as the source of ocular disease. Quills may not be visible grossly, and ancillary imaging techniques can be utilized with various rates of success.