Spinal cord disease (Yr 4)

Question 1

how can spinal disease be graded?

Answer 1

1 to 5

Question 2

what is grade 1 spinal disease?

Answer 2

no deficits, just pain

Question 3

what is grade 2 spinal disease?

Answer 3

paresis, ambulatory

Question 4

what is grade 3 spinal disease?

Answer 4

paresis, non-ambulatory

Question 5

what is grade 4 spinal disease?

Answer 5

paralysis

Question 6

what is grade 5 spinal disease?

Answer 6

no pain sensation

Question 7

where can spinal lesions be localised to?

Answer 7

C1-C5
C6-T2
T3-L3
L4-S3

Question 8

how do lesions of C1-C5 effect the spinal reflexes?

Answer 8

thoracic limb - normal
pelvic limb - normal

Question 9

how do lesions of C6-T2 effect the spinal reflexes?

Answer 9

thoracic limb - reduced
pelvic limb - normal

Question 10

how do lesions of T3-L3 effect the spinal reflexes?

Answer 10

thoracic limb - normal
pelvic limb - normal

Question 11

how do lesions of L4-S3 effect the spinal reflexes?

Answer 11

thoracic limb - normal
pelvic limb - reduced

Question 12

what are the spinal reflexes?

Answer 12

patella
withdrawal

Question 13

what are the paracute onset spinal diseases?

Answer 13

vascular (fibrocartilagenous embolism, stroke)
trauma (fractures, extrusions, luxations)

Question 14

what causes peracute vascular spinal disease in dogs?

Answer 14

fibrocartilagenous embolism

Question 15

what is ischaemia myelopathies?

Answer 15

when the blood supply to the spinal cord is interrupted leading to per-acute, non-painful lesions

Question 16

how do ischaemic myelopathies usually present?

Answer 16

peracute, non-painful, lateralised

Question 17

what are acute non-compressive nucleus pulpous extrusions?

Answer 17

acute onset, non-painful, non-progressive herniation of the nucleus pulpous following a traumatic event, hitting the spinal cord and causing small haemorrhages

Question 18

how does the 3 compartment rule help with diagnosis of spinal fractures?

Answer 18

split the spinal cord into 3 compartments (dorsal, middle, ventral) if 2 or more compartments are effected the fracture is likely to be unstable and lead to a poorer prognosis

Question 19

what is a very poor prognostic indicator for spinal fractures?

Answer 19

if they are deep pain negative

Question 20

what are some subacute causes of spinal disease?

Answer 20

intervertebal disc degeneration type 1 (extrusion)
infectious/inflammatory

Question 21

what are the general categories of intervertebal disc degeneration?

Answer 21

chondrodystrophic
non-chondrodystrophic

Question 22

when do chondrodystrophic breeds present with intervertebal disc degeneration?

Answer 22

<2 years old

Question 23

when do non-chondrodystrophic breeds present with intervertebal disc degeneration?

Answer 23

> middle aged

Question 24

what is type 1 intervertebal disc degeneration?

Answer 24

extrusion

Question 25

what happens with intervertebal disc degeneration type 1 (extrusion)?

Answer 25

herniation of nucleus pulposus through annular fibres and extrusion of the nuclear material into the spinal canal

Question 26

how does type 1 (extrusion) intervertebal disc degeneration present?

Answer 26

acute onset, progressive, painful

Question 27

what is type 2 intervertebal disc degeneration?

Answer 27

protrusion

Question 28

what happens with type 2 (protrusion) intervertebal disc degeneration?

Answer 28

annular protrusion caused by shifting of central nuclear material, it becomes flattened with a slight bulge of the nucleus

Question 29

what animals is type 2 (protrusion) intervertebal disc degeneration seen in?

Answer 29

older non-chondrodystrophic breeds

Question 30

how do animals with type 2 (protrusion) intervertebal disc degeneration present?

Answer 30

chronic onset, may or may not be painful less severe than type one

Question 31

how is intervertebral disc disease treated?

Answer 31

conservative (strict rest and analgesia) surgical

Question 32

when is surgery recommended for intervertebal disc disease?

Answer 32

severe neurological deficits (grade 3-5) severe/recurrent pain

Question 33

what is the most common immune mediated spinal disease?

Answer 33

steroid responsive meningitis-arteritis

Question 34

what are the clinical signs of steroid responsive meningitis-arteritis?

Answer 34

lethargy. anorexia, fever cervical rigidity and spinal pain often concurrent immune mediated polyarthritis

Question 35

what age do dogs present with steroid responsive meningitis-arteritis?

Answer 35

6-18 months

Question 36

how can steroid responsive meningitis-arteritis be diagnosed?

Answer 36

CSF analysis

Question 37

what is the main differential diagnosis for steroid responsive meningitis-arteritis?

Answer 37

discospondylitis

Question 38

what is discospondylitis?

Answer 38

infection of the intervertebral discs (most commonly L7-S1)

Question 39

how is discospondylitis diagnosed?

Answer 39

radiography (narrowing of IVD space, roughened endplates, proliferation of adjacent bone) bacteriology (blood, urine, CSF)

Question 40

how is discospondylitis treated?

Answer 40

antibiotics (8 weeks) analgesia

Question 41

what is MUO?

Answer 41

meningomyelitis of unknown origin

Question 42

how is meningomyelitis of unknown origin treated?

Answer 42

corticosteroids

Question 43

what are the chronic causes of spinal disease?

Answer 43

neoplasia degenerative malformations, instability

Question 44

where can spinal neoplasias be found?

Answer 44

extradural intradural extramedullary (inside meninges, outside the cord) intradural intramedullary

Question 45

what is wobblers also known as?

Answer 45

cervical spondylomyelopathy

Question 46

what are the clinical signs of wobblers?

Answer 46

paresis/ataxia (worse on back legs) short stilted gait muscle atrophy

Question 47

what is the main breed wobblers is seen in?

Answer 47

doberman

Question 48

what are some vertebral and spinal anomalies?

Answer 48

spinal arachnoid diverticulae butterfly vertebrae block vertebrae transitional vertebrae spinal stenosis

Question 49

what are the clinical signs of degenerative myelopathy?

Answer 49

insidious progressive ataxia/paresis of pelvic limbs ultimately leading to paralysis over an 18 month period

Question 50

what is the typical breed effected by degenerative myelopathy?

Answer 50

German shepherd

Question 51

what test can be done for degenerative myelopathy?

Answer 51

genetic test available (diagnosed by exclusion)

Question 52

what breeds is atlantoaxial instability seen in?

Answer 52

young toy breed dogs

Question 53

what are the clinal signs of atlantoaxial instability?

Answer 53

neck pain ataxia/tetraparesis

Question 54

what is chiari-like malformation?

Answer 54

mismatch between caudal fossa clime and its content leading to caudal displacement of the cerebellum through foramen magnum

Question 55

what are the clinical signs of chiari-like malformation?

Answer 55

neck pain thoracic limb weakness/atrophy scoliosis neck scratching (pins/needles)

Question 56

what is the medical treatment for chiari-like malformations?

Answer 56

gabapentin NSAIDs furosemide steroids and opioids