Prevalence, clinical presentation, prognosis, and outcome of 17 dogs with spinal shock and acute thoracolumbar spinal cord disease

Full, Amanda M.; Heller, Heidi Barnes; Mercier, Miyu

doi:10.1111/vec.12438

Cited by 18 publications

(25 citation statements)

References 27 publications

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“…In our study, we attempted to minimize this problem by only including dogs if the lesion was within 3 intervertebral spaces of the termination of the spinal cord. However, no diagnostic test or clinical data can differentiate spinal shock (which is shown to resolve within 60 days in dogs21) from LMN signs that resolve with resolution of the SCI, and our study was affected by the same limitation, albeit to a potentially lesser degree. The second problem is that these studies rely on a comparatively small number of dogs (11 dogs4 and 17 dogs5), that were part of larger studies of prognostic factors for dogs with intervertebral disk extrusions.…”

Section: Discussionmentioning

confidence: 85%

Prognostic Factors Associated with Recovery of Ambulation and Urinary Continence in Dogs with Acute Lumbosacral Spinal Cord Injury

Shaw

Risio

Laws

et al. 2017

Veterinary Internal Medicne

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BackgroundLimited information is available about prognostic factors for recovery after spinal cord injury (SCI) to the L4‐S3 segments. Previous research suggests that L4‐S3 SCI does not have a worse prognosis than T3‐L3 SCI.Hypothesis/ObjectivesTo elucidate prognostic factors for regaining urinary continence and ambulation in dogs with L4‐S3 SCI and compare prognosis to T3‐L3 SCI.Animals/MethodsA retrospective study on 61 nonambulatory dogs with L4‐S3 SCI, matched to dogs with T3‐L3 SCI, compared 3 weeks after onset. Prognostic factors explored using logistic regression and used for matching: nonchondrodystrophic dogs >15 kg versus dogs that were chondrodystrophic or <15 kg; compressive versus noncompressive lesions; presence versus absence of conscious pain perception (CPP); and lower vs upper motor neuron (LMN/UMN) incontinence.ResultsFewer L4‐S3 dogs regained continence compared to T3‐L3 dogs (64 vs 85%, P = .0033), but no difference existed for regaining ambulation (66 vs 75%, P = .1306). In L4‐S3 SCI dogs, fewer dogs regained continence with loss of CPP (P < .001), LMN incontinence (P = .004), and noncompressive lesions (P = .006). Negative prognostic factors for regaining ambulation included absent CPP (P < .001) and large nonchondrodystrophic breed (P = .022).Conclusions and Clinical ImportanceDogs with L4‐S3 SCI have a poorer short‐term prognosis than do dogs with T3‐L3 SCI. Dogs with L4‐S3 SCI had a poor prognosis with loss of CPP, or noncompressive lesions combined with LMN incontinence. Small‐breed or chondrodystrophic dogs with retained CPP, compressive lesions, and UMN incontinence had an excellent prognosis. These findings may help guide decision‐making in L4‐S3 SCI.

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Section: Discussionmentioning

confidence: 85%

Prognostic Factors Associated with Recovery of Ambulation and Urinary Continence in Dogs with Acute Lumbosacral Spinal Cord Injury

Shaw

Risio

Laws

et al. 2017

Veterinary Internal Medicne

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“…The age of the dog was taken into consideration to avoid including dogs with potential age‐related patellar reflex loss . Reduced or absent pelvic withdrawal reflexes alone, with a normal patellar reflex, were not considered as a sign of PMM as this finding could occur secondary to spinal shock . Dogs that were euthanized the day of admission before clinical progression could be established either had a histopathologic diagnosis of PMM or clearly demonstrated a combination of neurologic findings that established a wide lesion extent along with MRI evidence of PMM.…”

Section: Methodsmentioning

confidence: 99%

Clinical Characteristics of Dogs with Progressive Myelomalacia Following Acute Intervertebral Disc Extrusion

Castel

Olby

Mariani

et al. 2017

Veterinary Internal Medicne

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BackgroundProgressive myelomalacia (PMM) is a catastrophic disease associated with acute intervertebral disc extrusion (IVDE). Published data on the clinical characteristics of this disease are limited.ObjectiveTo describe the onset and progression of clinical signs of PMM in a large case cohort.AnimalsFifty‐one dogs, 18 with histopathologically confirmed PMM, 33 presumptively diagnosed based on clinical signs and diagnostic imaging.MethodsRetrospective study. Dogs with confirmed IVDE and either a histopathologic diagnosis of PMM or a high clinical suspicion were identified by medical record search. Data on nature and progression of signs were extracted.ResultsTwenty‐four of 51 dogs were Dachshunds. T12–T13 was the most common site of disc extrusion (12 of 56), and 18 of 55 of mid‐to‐caudal lumbar discs (between L3 and L6) were affected. Onset of PMM signs ranged from present at first evaluation (17/51) to 5 days after presentation, with 25 of 51 cases developing signs within 48 hours. Progression of signs from onset of PMM to euthanasia or death, excluding 7 cases euthanized at presentation, ranged from 1 to 13 days with 23 being euthanized within 3 days. Nonspecific systemic signs were documented in 30 of 51 dogs.Conclusion and Clinical ImportanceThe majority of dogs developed PMM within 2 days of presentation and was euthanized within another 3 days. However, onset can be delayed up to 5 days after presentation with progression to euthanasia taking as long as 2 weeks. Mid‐to‐caudal lumbar discs might be associated with an increased risk of PMM.

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“…The presence of spinal shock and Schiff Sherrington posture at presentation have been described in dogs (9,51). Spinal shock occurs much more frequently with FCEM and ANNPE due to the peracute onset of signs in these conditions (52). The prognostic significance of spinal shock has been evaluated and its presence is associated with the development of fecal incontinence in ANNPE but does not appear to affect recovery of ambulation (22,52).…”

Section: Spinal Shock and Schiff Sherrington Posturementioning

confidence: 99%

Prognostic Factors in Canine Acute Intervertebral Disc Disease

et al. 2020

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Knowledge of the prognosis of acute spinal cord injury is critical to provide appropriate information for clients and make the best treatment choices. Acute intervertebral disc extrusions (IVDE) are a common cause of pain and paralysis in dogs with several types of IVDE occurring. Important prognostic considerations are recovery of ambulation, return of urinary and fecal continence, resolution of pain and, on the negative side, development of progressive myelomalacia. Initial injury severity affects prognosis as does type of IVDE, particularly when considering recovery of continence. Overall, loss of deep pain perception signals a worse outcome. When considering Hansen type 1 IVDE, the prognosis is altered by the choice of surgical vs. medical therapy. Concentration of structural proteins in the plasma, as well as inflammatory mediators, creatine kinase, and myelin basic protein in the cerebrospinal fluid (CSF) can provide additional prognostic information. Finally, cross-sectional area and length of T2 hyperintensity and loss of HASTE signal on MRI have been associated with outcome. Future developments in plasma and imaging biomarkers will assist in accurate prognostication and optimization of patient management.

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Prevalence, clinical presentation, prognosis, and outcome of 17 dogs with spinal shock and acute thoracolumbar spinal cord disease

Cited by 18 publications

References 27 publications

Prognostic Factors Associated with Recovery of Ambulation and Urinary Continence in Dogs with Acute Lumbosacral Spinal Cord Injury

Prognostic Factors Associated with Recovery of Ambulation and Urinary Continence in Dogs with Acute Lumbosacral Spinal Cord Injury

Clinical Characteristics of Dogs with Progressive Myelomalacia Following Acute Intervertebral Disc Extrusion

Prognostic Factors in Canine Acute Intervertebral Disc Disease

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