Confirmed and presumptive cervical vertebral compressive myelopathy in older horses: a retrospective study (1992-2004)

BACKGROUND: Cervical vertebral compressive myelopathy (CVCM) is a common cause of myelopathy in horses aged 6 months to 4 years. Little information is available regarding the types of lesions, treatment, and outcomes in horses with CVCM that are > or =4 years old. ANIMALS: Twenty-two affected horses (10 with a confirmed diagnosis of CVCM and 12 presumptive cases) and 210 contemporaneous control horses. METHODS: Horses > or =4 years old that were diagnosed with CVCM between January 1992 and January 2004 were identified from medical records at Texas A&M University and the University of Florida. Data analyzed included history, signalment, neurologic examination findings, lesion location, treatment, and outcome. Signalment was also recorded in a population of contemporaneous controls. RESULTS: Horses identified had a median age of 8.4 years, and there was a greater percentage of male horses among the cases than among the controls. The most common breeds represented were warmblood (n=6) and quarter horse (n=5) types; warmbloods were significantly (P < .05) overrepresented relative to control horses. The caudal cervical vertebral column was the most common site of CVCM lesions, and the C5-C6 (4/9) and C6-C7 (3/9) articulations were most often identified as abnormal via myelography. The most common lesions seen with radiography and myelography were articular process osteophytes. Of the 22 affected horses, 8 were euthanized and a diagnosis of CVCM was confirmed by necropsy for all; 5 of 8 of these horses had spinal cord compression caused, entirely or in part, by articular process osteophytes. Medical management was the therapy chosen in all horses, and administration of corticosteroids and nonsteroidal anti-inflammatory drugs resulted in improvement in the greatest number of horses. CONCLUSIONS AND CLINICAL IMPORTANCE: CVCM should be a differential diagnosis in older horses with cervical myelopathy. Articular process osteophytes are the most frequently identified cause of spinal cord compression in this group. Male horses and horses of warmblood or Tennessee Walking Horse breeds may be predisposed to this condition.     

Inherited chondrodysplasia in Texel sheep

CASE HISTORY: A skeletal disease characterised by dwarfism, limb deformity and sometimes sudden death occurred over a period of 5 years in lambs born on a commercial sheep farm in Southland. The disease showed variable expression and occurred in crossbred sheep. A genetic aetiology was supported by the birth of affected lambs over two seasons in a flock of putative carrier and affected sheep transported to Massey University.

CLINICAL FINDINGS: Affected lambs appeared normal at birth but showed evidence of dwarfism, wide-based stance and exercise intolerance as early as 1 week of age. Most died within the first 3 months of life, often after developing bilateral varus deformity of the forelimbs. Some severely-affected lambs died suddenly of respiratory embarrassment, probably due to tracheal collapse. Mildly-affected individuals had a short, blocky stature and some survived to breeding age.

PATHOLOGICAL FINDINGS: Gross and microscopic lesions of variable severity were present in the tracheal, articular, epiphyseal and physeal cartilages. In severe cases, articular cartilage in major joints was eroded from weight-bearing surfaces. The trachea was flaccid, abnormally kinked, and had thickened cartilaginous rings and a narrow lumen. Affected sheep that survived to breeding age eventually developed severe degenerative joint disease. Histologically, chondrocytes were disorganised, surrounded by concentric rings of abnormal fibrillar material, and the matrix often contained focal to coalescing areas of chondrolysis.

DIAGNOSIS: Inherited chondrodysplasia of Texel sheep.

CLINICAL RELEVANCE AND CONCLUSIONS: This chondrodysplasia differs from those previously described in sheep and is considered to be a newly-recognised, recessively-inherited genetic disease of the Texel breed. A defect in the synthesis of glycosaminoglycans in cartilage matrix is suspected. This disease of sheep may provide a suitable model for studying various forms of therapy for human chondrodysplasias.     

Management of equine ataxia caused by cervical vertebral stenotic myelopathy: A European perspective 2010–2015

The diagnosis and therapy of cervical vertebral stenotic myelopathy (CVSM) are challenging and have been most frequently described in racehorses. We aimed to analyse CVSM cases presented for diagnostic work‐up and treatment in a nonracing horse population. We hypothesised that our diagnostic work‐up protocol including clinical/orthopaedic/neurological/radiographic and myelographic examinations may provide practical reference points for in vivo diagnosis/prognosis and adequate CVSM management. Medical records from 2010 to 2015 were reviewed retrospectively. Cases were included if our standardised work‐up protocol was followed, there was no evidence of any infectious diseases causing the neurological signs, and native cervical radiographs and myelograms confirmed CVSM. Age/breed/sex/type of performance/degree of neurological deficits and number/sites/quality/therapy of stenosis were recorded. Sixty‐two horses met the inclusion criteria. The majority of the horses were aged 5–10 years (44%) or >10 years (35%); nine horses (15%) were 1–4 years and four <1 year (6%) old. Forty‐six horses were Warmbloods (73%), 10 ponies (16%) and six of other breeds (11%). Males were more affected (69%) than females (31%). Sixty‐one percent were pleasure‐horses, 26% were sport‐horses and no information was available for 13%. Most cases presented with mild–moderate neurological signs (grade 2/5 = 18%, grade 2–3/5 = 31%). On myelograms, 23 horses (37%) had single‐level, 22 (35%) had double‐level, and eight (13%) triple‐level stenosis, while nine cases (15%) did not have stenosis. Fifty horses (55%) showed dynamic and 41 (45%) static stenosis. Dynamic stenosis was more common (46%) than static (29%) stenosis and/or combined stenosis (25%). Stenoses were more frequently observed in the mid‐to‐caudal vertebrae. Static stenoses tended to be located more caudally. Based on our protocol, 15% of horses were subjected to euthanasia without therapy, 62% treated conservatively and 23% underwent cervical ventral interbody fusion. In conclusion, our diagnostic work‐up protocol provided practical reference points for in vivo diagnosis/prognosis and adequate management of CVSM in a nonracing horse population.     

The 3D anatomy of the cervical articular process joints in the horse and their topographical relationship to the spinal cord

Reasons for study: Detailed anatomy of the equine cervical articular process joints (APJs) has received little attention in the literature and yet disorders of this joint have been linked to spinal cord compression resulting in severe clinical signs such as ataxia and weakness. This study aimed to describe the 3D anatomy of the APJ in relation to the spinal cord in the horse. Hypothesis: Artificial distension of the APJ causes the joint pouches to extend into the vertebral canal, with the potential for APJ effusion to cause spinal cord compressive disease. Methods: Six cadaveric necks (C1–C7) of clinically normal horses were used in this study. Computed tomography scans of the cervical APJ were acquired after injection of a negative contrast agent to maximal distension. The resulting images were semi‐automatically segmented using greyscale thresholding and reconstructed in 3D by polygonal surface meshing. The 3D reconstructions were used to assess the topographic anatomy of the APJ in relation to the spinal cord and to measure joint volume at each cervical vertebra in relation to vertebrae size. Results: Joint volume varied significantly between joint location (P<0.0001) and was positively correlated to the vertebral site (from cranial to caudal) (r = 0.781, P<0.0001). After distension, the medial outpouch of the APJ extended towards the vertebral canal from a dorsolateral location but in none of the 6 horses was there apparent compression of the dura mater surrounding the spinal cord. There was no significant difference in the extent of medial outpouch at any vertebral level (P = 0.104). Flexion of the neck resulted in minor changes to the shape of the APJ but did not result in the medial outpouch encroaching any closer to the spinal cord. Conclusions: From this study, it appears that in the absence of any other soft tissue or bony changes an effusion of the APJ is unlikely to cause spinal cord compression. However, given that the APJ and spinal cord are in close approximation, in the presence of other anatomical changes, an effusion may have the potential to cause compression. Potential relevance: This study confirms that the APJ extend into the dorsolateral aspect of the vertebral canal in a ventromedial direction, suggesting that oblique myelographic views are recommended for the diagnosis of spinal cord compression when pathology of the APJ is suspected.     

Clinical characterization of a familial degenerative myelopathy in Pembroke Welsh Corgi dogs

BACKGROUND: Adult dogs with degenerative myelopathy (DM) have progressive ataxia and paresis of the pelvic limbs, leading to paraplegia and euthanasia. Although most commonly reported in German Shepherd dogs, high disease prevalence exists in other breeds. OBJECTIVE: Our aim was the clinical and histopathologic characterization of familial degenerative myelopathy (FDM) in Pembroke Welsh Corgi (PWC) dogs. ANIMALS: Twenty-one PWCs were prospectively studied from initial diagnosis until euthanasia. METHODS: Neurologic examination, blood tests, cerebrospinal fluid (CSF) analysis, electrodiagnostic testing, and spinal imaging were performed. Concentrations of 8-iso-prostaglandin F2alpha (8-isoprostane) were measured in CSF. Routine histochemistry was used for neuropathology. Deoxyribonucleic acid and pedigrees were collected from 110 dogs. RESULTS: Median duration of clinical signs before euthanasia was 19 months. Median age at euthanasia was 13 years. All dogs were nonambulatory paraparetic or paraplegic, and 15 dogs had thoracic limb weakness at euthanasia. Electrodiagnostic testing and spinal imaging were consistent with noncompressive myelopathy. No significant difference was detected in 8-isoprostane concentrations between normal and FDM-affected dogs. Axonal and myelin degeneration of the spinal cord was most severe in the dorsal portion of the lateral funiculus. Pedigree analysis suggested a familial disease. CONCLUSIONS AND CLINICAL IMPORTANCE: Clinical progression of FDM in PWC dogs was similar to that observed in other breeds but characterized by a longer duration. Spinal cord pathology predominates as noninflammatory axonal degeneration. Oxidative stress injury associated with 8-isoprostane production is not involved in the pathogenesis of FDM-affected PWC dogs. A familial disease is suspected.     

Meningioangiomatosis in young dogs: a case series and literature review

Meningioangiomatosis (MA) is a proliferative disorder of the central nervous system (CNS) that has been reported rarely in humans and sporadically in dogs. Meningioangiomatosis may occur in the brainstem or cervical spinal cord of young dogs and can be identified tentatively by magnetic resonance imaging. The histopathologic hallmark of MA is a leptomeningeal plaque that extends along the CNS microvasculature and invades the adjacent neural parenchyma. This case series describes the neurologic signs, clinical progression, diagnostic imaging, and neuropathology of 4 dogs with MA. The 4 dogs with MA are compared and contrasted with 4 previously reported cases in dogs as well as with their human counterpart.     

Atypical parapoxvirus infection in sheep

This report describes the clinical and laboratory findings for 5 sheep from 3 different flocks with extensive proliferative skin lesions grossly resembling warts on the distal limbs. The lesions affected the front and rear extremities in all sheep, and 2 sheep also had lesions around the head. The sheep exhibited signs of pain when the lesions were touched, and most sheep were reluctant to move. Various empirical treatments, including systemic antibiotics, topical antibiotics, and antifungal ointments, were administered without clinical improvement. Diagnostic tests including skin biopsy and histopathology, examination of skin scrapings, bacteriology, mycology, electron microscopy of lesions, and immunohistochemical analysis demonstrated that the lesions were the result of parapoxvirus infection. All 5 animals were euthanized either because of the lack of resolution of clinical signs or a decision by the owner. These animals illustrate an atypical presentation of parapoxvirus infection in sheep (orf, contagious ecthyma, and scabby mouth). The infection appeared to be minimally contagious; however, the lesions did not spontaneously resolve. This appears to be the 1st report of such lesions in multiple sheep in North America, although similar lesions have been reported in Israel and the United Kingdom.     

Involvement of opioidergic and alpha2-adrenergic mechanisms in the central analgesic effects of non-steroidal anti-inflammatory drugs in sheep

The level within the central nervous system where non-steroidal anti-inflammatory drugs (NSAIDs) produce analgesia and the mechanisms by which they mediate this effect are still uncertain. This study assessed the central analgesic effects of ketoprofen, phenylbutazone, salicylic acid and tolfenamic acid in sheep implanted with indwelling intrathecal (i.t.) catheters and submitted to mechanical noxious stimulation. The sheep received i.t. cumulative concentrations (0.375-200 microM; 100 microL) as well as a single intravenous (i.v.) dose (3, 8, 10 and 2 mg/kg, respectively) of each NSAID. The sheep were also given i.t. naloxone (5.49 mM; 100 microL) and atipamezole (4.03 mM; 100 microL) prior to i.v. ketoprofen. None of the i.t. NSAIDs increased mechanical thresholds. Intravenously, only ketoprofen and tolfenamic acid raised the pain thresholds. The hypoalgesic effect of i.v. ketoprofen was prevented by i.t. naloxone or atipamezole. Although NSAIDs had no direct effect on the spinal cord, their analgesic action appeared to be spinally mediated.     

陶赛特羊和特克赛尔羊在青海湟源地区的生长发育测定分析

为了解陶赛特羊和特克赛尔羊的地区适应性,对引入青海省江河源公司湟源县良种羊繁育基地的陶赛特羊和特克赛尔羊体高、体重等生长发育指标进行了测定分析,结果表明,引进的陶赛特羊和特克赛尔羊早期生长发育快的特点得到了较好的发挥,其体高、体重等生长发育指标明显高于我省的地方品种,表现出良好的适应性。     

The clinical neurology of scrapie in Irish sheep

One hundred twenty-nine sheep with scrapie were identified from 20 flocks in which scrapie previously had been confirmed. Physical and neurologic examinations were performed on all animals. Videotape recordings were made and reviewed to assess gait. These procedures were repeated in 46 sheep at 2- to 3-week intervals until recumbency or inappetence necessitated euthanasia. Confirmation of scrapie was made by histopathologic and immunohistochemical examinations of brain tissue. The clinical signs most frequently recorded in the 129 animals on initial presentation were hindlimb ataxia (71%), head tremor (61%), altered mental status (57%), positive nibble reflex (51%), crouching posture (51%), teeth grinding (44%), low head carriage (38%), body condition score (BCS) < 1.5 (38%), and conscious proprioceptive deficits of the hindlimbs (36%). Progression of the disease was characterized by an increase in the frequency and severity of ataxia, weakness and hypermetria of the hindlimbs, a decreasing sway response, a decreasing extensor response to thoracolumbar pressure, and a reduction in the BCS. No effect of farm of origin on the clinical presentation could be shown. The presence of a nibble reflex was strongly associated (P < .0005) with prion protein (PrP) genotypes AA136RR154QH171 and AA136RR154QQ171. Logistic regression modeling of groups with associated clinical signs showed that animals with a crouching posture (odds ratio [OR], 20.036) and an abnormal yield to thoracolumbar pressure (OR, 7.117) were at increased risk of ataxia. Pruritus (OR, 0.168) was negatively associated with ataxia. Pruritus (OR, 4.974) and teeth grinding (OR, 4.279) were associated with a positive nibble reflex.     

Cranial thoracic disc protrusions in three German Shepherd dogs

Although intervertebral disc degeneration can occur at any level of the spine, cervical and thoraco-lumbar discs are more commonly affected. The presence of the inter-capital ligament between the rib heads results in an extremely low incidence of cranial thoracic intervertebral disc herniation. In this case series, the clinical, radiological, and surgical findings, as well as the post-operative outcome, in three German Shepherd dogs with T2–T3 disc protrusions is reported. These dogs had chronic progressive paraparesis and lumbar myelography and post-myelographic computerised tomography revealed ventrolateral, extra-dural spinal cord compressions over the T2–T3 intervertebral disc. All animals exhibited transient deterioration in their clinical signs and one developed unilateral Horner’s syndrome following T2–T3 hemi-dorsal laminectomy. Subsequently two of the dogs improved progressively and neurological dysfunction had completely resolved by 2 months. To the authors’ knowledge, this is the first case series describing T2–T3 disc protrusions in the dog.     

Radiographic,computed tomographic and CT myelographic findings of an extensive cervical osteochondroma resulting in spinal cord compression at the atlanto-occipital junction

A 13-year-old, crossbred grey mare was referred for examination of a left-sided head tilt and neck stiffness which had been noted for several months. Radiographic examination of the head revealed severe periarticular bone formation surrounding the dorsal and ventral margins of the atlanto-occipital joint and a large multilobular bony mass encroaching on the guttural pouch. Computed tomographic examination confirmed a multiloculated bony mass invading the vertebral canal and causing marked spinal cord compression and displacement. Histologically, this was identified to be an osteochondroma and the horse was conservatively managed.     

An outbreak of subacute fasciolosis in Soay sheep: ultrasonographic biochemical and histological studies

A naturally occurring outbreak of subacute fasciolosis in a group of 17 seven-month-old Soay ram lambs was studied following the sudden death of two sheep. In addition to standard biochemical investigations, ultrasound examination of the liver and cranial abdominal cavity was undertaken. There was a significant positive linear correlation between liver weight and ultrasonographic determination of liver size (R=0.72, P<0.05). Ultrasonographic examination of the liver revealed multiple hyperechoic dots in the parenchyma giving a granular appearance to the hepatic texture in three sheep corresponding to the most advanced histopathological changes as determined by the size of the abscesses and their relatively mature fibrous capsules, and areas of hepatic necrosis. No distension of the bile duct system was noted nor was the gall bladder imaged. While serum concentrations of albumin, globulin and certain liver enzymes assisted in the diagnosis of subacute fasciolosis in sheep, only glutamate dehydrogenase, and gammaglutamyl transferase remained elevated four weeks after triclabendazole treatment.     

Strain-specific sensitivity estimates of Mycobacterium avium subsp. paratuberculosis culture in Greek sheep and goats

The requirements for the isolation of Mycobacterium avium subsp. paratuberculosis (Map) may be related to the strain-type [sheep (S)- or cattle (C)-type] and not to the host. The objective of this paper was to estimate and compare strain- and biological sample (faeces or pooled-tissue)--specific sensitivities (Ses) of two solid culture media, Herrold's egg yolk medium (HEYM) and Lowenstein-Jensen (LJ) medium, for the isolation of Map from Greek dairy sheep and goats. From 400 faecal samples collected from sub-clinically infected sheep and goats of four flocks and from 214 pooled-tissue samples (142 from sheep and 72 from goats) collected, at the abattoir, from >1-year-old routinely slaughtered animals, with gross pathology suggestive of paratuberculosis, we isolated 34 Map strains. Of those, by the IS1311 PCR, 18 were categorized into the C-type and nine into the S-type; seven were not typed. We used a Bayesian approach to estimate the strain-specific Ses. SeHEYM-C-faecal=17% (95% credible interval: 7, 40) was higher than SeHEYM-S-faecal=2% (0.3, 11). Also, SeHEYM-C-faecal was higher than SeLJ-C-faecal=4% (1, 12). In pooled-tissue samples, the strain-specific Ses did not differ between the two media.     

Compressive myelopathy associated with ectasia of the vertebral and spinal arteries in a dog

A 4-year-old dog was presented for acute, progressive tetraparesis and cervical hyperesthesia. Symmetrical tubular structures coursing along the lateroventral aspects of the spinal cord at the fourth and fifth cervical vertebrae were identified in magnetic resonance images. At necropsy, vertebral arteries and their spinal branches were severely ectatic bilaterally, and the cervical spinal cord was compressed. Histologically, the ectatic branches of the vertebral and ventral spinal arteries were surrounded by fibrosis with scant mononuclear cell infiltrates and hemorrhage. Spinal branches of the vertebral arteries had focally severe reduction in the tunica media. A thrombus was in an arterial branch. Smaller vessels in adjacent tissue had fibrinoid degeneration. Axonal degeneration was detected in the affected spinal cord and nerve roots. The segmental degenerative radiculomyelopathy in this dog was attributed to anomalous ectasia of the vertebral and ventral spinal arteries.     

Detection and clinical evolution of scrapie in sheep by 3rd eyelid biopsy

The goal of this article was to characterize the clinical evolution of scrapie in naturally affected sheep. Eighteen sheep with scrapie diagnosed by examination of 3rd eyelid biopsy and 12 control ewes were studied throughout the duration of their disease. Diagnosis was confirmed postmortem by histopathologic, immunohistochemical, and Western blot analysis of nervous tissue. Complete clinical examinations were performed every 2 weeks for each animal, of which 3 clinical examinations per animal are reported. Those clinical signs that showed a significant frequency within the corresponding clinical examination were considered representative of each stage of the disease (ie, early, middle, and late). The representative clinical signs for the early stage were hypoesthesia in the limbs, alteration of mental status, and a body condition score <3. Remarkably, hypoesthesia in the limbs was one of the 1st signs appearing during the early clinical stage in the affected animals, even before the appearance of other signs. For the middle stage, representative signs were the same as those for the early stage, together with hyporreflexia in the limbs, cardiac arrhythmia, pruritus/wool loss, and the appearance of the nibbling reflex. Representative clinical signs for the late stage were the same as those for the early and middle stage, together with head tremors, hyperexcitability to external stimuli, ataxia or gait abnormalities, and teeth grinding. On the basis of these results, we propose the calculation of an objective clinical index that allows the differentiation among clinical stages and that could be useful for further studies. The usefulness of 3rd eyelid lymphoid tissue biopsies for sequential clinical studies in naturally scrapie-affected sheep is demonstrated.     

Compressive myelopathy caused by epidural haematoma associated with fibrocartilaginous embolism in a horse

Compressive myelopathy caused by an epidural haematoma associated with fibrocartilage embolism was diagnosed in a 2.5‐year‐old Hanoverian gelding. The patient showed severe ataxia with no improvement following medical therapy and a poor prognosis after myelography. An epidural mass located dorsal to the intervertebral disc between C4 and C5 was compressing the spinal cord dorsally to approximately one‐third of its normal height. The epidural tissue was characterised histologically as an organised thrombus, and its major com‐ponents were fibrin and macrophages with intracytoplasmic brown, iron‐rich granules. Positive Alcian blue stain confirmed the presence of cartilage within the thrombus.