OBJECTIVE To characterize outcomes following nonsurgical treatment of congenital thoracic vertebral body malformations causing neurologic deficits in dogs. DESIGN Retrospective case series. ANIMALS 13 client-owned dogs treated nonsurgically for congenital thoracic vertebral body malformations at 3 veterinary referral hospitals from June 2009 through May 2016. PROCEDURES Data were extracted from the medical records regarding dog signalment, duration and type of clinical signs before referral, general physical and neurologic examination findings, radiographic and MRI findings, and treatments provided after diagnosis. Follow-up data were obtained from records of recheck examinations and via a standardized owner questionnaire. RESULTS All included dogs were screw-tail brachycephalic breeds with a median age of 6 months. All dogs had ambulatory paraparesis and ataxia, and in 1 dog, signs of spinal hyperesthesia could be elicited. Nonsurgical treatments consisted of restricted exercise without (n = 5) or with (3) physiotherapy, physiotherapy without restricted exercise (3), and no exercise modification (2). Seven dogs received additional nonsurgical treatment consisting of prednisolone (n = 5) or gabapentin (2). Four dogs were eventually euthanized because of progressive neurologic deterioration, 2 underwent surgery for the same reason, and the remaining 7 dogs survived for ≥ 170 days after diagnosis, despite progressive neurologic deterioration. CONCLUSIONS AND CLINICAL RELEVANCE Nonsurgical treatment of congenital thoracic vertebral body malformations was associated with an unfavorable outcome in this group of dogs. Despite this treatment, all dogs had progression of clinical signs.
The study objective was to compare temporal-spatial and kinetic gait variables in neurologically normal French bulldogs with and without vertebral kyphosis. French bulldogs presented to a dedicated brachycephalic clinic were prospectively enrolled. All dogs underwent general physical, orthopaedic, and neurological examination prior to study inclusion. The presence of vertebral kyphosis was evaluated by computed tomography and kyphosis was defined as a Cobb angle exceeding 10°. Gait variables were collected using a pressure-sensitive GAITRite walkway with GAITFour software and included measurement of total pressure index (TPI) defined as the sum of peak pressure values recorded from each activated sensor by a paw during mat contact. Fifteen French bulldogs with (n=8) and without kyphosis (n=7) were included. Cobb angle in kyphotic dogs ranged from 14.9° to 39.5°. Univariate analyses were initially performed to examine the association between kyphosis and 16 gait variables. When those variables found to be associated (P<0.2) were taken forward into multivariate generalised linear mixed models (accounting for dog, velocity and side), kyphosis had a significant effect upon TPI of the forelimbs and TPI symmetry ratio (P<0.05); however, the size of these effects was small. Although vertebral kyphosis is rarely associated with neurological deficits, it was associated with subtle alterations in kinetic gait variables (TPI forelimbs and TPI symmetry ratio). Further studies are needed to evaluate the clinical importance of altered gait variables in French bulldogs with kyphosis.
26 November 2020 in Veterinary Radiology & Ultrasound
Objective: To describe the approach for placement of a transcerebellar fourth ventriculoperitoneal shunt for management of presumed fourth ventricle arachnoid diverticulum and secondary obstructive hydrocephalus of a dog. To describe the outcome of this procedure.Study design: Case report.Animals: Male entire English springer spaniel, 3 years 9 months of age.Methods: The dog was initially presented for management of acute, progressive, and multifocal brainstem and forebrain dysfunction. Magnetic resonance imaging revealed internal obstructive hypertensive hydrocephalus. The dog was managed via ventriculoperitoneal shunting from the left lateral ventricle and made an excellent recovery. The dog acutely deteriorated 18 months after initial discharge and follow‐up magnetic resonance imaging confirmed the ventricular shunt remained in situ with normal‐sized lateral ventricles but revealed a cystlike lesion within the fourth ventricle, presumed to be a fourth ventricle arachnoid diverticulum. The diverticulum was causing mass effect and resultant compression of adjacent neuroparenchyma. A second ventriculoperitoneal shunt was subsequently placed into the fourth ventricle via the caudal cranial fossa and cerebellum. This was attached to a three‐way connector, to which the existing shunt (within the left lateral ventricle) was also attached, and then secured to the existing medium‐pressure valve.Results: Postoperatively, the dog immediately developed mild vestibular‐cerebellar ataxia, with a marked improvement after 3 months. There were no shunt‐associated complications. Long‐term follow up at 40 months after the second surgical procedure revealed a normal neurological examination.Conclusion: Transcerebellar ventriculoperitoneal shunt placement for treatment of a presumed fourth ventricle arachnoid diverticulum was performed and was associated with a favorable long‐term outcome.
1 September 2020 in Journal of the American Veterinary Medical Association