Veterinary Neurology: Spinal Cord Diseases

Front 1

Signalment of type I disc disease

Back 1

Chondrodystrophoid dogs 3+ years or older typically, but any breed possible

Front 2

Onset of type I disc disease

Back 2

Acute

Front 3

Which disease is more painful on presentation: Type I disc disease or type II disc disease?

Back 3

Type I

Front 4

Signalment of type II disc disease

Back 4

Large non-chondrodystrophic breeds of dogs over 5 years of age

Front 5

Most common spinal cord disease

Back 5

Intervertebral disc disease

Front 6

DIsease in which the intervertebral disc becomes calcified

Back 6

Chondroid metaplasia

Front 7

Chondroid metaplasia frequently associated with this disc disease.

Back 7

Type I

Front 8

Fibrinoid metaplasia more frequently associated with this disc disease

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Type II

Front 9

Disc disease in which the disc material extrudes from the anulus fibrosis

Back 9

Type I

Front 10

Disc disease in which the disc material remains within the anulus fibrosis but protrudes dorsally into the spinal canal

Back 10

Type II

Front 11

This kind of intervertebral disc disease is acute in onset of CS, and causes both spinal cord compression and trauma.

Back 11

Type I

Front 12

Disc disease in this spinal region tends to cause minimal motor deficits due to the larger diameter of the spinal canal at this site

Back 12

Cervical

Front 13

The prognosis for Type I disc disease becomes grave if...

Back 13

Deep pain sensation is lost

Front 14

How can disc disease be addressed if a patient has hyperpathia and mild ataxia?

Back 14

Strict cage rest 2-4 weeks and prednisolone for pain

Front 15

How should disc disease be addressed if there are serious motor and possibly sensory deficits?

Back 15

Surgical decompression, preferably within hours of injury

Front 16

Best surgical appraoch to disc disease of the cervical spine

Back 16

Ventral slot

Front 17

Only definitive treatment for Type II disc disease

Back 17

Surgical decompression

Front 18

Which disc disease carries a better prognosis: Type I or type II? WHy?

Back 18

Type I

(Chronic compression of cord causes it to atrophy)

Front 19

Only spinal cord disease in which clinical signs are worse in forelimbs than in hindlimbs.

Back 19

Cervical vertebral stenosis

Front 20

This disease may be caused by a variety of factors, including Type II disc protrusion, ligamentous hypertrophy, vertebral malformation, or vertebral instability and subluxation.

Back 20

Cervical vertebral stenosis

Front 21

Cervical vertebrae most commonly affected in Dobermans and Great Danes

Back 21

C5-C7

Front 22

Cervical vertebrae most commonly affected in Dobermans and Great Danes

Back 22

C5-C7

Front 23

Basset hounds can get cervical vertebral stensosis in this region.

Back 23

C2-C4

Front 24

Basset hounds can get cervical vertebral stensosis in this region.

Back 24

C2-C4

Front 25

Spinal cord injury in this region causes a distinctive "two-engine" gait described as the "Japanese princess followed by the drunk cowboy."

Back 25

Cervical spine

Front 26

Cervical vertebrae most commonly affected in Dobermans and Great Danes

Back 26

C5-C7

Front 27

Spinal cord injury in this region causes a distinctive "two-engine" gait described as the "Japanese princess followed by the drunk cowboy."

Back 27

Cervical spine

Front 28

Ataxia of the pelvic limbs and cervical pain are seen with this disease

Back 28

Cervical vertebral stenosis

Front 29

Basset hounds can get cervical vertebral stensosis in this region.

Back 29

C2-C4

Front 30

Ataxia of the pelvic limbs and cervical pain are seen with this disease

Back 30

Cervical vertebral stenosis

Front 31

Muscles may atrophy at this site with cervical vertebral stenosis.

Back 31

Over the shoulders

Front 32

Spinal cord injury in this region causes a distinctive "two-engine" gait described as the "Japanese princess followed by the drunk cowboy."

Back 32

Cervical spine

Front 33

Muscles may atrophy at this site with cervical vertebral stenosis.

Back 33

Over the shoulders

Front 34

Ataxia of the pelvic limbs and cervical pain are seen with this disease

Back 34

Cervical vertebral stenosis

Front 35

Muscles may atrophy at this site with cervical vertebral stenosis.

Back 35

Over the shoulders

Front 36

How is prognosis related to the duration of cervical vertebral stenosis?

Back 36

The longer the duration of compression, the worse the prognosis

Front 37

True or false: The treatment for cervical vertebral stenosis varies with the cause.

Back 37

True

Front 38

How frequently is congenital lumbosacral stenosis seen?

Back 38

Rare

Front 39

In what kind of dogs is congenital lumbosacral stensosis seen?

Back 39

Small and medium breed dogs

Front 40

In what kind of dogs is acquired lumbosacral stenosis seen?

Back 40

Large breed dogs, M > F
Predisposition in GSD

Front 41

WIth this disease, lower motor neuron signs affect the tail, perineum, and sciatic nerves. THere is muscle atrophy to the caudal thigh and distal limb muscles, paraparesis, tail weakness, and urinary and anal sphincter disturbances. Lesions may be asymmetrical.

Back 41

Lumbosacral stenosis

Front 42

Why is myelopgraphy not useful in diagnosis lumbosacral stenosis?

Back 42

Subarachnoid space does not extend that far caudally

Front 43

Describe conservative therapy for lumbosacral stenosis.

Back 43

Strict confinement and leash walking

Front 44

Most effective treatment for lumbosacral stenosis

Back 44

Surgical decompression

Front 45

A chronic, progressive, degenerative condition affecting spinal cord white matter tracts and occasionally nerve roots

Back 45

Degenerative myelopathy

Front 46

Classical signalment for degenerative myelopathy

Back 46

Originally GSD, now seen in various large breeds between ages of 5 and 14

Front 47

Disease characterized by demyelination and axonal loss, primarily in thoracic spinal cord. Often lesions are asymmetrical.

Back 47

Degenerative myelopathy

Front 48

In an older dog with chronic progressive paresis, you should suspect this degenerative condition.

Back 48

Degenerative myelopathy

Front 49

Only means of diagnosis for degenerative myelopathy

Back 49

Histopathology

Front 50

How will a dog suffering from degenerative myelopathy respond to steroid therapy?

Back 50

No response

Front 51

Most effective treatment for degenerative myelopathy

Back 51

None.
(Can try nutraceuticals, but not very effective)

Front 52

The ventral compartment of the spinal column includes:

Back 52

Vertebral body and disc

Front 53

The dorsal compartment of the spinal cord includes:

Back 53

Vertebral arch and spinal cord

Front 54

Spinal cord defects are seen when this compartment is abnormal.

Back 54

Dorsal

Front 55

The spinal cord is usually unaffected with abnormalities of this vertebral compartment.

Back 55

Ventral

Front 56

Fusion of two vertebrae. The sacrum is an example.

Back 56

Block vertebrae

Front 57

Results from the incomplete fusion of the right and left halves of the vertebral bodies. Appears as a dorsal-ventral cleft in the vertebral body.

Back 57

Butterfly vertebrae

Front 58

Shortened, wedge-shaped vertebrae that may cause curvature of the spine. Result of incomplete development. Seen in dog breeds bred for "screw tailed" conformation.

Back 58

Hemivertebrae

Front 59

Condition in which the vertebral arches fail to fuse, resulting in a bony defect in the dorsal vertebrae.

Back 59

Spina bifida

Front 60

Spina bifida that affects only the vertebral bone.

Back 60

Occulta

Front 61

Spina bifida that affects the meninges.

Back 61

Cystica

Front 62

Spina bifida that affects the spinal cord.

Back 62

Manifesta

Front 63

Spina bifida in which the spinal cord may communicate with the outer environment.

Back 63

Aperta

Front 64

High incidence of spina bifida seen in this dog breed and this cat breed.

Back 64

Bulldogs
Manx cats

Front 65

Why is surgery not always the perfect treatment for spina bifida?

Back 65

Often there are other neural defects that are not as readily apparent on radiograph.

Front 66

Prognosis for dorsal compartment abnormalities.

Back 66

Guarded to grave

Front 67

Dorsal sagittal defect in the spinal cord caused by failure of fusion of the neural tube.

Back 67

Spinal dysraphism

Front 68

Spinal dysraphism may be heritable, especially in this dog breed.

Back 68

Weinmaraner

Front 69

Why can there be a differing degree of paraparesis among dogs affected by spinal dysraphism?

Back 69

Varying degrees of spinal cord disorganization.

Front 70

In cases of spinal dysraphism, the withdrawal reflex causes...

Back 70

Flexion of both pelvic limbs

Front 71

This spinal cord defect is often associated with a misshapen thorax, disproportion in length of the extremeties and body, kinking of the tail and abnormal hair patterns along the dorsal trunk.

Back 71

Spinal dysraphism

Front 72

Treatment for intrinsic spinal cord malformations.

Back 72

None

Front 73

Prognosis for intrinsic spinal cord malformations.

Back 73

Depends upon severity of CS.

Front 74

Malformation of this structure can cause instability and subluxation of the atlantoaxial joint.

Back 74

Dens

Front 75

Congenital absence of the dens is seen most commonly in these kinds of dogs.

Back 75

Miniature and toy breeds

Front 76

Why is the dens so important to proper articulation of the atlantoaxial joint?

Back 76

Lots of ligaments attach there.

Front 77

Clinical signs seen with subluxation of the atlantoaxial joint

Back 77

Vary from intermittent pain to complete spinal cord transection and death

Front 78

How is subluxation of the atlantoaxial joint diagnosed?

Back 78

Survey radiographs

Front 79

How is subluxation of the atlantoaxial joint treated?

Back 79

Surgical stabilization, either by ventral pinning or dorsal suturing.

Front 80

Top three spinal cord diseases in order.

Back 80

1. Intervertebral disc disease
2. Inflammatory
3. Neoplasia

Front 81

Most common location for spinal cord tumors.

Back 81

Extradural

Front 82

Most common metastatic extradural tumor of the spinal cord.

Back 82

Lymphosarcoma

Front 83

Prognosis for spinal cord neoplasia.

Back 83

Poor

Front 84

Most common intradural spinal cord tumors.

Back 84

Meningioma and nerve root tumor

Front 85

Spinal cord neoplasms are most likely to be painful when located...

Back 85

Extradural or intradural/extramedullary

Front 86

Most common types of intramedullary spinal cord tumors.

Back 86

Astrocytomas, gliomas, and ependymomas.

Front 87

On myelogram, these tumors cause a "golf-tee" widening of the CSF space.

Back 87

Intradural/extramedullary

Front 88

Pain is usually absent when spinal cord neoplasm is located...

Back 88

Intramedullary

Front 89

How do spinal cord neoplasms present? Acute or chronic?

Back 89

Both
Truly chronic and insidious in nature, but owner may notice acute onset of CS.

Front 90

Infection of the intervertebral disk with concurrent osteomyelitis of the associated vertebrae is called

Back 90

Discospondylitis

Front 91

Most frequent agent isolated from a case of discospondylitis

Back 91

Staph intermedius

Front 92

Most common signalment of patient with discospondylitis

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Adult large breed male

Front 93

Most common CS seen with discospondylitis.

Back 93

Stiff gait, pain, hyperesthesia
+/- neurologic deficits

Front 94

Name the factors that influence a client's susceptibility to infection.

Back 94

immune system
diseases
Number of organisms
Host’s defenses

Front 95

A patient presents with a stiff gait and hyperesthesia. On radiograph of the thorax there is lysis of adjacent vertebral end plates. WHat is the likely cause?

Back 95

Diskospondylitis

Front 96

Treatment for diskospondylitis includes

Back 96

Antibiotic appropriate for causative organism (or 4-6 weeks of cephalosporin)

Vertebral decompression or stabilization if needed

Front 97

Prognosis of diskospondylitis

Back 97

Good if bacterial, except with Brucella
Poor if fungal

Front 98

This inflammatory disease may be caused by virus, protozoa, fungus, and bacteria.

Back 98

Meningomyelitis

Front 99

Causes multifocal neurologic disease

Back 99

Meningomyelitis

Front 100

Three non-infectious causes of meningomyelitis

Back 100

Canine granulomatous meningomyelitis
Feline polioencephalomyelitis
Steroid responsive meningitis

Front 101

A suppurative meningitis for which an infectious cause cannot be found. Corticosteroids are effective.

Back 101

Steroid-responsive meningitis

Front 102

Typical signalment with steroid responsive meningitis.

Back 102

Beagles, Pointers, Bernese Mountain Dogs under 2 years of age

Front 103

Clinical signs seen with steroid responsive meningitis

Back 103

Cervical pain
Fever
Lethargy
Anorexia
No or mild neurologic deficits

Front 104

Diagnosis of steroid responsive meningitis is based on...

Back 104

Leukocytosis with non-regenerative anemia on CBC

CSF: Marked leukocytosis with non-degenerate PMN predominating

Lack of infectious agent and resposne to steroids

Front 105

Treatment of non-infectious meningitis

Back 105

Prednisolone, tapered down to EOD and discontinued after 2-6 months

Front 106

The initial trauma to the spinal cord is referred to as...

Back 106

Primary injury

Front 107

How does secondary spinal cord injury occur?

Back 107

Primary injury initiates series of biochemical events that result in additional neurologic injury

Front 108

What is hematomyelia?

Back 108

Hemorrhagic necrosis of the spinal cord

Front 109

End result of hematomyelia.

Back 109

Spread cranial and caudal to injury site until respiratory failure and death occur.

Front 110

Flaccid paralysis of the rear limbs and involuntary extension of the forelimbs occurs when this region of the spinal cord is injured.

Back 110

Thoracolumbar

Front 111

When thoracolumbar injury leads to forelimb extensor rigidity, how will the animal's postural reactions appear in these limbs?

Back 111

Normal

Front 112

Describe the Schiff-Scherrington syndrome seen with thoracolumbar spinal cord injury.

Back 112

Postural reactions are intact in the front limbs in spite of their apparent rigidity.

Front 113

Top differential in any animal with an acute, rapidy progressive paraparesis or quadriparesis.

Back 113

Spinal cord trauma

Front 114

In cases of spinal cord trauma, this drug is given IV ASAP to minimize secondary injury from inflammation

Back 114

Methylprednisolone sodium succinate

(Bolus, then CRI)

Front 115

Prognosis for spinal cord trauma

Back 115

Depends upon severity of injury

Absence of deep pain for over 24h is a negative prognostic indicator

Front 116

Vascular disorder that is acute in onset over a few hours to 1-2 days. Signs are usually asymmetrical.

Back 116

Fibrocartilaginous infarct

Front 117

Clinical signs associated with fibrocartilaginous infarct.

Back 117

Acute quadriplegia, hemiplegia, paraplegia, or monoplegia. Dog may cry out and suddenly develop CS

Front 118

How can the diagnosis of fibrocartilagenous infarct be made?

Back 118

MRI can visualize

Myelogram: May see diffuse swelling of cord in acute stage

Front 119

Is the prognosis for fibrocartilaginous infarct better if there are LMN signs or UMN signs present?

Back 119

LMN signs are better

Front 120

An animal is euthanized after developing a non-resolving hemiplegia and goes to necropsy. The pathologist notes an ischemic necrosis of the spinal cord and fibrocartilage in the spinal arteries and veins. What was the disease process?

Back 120

Fibrocartilaginous infarct.