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Michaelmas 5th year > Small animal neuro spinal cord diseases > Flashcards

Small animal neuro spinal cord diseases Flashcards

1
Q

Onset and progression of VITAMIN D

A

Vascular = rapid onset, then improves
Inflammatory or infectious; get worse [inflammatory may way or wane]
Trauma: stays the same
Metabolic: waxes and wanes
Neoplastic gets worse
Degenerative gets worse

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2
Q

What is fibrocartilagenous embolic myelopathy

A

Where fibrocartilagenous material from the disc embolises into the spinal cord vessels causing ischemic necrosis
- Gives one sided myelopathy of muscles

= vascular

Sudden onset and may make pain noise at first; then improves and painless

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3
Q

What is the signalment for fibrocartilagenous embolic myelopathy

A

Non-chondrodystrophic breeds since need healthy ‘fluid’ discs to be able to jump into vessels
Typically young adult dogs

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4
Q

What is the treatment for FCE

A

Time for regeneration and rehabilitation
Prognosis good; better when deep pain present

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5
Q

What would we see on an MRI in a patient with FCE

A

Small one sided well defined lesion of necrosis (white) in the spinal cord

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6
Q

What is steroid responsive meningitis arteritis

A

Immune mediated inflammation of the meninges

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7
Q

Symptoms of SRMA

A

Acute onset, pyrexia, anorexia neck pain
Normal neruological exam since it is meninges affected NOT the nerves

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8
Q

Why would we check joints of an animal with suspected SRMA

A

50% have concurrent IMPA; immune mediated polyarthritis

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9
Q

Signalment of SRMA
Which breeds are predisposed

A

Yound dogs <2y/o since occurs when immune system maturing
esp Beagles, Bernese mountain dogs, Boxers

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10
Q

Blood and CSF characteristcs with SRMA

A

Bloods show left shifted neutrophilia, high CRP, high IgA
CSF is ASEPTIC with neotrphilic pleocytosis, high IgA

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11
Q

Treatment of SRMA

A

Long term immune suppression with high dose steroids and gradual tapering

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12
Q

What is discospondylitis

A

Inflammation of the spinal cord due to infection of the disc and verteral end plates

Usually via haematogenous spread from distant infectious foci
Could be iatrogenic, abscesses, penetrating wounds

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13
Q

What is the signalment for discospondylitis

A

Large middle aged male entire dogs
(due to associated with prostatitis)

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14
Q

What signs would we see with discospondylitis and how is the diagnosis made

A

Signs = neck pain/multifocal spinal pain, normal neuro signs
[don’t have as many systemic signs as with SRMA e.g IMPA)

X ray/MRI see abnormal end plates, narrowed disc space due to bony growth, MRI contrast shows inflammation
NB: X ray is normal for first few weeks of infection
Leucocytosis on bloods

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15
Q

Why should we do room rest for an animal with discospondylitis

A

Due to risk of pathological fractures of vertebral column or disc herniation

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16
Q

What organisms cause discospondylitis and how does this affect prognosis

A

Usually bacterial e.g staph intermedius
Could be fungal; this gives worse prognosis

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17
Q

When all 4 limbs are affected in terms of gait which ones look worse

A

Pelvic limbs always look worse

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18
Q

WHat is the usual cause of atlanto-axial instability

A

Congenital absence or hypoplasia of the dens

Can be breaking the dens
Missing ligaments

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19
Q

What is the signalment of atalanto-axial instability

A

Young toy breed dogs with history of trauma e.g big jump down

20
Q

Signs seen with atlanto-axial instability and what do we need to be aware of

A

Cervical pain, C1-C5 neurological deficits i.e UMN signs in forelimbs + hindlimbs
Do not flex the neck if this is a suspected cause

21
Q

Options for treating atlanto-axial instability

A

Conservative: neck/shoulder bandage for 6-12 weeks and cage rest

Surgical: fix axis and atlas together using pins

22
Q

What spinal cord neoplasia do we get in different areas

A

Extra-dural i.e outside of the dura
- Vertebral tumours, lymhpoma

Intra-dural extra medullary: meningiomas, nerve sheath tumours mostly

Intra-medullayy: ependymomas, gliomas, lymphoma

23
Q

Signs of spinal cord neoplasia

A

If tumour is extra-dural or intradural-extra medullary get spinal hyperaesthesia

Neurological signs are related to the position of the tumour and spinal cord compression

24
Q

What is degenerative myelopathy and how does it progress

A

= neurodegenerative disease
Slow progressing myelopathy

Starts usually in T3-L3 region with asymmetric proprioceptive ataxia and spastic paresis in pelvic limbs
Then progresses to to thoracic limbs and from UMN to LMN involvement [caudal then cranial progressino]

25
Q

Signalment for degenerative myelopathy

A

Older dogs (>8), GSD, boxer, pembroke welsh corgi etc predisposed

26
Q

Diagnosis of degenerative myelopathy

A

Hard; best is post-mrtem
Diagnosis of exclusion
on CSF see phosphorylated neurofilament heavy, may see SOD1 mutation as risk factor

27
Q

What should healthy discs look like on X ray

A

Radiolucent
If radiodense areas between vertebrae suggests calcification of the disc related to degeneration

If reduced space b/w vertebrae suggests disc rpture

28
Q

What approach do we take for spinal cord surgery in different areas of the body

A

Cervical = ventral
Thoracolumbar - hemilaminectomy; from the side
Lumbosacral = from dorsal

29
Q

What is progressive myelomalacia

A

Fatal complication of acute type 1 intervertebral disc extrusion
Progressive harmorrhagic necrosis of spinal cord

More likely wth paraplegia without deep pain sensation

30
Q

Two types of cervical spondylomyelopathy and their signalment

A

Disc assocaited; large breed dogs of middle age +
Osseous associated; giant breed dogs usually <1y/o

31
Q

How does disc associated cervical spondylomyelopathy present

A

Two engine gait; tetraparesis Usually C5-C7 discs compressing the spinal cord from ventrally
On MRI see misshapen vertebrae, herniated disc

32
Q

How does osseous associated CSM work

A

Bones are hyperplastic and irregular in shape so get narrowing of the vertebral canal and compression of spinal cord from all aspects
Usually cranial cervical region; C3-C6

Present with clumsiness

33
Q

What is acute non-compressive nucleus pulposus extrusion

A

High velocity, low volume disc extrusion due to traumatic rupture of annulus fibrosis
THe jelly NP dissipates quickly so the effect is contusion NOT any compression

34
Q

Signs with acute non-compressive nucleus pulposus extrusion

A

Usually lateralised signs; C1-C5
No pain after a couple of days and signs stabilise

35
Q

What is a ‘seagull sign’ lesion on MRI

A

= compressive lesion of nucleus pulposis within the spinal column in hydrated nucleus pulposus extrusion

36
Q

What happens in hydrated nucleus pulposus extrusion and how are signs different to ANNPE

A

Extrusion of nucleus pulposis which contuses spinal cord and then stays there causing compressive myelopathy
Signs are non-lateralised and onset not associated with trauma/exercise

37
Q

What is a type 1 vs type 2 Hansen disc issue

A

Type 1 = extrusion; due to chondroid metaplasia get rupture of annulus fibrosis

Type 2 = protrusion where annulus fibrosis is misshapen and protrused into spain cord
Due to fibroid metaplasia

38
Q

What is the signalment of type 1 Hansen disc extrusion

A

Chondrodystrohic breeds
Here to nucleus pulposus ages prematurely and mineralises
- Then can get extrusion of abnormal NP to compress spinal cord

= acute progression

39
Q

How does type 1 disc extrusion work

A

High impact compression and contusion on spinal cord by extrusion of calcified nucleus pulposus

causes contusion, oedema, haemorrhage, inflammation and necrosis

Painful and progresses to ataxia, parasis/plegia

Can be quite young animals so >2y/o

40
Q

How does type 2 disc protrusion work

A

Get fibroid degeneration cause progressive thickening of dorsal annulus fibrosis dorsally to protrude into spinal cord

41
Q

Signalment of type 2 disc protrusion

A

Older dogs 5-7y/o
Large non-chondrodystrophic dogs e.g rottweilier, GSD

Chronic slow progression via slow compression of spinal cord, impaired spinal cord perfusion, ischaemia, demylination, atrophy

42
Q

Why is disc herniation between T2 and T10 rare

A

Due to presence of intercapital ligament here

43
Q

Where do small vs larger breed dogs tend to get disc herniation

A

Small breeds more cranial i.e C2-3
Larger breeds C6-7
GSDs typically get it at T1-T3

44
Q

Where do GSDs typically get disc hernitation

A

T1-3

45
Q
A

Michaelmas 5th year (41 decks)

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