Spinal Epidural Abscess in Two Calves

Objective— To report clinical signs, diagnostic and surgical or necropsy findings, and outcome in 2 calves with spinal epidural abscess (SEA). Study Design— Clinical report. Animals— Calves (n=2). Methods— Calves had neurologic examination, analysis and antimicrobial culture of cerebrospinal fluid (CSF), vertebral column radiographs, myelography, and in 1 calf, magnetic resonance imaging (MRI). A definitive diagnosis of SEA was confirmed by necropsy in 1 calf and during surgery and histologic examination of vertebral canal tissue in 1 calf. Results— Clinical signs were difficulty in rising, ataxia, fever, apparent spinal pain, hypoesthesia, and paresis/plegia which appeared 15 days before admission. Calf 1 had pelvic limb weakness and difficulty standing and calf 2 had severe ataxia involving both thoracic and pelvic limbs. Extradural spinal cord compression was identified by myelography. SEA suspected in calf 1 with discospondylitis was confirmed at necropsy whereas calf 2 had MRI identification of the lesion and was successfully decompressed by laminectomy and SEA excision. Both calves had peripheral neutrophilia and calf 2 had neutrophilic pleocytosis in CSF. Bacteria were not isolated from CSF, from the surgical site or during necropsy. Calf 2 improved neurologically and had a good long‐term outcome. Conclusion— Good outcome in a calf with SEA was obtained after adequate surgical decompression and antibiotic administration. Clinical Relevance— SEA should be included in the list of possible causes of fever, apparent spinal pain, and signs of myelopathy in calves.     

ATLANTO-AXIAL MALARTICULATION IN ANGORA GOATS

SUMMARY Two male Angora goats presented with ataxia and weakness of the hind limbs. Both tired easily when exercised and often stumbled and fell. In both cases, post-mortem examination revealed focal areas of gliosis and diffuse Wallerian degeneration in the spinal cord at the level of the atlanto-axial joint. There were also two areas of myelomalacia in one of the goats. In the other, the caudal articular surfaces of the atlas were unusually convex and the odontoid process of the axis was laterally compressed. It is suggested that these vertebral anomalies resulted in excessive mobility of the joint leading to the development of a compressive myelopathy.     

MAGNETIC RESONANCE IMAGING OF THE CERVICAL SPINE IN 27 DOGS

The cervical spine of 27 dogs with cervical pain or cervical myelopathy was evaluated using magnetic resonance imaging (MRI). Spin echo T1, T2, and post-contrast T1 weighted imaging sequences were obtained with a 0.5 Tesla magnet in 5 dogs and a 1.5 Tesla magnet in the remaining 22 dogs. MRI provided for visualization of the entire cervical spine including the vertebral bodies, intervertebral discs, vertebral canal, and spinal cord. Disorders noted included intervertebral disc degeneration and/or protrusion (12 dogs), intradural extramedullary mass lesions (3 dogs), intradural and extradural nerve root tumors (3 dogs), hydromyelia/syringomyelia (1 dog), intramedullary ring enhancing lesions (1 dog), extradural synovial cysts (1 dog), and extradural compressive lesions (3 dogs). The MRI findings were consistent with surgical findings in 18 dogs that underwent surgery. Magnetic resonance imaging provided a safe, useful non-invasive method of evaluating the cervical spinal cord.     

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.     

Iatrogenic fractures of ribs and vertebrae during delivery in perinatally dying calves: 235 cases (1978-1988)

To determine the pathogenesis of vertebral fractures in calves during the perinatal period, a retrospective study was done to determine the relationships between clinical factors at dystocia and the findings during necropsy of 235 perinatally dying calves. It was concluded that excessive traction is the most important cause of rib and vertebral fractures in the calf during dystocia. Vertebral fractures in perinatally dying calves may not be simply judged as a sign of asphyxia. The occurrence of vertebral fractures is highly correlated with the type of delivery and the force of traction. The veterinarian as well as the type of calf also are influencing factors. More perinatally dying calves were delivered after hips were locked, when extraction had been forced, or through induction of trauma when the head of the calf had the pelvic canal during the first obstetric examination. Consequently, fetal position at delivery may predispose calves to risky extractions and to the risk of perinatal death secondary to trauma. In light calves, significantly more vertebral fractures occurred during extractions than in other calves. Therefore, the veterinarian should accurately estimate the birth weight of the calf and the force of traction that should be applied.     

Standing low‐field magnetic resonance imaging of a comminuted central tarsal bone fracture in a horse

This report describes the use of low‐field standing magnetic resonance imaging (MRI) in the diagnosis and clinical decision making process in a 14‐year‐old Dutch Warmblood mare with a comminuted central tarsal bone fracture. Magnetic resonance imaging in the standing horse was preferred over computed tomography examination under general anaesthesia because the animal had sustained the injury during a poor recovery from a previous general anaesthetic episode. Magnetic resonance imaging examination identified a comminuted central tarsal bone fracture with a configuration that was not identifiable with radiography. Due to extensive comminution of this fracture, conservative management was pursued. Standing low‐field MRI examination enabled safe examination of this animal and provided useful diagnostic information whilst facilitating the clinical decision making process.     

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.     

Tetraparesis due to vertebral physeal fracture in an adult dog with congenital hypothyroidism

A four-year-old male affenpinscher was referred for evaluation of hindlimb weakness that had progressed to tetraparesis over a period of four weeks. Neurological examination was suggestive of a cervical spinal cord lesion. Radiographic examination revealed diffuse skeletal immaturity with open physes and epiphyseal dysplasla in long bones and vertebrae, consistent with a diagnosis of congenital hypothyroidism. Total and free serum T4 concentrations were very low, indicative of hypothyroidism. Survey radiographs of the cervical spine revealed a dorsally displaced Salter-Harris type I fracture of the cranial portion of the fourth cervical vertebra with the endplate present in the vertebral canal. Although signs of transverse myelopathy are uncommon In dogs with congenital hypothyroidism, they may be associated with either intervertebral disc protrusion or endplate displacement into the vertebral canal secondary to the epiphyseal abnormalities associated with congenital hypothyroidism.     

The clinical pathology of heartwater. II. Studies on cardiac and pulmonary function in 4 calves with experimentally-induced heartwater

Studies to evaluate cardiac and pulmonary function were undertaken in 4 calves suffering from experimentally-induced heartwater. There was a marked variation in the course of the disease. Three of the calves recovered spontaneously after developing clinical signs. These included a rectal temperature in excess of 40 degrees C, anorexia and listlessness but no neurological signs. The remaining calf died 2 days after developing a fever and neurological signs. In the 3 calves that recovered, a mild hypoxemia developed during the acute stage of the disease. Arterial CO2 tension remained within normal limits, but there was a tendency towards an alkalosis. Increases in pulmonary dead space and fluctuations in venous admixture were observed. The calf that died showed similar mild changes in blood gas parameters, despite the presence of a marked reduction in minute volume, and a lung oedema was demonstrated on post-mortem examination. No marked changes in systolic and diastolic blood pressures and in right cardiac intraventricular pressures were observed. Terminally, however, there were marked decreases in stroke volume and cardiac output. These changes were associated with a sharp increase in heart rate. No primary cardiac pathology was observed on clinical and post-mortem examinations.     

Magnetic resonance imaging characteristics of suspected vertebral instability associated with fracture or subluxation in eleven dogs

The purpose of this study was to describe the magnetic resonance imaging (MRI) characteristics of suspected instability in dogs with vertebral fractures or subluxations. Eleven dogs that had MRI examinations of the spine prior to surgical stabilization of vertebral fractures and/or subluxations were included in the study. Nine dogs also had survey radiographs. Four dogs had cervical fracture or fracture-subluxation and presented with tetraplegia with intact nociception (n = 2) or nonambulatory tetraparesis (n = 2). Seven dogs had thoracolumbar fracture-subluxation or subluxation and presented with paraplegia with intact nociception (n = 5) or nonambulatory paraparesis (n = 2). A three-compartment model was applied to the interpretation of both the radiographic and MRI studies. Radiography identified compartmental disruption consistent with spinal instability in seven out of the nine cases radiographed. In MRI studies, rupture of the supportive soft tissue structures and/or fracture in at least two compartments could be visualized. Nine cases had spinal cord changes on MRI including signal intensity changes, swelling, compression, and intramedullary hemorrhage. Paravertebral muscle intensity changes were also visible at each trauma site. Magnetic resonance imaging provided helpful information on the location and extent of damage to supportive soft tissue structures and enabled assessment of spinal cord injury in this group of dogs with surgically confirmed vertebral fractures and subluxations.     

THE USE OF MAGNETIC RESONANCE IMAGING IN EVALUATING HORSES WITH SPINAL ATAXIA

To determine the accuracy of magnetic resonance imaging for diagnosing cervical stenotic myelopathy in horses, 39 horses with spinal ataxia and 20 control horses underwent clinical and neurologic examinations, cervical radiographs, euthanasia, magnetic resonance (MR) imaging of the cervical spine and necropsy. Twenty‐four horses were diagnosed with cervical stenotic myelopathy, 5 with cervical vertebral stenosis, 7 with idiopathic ataxia, 3 horses had other causes of ataxia, and 20 were controls. The MR images were assessed for spinal cord intensity changes, presence of spinal cord compression, spinal cord compression direction, shape of spinal cord, and the presence of synovial cysts, joint mice, and degenerative joint disease. The height, width, and area of the spinal cord, dural tube and vertebral canal were measured. The identification of spinal cord compression on MR images was significantly different in horses with cervical stenotic myelopathy (P < 0.02), but in the cervical stenotic myelopathy group the identification of spinal cord compression on MR images had poor to slight agreement with histopathologic evidence of compression (κ = 0.05). Horses with cervical stenotic myelopathy were more likely to have a T2 hyperintensity in the spinal cord (P < 0.05). Horses with cervical stenotic myelopathy or cervical vertebral stenosis were more likely to have degenerative joint disease than control horses or horses with other or idiopathic ataxia.     

USE OF MAGNETIC RESONANCE IMAGING FOR DIAGNOSIS OF A SPINAL TUMOR IN A CAT

Magnetic resonance imaging was used to identify a spinal mass at the level of the 6th-7th cervical vertebral body in a cat. The MRI images were most consistent with the presence of an intradural, extramedullary meningioma that was confirmed by subsequent histological examination.     

Comminuted basilar skull fracture in a colt: Use of computed tomography to aid the diagnosis

The case of a one‐year‐old colt with acute onset of neurological dysfunction and epistaxis after a traumatic event is presented. After initiating emergency treatment, the colt was anaesthetised for diagnostic imaging. Radiographic examination of the head was suggestive of soft tissue opacity in the area of the guttural pouches, but was inconclusive about osseous involvement. A computed tomography (CT) scan, used to obtain further details, showed a comminuted basilar skull fracture with 2 displaced fragments that were not detected by radiography. Because of the poor prognosis for survival and return to athletic function, the horse was subjected to euthanasia. CT imaging provided the most useful diagnostic information about type, localisation, extension and severity of the basilar skull fracture.     

METRIZAMIDE MYELOGRAPHY OF THE EQUINE CERVICAL SPINE

Case histories of 14 horses with pelvic limb ataxia requiring myelography were reviewed. Because differential diagnosis requires radiography, comparisons of lesion location, radiographic techniques, and lesion patterns were studied. Survey radiography and myelography were performed under general anesthesia, with recumbent-lateral and flexed-lateral views of the carnial and caudal cervical spine. Metrizamide was the myelographic contrast medium. Assessment of radiography as a diagnostic aid for cervical vertebral instability and cervical stenotic myelopathy was made through the comparison of survey radiographs and myleograms, in nonflexed and flexed positions, using these criteria: width of dorsal and ventral columns of contrast medium, compression of intervertebral disc spaces, presence or absence of bone proliferation at articular facets, remodeling secondary to vertebral instability. Radiography was an adequate diagnostic aid for cervical vertebral instability and cervical stenotic myelopathy. Distribution of lesions showed C_3–4 most common, with C_2–3 and C_4–5 following.     

Rostral cerebellar arterial infarct in two cats

A 10-year-old female neutered domestic shorthair (DSH) cat and a 6-year-old female neutered Siamese cat were presented following a peracute onset of decerebellate rigidity and a cerebellar vestibular syndrome, respectively. In both cats, physical examination and routine blood tests were unremarkable, as was routine analysis of cerebrospinal fluid obtained from the DSH cat. Based on the magnetic resonance imaging (MRI) features - focal wedge-shaped lesion in the cerebellum characterised by hyperintensity in T2-weighted, T2( *)-gradient echo and fluid attenuated inversion recovery (FLAIR) images - a presumptive diagnosis of cerebellar infarct was made in both cases. In the DSH cat, the post-mortem examination confirmed the diagnosis of cerebellar infarct and additionally found acute renal infarcts and a pulmonary neoplasia. In the Siamese cat, ultrasonographic evaluation of the heart revealed a probable low-grade chronic valvular endocarditis which was thought to be a potential source of thromboembolism. This paper describes the first two cases - one confirmed and the other suspected - of cerebellar infarct in the cat. The in vivo potential diagnostic value of the MRI study is highlighted. Cerebellar infarcts should be included in the differential diagnosis of cat with a peracute onset of cerebellar signs regardless of the severity of neurological deficits.     

A MYELOGRAPHIC TECHNIQUE FOR AVIAN SPECIES

A post-mortem myelogram was used to diagnose a vertebral fracture in a Red-tailed Hawk ( Buteo jamaicenis ). This diagnosis led the authors to believe that myelography would be useful in live birds. In a pilot study using live adult female chickens (Gallus domesticus) , mammalian myelographic techniques were modified for avian anatomic differences. A thoracolumbar puncture site was used rather than the lumbar or cisternal site which is commonly used in mammals. The volume of contrast medium needed to produce a diagnostic myelogram in birds(0.8–1.2 ml/kg) was found to be approximately four times that needed in mammals. A 25 gauge spinal needle was used rather than a 23 gauge needle. Myelograms of diagnostic quality were obtained with normal subject recovery. Seizures, the most common post-myelographic complication in mammals, were not observed in any of the birds studied. Avian myelography was found to be a cost effective and humane technique with potential application to avian practice.     

Pulmonary function changes and clinical findings associated with chronic respiratory disease in calves.

Thirteen field cases of chronic respiratory disease in crossbred calves aged between 1 and 8 months were subjected to a standardized examination in which clinical criteria were scored and weighted to allow quantification. Predicted values for pulmonary function variables were generated using regression equations previously established in normal calves which related measured pulmonary function variables to thoracic perimeter. Subsequent pulmonary function testing of each calf was undertaken and values obtained compared with predicted values and correlated with clinical scores. Diagnosis was confirmed at post-mortem examination. Calves with chronic respiratory disease had significantly reduced inspiratory and expiratory times, tidal volume, dynamic compliance and PaO2, significantly increased respiratory frequency, airway resistance and PaCO2 and more negative transpulmonary pressure values when compared to predicted pulmonary function values for the same calves. PaO2 and PaCO2 were the only variables correlated with clinical scores, suggesting their value in the assessment of severe cases of calf respiratory disease.     

Characteristic computed tomographic myelography findings in 23 Thoroughbred horses

The purpose of this observational study was to determine the characteristic computed tomographic (CT) myelography findings of cervical vertebral stenotic myelopathy (CVSM) lesions in Thoroughbred horses. A total of 23 Thoroughbred horses (age range, 155–717 days on CT examination; mean, 410.9 days) were analyzed. All 23 Thoroughbred horses underwent unenhanced radiography, radiographic myelography, and CT myelography. Unenhanced radiographs were observed the presence of cervical vertebral malalignment and osseous lesions. Radiographic myelograms were observed for signs of cervical spinal cord compression; additionally, CT myelograms were used to detect cervical vertebral osseous lesions. Ventral compressions were frequently observed in the cranial cervical vertebrae (C2–C4), whereas dorsal compressions were frequently observed in the caudal cervical vertebrae (C5–C7). Furthermore, osseous lesions of the caudal articular process developed more frequently than those of the cranial articular process. CT myelography in Thoroughbred horses is a useful method for detecting CVSM changes.     

Acute basophilic leukaemia in a three-month-old calf

A three-month-old female Holstein–Friesian calf was presented with acute tetraparesis. After neurological examination a multifocal lesion in the central nervous system was suspected with the most pronounced lesions between the third thoracic and the third lumbar vertebrae. Haematological examination revealed moderate anaemia as well as severe thrombocytopenia, neutropenia and leucocytosis. A blood smear and bone marrow aspirate exhibited predominantly blasts with basophilic granulation leading to a diagnosis of acute (myeloid) leukaemia with involvement of the basophilic lineage or an acute basophilic leukaemia. Magnetic resonance imaging revealed spinal cord compression; at necropsy, extensive localised haemorrhages extending into the thoracic vertebral canal were found. Histopathology revealed a large population of blast cells in several tissues including the meninges. Due to multifocal detection of neoplastic cells in the vascular system, neoplasia of the haematopoietic system was assumed in agreement with haematological findings. Signs of paresis could be explained by intramedullary spinal cord haemorrhage and myeloid infiltrations of meningeal vessels. In conclusion, despite its rarity, acute myeloid leukaemia with involvement of the basophilic lineage may be considered in diagnosing calves with progressive deteriorating general condition, paresis, leucocytosis with moderate basophilic differentiation or haemorrhagic disorders.