Ultrasonographic imaging of loggerhead sea turtles (Caretta caretta)

Twenty live and five dead juvenile and subadult loggerhead sea turtles were examined ultrasonographically. Ten soft tissue areas of the integument were used as acoustic windows: cervical-dorsal and cervical-ventral, left and right cervicobrachial, left and right axillary, left and right prefemoral and left and right postfemoral windows. Anatomical cross-sections were performed on the dead turtles to provide reference data. The fourth and fifth cervical vertebrae, the spinal cord, and the venous sinuses of the external jugular vein were clearly visible through the cervical-dorsal acoustic window, and the oesophagus and the heart were imaged through the cervical-ventral acoustic window. The stomach was more frequently visible through the left axillary acoustic window. The liver could be imaged through both sides, but the right axillary acoustic window was better for visualising the gall bladder. The large and small intestines and the kidneys were visible through the right and left prefemoral acoustic windows; the kidneys were easily identified by their intense vasculature.     

Ultrasonographic appearance of the craniocervical junction in normal brachycephalic dogs and dogs with caudal occipital (Chiari-like) malformation

Ultrasonographic evaluation of the spine, especially of the spinal cord, has been rarely reported in dogs. The atlanto-occipital junction provides a small acoustic window through which examination of the craniocervical transition can be performed. Normal sonographic findings of this region in 10 normal brachycephalic dogs are presented and compared with sonographic findings from 25 Cavalier King Charles Spaniels with the caudal occipital malformation syndrome. Sonographic findings were compared with magnetic resonance imaging findings to determine the extent of cerebellar herniation and syringohydromyelia. Cerebellar displacement into the foramen magnum was clearly identified sonographically; however, syringohydromyelia was not discernable due to bone overlay.     

RELATIONSHIP OF CERVICAL SPINAL CORD DIAMETER TO VERTEBRAL DIMENSIONS: A RADIOGRAPHIC STUDY OF NORMAL DOGS

Cervical spinal cord abnormalities are often unapparent on myelographic studies, because no normal values for cervical spinal cord diameter are currently available. The purpose of this study was to establish, myelographically, the normal sagittal diameter of the cervical spinal cord in large and small breed dogs and its relationship to the sagittal diameter of the vertebral canal and sagittal height/length of the corresponding vertebral bodies. Forty-one adult dogs underwent cervical radiography and myelography. Spinal cord and vertebral canal sagittal diameter, vertebral body height at C2 to 5, body length at C3 to 5, and dorsal spine length of C2 were measured on lateral views. Ratios of spinal cord:vertebral canal diameter, spinal cord:body height, and spinal cord:body length/spine were calculated, and a normal range was determined for small and large breed dogs. The spinal cord:vertebral canal ratios showed that small breeds have a higher cervical cord-to-canal ratio than large breeds. The mean values and ranges of 14 ratios are reported. The ratios of spinal cord:body length at C2 to 4 in small breeds and spinal cord:body height at C3 to 5 in large breeds were found to be the most accurate for assessing spinal cord sagittal diameter. These normal ranges would allow quantitative and objective evaluation of the cervical spinal cord by myelography and early identification of dogs with altered spinal cord diameter, which could be further evaluated by means of alternative imaging techniques.     

Study on the Developmental Changes in Angulation of Spinal Nerves, the Length of the Dorsal Roots and Spinal Nerves in Sheep

This study reports the angulation of spinal nerves, the length of dorsal roots, the length of spinal nerves and the transverse and vertical diameters of the spinal cord during pre- and postnatal life in sheep of the Mehraban breed in Iran. The spinal cord of these animals was divided into 4 regions with respect to the angulation of spinal nerves. The first region was from the first to fifth cervical and the second was from the sixth cervical to the eighth thoracic in fetuses and from the six cervical to fourth thoracic in adults. The third region was from the ninth thoracic to second lumbar in fetuses and from the fifth thoracic to second lumbar in adults, and the fourth region was from third lumbar to fourth sacral in the animals of all age groups. The length of dorsal roots from their point of emergence from the spinal cord to the dorsal root ganglia showed a direct correlation with the length of the spinal nerves. While angulation of the spinal nerves showed a converse correlation with the length of either spinal nerves or dorsal roots. The transverse diameters of the spinal cord were always longer than the vertical diameters. The greatest diameters (vertical — 7.00 mm; transverse — 10.00 mm) are recorded at C1, T1 and L6 in adult sheep.     

IMAGING DIAGNOSIS—SPINAL CORD HISTIOCYTIC SARCOMA IN A DOG

A 12‐year‐old mixed breed dog was presented for evaluation of progressive paraparesis and ataxia. Magnetic resonance (MR) imaging was performed and identified multifocal intradural spinal cord mass lesions. The lesions were hyperintense in T2‐weighted sequences, isointense to mildly hyperintense in T1‐weighted sequences with strong contrast enhancement of the intradural lesions and spinal cord meninges. Spinal cord neoplasia was suspected. A diagnosis of intramedullary spinal cord histiocytic sarcoma, confined to the central nervous system, was confirmed histopathologically. Spinal cord histiocytic sarcoma is a rare neoplasm, but should be included in the differential diagnosis for dogs with clinical signs of myelopathy.     

IMAGING DIAGNOSIS—CT MYELOGRAPHY IN A DOG WITH INTRAMEDULLARY INTERVERTEBRAL DISC HERNIATION

A 5‐year‐old Chihuahua was examined for peracute pain and paraparesis. Neuroanatomic localization was consistent with a symmetric T3‐L3 myelopathy. Computed tomography (CT) of the T9‐L5 vertebrae was normal. Myelography disclosed attenuation of the subarachnoid space from T11 to L1, consistent with spinal cord swelling. CT following the myelogram disclosed a focal area of intramedullary iodinated contrast medium at T13‐L1. At surgery, intervertebral disc material was removed from the spinal cord. Based on the findings in this patient, intramedullary disc herniation should be considered a cause for focal intramedullary contrast medium accumulation.     

Pathophysiology,Clinical Importance,and Management of Neurogenic Lower Urinary Tract Dysfunction Caused by Suprasacral Spinal Cord Injury

Management of persistent lower urinary tract dysfunction resulting from severe thoracolumbar spinal cord injury can be challenging. Severe suprasacral spinal cord injury releases the spinal cord segmental micturition reflex from supraspinal modulation and increases nerve growth factor concentration in the bladder wall, lumbosacral spinal cord, and dorsal root ganglion, which subsequently activates hypermechanosensitive C‐fiber bladder wall afferents. Hyperexcitability of bladder afferents and detrusor overactivity can cause urine leaking during the storage phase. During urine voiding, the loss of supraspinal control that normally coordinates detrusor contraction with sphincter relaxation can lead to spinal cord segmental reflex‐mediated simultaneous detrusor and sphincter contractions or detrusor‐sphincter dyssynergia, resulting in inefficient urine voiding and high residual volume. These disease‐associated changes can impact on the quality of life and life expectancy of spinal‐injured animals. Here, we discuss the pathophysiology and management considerations of lower urinary tract dysfunction as the result of severe, acute, suprasacral spinal cord injury. In addition, drawing from experimental, preclinical, and clinical medicine, we introduce some treatment options for neurogenic lower urinary tract dysfunction that are designed to: (1) prevent urine leakage arising because of detrusor overactivity during bladder filling, (2) preserve upper urinary tract integrity and function by reducing intravesical pressure and subsequent vesicoureteral reflux, and (3) prevent urinary tract and systemic complications by treating and preventing urinary tract infections.     

A case report of traumatic neuroma of the cervical spinal cord in a dog

Traumatic neuroma of the cervical spinal cord was diagnosed in a 14-year-old male mixed-breed dog. A gross view showed two intradural extramedullary masses, measuring 1 and 0.6 cm in length and 0.7 and 0.4 cm in diameter, attached to the left side of the spinal cord at the level of the sixth and seventh cervical vertebrae. Microscopically, the cervical spinal masses comprised interlacing fascicles of axons and Schwann cells surrounded by collagenous stroma. Immunohistochemically, the fascicles were stained positively for neurofilament and S-100 proteins. Ultrastructurally, variably sized myelinated fibers and onion bulb-like structures were observed. To our knowledge, this is the first report of a traumatic neuroma in the cervical spinal cord of a dog.     

Evaluation of osseous‐associated cervical spondylomyelopathy in dogs using kinematic magnetic resonance imaging

Osseous‐associated cervical spondylomyelopathy in dogs is characterized by both static and dynamic spinal cord compression; however, standard MRI methods only assess static compression. In humans with cervical spondylotic myelopathy, kinematic MRI is commonly used to diagnose dynamic spinal cord compressions. The purpose of this prospective, analytical study was to evaluate kinematic MRI as a method for characterizing the dynamic component of osseous‐associated cervical spondylomyelopathy in dogs. We hypothesized that kinematic MRI would allow visualization of spinal cord compressions that were not identified with standard imaging. Twelve client‐owned dogs with osseous‐associated cervical spondylomyelopathy were enrolled. After standard MRI confirmed a diagnosis of osseous‐associated cervical spondylomyelopathy, a positioning device was used to perform additional MRI sequences with the cervical vertebral column flexed and extended. Morphologic and morphometric (spinal cord height, intervertebral disc width, spinal cord width, vertebral canal height, and spinal cord area) assessments were recorded for images acquired with neutral, flexion, and extension imaging. A total of 25 compressions were seen with neutral positioning, while extension identified 32 compressions. There was a significant association between extension positioning and presence of a compressive lesion at C4‐C5 (p = 0.02). Extension was also associated with a change in the most severe site of compression in four out of 12 (33%) dogs. None of the patients deteriorated neurologically after kinematic imaging. We concluded that kinematic MRI is a feasible method for evaluating dogs with osseous‐associated cervical spondylomyelopathy, and can reveal new compressions not seen with neutral positioning.     

IMAGING DIAGNOSIS—METASTATIC ADRENAL PHEOCHROMOCYTOMA IN A DOG

A 10‐year‐old Akita mix became acutely paraplegic. Upon magnetic resonance imaging, multiple, slightly T2‐hyperintense, T1‐isointense extradural masses, relative to spinal cord were found in the vertebral canal. The retroperitoneal masses had mixed T2‐signal intensity. The contrast enhancement pattern for the spinal masses was both homogenous and heterogenous. The diagnosis was metastatic pheochromocytoma. Signal intensity of the tumors in this dog was similar to reports of pheochromocytoma in human beings.     

IMAGING DIAGNOSIS—SPINAL EPIDURAL HEMANGIOSARCOMA IN A DOG

An 8‐year‐old, male Boxer was examined for an acute onset of ambulatory paraparesis. Neurologic examination was consistent with a T3‐L3 myelopathy. Myelography revealed an extradural spinal cord compression in the region of the T10‐T13 vertebrae. On magnetic resonance (MR) imaging, a well‐defined epidural mass lesion was detected. The mass was mildly hyperintense on T1‐weighted, hyperintense on T2‐weighted and STIR images compared to normal spinal cord and enhanced strongly and homogenously. Postmortem examination confirmed a primary epidural hemangiosarcoma. Findings indicated that the MRI characteristics of spinal epidural hemangiosarcoma may mimic other lesions including meningioma and epidural hemorrhages/hematomas of non‐neoplastic etiology.     

A morphometric and stereological study on cervical spinal cord segment of goose

In this study, volume density of white matter and grey matter areas of cervical segment of spinal cord in adult geese weighing 3–4 kg was examined using stereological methods. 10 geese were used as material without sex discrimination. All animals underwent perfusion with 10% buffered formaldehyde. Following the perfusion, animals were kept in 10% formaldehyde for 1 week. Geese were then dissected. Cervical area of spinal cord was revealed removing cervical spine. Tissue samples were obtained from each segment of cervical area. 5 μm thick cross‐sections were taken from these tissue samples via microtome. Series of cross‐sections were obtained by sampling in the ratio of 1/250 including 12 cross‐sections from each cervical segment of every animal. Cross‐sections were stained by haematoxylin eosin. They were photographed under microscope. Volume density (volume fractions) of both whole tissue and white matter and grey matter parts in each cervical segment of spinal cord were calculated using Cavalieri’s Principle. In the study, total volume of cervical segment, volume of white matter and grey matter, and ratios of these volumes one another were assessed in goose.     

ULTRASONOGRAPHIC ANATOMY OF THE NORMAL CANINE SPINAL CORD AND CORRELATION WITH HISTOPATHOLOGY AFTER INDUCED SPINAL CORD TRAUMA

Prior to trauma, intraoperative ultrasound of the spinal canal in 31 normal dogs was performed through a hemilaminectomy in the left pedicle of L2. A ventral compressive model of spinal cord injury was performed as part of a clinical drug trial. Maximum ultrasonographic spinal cord diameter ranged from 4.9–7.2 mm (5.7 × 0.6). Significant positive correlation (p = 0.023, r = 0.49) was found between age and spinal cord diameter. The dura mater was a separate, well-defined, echogenic horizontal line in 28 (90%) dogs, dorsally, and in 29 (94%) dogs, ventrally. Cerebrospinal fluid was anechoic. Eighteen (58%) dogs had a well-defined anechoic dorsal subarachnoid space, whereas 22 (71%) had a well-defined ventral space. Pia mater was thin but strongly echogenic and covered spinal cord. Central canal was a double hyperechoic line in 17 (55%) dogs and a single-line in 14 (45%) dogs. A difference in the ultrasonographic appearance between gray and white matter was not seen. Epidural fat and connective tissue was a lobular echogenic material in the ventral epidural space. The periosteal-vertebral body interface was seen as a bright curvilinear echo with distal acoustic shadowing. Spinal cord parenchyma could be classified subjectively into four groups based upon ultrasonographic appearance. Spinal cord parenchyma had a uniform hypoechogenicity in 8 (27%) dogs (Group 1), subtle low level echoes in 7 (23%) dogs (Group 2), multiple clusters of defined echogenic foci in 12 (37%) dogs (Group 3), and multiple sharply-defined linear echoes in 4 (13%) dogs (Group 4). There was a significant relationship between pre-trauma ultrasonographic appearance of the spinal cord and histopathology 21 days after trauma. One (13%) dog in Group 1, 4 (57%) dogs in Group 2,10 (91%) dogs in Group 3, and 3 (75%) dogs in Group 4 had malacia on histological evaluation. Therefore, dogs with echogenic spinal cords or linear echoes within cord parenchyma were significantly more likely to develop malacia rather than Wallerian degeneration after induced spinal cord trauma (p = 0.002). Spinal cord echogenicity may indicate vascularity in a segment of spinal cord and might be prognostic following spinal cord trauma. No complications were found related to intraoperative ultrasound. Hematoma or fibrous tissue formation appeared to impede percutaneous ultrasound of the spinal cord in dogs re-evaluated forty-eight hours and one week after surgery.     

Leukoencephalomyelopathy in cats linked to abnormal fatty acid composition of the white matter of the spinal cord and of irradiated dry cat food

Four outbreaks of leukoencephalomyelopathy in colonies of SPF cats on a long‐term diet of irradiated dry cat food were observed in the Netherlands between 1989 and 2001. As a primary defect in myelin formation was suspected to be the cause of the disease and myelin consists mainly of lipids and their fatty acids, we investigated the fatty acid composition of the white matter of the spinal cord of affected and control cats and of irradiated and non‐irradiated food. The irradiated food had low levels of alpha‐linolenic acid compared to linoleic acid as well as a high total omega‐6:omega‐3 ratio of 7:1 in the irradiated and of 2:1 in the non‐irradiated food. The white matter of the spinal cord showed low levels of linoleic acid and absence of alpha‐linolenic acid in affected cats as well as absence of lignoceric and nervonic acid in both affected and control cats. These abnormalities in fatty acid composition of the white matter of the spinal cord may reflect an increased need for alpha‐linolenic acid as a substrate for longer chain omega‐3 fatty acids to compose myelin and thus indicate a particular species sensitivity to dietary deficiency in omega‐3 polyunsaturated fatty acids, particularly alpha‐linolenic acid in cats. Our findings indicate that abnormalities in fatty acid metabolism in myelin play an essential role in the pathogenesis of this acquired form of leukoencephalomyelopathy in cats.     

Investigations on the Postnatal Development of the Macroscopic Proportions and the Topographic Anatomy of the Feline Spinal Cord

The aim of this work was to investigate the postnatal development of the feline spinal cord. Our study showed that the main period of growth leading to the cervical and lumbar enlargements begins after birth and is completed at the age of 5–6 months. Comparing the relationship between the length of the spinal cord and the vertebral column, we found that in contrast to the adult cat, in the newborn cat, length, area and volume of segments show similar values along the spinal cord. This also applied to the length of the vertebrae. Due to a heterogeneous growth, not all segments of the spinal cord end up situated cranial to their corresponding vertebrae. As a consequence, the end of the conus medullaris is still located within the sacral canal in animals older than 2 months. These findings strongly propose that injections into the vertebral canal of the cat have to be performed caudal to the sacral vertebrae.     

MAGNETIC RESONANCE IMAGING FINDINGS IN THE SPINE OF SIX DOGS DIAGNOSED WITH LYMPHOMA

Lymphoma is one of the most common neoplasms in the dog. Despite its prevalence and the increasing use of advanced diagnostic imaging in veterinary patients only few reports of magnetic resonance imaging (MRI) findings in spinal lymphoma have been published to date. The purpose of this retrospective case series study was to describe the MRI findings in dogs with confirmed lymphoma affecting the spine and/or paraspinal soft tissues. Medical records were searched for patients that had MRI of the spine and a diagnosis of lymphoma during the period of 2005–2015. Data recorded from retrieved MRI studies were presence of focal or multifocal disease, structures involved, and signal characteristics on T2‐W, short tau inversion recovery (STIR), and T1‐W sequences prior to and following intravenous contrast medium administration. Six dogs met the inclusion criteria. Common findings included multifocal disease (4/6), vertebral involvement (5/6), spinal cord compression (4/6), and involvement of more than one spinal compartment (medullary cavity, vertebral canal, paraspinal soft tissues) (6/6). Vertebral changes were confined to the medullary cavity without evidence of cortical osteolysis. There was questionable involvement of the spinal cord in one case. All spinal and paraspinal lesions identified were T2‐W isointense to hyperintense, STIR hyperintense, T1‐W hypointense to isointense, and showed variable moderate to strong contrast enhancement. Additional lesions identified were enlarged intraabdominal lymph nodes, hepatomegaly, splenomegaly, and a splenic nodule. The STIR and T1‐W postcontrast sequences were subjectively the most useful in identification of the spinal and paraspinal lesions.     

Endoscopic anatomy of the cervical vertebral canal in the horse: a cadaver study

Reason for performing study: Localisation of spinal cord compression in horses with cervical vertebral stenotic myelopathy is inexact. Vertebral canal endoscopy has been used in man to localise spinal cord lesions and has the potential to become a useful diagnostic technique in horses. Objective: To establish a surgical approach via the atlanto‐occipital space to the cervical vertebral canal in equine cadavers and describe the endoscopic anatomy of the cervical epidural and subarachnoid spaces. Methods: The cadavers of 25 mature horses were used to assess 3 surgical methods to approach the cervical vertebral canal, including 2 minimally invasive and one open technique. Once the approach had been made, a flexible videoendoscope was inserted into the epidural space (epiduroscopy) or the subarachnoid space (myeloscopy) and advanced caudally until the intervertebral space between C7 and T1 was reached. Results: The epidural and subarachnoid spaces could not be accessed reliably using the minimally invasive techniques. Furthermore, damage to the nervous tissues was a frequent complication with these procedures. The open approach allowed successful insertion of the videoendoscope into the epidural and subarachnoid spaces in all horses and no inadvertent damage was observed. Anatomical structures that could be seen in the epidural space included the dura mater, nerve roots, fat and the ventral internal vertebral venous plexus. In the subarachnoid space, the spinal cord, nerve roots, blood vessels, denticulate ligaments and external branch of the accessory nerve were seen. Conclusions: Using the open approach, epiduroscopy and myeloscopy over the entire length of the cervical vertebral canal are possible in the mature horse. Potential relevance: Cervical vertebral canal endoscopy may become a valuable tool to localise the site of spinal cord injury in horses with cervical vertebral stenotic myelopathy and could aid in the diagnosis of other diseases of the cervical spinal cord.     

Fluorine‐18 fluorodeoxyglucose positron emission tomography imaging exhibits increased SUVmax at the level of the spinal intumescence in normal dogs

Positron emission tomography (PET) imaging utilizing fluorine‐18 labeled fluorodeoxyglucose is a relatively new imaging modality in veterinary medicine that is becoming more common for oncological staging and for musculoskeletal imaging. Thus, it is important to identify the normal variations on PET imaging that may be mistaken for pathology. Variation in standardized uptake values (SUVmax) have been anecdotally identified in the spinal cord of dogs undergoing fluorodeoxyglucose (FDG) PET–CT examinations for oncological staging, with notable increase in SUVmax values identified in the region of the cervical and lumbar spinal intumescences. The aim of this retrospective, analytical study was to compare the SUVmax values at four different locations throughout the spinal cord (C3, C5‐T1, T13, and L3‐S1) of a group of dogs with no evidence of neurologic disease and compare those findings to histologic specimens from dogs euthanized for unrelated disease. SUVmax values were significantly higher at the cervical and lumbar intumescences in comparison to the control regions (P < .0001 and P < .0001, respectively). Neuronal count and spinal cord gray matter area were also significantly greater at the cervical and lumbar intumescences (neuronal count P = .0025 and P = .0001; area P = .0004 and P = .0009, respectively) while overall neuronal density was lower (P = .003 and P = .028, respectively). We presume the increased SUVmax values at the spinal cord intumescences are the result of overall increased neuron count, increased proportion of gray matter, and increased spinal cord gray matter area. These findings will aid in the interpretation of future PET–CT studies and hopefully prevent the misdiagnosis of spinal cord disease in normal canines.     

Current Concepts in the Management of Acute Spinal Cord Injury

Acute injury to the spinal cord initiates a sequence of vascular, biochemical, and inflammatory events that result in the development of secondary tissue damage. Experimental studies and clinical trials in humans have demonstrated that the extent of this secondary tissue damage can be limited by pharmacologic intervention at appropriate intervals after injury. High doses of methylprednisolone sodium succinate (MPSS) improve the outcome of acute spinal cord injury in humans if treatment is initiated within 8 hours of injury. Starting therapy more than 8 hours after injury is detrimental to outcome. The clinical efficacy of methylprednisolone in improving the outcome of canine spinal cord injuries has not yet been demonstrated and its use by veterinarians is controversial. Many dogs are not seen by a veterinarian within the 8-hour window after injury, and these dogs frequently are treated with nonsteroidal anti-inflammatory drugs or large doses of dexamethasone or prednisone before methylprednisolone treatment can be initiated, thus increasing the risk of severe adverse effects. Other drugs that may provide safer and more effective alternatives to methylprednisolone include thyrotropin-releasing hormone (TRH), the 21-aminosteroids, and kappa opioid agonists. Recent studies suggest that modulation of the influx of inflammatory cells and activation of endogenous microglial cells may provide another means of improving the outcome of acute spinal cord injuries. Many drugs being developed to treat acute spinal cord injury have shown promising results when evaluated experimentally. However, any proposed therapeutic strategy should be evaluated in prospective blinded clinical trials before being adopted in clinics.     

Cervical spinal intradural arachnoid cysts in related,young pugs

Seven related young pugs were diagnosed with cervical spinal intradural arachnoid cysts by magnetic resonance imaging (n = 6) and myelography (n = 1). All dogs were presented with skin abrasions on their thoracic limbs and non‐painful neurological deficits, indicating a C1‐T2 myelopathy. In all six dogs examined by magnetic resonance imaging not only the spinal arachnoid cyst but also a concomitant, most likely secondary, syringohydromyelia was confirmed. Pedigree analysis suggested a genetic predisposition for spinal arachnoid cysts in this family of pugs. Generalised proprioceptive deficits more pronounced in the thoracic limbs suggesting a focal cervical spinal cord lesion, with concomitant skin abrasions on the dorsal aspect of the thoracic limbs in a young pug, should alert veterinarians to the possibility of cervical spinal arachnoid cysts.