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Outcome comparison in dogs with a presumptive diagnosis of thoracolumbar fibrocartilaginous embolic myelopathy and acute non-compressive nucleus pulposus extrusion
  1. Lorenzo Mari, DVM, MRCVS1,
  2. Sebastien Behr, DVM, DipECVN, MRCVS2,
  3. Anita Shea, BVSc, DipECVN, MRCVS1,
  4. Elisabet Dominguez, DVM, PhD, DipECVDI, MRCVS3,
  5. Philippa J Johnson, BVSc, MSc, CertVDI, DipECVDI, MRCVS4,
  6. Abel Ekiri, BVM, MS, PhD, DipACVPM5 and
  7. Luisa De Risio, DVM, PhD, DipECVN, MRCVS1
  1. 1Department of Neurology/Neurosurgery, Centre for Small Animal Studies, Animal Health Trust, Newmarket, Suffolk, UK
  2. 2Neurology/Neurosurgery Service, Willows Veterinary Centre and Referral Services, Solihull, UK
  3. 3Diagnostic Imaging Service, Centre for Small Animal Studies, Animal Health Trust, Newmarket, UK
  4. 4Diagnostic Imaging Section, College of Veterinary Medicine, Cornell University, Ithaca, USA
  5. 5One Health Institute, School of Veterinary Medicine, University of California, Davis, USA
  1. E-mail for correspondence; lorenzo.mari{at}aht.org.uk

Abstract

Dogs with fibrocartilaginous embolic myelopathy (FCEM) or acute non-compressive nucleus pulposus extrusion (ANNPE) are reported to have a fair prognosis; however, persistent motor/autonomic deficits are possible. Specific MRI patterns have been suggested to differentiate these diseases although never been validated with histopathology in large studies. The aim of this retrospective study was to evaluate if these MRI patterns are associated with different clinical outcomes in dogs with peracute non-progressive T3-L3 myelopathy. Two hundred and one dogs were included. Outcome data were obtained via medical records and telephone questionnaires. MRIs were blindly reviewed by three board-certified observers, obtaining substantial to almost perfect interobserver agreement on diagnoses (κ=0.635–0.828). Presumptive ANNPE and FCEM were diagnosed in 157 and 44 dogs , respectively. Ambulatory function was regained in 99 per cent of cases, with persistent motor deficits in 83.6 per cent and 92.5 per cent of dogs with presumptive ANNPE and FCEM, respectively. The presumptive diagnosis was not associated with motor function recovery, recovery times or urinary continence. Faecal incontinence was five times more likely in dogs with presumptive ANNPE (23 per cent) compared with presumptive FCEM (7.5 per cent).

Distinguishing between MRI patterns of presumptive ANNPE or FCEM in dogs with peracute non-progressive T3-L3 myelopathy may help predict the risk of developing faecal incontinence.

  • ischaemic myelopathy
  • spinal cord injury
  • incontinence
  • neurogenic bowel dysfunction
  • Received September 1, 2016.
  • Revision received June 6, 2017.
  • Accepted June 19, 2017.

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  • Received September 1, 2016.
  • Revision received June 6, 2017.
  • Accepted June 19, 2017.
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Footnotes

  • Competing interests None declared.

  • Ethics approval Ethical committee of the Animal Health Trust (AHT35_2014).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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