Lesions of spinal cord parelaphostrongylosis in sheep. Sequential changes following intramedullary larval migration

Spinal cord nematodiasis epidemiologically, clinically, and histologically consistent with Parelaphostrongylus tenuis infection was noted in two flocks of sheep. Spinal cords from two sheep with active infection and one from a partially recovered animal were studied in an effort to determine the sequence of lesions following larval invasion of the central nervous system. In the former two sheep, migration of larvae within the spinal cord induced asymmetrically irregular tracks of disrupted and necrotic tissue, primarily in white matter. Subsequently, macrophages infiltrated these regions and phagocytized the necrotic tissue, which led to cavity formation. Swelling and loss of axons, diminished myelin staining, mononuclear cell infiltration and increase in astrocytic fibers were often seen in adjacent tissue. Only occasional coiled larvae were found in these actively infected animals. Late stage lesions in the white matter in the partially recovered sheep included multiple small astrogliotic regions with diminished myelin and axonal content, and a single large multicavitary, atrophic, gliotic zone.     

Anatomy of the spinal cord and how the spinal cord is affected by local anesthetics and other drugs.

The spinal cord can be affected by several categories of drugs: local anesthetics, opiate agonist, alpha 2 adrenergic agonists, and ketamine. The mechanism of action, side effects, and usefulness of these injections vary with the type of drug used.     

Morphometry of cervical spinal cord in cat using design-based stereology

The spinal cord harbours nerve fibres that facilitate reflex actions and that transmit impulses to and from the brain. The cervical spinal cord is an area of particular interest in medicine and veterinary due to frequent pathologic alterations in this region. This study describes the morphometric features of the cervical spinal cord in cat using design-unbiased stereological methods. The cervical spinal cords of four male cats were dissected and samples were taken according to systematic uniform random sampling. Each sample was embedded in agar and cut into 60-µm thick sections and stained with cresyl violet 0.1% for stereological estimations. The total cervical spinal cord volume obtained by the Cavalieri estimator was 2,321.21 ± 285.5 mm³. The relative volume of grey matter and white matter was 23.8 ± 1.3% and 76.1 ± 1.3%. The dorsal horn and ventral horn volume were 12.3 ± 1.2% and 11.4 ± 0.7% of the whole cervical spinal cord. The volume of central canal was estimated to 3.8 ± 1 mm³. The total number of neurons was accounted 3,405,366.2 ± 267,469.4 using the optical disector/fractionator method. The number of motoneurons and interneurons was estimated to be 1,120,433.2 ± 174,796.7 and 2,284,932.9 ± 127,261.5, respectively. The average volume of the motoneurons and interneurons was estimated to 1980 µm³ and 680 µm³, respectively, using the spatial rotator method. This knowledge of cat spinal cord findings may serve as a foundation as a translational model in spinal cord experimental research and provide basic findings for diagnosis and treatment of spinal cord disorders.     

Dermoid cyst of the spinal cord associated with ataxia in a cat

A young adult Balinese cat developed complete hindlimb paralysis which persisted for six weeks. Clinical findings suggested a lesion compressing the spinal cord and this was confirmed at necropsy. A dermoid cyst was present at the level of the third thoracic vertebra. The cyst was lined by stratified squamous epithelium and contained desquamated keratinised material and hair fragments. Sebaceous glands and hair follicles were present in the connective tissue wall. This is the first report of a dermoid cyst in the spinal cord of a cat. The lesion is considered to be a congenital anomaly.     

Myelographic localization of spinal cord compression in dogs. A comparison between cisternal and lumbar injections of metrizamide "Amipaque" in diagnosing and locating spinal cord compression.

Metrizamide is a new water-soluble contrast medium possessing unique properties, one of which is that even in an isotonic solution it has a radiographic density sufficient for a diagnostic myelogram. Whereas in the past myelography with water-soluble preparations invariably entailed lumbar injections, which are technically difficult in dogs, the fact that isotonic metrizamide causes so little tissue irritation has made it possible to inject the contrast solution into the cisterna magna. The author has compared metrizamide myelograms obtained with both cisternal and lumbar injections. Myelography with a cisternal injection is preferable for demonstrating cervical cord compressions and also in cases in which it is desirable to obtain myelographic information on both the cervical and the thoraco-lumbar areas. If, on the other hand, it is necessary to determine exactly the extent of a thoraco-lumbar compression before decompressive laminectomy, the contrast should be injected in the lumbar region in such an amount and at a pressure high enough to ensure that the contrast is forced past the site of the compression. The safety of metrizamide will probably enable a better prognosis following surgery than was previously possible.     

Functional recovery from spinal cord trauma following normothermic irrigation in dogs.

The spinal cords of 16 normal dogs were exposed via dorsal laminectomies and damaged with a known impact force. In eight dogs the injured portions of the spinal cords were irrigated, without durotomy, for 2 h with normothermic saline. The remaining eight dogs were used as controls and were not irrigated. The results showed that normothemic irrigation of damaged spinal cords, immediately after impact trauma, had a significant beneficial effect on the functional recovery of the spinal cords.     

Acute spinal cord injury in the cat: causes, treatment and prognosis

PRACTICAL RELEVANCE: Acute spinal conditions are a common emergency presentation in general veterinary practice and have the potential to cause devastating spinal cord injury (SCI) and consequent severe neurological deficits. SCI can be divided into two subgroups: exogenous SCI (vertebral fracture and/or luxation/subluxation) and endogenous SCI (intervertebral disc extrusion and ischaemic myelopathy). CLINICAL CHALLENGES: The majority of cats with SCI have concurrent injuries. The clinician must perform a thorough physical examination and prioritise and then stabilise the life-threatening problems before focusing on the neurological examination. The possibility of multiple sites of SCI and spinal shock can make interpretation of the neurological examination challenging. While plain radiographs or myelography are usually diagnostic, they do not give direct information about the integrity of the spinal cord parenchyma or the severity of any damage. If facilities or experienced staff capable of performing the necessary surgery are not available, or advanced imaging is indicated, referral to a specialist veterinary institution should be considered. AUDIENCE: This review is aimed at clinicians dealing with feline SCI in the emergency setting or at first-opinion level, and discusses causes, initial management, specific treatment and prognosis. PATIENT GROUP: While any cat may potentially be affected by SCI, there is a tendency for exogenous SCI to be more common in younger individuals and, in the authors' experience, pure-breed cats are very rarely presented. Endogenous SCI can be seen in any breed and is typically a condition of adult cats.     

Surgical removal of an intramedullary chopstick fragment penetrating the spinal cord in a cat

A 3-year-old male domestic shorthair cat presented with sudden ataxia. Neurologic examination showed complete loss of proprioception in the thoracic and pelvic limbs. Computed tomography and magnetic resonance imaging revealed a non-metallic foreign body penetrating the spinal cord. The foreign body was removed by the ventral approach to the atlanto-occipital junction. Mild improvement of proprioception was observed the day after surgery. In a follow-up two months after surgery, the owner reported a complete recovery of the patient, showing a normal gait. To the author’s knowledge, this is the first case report describing successful removal of an intramedullary foreign body penetrating cervical spinal cord by ventral approach in a cat.     

Ocular lesions of 6-aminonicotinamide toxicosis in rabbits

6-Aminonicotinamide, an antimetabolite of nicotinamide, given by intraperitoneal injection produced diarrhea, ascending paresis/paralysis, death, and bilateral ocular alterations in both sexes of New Zealand white and Dutch belted rabbits. Ocular vascular lesions consisted of iridal congestion with iridal hemorrhage and associated acute iritis and aqueous flare in some rabbits. Cytoplasmic swelling, vacuolation, and loss of staining affinity that represented hydropic change were present in both layers of ciliary epithelium and the inner layer of iridal epithelium. Cells in the outer layer of the iridal processes and the ciliary ridge, were most severely affected. Vacuoles were also present in the retinal pigment epithelium and scattered throughout the outer plexiform layer of the retina with a few in the inner and outer nuclear layers. Ocular alterations were prevented by simultaneous administration of nicotinamide and their development appeared related to nicotinamide deficiency. No ocular alterations were caused by nicotinamide administration alone.     

Acute intraparenchymal spinal cord injury in a cat due to high-rise syndrome

A 9-year-old spayed female Bengal Red cat was evaluated for high-rise syndrome. The cat had paraplegia of the hind limbs, intact reflexes and pain perception, and hyperesthesia in the caudal thoracic area. Mentation, cranial nerve function, forelimb proprioceptive responses, and spinal reflexes were normal. There were no abnormalities on radiographs or computed tomography scan, but magnetic resonance imaging revealed a hyperintense intraparenchymal spinal cord lesion on T2-weighted and T2 fat saturation images.     

Ultrastructural ocular lesions of 6-aminonicotinamide toxicosis in rabbits

6-Aminonicotinamide, given by intraperitoneal injection to male and female Dutch belted rabbits, produced swelling and vacuolation of ciliary and iridal epithelium plus vacuolation of the retinal pigment epithelial and outer plexiform layers of the retina. By transmission electron microscopy, inner and outer ciliary epithelial cells and inner iridal epithelial cells contained numerous coalescing, membrane-bound vacuoles of the cytocavitary network. These vacuoles were viewed as numerous interconnecting, intracytoplasmic cavities in scanning electron micrographs. Swelling of vacuolated epithelial cells and the presence of fibrin and proteinaceous fluid in the ciliary stroma resulted in thickening of the anterior ciliary processes with the formation of surface alterations detectable by scanning electron microscopy. In transmission electron micrographs the vacuoles in the retinal pigment epithelium were large, electron-lucent spaces and the vacuoles in the outer plexiform layer of the retina appeared to be intracytoplasmic spaces in axons of photoreceptor cells. Distention of cytocavitary structures has been reported in glial cells of animals given 6-aminonicotinamide and this change was apparently due to alterations in ion and water movement across cellular membranes that resulted in intracellular edema.     

Partial lateral corpectomy for ventral extradural thoracic spinal cord compression in a cat

A 7-year-old, female spayed, domestic shorthair cat was presented for ambulatory paraparesis. No trauma history was reported. Myelography and subsequent computed tomography revealed multiple ventrally located extradural spinal cord compressive lesions possibly due to intervertebral disc disease. Compression at the level of Th3-Th4 intervertebral disc space was considered responsible for the paraparesis. The lesion was approached via a right-sided lateral partial corpectomy as described for dogs. Complete spinal decompression was achieved, as documented intraoperatively by visual inspection and palpation of the spinal canal. No surgery related complications were encountered and the cat improved gradually within 8 weeks after the procedure. At 1 year follow-up only a slight proprioceptive deficit in the right hind limb could be noted. This is the first report of partial lateral corpectomy in a cat and should encourage the use of this technique even in small patients.     

Treatment of thoracolumbar spinal cord compression associated with Histoplasma capsulatum infection in a cat

CASE DESCRIPTION: A 7-year-old domestic shorthair cat with a 2-month history of decreased appetite and weight loss was examined because of paraparesis of 1 week's duration that had progressed to paraplegia 3 days earlier. CLINICAL FINDINGS: Neurologic examination revealed normo- to hyperreflexia and absence of deep pain sensation in the hind limbs and thoracolumbar spinal hyperesthesia. Neuro-anatomically, the lesion was located within the T3 through L3 spinal cord segments. Biochemical analysis and cytologic examination of CSF revealed no abnormalities. Radiography revealed narrowing of the T11-12 intervertebral disk space and intervertebral foramen suggestive of intervertebral disk disease. Myelography revealed an extradural mass centered at the T12-13 intervertebral disk space with extension over the dorsal surfaces of T11-13 and L1 vertebral bodies. TREATMENT AND OUTCOME: A right-sided hemilaminectomy was performed over the T11-12, T12-13, and T13-L1 intervertebral disk spaces, and a space-occupying mass was revealed. Aerobic bacterial culture of samples of the mass yielded growth of a yeast organism after a 10-day incubation period; histologically, Histoplasma capsulatum was identified. Treatment with itraconazole was initiated. Nineteen days after surgery, superficial pain sensation and voluntary motor function were evident in both hind limbs. After approximately 3.5 months, the cat was ambulatory with sling assistance and had regained some ability to urinate voluntarily. CLINICAL RELEVANCE: In cats with myelopathies that have no overt evidence of fungal dissemination, differential diagnoses should include CNS histoplasmosis. Although prognosis associated with fungal infections of the CNS is generally guarded, treatment is warranted and may have a positive outcome.