Fibrocartilaginous Embolism of the Spinal Cord in Dogs: Review of 36 Histologically Confirmed Cases and Retrospective Study of 26 Suspected Cases

Clinical features of 36 dogs with histologically confirmed fibrocartilaginous embolism (FCE) were contrasted with those of 26 dogs in which FCE was suspected based on characteristic clinical findings and the absence of compressive spinal cord disease on myelography. Dogs with confirmed and suspected FCE were of similar signalment, and had acute, nonprogressive dysfunction, often associated with trauma or exercise. The "suspected" group included fewer giant breeds and more often had asymmetric lesions, intact nociception, and upper motor neuron involvement. Dog size and severity of clinical signs probably contributed to owners choosing euthanasia in dogs with confirmed lesions. Accordingly, data from such patients may be skewed relative to these clinical features. J Vet Intern Med 1996;10:241–245. Copyright © 1996 by the American College of Veterinary Internal Medicine .     

Fibrocartilaginous embolism in the dog

Eighteen dogs with acute neurological symptoms suggestive of ischaemic myelopathy are described. A presumptive diagnosis of spinal parenchymal infarction, due to fibrocartilaginous embolism (FCE), was made in 16 cases. This was confirmed by histological examination post mortem in the remainder. Clinical neurological parameters were the most reliable prognostic indicators following FCE. High dose corticosteroid therapy should be administered as soon as possible to influence the secondary pathophysiological reaction in such cases. Only one dog made a complete neurological recovery, however nine returned to normal activity with-out regaining normal neurological function. Eight dogs required euthanasia.     

Suspected fibrocartilaginous embolism in a cat

A 12-year-old cat was presented to the University of Queensland's Small Animal Teaching Hospital with a 1-day history of left hemiparesis of acute onset, with no evidence of trauma or toxin exposure. Neurological examination findings were consistent with a lesion in the caudal left cervical spinal cord (C6 to C8), which was non-painful and had not progressed since the onset of clinical signs. No other abnormalities were found, although myelography showed a mild swelling involving the caudal cervical and cranial thoracic spinal segments. A diagnosis of suspected fibrocartilaginous embolism was made on the basis of the history, clinical presentation and diagnostic tests results, making this case the first report of a suspected fibrocartilaginous embolism in a cat that returned to normal function.     

Fibrocartilaginous embolic myelopathy in dogs: a retrospective study

The clinical aspects of 26 dogs suspected of fibrocartilaginous embolic myelopathy (FEM) were documented and compared to results from 2 studies published in the literature. The short-term recovery capacity of 15 of these patients was also evaluated during a 30 day period by giving a neurological score. We have observed, compared to other studies, a larger proportion of cervical localization (15.4%) as well as a larger variety of race sizes for FEM. We have established that, after 30 days, 67% of patients had improved and that 88% of non-ambulatory patients had regained their ambulatory capacity. Also, patients showing signs of grey matter lesions (inferior motor neuron--IMN) as well as those having white matter lesions (superior motor neuron--SMN) had shown signs of neurological progress. Therefore, we have observed that the recovery capacity of an animal suffering from FEM does not seem to be impacted by its initial ambulatory state, nor by its lesions to IMN or SMN, although the low number of cases does not allow us to positively confirm this situation.     

Fibrocartilaginous embolism and ischemic myelopathy in a four month old German shepherd dog.

Clinical signs and postmortem findings are described in a four month old German Shepherd dog with fibrocartilaginous embolism of the spinal cord. Ischemic myelopathy involved spinal cord segments C7 to L1. No evidence of degeneration or herniation of intervertebral discs was found at necropsy.     

Fibrocartilaginous embolism of the spinal cord (FCE) in juvenile Irish Wolfhounds

This study describes the occurrence of fibrocartilaginous embolism of the spinal cord (FCE) in eight juvenile Irish Wolfhounds that were presented within a period of 16 months (1996-1997). The dogs, seven males and one female between eight and 13 weeks of age, were presented because of an acute onset of abnormal locomotion. Five dogs were euthanized and FCE was diagnosed by the histomorphological presence of focal myelomalacia and Alcian blue-positive-nucleus-pulposus material in the spinal cord vasculature. Three dogs, which were thought to have FCE because of their clinical symptoms, improved with partial or almost complete return to normal locomotion. Although the observed high incidence may be a coincidence, oral information from breeders and lay reports of similar cases in journals for dog breeders from various countries suggest that FCE is a common disorder in young Irish Wolfhounds.     

INTRAVERTEBRAL DISC HERNIATION (SCHMORL'S NODE) IN FIVE DOGS

The herniation of intervertebral disc material into the vertebral body, known as Schmorl's nodes, is a well described disease process in man. Schmorl's nodes have not until now been described in the dog. This paper describes intravertebral disc herniation in the dog based on five patients taken from a retrospective study of dogs suspected of having cauda equina syndrome. The significance of intravertebral disc herniation in the dog at this time is that they indicate a disturbance in the vertebral endplate, they present definite radiographic signs, should be considered in patients with ostecohondrosis, and remain a possibls etiology for fibrocartilaginous emboli. Back pain is a common sign in people when Schmorl's nodes were the only pathologic findings. The common signs of palpatory pain in the lumbosacral region of the dogs in this report is noted but cannot be directly correlated at this time to the intravertebral disc herniation; however, it is suspected in two of the cases.     

A comparison between ethanol-induced chemical ablation and ivermectin plus prednizolone in the treatment of symptomatic esophageal spirocercosis in the dog: a prospective study on 14 natural cases

This study included a total of 14 dogs with spontaneous esophageal spirocercosis. Historical and clinical evidence of esophageal dysphagia, detection of parasitic ova in fecal samples and endoscopic documentation of esophageal nodules were the inclusion criteria. The animals were randomly assigned into two groups: group A (n = 6 ) dogs received two intranodular injections of absolute ethanol (96%) via a through-the-endoscope injector, at weekly intervals; group B (n = 8) dogs were put on ivermectin (600 microg/kg BW, subcutaneously, twice, 14 days apart) and oral prednisolone (0.5mg/kg BW, every 12h, for a total of 3 weeks, tapering the dose accordingly). Clinical and fecal examination as well as endoscopy, were performed on admission and at 20, 60 and 180 days from the beginning of the treatment. One group A dog responded poorly and died of pyothorax during the trial and another developed esophagitis due to accidental intraluminal ethanol infusion, only to experience an uneventful recovery. At different times during the 6-month follow-up period, there was a complete disappearance of the clinical signs in 4/6 group A dogs. However, full nodular regression was achieved only in one dog, and parasitic ova were still found in the feces of 4/6 dogs. At the same period of time in five group B dogs still available for evaluation, resolution of the clinical signs and complete nodular regression were seen in four and five animals, respectively, while negative fecal results were obtained in all dogs (8/8) of the same group 2 months from the beginning of the treatment. No significant difference was found between the groups, regarding the resolution of clinical signs, though group B dogs demonstrated a significantly higher rate of regression of esophageal nodules as well as negative fecal results, compared to group A dogs. The combination of ivermectin and prednizolone may be considered an effective treatment in the symptomatic and evidently asymptomatic esophageal spirocercosis of the dog.     

Fibrocartilaginous embolism of the spinal cord (FCE) in juvenile Irish Wolfhounds

Summary

This study describes the occurrence of fibrocartilaginous embolism of the spinal cord (FCE) in eight juvenile Irish Wolfhounds that were presented within a period of 16 months (1996–1997). The dogs, seven males and one female between eight and 13 weeks of age, were presented because of an acute onset of abnormal locomotion. Five dogs were euthanized and FCE was diagnosed by the histomorphological presence of focal myelomalacia and Alcian blue‐positive‐nucleus‐pulposus material in the spinal cord vasculature. Three dogs, which were thought to have FCE because of their clinical symptoms, improved with partial or almost complete return to normal locomotion. Although the observed high incidence may be a coincidence, oral information from breeders and lay reports of similar cases in journals for dog breeders from various countries suggest that FCE is a common disorder in young Irish Wolfhounds.     

Efficacy of dog-appeasing pheromone (DAP) for ameliorating separation-related behavioral signs in hospitalized dogs

Dogs hospitalized in veterinary clinics are likely to show signs of separation-induced anxiety from hospitalization. The study assessed the effect of dog-appeasing pheromone (DAP) on 10 typical separation-related behavioral signs in hospitalized dogs. A DAP treated group (n = 24) was compared with a placebo control group (n = 19). There was overall amelioration of the signs without ‘vigilance’ and ‘anorexia’ in the DAP-treated dogs; marked decreases were noted in elimination (P = 0.038), excessive licking (P = 0.005), and pacing (P = 0.017). The results suggest that the use of DAP could decrease separation-induced anxiety, distress, and fear in inpatients, and possibly facilitate recovery in hospitalized dogs.     

RADIOGRAPHIC FINDINGS DURING RECOVERY FROM DISCOSPONDYLITIS

The diagnosis of discospondylitis is based on radiographic changes in the vertebrae. The limitations of this method are the time gap between the onset of clinical signs and the first appearance of the radiographic findings, as well as the disassociation between the clinical and radiographic signs during recovery. It is known that the radiographic changes appear only two to four weeks after the onset of clinical signs, but the characteristics of radiographic changes during recovery has yet to be documented, thus making follow-up radiographs difficult to interpret. A prospective and retrospective study was designed to document typical radiographic changes during recovery from discospondylitis. We reviewed 12 dogs that had complete and uneventful recovery with antibiotic therapy alone. Periodic follow-up radiographs and clinical examinations were conducted up to five months after the onset of clinical signs to correlate between the clinical status and radiographic changes during recovery. Although the clinical signs improved within the first 10 days of antibiotic therapy, the radiographic deterioration continued before regression and signs of radiographic recovery were noticed. This radiographic deterioration, despite successful antibiotic therapy, appeared shorter in young dogs (less than one year old) and lasted three to nine weeks in older dogs.     

Fibrocartilaginous embolism in a cat

A nine-year-old cat was presented with a history of an acute onset of paraplegia. On the basis of the neurological examination, the lesion was localised between the fourth lumbar and third sacral segments (L4 to S3) of the spinal cord. Investigations included radiography, myelography, cerebrospinal fluid analysis, routine haematology and biochemistry, feline leukaemia virus testing and urinalysis. A definitive diagnosis was not achieved and the cat was euthanased 12 days after presentation. Post mortem examination revealed infarction of the spinal cord secondary to fibrocartilaginous embolisation. This is the first reported case of fibrocartilaginous embolism in the cat in the UK.     

Pulmonary Thromboembolism in 29 Dogs: 1985–1995

Pulmonary thromboembolism (PTE) occurs as a complication to a number of commonly encountered clinical diseases. Antemortem recognition of this life-threatening disorder is hampered by nonspecificity of clinical signs. This retrospective study was performed to analyze clinical features, laboratory findings, imaging abnormalities, and concurrent postmortem diagnoses in 29 dogs with confirmed pulmonary embolism. A variety of clinicopathologic and radiographic abnormalities were noted but there were no pathognomonic findings for PTE. Arterial blood gas analyses were performed in 15 (52%) of 29 dogs; 12 (80%) of 15 exhibited hypoxemia and 15 (100%) of 15 had increased alveolar-arterial oxygen gradients. Response to supplemental O2 was variable and did not correlate with the presence or absence of additional pulmonary pathology on postmortem. At postmortem, 25 (86%) of 29 dogs had grossly visible emboli, 17 (59%) of 29 dogs had multiple disease processes, and 16 (55%) of 29 dogs had additional pulmonary pathology. PTE was suspected antemortem in 11 (38%) of 29 dogs. In dogs with respiratory signs consistent with PTE, the condition was a differential diagnosis in 11 of 17 animals; all had diseases previously reported to be associated with PTE. Neoplasia, systemic bacterial disease, and immune-mediated hemolytic anemia were diagnosed most frequently.     

Fibrocartilaginous embolism

Fibrocartilaginous embolism (FCE) is an acute myelopathy that affects primarily dogs and human beings, and occasionally other mammalian species. It is frequently associated with trauma or vigorous exercise; in dogs it tends to affect mature non-chondrodystrophoid and giant breeds. Signs are acute and frequently indicate a very lateralized or focal lesion within the spinal cord, with resultant disparities in sensory and motor function. Lower motor neuron disease is common and hyperesthesia is unusual. The primary differential diagnoses are concussive trauma and intervertebral disc herniation, but the acute onset of strongly lateralizing spinal cord deficits without hyperesthesia in a breed at risk is strongly suggestive of the FCE syndrome. Attention must be given to other systemic diseases that might also give rise to emboli in the absence of FCE. Diagnosis is based on history, clinical signs, and elimination of other differential diagnoses. Treatment is largely supportive, although high doses of methylprednisolone may be beneficial early in the course of the disease. Affected patients may make a functional recovery if deep pain sensation is preserved and there are not complete lower motor neuron signs in affected limbs or sphincters.     

Case report: fibrocartilaginous embolic myelopathy in a dog

This case report gives details concerning fibrocartilaginous arterial embolism leading to an ischemic myelopathy in a dog. Using various histochemical techniques, the material occluding the vessels was found to be similar to that reported for fibrocartilaginous ground substance of the nucleus pulposus. The pathway by which this material enters the arterial vasculature of the spinal cord is not known.     

Fibrocartilaginous Embolic Myelopathy in a Dog

This case report gives details concerning fibrocartilaginous arterial embolism leading to an ischemic myelopathy in a dog. Using various histochemical techniques, the material occluding the vessels was found to be similar to that reported for fibrocartilaginous ground substance of the nucleus pulposus. The pathway by which this material enters the arterial vasculature of the spinal cord is not known.     

SNAKE BITE IN DOGS

In 7 years snake bite was diagnosed in 80 dogs. Sporting breeds figured prominently. The average was 3.6 years. The commonest presenting signs were salivation, vomiting, dilated pupils, absence of the pupillary light reflex, depression and generalised muscle weakness, hindlimb ataxia and respiratory distress. Sixty-seven cases (84%) occurred in 6 warmer months on the year. Fifty-one dogs (64%) were seen either to be bitten or in contact with a snake. Tiger and Brown snakes were implicated on 32 and 3 occasions respectively. An overall recovery rate of 87% was obtained for patients receiving antivenene, fluid and support therapy. The period from treatment-to-full recovery was shorter for cases in which the bite-to-treatment period was one hour or less (24 hours) when compared with the recovery time for all cases (36 hours). The prognosis was poor for dogs presenting with the triad of complete flaccid paralysis, dyspnoea and a sub-normal temperature.     

COMPUTED TOMOGRAPHY ANGIOGRAPHY FOR EVALUATION OF PULMONARY EMBOLISM IN AN EXPERIMENTAL MODEL AND HEARTWORM INFESTED DOGS

This study was performed to characterize pulmonary embolism with computed tomography pulmonary angiography in experimental pulmonary embolism and heartworm infected dogs. In the experimental group, there were pulmonary changes after pulmonary embolism induction as follows: hypoattenuating round filling defects in pulmonary arteries, arterial dilations with straight and abrupt cut‐off appearances in the pulmonary embolism regions, pulmonary infarctions, a cavity formation and spontaneous pneumothorax, and emboli migration. In the heartworm‐infected group, three out of eight dogs developed pulmonary embolism, especially in the right caudal arteries. Arterial dilations with typical tortuosity were also identified, mainly in the right caudal arteries in five dogs. Computed tomography pulmonary angiography can be an important imaging modality in the diagnosis of pulmonary embolism and the evaluation of pulmonary arterial and parenchymal changes in dogs.     

Suspected air embolism associated with post-anesthetic pulmonary edema and neurologic sequelae in a horse

A 523 kg Quarter Horse was anesthetized for unilateral eye enucleation. The anesthetic period was unremarkable. During anesthetic recovery the cap on the jugular venous catheter became dislodged. Clinical signs of pulmonary edema associated with moderate arterial hypoxemia subsequently developed. Although pulmonary edema resolved with medical therapy, the day following anesthetic recovery, clinical signs of vestibular disease and blindness developed. Treatment included nasal oxygen insufflation, flunixin meglumine, furosemide, dexamethasone, thiamine, dimethylsulfoxide, antimicrobials, and phenylbutazone. The horse recovered and was discharged from the hospital after 7 days of treatment and was neurologically normal at 6 weeks. While venous air embolism was not confirmed in this case, the catheter cap complication followed by signs of pulmonary edema and neurologic sequelae support the presumptive pathogenesis of this horse's complications. Diagnostic confirmation of air embolism in horses with compatible acute clinical signs should be documented with echocardiography.     

Assessment of the usefulness of the fenestration method in cases of disc extrusion in the cervical and thoraco-lumbar spine in chondrodystrophic dogs

The aim of this paper was to assess the effectiveness of treatment of Type I (according to Hansen) intervertebral disc extrusion using the fenestration method. The evaluated clinical material included 37 chondrodystrophic dogs in which multiple fenestration (from 2 to 6 intervertebral spaces) was performed. Dachshunds comprised 86.5% of patients. All dogs were administered corticosteroids during the operation. A mass similar to a slightly jelly-like yogurt, cottage cheese or plaster-like consistency was extracted. In one case a post-surgical pyogenic infection of the wound occured. In two cases, a deterioration in the neurological state followed the fenestration procedure of the cervical spine. In one case of thoraco-lumbar spine fenestration, a deterioration of clinical state was found. Recovery was observed after disc extrusion from the cervical spine in 8 out of 11 dogs, from the thoraco-lumbar spine in 12 out of 14 dogs with the 2nd grade clinical signs and in 11 out of 12 dogs with the 3rd grade clinical sings. In 6 dogs, recurrence of first or second grade clinical signs occurred, but only half of them had to undergo treatment. The probability of dog recovery did not depend on the degree of symptom intensity in a statistically significant way (p=0.11) or on the duration of the disease before the surgical treatment (p=0.87).