Complications Related to Surgical Treatment of Intervertebral Disc Disease in Dogs

Abstract

Lexmaulová L., R. Novotná, P. Raušer, A. Nečas: Complications Related to Surgical Treatment of Intervertebral Disc Disease in Dogs. Acta Vet. Brno 2008, 77: 269-276. After intervertebral disk surgery we often have to deal with various complications (seizures, gastrointestinal tract (GIT) ulcerations, cystitis, and surgical wound healing problems). These complications may lead to the death of the patient. We performed clinical and laboratory investigations in 161 dogs with an intervertebral disc disease. After that, we performed a cranial (n = 31), caudal (n = 125) or both (n = 5) types of myelography at the same time, and surgery -ventral slot decompression (SLOT) (n = 18) or hemilaminectomy (n = 143). During the postsurgical period we observed seizures, GIT complications, cystitis, and surgical wound healing problems or even death of the patients. These complications appeared to be related to the lesion site, the degree of clinical signs and the type of surgical procedure. In our study we found a higher incidence of seizures after cranial myelography, higher incidence of gastrointestinal (GI) complications particularly in paraplegic dogs, and a higher risk of death in patients after the SLOT surgery. The occurrence of cystitis was not significant (p = 0.5524, p = 0.1655, respectively). We consider seizures, GI ulcerations, and death the most frequent complications after intervertebral disc surgery. Their incidence depends on the lesion site and the degree of neurologic symptoms.

Clinical Features and Risk Factors for Gastrointestinal Complications in Dogs Treated Surgically for Thoracolumbar Intervertebral Disc Extrusion

“…The presence, type and severity of GI signs were associated with duration of hospitalization and the severity of GI signs was also associated with anesthetic duration. The clinical GI complication rate in this study (47%) is higher than previous reports, from which a GI complication rate in dogs with IVDE of 15-39% can be extrapolated (2)(3)(4)(5)(10)(11)(12). Among prior studies, only a subset focused on reporting clinical GI signs as a main objective (2,3,11), and specific details such as frequency, severity or duration of GI signs were often lacking (2,4,5,10,11).…”

“…Intervertebral disc extrusion (IVDE) is the most common cause of acute thoracolumbar (TL) spinal cord injury (SCI) in dogs (1). Gastrointestinal (GI) signs, including diarrhea, vomiting, melena, or hematochezia, are among the reported complications in dogs undergoing surgery for acute thoracolumbar intervertebral disc extrusion (TL-IVDE) (2)(3)(4)(5). Colonic perforation (6)(7)(8) and pancreatitis (3,9,10) have also been reported.…”

“…Development of GI complications following SCI is complex and multifactorial. Contributing factors that have been proposed in both people and dogs include more severe neurologic status (2,3) as well as undergoing hospitalization, anesthesia and surgery (3,4,7,17,18). Imbalance of the autonomic nervous system (ANS) secondary to disruption of sympathetic outflow (resulting in unchecked parasympathetic output) is also implicated as a cause of GI signs (4,10,13,(15)(16)(17).…”

Recuperação funcional em cães com doença do disco intervertebral toracolombar sem percepção à dor profunda: 37 casos (2002-2010)

“…Em outros dois cães as causas da morte foram comprometimento cardiorrespiratório e gastrenterite hemorrágica devido ao uso prolongado de corticosteróides. Para Sharp & Wheeler (2005) & Lexmaulová et al (2008, a gastroenterite hemorrágica é a causa mais frequente de morte em pacientes com DDIV toracolombar.…”

Complicações observadas em cães e gatos com doenças neurológicas

“…Outras complicações que podem estar associadas a essa abordagem cirúrgica incluem síndrome de Horner, hipotensão, arritmias cardíacas, instabilidade e subluxação vertebral (Slatter 2003). Beal et al (2001) verificaram a ocorrência de complicações respiratórias em cães submetidos ao tratamento cirúrgico de doenças cervicais constatando que cães com lesões entre a segunda e a quarta vértebra cervical possuem maior risco de desenvolver hipoventilação no período pós-operatório, além de possuírem menor chance de sobrevivência do que cães submetidos à cirurgia de descompressão toracolombar (Lexmaulová et al 2008, Posner et al 2014.…”