Abstract

OBJECTIVE To compare clinical signs and outcomes between dogs with presumptive ischemic myelopathy and dogs with presumptive acute noncompressive nucleus pulposus extrusion (ANNPE). DESIGN Retrospective study. ANIMALS 51 dogs with ischemic myelopathy and 42 dogs with ANNPE examined at 1 referral hospital. PROCEDURES Medical records and MRI sequences were reviewed for dogs with a presumptive antemortem diagnosis of ischemic myelopathy or ANNPE. Information regarding signalment, clinical signs at initial examination, and short-term outcome was retrospectively retrieved from patient records. Long-term outcome information was obtained by telephone communication with referring or primary-care veterinarians and owners. RESULTS Compared with the hospital population, English Staffordshire Bull Terriers and Border Collies were overrepresented in the ischemic myelopathy and ANNPE groups, respectively. Dogs with ANNPE were significantly older at disease onset and were more likely to have a history of vocalization at onset of clinical signs, have spinal hyperesthesia during initial examination, have a lesion at C1-C5 spinal cord segments, and be ambulatory at hospital discharge, compared with dogs with ischemic myelopathy. Dogs with ischemic myelopathy were more likely to have a lesion at L4-S3 spinal cord segments and have long-term fecal incontinence, compared with dogs with ANNPE. However, long-term quality of life and outcome did not differ between dogs with ischemic myelopathy and dogs with ANNPE. CONCLUSIONS AND CLINICAL RELEVANCE Results revealed differences in clinical signs at initial examination between dogs with ischemic myelopathy and dogs with ANNPE that may aid clinicians in differentiating the 2 conditions.

Highlights

  • MethodsAnimalsThe study was approved by the Royal Veterinary College Ethics and Welfare Committee

  • Comparison of clinical signs and outcomes between dogs with presumptive ischemic myelopathy and dogs with acute noncompressive nucleus pulposus extrusion

  • Compared with the hospital population, English Staffordshire Bull Terriers and Border Collies were overrepresented in the ischemic myelopathy and acute noncompressive nucleus pulposus extrusion (ANNPE) groups, respectively

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Summary

Methods

AnimalsThe study was approved by the Royal Veterinary College Ethics and Welfare Committee. Dogs examined at the University of London Royal Veterinary College between November 2009 and December 2013 because of acute onset of signs of spinal cord dysfunction that became nonprogressive 24 hours after onset were considered for study inclusion. Dogs were included in the study if a board-certified veterinary neurologist (SDD) and a board-certified veterinary radiologist (RD) agreed on a presumptive diagnosis of ischemic myelopathy or ANNPE following independent review of available MRI sequences. Each investigator was unaware of (blinded to) the diagnosis on record for each dog when reviewing the MRI images. Dogs with concurrent spinal column disease (eg, vertebral fractures or Hansen type I disk disease) or that underwent spinal decompression surgery were excluded from the study as were dogs for which the medical record was incomplete or the MRI sequences were incomplete or of inadequate quality for review. All dogs included in this study were included in a previous study[16] that was conducted to evaluate inter- and intraobserver agreement in the differentiation of dogs with ischemic myelopathy from dogs with ANNPE by evaluation of MRI sequences

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