Outcomes and prognostic indicators in 59 paraplegic medium to large breed dogs with extensive epidural hemorrhage secondary to thoracolumbar disc extrusion

Woelfel, Christian W; Robertson, James; Mariani, Christopher L.; Muñana, Karen R.; Early, Peter J; Olby, Natasha J.

doi:10.1111/vsu.13592

Cited by 7 publications

(26 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Compared to Woelfel et al ( 4 ), our DEEH compression group had a smaller body weight. There was a significant difference between our control group's body weight and the DEEH compression group.…”

Section: Discussioncontrasting

confidence: 82%

“…There was a significant difference between our control group's body weight and the DEEH compression group. Our DEEH group was heavier than the control group but somewhat lower in mean body weight than affected dogs represented in the Woelfel et al ( 4 ) study. This discrepancy reflects differing inclusion criteria between these two studies.…”

Section: Discussioncontrasting

confidence: 54%

“…The association between functional recovery and various metrics has been extensively described for routine IVDE populations ( 10 – 14 ). Individual case series have looked at a variety of parameters looking for any association with outcome for dogs with DEEH compression ( 4 ) without a control group. Mateo et al ( 8 ) compared dogs with DEEH compression on imaging to non-DEEH compression cases but did not control for neurological severity when selecting their surgical cases.…”

Section: Discussionmentioning

confidence: 99%

“…Mateo et al also found similar outcomes (93–95%) in 46 dogs with DEEH compression compared to 50 unmatched control dogs with non-hemorrhagic IVDE ( 8 ). In contrast, Woelfel et al in a case series of 59 medium-to-large-breed dogs with DEEH compression, observed that only 77.3% of paraplegic dogs, and 37.8% of dogs with absent pain perception, regained ambulation ( 4 ). This study found an association between larger surgical decompressions and improved outcomes in their subpopulation of dogs.…”

Section: Introductionmentioning

confidence: 96%

“…Few studies report the presence of hemorrhage associated with IVDE, and its incidence is unknown ( 3 ). Some investigators have termed intervertebral disk disease with hemorrhage “disk extrusions with extensive epidural hemorrhage” (DEEH) ( 4 , 5 ).…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Comparison of Surgical Outcomes Associated With Compression Secondary to Hemorrhage and Intervertebral Disk Extrusions in Dogs

et al. 2022

View full text Add to dashboard Cite

Acute intervertebral disk extrusion (IVDE) is one of the most commonly reported neurologic disorders seen in veterinary practice. There is a recognized subset of IVDE cases that have a hemorrhagic inflammatory reaction within the epidural space that causes compression in addition to compression from herniated disk material. Previous reports have been conflicting in the outcomes of these cases. The goals of this retrospective case-control cross-sectional study are to (1) compare the success rate of routine surgical decompression in dogs with DEEH compression compared to Modified Frankel Score (MFS) matched dogs with non-hemorrhagic disk extrusions; (2) evaluate the extent of spinal cord compression on MRI compared to final patient outcomes in DEEH compression and (3) determine the surgical compression to decompression ratio and its relation to patient outcomes in cases of DEEH compression. A total of 143 dogs were included in this study and divided into two groups: DEEH compression dogs (n = 78) and non-hemorrhagic IVDE dogs (n = 65). Outcomes were assigned for each patient [0 = deceased, 1 = alive and non-ambulatory (MFS 0–3), 2 = alive and ambulatory (MFS 4 or 5)] in both groups. Outcomes of DEEH and non-hemorrhagic IVDE did not differ when taken to surgery with comparable success rates when stratified by MFS. Similarly, outcomes did not differ between DEEH and non-hemorrhagic IVDE dogs when assessed by compression to decompression ratio. Dogs with DEEH compression had more compressed sites than dogs with non-hemorrhagic IVDE (P = 0.001) and had more sites decompressed surgically than dogs with non-hemorrhagic IVDE (P < 0.001). Consequently, the compression to decompression ratio did not differ between the two groups (P = 0.52). Our results support the finding that when a similar level of surgical decompression is achieved, dogs with DEEH compression have similar outcomes to dogs with non-hemorrhagic IVDE for similar degrees of neurological dysfunction.

show abstract

Section: Discussioncontrasting

confidence: 82%

Section: Discussioncontrasting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Comparison of Surgical Outcomes Associated With Compression Secondary to Hemorrhage and Intervertebral Disk Extrusions in Dogs

et al. 2022

View full text Add to dashboard Cite

show abstract

Prevalence and clinical features of thoracolumbar intervertebral disc‐associated epidural hemorrhage in dogs

Bridges¹,

Windsor²,

Stewart³

et al. 2022

Veterinary Internal Medicne

View full text Add to dashboard Cite

Background: Intervertebral disc-associated epidural hemorrhage (EH) in dogs is a poorly understood neurological condition.Objective: To compare the clinical presentation, magnetic resonance imaging (MRI) changes, and clinical outcome of dogs with acute thoracolumbar intervertebral disc herniation (TL-IVDH) with and without EH. Animals: One hundred sixty client-owned dogs that underwent MRI and hemilaminectomy for acute TL-IVDH at a private practice in Colorado, including 63 dogs with EH and 97 dogs without EH. Methods: Retrospective review of medical record data from 160 dogs presenting sequentially to a single practice with acute TL-IVDH that underwent MRI and hemilaminectomy surgery. Results: Sixty-three of 160 (39%) dogs had confirmed EH. French Bulldogs were significantly overrepresented (23/63; odds ratio [OR]: 4.1; 95% confidence interval [CI]:1.8-9.0; P < .001) of the EH cases. Dogs with EH were more likely to present with clinical signs less than 48 hours than were dogs without EH (24-48 vs 48-72 hours; OR: 2.4; 95% CI: 1.2-4.6; P = .02) and were more likely to be nonambulatory on presentation (OR: 2.1; 95% CI: 1.0-4.1; P = .04). Dogs with EH were more likely to have <50% cross-sectional spinal cord compression than dogs without EH (OR: 2.3 vs. 0.4; 95% CI: 1.2-4.4 and 0.2-0.9, respectively), longer longitudinal spinal cord compression (3 spaces vs 1 space, P < .001), and greater intrinsic spinal cord change (grade 3/severe vs grade 1/mild; P < .001) based on MRI. The location of the intervertebral disc herniation in French Bulldogs with EH was more likely to be thoracolumbar

show abstract

ACVIMconsensus statement on diagnosis and management of acute canine thoracolumbar intervertebral disc extrusion

Moore

Olby

Brisson³

et al. 2022

Veterinary Internal Medicne

Self Cite

View full text Add to dashboard Cite

Background Thoracolumbar intervertebral disc extrusion (TL‐IVDE) is the most common cause of acute paraparesis and paraplegia in dogs; however, guidelines on management of the condition are lacking. Objectives To summarize the current literature as it relates to diagnosis and management of acute TL‐IVDE in dogs, and to formulate clinically relevant evidence‐based recommendations. Animals None. Methods A panel of 8 experts was convened to assess and summarize evidence from the peer‐reviewed literature in order to develop consensus clinical recommendations. Level of evidence available to support each recommendation was assessed and reported. Results The majority of available literature described observational studies. Most recommendations made by the panel were supported by a low or moderate level of evidence, and several areas of high need for further study were identified. These include better understanding of the ideal timing for surgical decompression, expected surgical vs medical outcomes for more mildly affected dogs, impact of durotomy on locomotor outcome and development of progressive myelomalacia, and refining of postoperative care, and genetic and preventative care studies. Conclusions and Clinical Importance Future efforts should build on current recommendations by conducting prospective studies and randomized controlled trials, where possible, to address identified gaps in knowledge and to develop cost effectiveness and number needed to treat studies supporting various aspects of diagnosis and treatment of TL‐IVDE.

show abstract

Outcomes and prognostic indicators in 59 paraplegic medium to large breed dogs with extensive epidural hemorrhage secondary to thoracolumbar disc extrusion

Cited by 7 publications

References 41 publications

Comparison of Surgical Outcomes Associated With Compression Secondary to Hemorrhage and Intervertebral Disk Extrusions in Dogs

Comparison of Surgical Outcomes Associated With Compression Secondary to Hemorrhage and Intervertebral Disk Extrusions in Dogs

Prevalence and clinical features of thoracolumbar intervertebral disc‐associated epidural hemorrhage in dogs

ACVIMconsensus statement on diagnosis and management of acute canine thoracolumbar intervertebral disc extrusion

Contact Info

Product

Resources

About