Medical management of spinal epidural empyema in five dogs

Monteiro, Susana R. Monforte; Gallucci, A.; Rousset, Nicolas; Freeman, Paul; Ives, Edward; Gandini, Gualtiero; Granger, Nicolas; Vanhaesebrouck, An

doi:10.2460/javma.249.10.1180

Cited by 17 publications

(62 citation statements)

References 32 publications

(76 reference statements)

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“…Human SEE is a rare medical emergency and accounts for 0•2 to 2/10,000 hospital admissions (Grieve et al 2000). It is even more rarely reported in animals, the majority have been in dogs (Remedios et al 1996, Jerram & Dewey 1998, Cherrone et al 2002, Nykamp et al 2003, Lavely et al 2006, Cross et al 2008, Sutton et al 2010, Monteiro et al 2016 and it has also been reported in two cats (Granger et al 2007, Maeta et al 2010. Clinical signs in dogs and cats are comparable to those in humans, varying from fever, spinal hyperaesthesia to spinal cord dysfunction (Hanigan et al 1990, Rigamonti et al 1999, Grieve et al 2000, Reihsaus et al 2000, Curry Jr et al 2005, Duarte & Vaccaro 2013.…”

Section: Introductionmentioning

confidence: 99%

Clinical presentation, diagnosis, treatment and outcome of spinal epidural empyema in four cats (2010 to 2016)

Guo

2018

J of Small Animal Practice

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This case series reviews previous publications and reports four feline spinal epidural empyema cases that presented with non-ambulatory thoracolumbar myelopathy. Two cats underwent myelography and two MRI. Bacteria were obtained in three cases, in two from epidural abscesses and from a tail base wound in one; histopathological examination of epidural tissue showed pyogranulomatous changes in the remaining cat. Three cats were treated by surgical decompression plus antimicrobial therapy and one cat was treated medically. All cats showed satisfactory improvement following treatment over a follow-up period of 3 months. Spinal epidural empyema is a rare condition but all cats in this series had favourable outcomes.

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Section: Introductionmentioning

confidence: 99%

Clinical presentation, diagnosis, treatment and outcome of spinal epidural empyema in four cats (2010 to 2016)

Guo

2018

J of Small Animal Practice

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“…Successful medical management has been recently described in veterinary medicine suggesting that non-surgical treatment should also be considered (Granger and others 2007, Escriou and others 2011, Song and others 2015, Monteiro and others 2016). …”

Section: Discussionmentioning

confidence: 99%

“…To the authors’ knowledge there are only eight previous cases described in the veterinary literature of spinal epidural infections and successful medical management, of which only two were described as abscesses (Remedios and others 1996, Song and others 2015) as opposed to empyemas/infections (Escriou and others 2011, Monteiro and others 2016). In one case the abscess was localised at the level of the lumbosacral junction (Remedios and others 1996) and in the other it extended from the foramen magnum to C2 (Song and others 2015).…”

Section: Discussionmentioning

confidence: 99%

“…Epidural infections can present as a diffuse purulent exudate in a natural cavity without a capsule (empyema) or in a newly formed cavity (abscess) (Lavely and others 2006, Remedios and others 1996). The former is uncommonly reported in the veterinary literature and the latter has only rarely been described (Cherrone and others 2002, Linon and others 2014, Nykamp and others 2003, Schmiedt and Thomas 2005, Lavely and others 2006, De Stefani and others 2007, Granger and others 2007, Escriou and others 2011, Linon and others 2014, Song and others 2015, Monteiro and others 2016). Although both terms are distinct, they are usually used interchangeably in the literature.…”

Section: Introductionmentioning

confidence: 99%

“…Although historically myelography has been the most widely used diagnostic tool (Schmiedt and Thomas 2005). The current treatment of choice is surgical drainage and decompression (Lavely and others 2006, Granger and others 2007), although medical management has recently been described (Escriou and others 2011, Song and others 2015, Song and others 2015, Monteiro and others 2016) suggesting non-surgical treatment should also be considered an option.…”

Section: Introductionmentioning

confidence: 99%

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Successful medical management of an epidural abscess in a dog

Romero-Fernandez

José-López

Durand

et al. 2017

Vet Record Case Reports

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A seven‐month‐old entire male dobermann presented with acute onset neck pain and left thoracic limb lameness. The dog had a similar episode eight weeks before presentation that responded to meloxicam. A cervical spinal epidural abscess secondary to Staphylococcus pseudintermedius bacteraemia was diagnosed following investigations, including MRI of the cervical vertebral column and blood cultures. Treatment with cephalexin, gabapentin and meloxicam was started. The dog was doing clinically well one month later. A control MRI and radiographs of the cervical vertebral column showed evidence of discospondylitis and resolution of the primary lesion, therefore the treatment course with cephalexin was continued. Three months after initial presentation the clinical signs had resolved, radiographs showed improvement of the discospondylitis and antibiotics were stopped. Seven months later the dog continued doing well with no relapse.

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Preclinical models of vertebral osteomyelitis and associated infections: Current models and recommendations for study design

2021

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Spine-related infections, such as vertebral osteomyelitis, discitis, or spondylitis, are rare diseases that mostly affect adults, and are usually of hematogenous origin. The incidence of this condition has gradually risen in recent years because of increases in spine-related surgery and hospital-acquired infections, an aging population, and intravenous (IV) drug use. Spine infections are most commonly caused by Staphylococcus aureus, while other systemic infections such as tuberculosis and brucellosis can also cause spondylitis. Various animal models of vertebral osteomyelitis and associated infections have been investigated in mouse, rat, chicken, rabbit, dog, and sheep models by hematogenous and direct inoculation in surgery, each with their strengths and limitations. This review is the first of its kind to concisely analyze the various existing animal models used to reproduce clinically relevant models of infection. Spine-related infection models must address the unique anatomy of the spine, the avascular nature of its structures and tissues and the consequences of tissue destruction such as spinal cord compression. Further investigation is necessary to elucidate the specific mechanisms of host-microbe response to inform antimicrobial therapy and administration techniques in a technically demanding body cavity. Small-animal models are not suitable for large instrumentation, and difficult IV access thwarts antibiotic administration. In contrast, large-animal models can be implanted with clinically relevant instrumentation and are resilient to repeat procedures to study postoperative infection. A canine model of infection offers a unique opportunity to design and investigate antimicrobial treatments through recruitment a rich population of canine patients, presenting with a natural disease that is suitable for randomized trials.

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Medical management of spinal epidural empyema in five dogs

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Cited by 17 publications

References 32 publications

Clinical presentation, diagnosis, treatment and outcome of spinal epidural empyema in four cats (2010 to 2016)

Clinical presentation, diagnosis, treatment and outcome of spinal epidural empyema in four cats (2010 to 2016)

Successful medical management of an epidural abscess in a dog

Preclinical models of vertebral osteomyelitis and associated infections: Current models and recommendations for study design

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