Spinal epidural empyema concurrent with sequestrum in a cat: a case report.

A 5-month-old intact female mixed cat presented with repetitive paraplegia and drainage of pus from the back despite continuous antibiotic medication. Neurologic examination was consistent with below T3-L3 myelopathy. Computed tomography and magnetic resonance imaging revealed a contrast-enhanced mass in the L1-3 spinal canal, and bone fragments in the T13 and L1 spinal canal. Spinal epidural empyema was suspected, and hemilaminectomy was performed for T12-L2 on the right side and T11-12 on the left side. Bone fragments were diagnosed as sequestrum infected with Bacteroides sp. The cat recovered enough to ambulate next day. One month after surgery, there was no deficit in neurological function. This is the first report of spinal epidural empyema concurrent with sequestrum in a cat.

Chronic spinal epidural abscess in a cat: a case report with an unusual imaging finding.

A 1-year-old domestic shorthair cat was evaluated for a chronic history of back pain, dysuria, and paraplegia. Radiographic and computed tomographic examinations showed circumferential widening of the vertebral canal at T13 and T14. A spinal epidural abscess (SEA) compressing the spinal cord from the level of T11 to L1 was suspected following intravenous contrast administration, and was confirmed by surgical exploration and histopathological analysis. The cat recovered its motor and bladder functions following surgical decompression and antibiotic therapy. SEA is a neurological emergency requiring prompt treatment. However, the present case had a prolonged disease course and pressure atrophy of the vertebrae was strongly suspected. To our knowledge, this imaging finding has not been reported in dogs or cats with SEA.

Clinical presentation, diagnosis, treatment and outcome of spinal epidural empyema in four cats (2010 to 2016).

This case series reviews previous publications and reports four feline spinal epidural empyema cases that presented with non-ambulatory thoracolumbar myelopathy. Two cats underwent myelography and two MRI. Bacteria were obtained in three cases, in two from epidural abscesses and from a tail base wound in one; histopathological examination of epidural tissue showed pyogranulomatous changes in the remaining cat. Three cats were treated by surgical decompression plus antimicrobial therapy and one cat was treated medically. All cats showed satisfactory improvement following treatment over a follow-up period of 3 months. Spinal epidural empyema is a rare condition but all cats in this series had favourable outcomes.

Concurrent spinal epidural empyema and endocarditis in a dog.

A 9-year-old neutered male Rhodesian ridgeback cross dog was evaluated for progressive non-ambulatory paraparesis, fever, and leukocytosis. The dog was diagnosed with spinal epidural empyema (SEE) and infectious endocarditis (IE) of the mitral valve based on the findings of contrast-enhanced computed tomography (CT), CT myelography, echocardiography, and bacterial culture. The report herein describes the clinical presentation, CT findings, clinical and surgical management of this case, together with the electrocardiography, and echocardiography findings. To the authors' knowledge, this is the first reported case of spinal epidural empyema likely to be caused by infectious endocarditis of the mitral valve in a dog.

Empyème épidural spinal concomitant à une endocardite chez un chien. Un chien mâle castré croisé Rhodesian Ridgeback âgé de 9 ans a été évalué pour une paraparésie progressive non-ambulatoire, de la fièvre et une leucocytose. Un diagnostic d'empyème épidural spinal (SEE) et d'endocardite infectieuse (IE) de la valvule mitrale a été émis basé sur les trouvailles de la tomodensitométrie (CT), d'une myélographie CT, de l'échocardiographie, et de la culture bactérienne. Le présent rapport décrit la présentation clinique, les trouvailles de CT, la gestion clinique et chirurgicale de ce cas, de même que les trouvailles par électrocardiographie et échocardiographie. À la connaissance des auteurs, ceci représente le premier cas rapporté d'empyème épidural spinal à être causé par une endocardite infectieuse de la valvule mitrale chez un chien.(Traduit par Dr Serge Messier).

Successful surgical management of an Escherichia coli epidural-subdural abscess secondary to sino-rhinotomy.

OBJECTIVE: To describe a case of successful management of epidural-subdural abscess and severe meningitis with secondary brain herniation in a dog. CASE SUMMARY: A rhino-sinusotomy was performed in a 3-year-old mixed-breed dog for management of refractory sinonasal aspergillosis. Initial recovery was good, but the dog became acutely stuporous 36 hours after surgery. Evidence of increased intracranial pressure with brain herniation and midline shift secondary to an epidural abscess was observed on magnetic resonance imaging. Decompressive craniectomy and drainage of the abscess was performed. Intensive nursing care and physiologic support was performed with consciousness returning 7 days after initial stupor. The dog was discharged 14 days after craniectomy and was ambulatory with support. NEW/UNIQUE INFORMATION PROVIDED: Intracranial abscesses are rarely described in dogs and few had a successful outcome reported. All previous reports have been of brain abscesses or empyema, rather than a combination of epidural and subdural abscessation. Additionally, the process of sino-rhinotomy for management of aspergillosis has not been previously linked to intracranial abscess formation. To the authors' knowledge, this is the first report of successful management of an epidural-subdural abscess and suggests that even with cases with low modified Glasgow Coma Scale scores outcome may be positive.

Medical management of spinal epidural empyema in five dogs.

CASE DESCRIPTION 5 dogs were examined because of clinical signs of myelopathy, including signs of pain associated with the spinal region and rapidly progressive neurologic deficits. CLINICAL FINDINGS In all dogs, results of MRI were consistent with spinal epidural empyema. Concurrent infectious processes were identified at adjacent or distant sites in all dogs, including diskospondylitis, prostatitis, dermatitis, paraspinal infection following a penetrating injury, urinary tract infection, and pyothorax. Bacteria were isolated from 3 dogs; Escherichia coli was isolated from blood, urine, and prostatic wash samples from 1 dog; a Pasteurella sp was isolated from a percutaneous aspirate from an adjacent infected wound in a second dog; and a Corynebacterium sp was isolated from a thoracic fluid sample from a third dog. For the remaining 2 dogs, results of bacterial culture were negative. TREATMENT AND OUTCOME All dogs showed clinical improvement within 2 weeks after initiation of antimicrobial treatment, and all had an excellent long-term outcome. CLINICAL RELEVANCE In dogs, spinal epidural empyema has previously been regarded as a surgical emergency. Findings for dogs in the present report suggested that, as is the case for humans, selected dogs with spinal epidural empyema may be successfully managed with medical treatment alone.

Long-term survival in a dog with meningoencephalitis and epidural abscessation due to Actinomyces species.

A 2-year-old, female spayed Golden Retriever dog was presented to The Ohio State University Veterinary Medical Center for evaluation of ataxia, cervical pain, 1 episode of acute collapse, dull mentation, and inappetence. Physical examination revealed an elevated temperature of 39.7°C and severe cervical pain. Blood work revealed a mature neutrophilia. Cerebrospinal fluid (CSF) analysis revealed nondegenerative neutrophilic pleocytosis with no infectious agents. A presumptive diagnosis of steroid-responsive meningitis-arteritis was made, and corticosteroid therapy was started. The patient improved initially but experienced a vestibular episode characterized by falling and vertical nystagmus. A magnetic resonance imaging of the brain revealed an epidural abscess in the cervical vertebral canal and diffuse meningeal enhancement in the brain and cranial cervical spine. Abscess drainage revealed degenerate neutrophils and several filamentous, branching organisms. Culture of the initial CSF using an enrichment broth revealed growth of a Gram-positive organism 5 days after fluid collection. The isolate was identified by partial 16S ribosomal DNA sequencing as Actinomyces spp. The patient was successfully treated with long-term antibiotics. Our study reports the long-term survival after medical treatment of bacterial meningoencephalitis and epidural abscessation due to Actinomyces sp. infection in a dog. Bacterial meningoencephalitis should be included as a differential diagnosis in patients with cervical pain and fever, even when a nondegenerative neutrophilic pleocytosis is found on CSF analysis. Culture of the CSF with use of an enrichment broth should be considered in all cases of neutrophilic pleocytosis to rule out infections of the central nervous system.

Partial lateral corpectomy associated with pediculectomy to treat extradural chondroma in a dog: technique description / Corpectomia lateral parcial associada à pediculectomia no tratamento de condroma extradural em um cão: descrição da técnica

This study aimed to describe in detail the surgical technique of partial lateral corpectomy (PLC) associated with pediculectomy to treat an in vitro extradural chondroma. A 12-year old female Cocker Spaniel was seen in the hospital with proprioceptive ataxia of hind limbs associated with extradural compression between the 1st and 2nd lumbar vertebrae. The owner opted for euthanasia since the patient's condition changed due to simultaneous illnesses that culminated in a poor prognosis. The patient's body was formally ceded to perform experimental spinal decompression. The technique was effective to completely remove the epidural mass with minimal manipulation of the spinal cord...

Objetivou-se descrever detalhadamente a técnica cirúrgica de corpectomia lateral parcial associada à pediculectomia no tratamento de um condroma extradural in vitro. Uma cadela de 12 anos de idade, raça Cocker Spaniel, foi atendida com ataxia proprioceptiva dos membros pélvicos associada à compressão extradural entre a primeira e a segunda vértebras lombares. Devido a alterações secundárias decorrentes de afecções concomitantes que culminavam em um prognóstico desfavorável, o proprietário optou pela eutanásia do paciente, e o cadáver foi formalmente cedido para realização de descompressão medular experimental. A técnica utilizada foi eficaz na remoção completa da massa extradural, com mínima manipulação da medula espinhal...

Atlantoaxial epidural abscess secondary to grass awn migration in a dog.

A two-year-old female Lucerne Hound was presented with a one-week history of signs of progressive neck pain, inappetence, apathy, and an elevated rectal temperature. Findings of magnetic resonance imaging (MRI) were consistent with a foreign body abscess in the epidural space at the level of the first and second cervical vertebrae. A left-sided dorso-lateral atlantoaxial approach was performed, revealing an epidural abscess containing a grass awn. The clinical signs resolved within three days of surgery and the dog made a full recovery. This case report shows that grass awns can migrate to the atlantoaxial region in dogs and MRI findings lead to a suspicion of caudo-cranial migration within the spinal canal.

Chronic compressive myelopathy and progressive neurologic signs associated with melarsomine dihydrochloride administration in a dog.

A 7 yr old castrated male Great Dane presented with a history of progressive myelopathy following the intramuscular injection of melarsomine dihydrochloride 8 wk previously. MRI revealed paraspinal and epidural abscesses at the 13th thoracic (T13) and first lumbar (L1) disc space. The dog's condition worsened despite medical management, necessitating surgical decompression. Surgical decompression resulted in rapid improvement of the patient's clinical signs. Histopathologic evaluation of the lesions revealed pyogranulomatous inflammation. Cultures of fluid and tissue within the lesions were negative for bacterial growth, and no infectious organisms were visualized histologically. Melarsomine-associated neurologic signs can be chronic and progressive in nature, presumably secondary to ongoing sterile inflammation that may result in spinal cord compression.

Spinal epidural empyema in a cat.

The diagnosis and surgical treatment of spinal epidural empyema (SEE) in a 2-year-old neutered male domestic shorthaired cat is described. SEE was diagnosed by computed tomographic myelography (CT myelography) and surgical exploration. The lesion was missed on both non-enhanced CT and conventional myelography. SEE should be considered in the differential diagnosis of progressive myelopathy in cats, and CT myelography should be undertaken when magnetic resonance imaging (MRI) cannot be performed.

Spinal epidural abscess in two calves.

OBJECTIVE: To report clinical signs, diagnostic and surgical or necropsy findings, and outcome in 2 calves with spinal epidural abscess (SEA). STUDY DESIGN: Clinical report. ANIMALS: Calves (n=2). METHODS: Calves had neurologic examination, analysis and antimicrobial culture of cerebrospinal fluid (CSF), vertebral column radiographs, myelography, and in 1 calf, magnetic resonance imaging (MRI). A definitive diagnosis of SEA was confirmed by necropsy in 1 calf and during surgery and histologic examination of vertebral canal tissue in 1 calf. RESULTS: Clinical signs were difficulty in rising, ataxia, fever, apparent spinal pain, hypoesthesia, and paresis/plegia which appeared 15 days before admission. Calf 1 had pelvic limb weakness and difficulty standing and calf 2 had severe ataxia involving both thoracic and pelvic limbs. Extradural spinal cord compression was identified by myelography. SEA suspected in calf 1 with discospondylitis was confirmed at necropsy whereas calf 2 had MRI identification of the lesion and was successfully decompressed by laminectomy and SEA excision. Both calves had peripheral neutrophilia and calf 2 had neutrophilic pleocytosis in CSF. Bacteria were not isolated from CSF, from the surgical site or during necropsy. Calf 2 improved neurologically and had a good long-term outcome. CONCLUSION: Good outcome in a calf with SEA was obtained after adequate surgical decompression and antibiotic administration. CLINICAL RELEVANCE: SEA should be included in the list of possible causes of fever, apparent spinal pain, and signs of myelopathy in calves.

Successful treatment of cervical spinal epidural empyema secondary to grass awn migration in a cat.

Spinal epidural empyema (SEE) represents a severe pyogenic infection of the epidural space. Clinical signs of the disease are non-specific--increased body temperature, intense neck pain, neurological signs of a transverse myelopathy--and can lead to severe and permanent neurological deficits. This report describes the diagnosis and successful surgical treatment of cervical SEE secondary to grass awn migration in a cat. Although it is uncommon, this disease should be suspected in cats with progressive myelopathy. Early diagnosis and emergency surgery combined with antibiotic therapy are required to allow a complete recovery.

Spinal epidural empyema in seven dogs.

OBJECTIVE: To characterize the clinical signs, diagnostic and surgical findings, and outcome in dogs with spinal epidural empyema (SEE). STUDY DESIGN: Retrospective study. ANIMALS: Seven dogs. METHODS: Dogs with SEE between 1992 and 2001 were identified from a computerized medical record system. Inclusion criteria were: neurologic examination, vertebral column radiographs, myelography, antimicrobial culture and susceptibility of material collected surgically from the vertebral canal, a definitive diagnosis of SEE confirmed by surgery, and microscopic examination of tissue from the vertebral canal. RESULTS: Common signs were lethargy, fever, anorexia, apparent spinal pain, and paraparesis/plegia. Common laboratory abnormalities were peripheral neutrophilia, and neutrophilic pleocytosis in cerebrospinal fluid (CSF). Three dogs had concurrent discospondylitis and 1 of these had vertebral luxation. On myelography, extradural spinal cord compression was focal (2 dogs), multifocal (3), or diffuse (2). Bacteria were isolated not from CSF but from blood, surgical site, pleural fluid, or urine in 6 dogs. Dogs were administered antibiotics and had surgical decompression by hemilaminectomy. Five dogs improved neurologically and had a good long-term outcome. Two dogs were euthanatized, 1 because of worsening of neurologic signs and pneumonia, and the other because of herniation of a cervical intervertebral disc 1 month postoperatively, unrelated to the SEE. CONCLUSION: Dogs with SEE may have a good outcome when treated by surgical decompression and antibiotic administration. CLINICAL RELEVANCE: SEE should be included in a list of possible causes for dogs with fever, apparent spinal pain, and myelopathy.

Intracranial abscess caused by Rhodococcus equi infection in a foal.

CASE DESCRIPTION: A 4-month-old Missouri Fox Trotter colt was examined for a 5-week history of head tilt after treatment for suspected pulmonary Rhodococcus equi infection. CLINICAL FINDINGS: Computed tomography revealed osteolysis of the occipital, temporal, and caudal portion of the parietal bones of the left side of the cranium. A soft tissue mass compressing the occipital region of the cerebral cortex and cerebellum was associated with the osteolytic bone. TREATMENT AND OUTCOME: A rostrotentorial-suboccipital craniectomy approach was performed to remove fragmented occipital bone, debulk the intracranial mass, and obtain tissue samples for histologic examination and bacterial culture. All neurologic deficits improved substantially within 3 days after surgery. Bacterial culture of the resected soft tissue and bone fragments yielded R equi. CLINICAL RELEVANCE: Intracranial surgery in veterinary medicine has been limited to dogs and cats; however, in select cases, extrapolation of surgical techniques used in humans and small animals can assist with intracranial procedures in horses.

Spinal epidural abscess in a juvenile dog.

A six-month-old, intact female, Miniature Pinscher was admitted with signs of progressive neurological deficits in the hind legs, an elevated rectal temperature, and spinal pain of 48 hours duration. A myelogram was performed which demonstrated a dorsal, left sided compressive lesion extending from T11-T13. A left-sided hemilaminectomy was performed from T11-T13. A friable, poorly organized, pale tan and red mass was identified within the epidural space. Cytopathological and histopathological analyses of the mass demonstrated marked, subacute, suppurative cellulitis. A culture of the purulent material revealed beta haemolytic Streptococcus sp.

Computed tomographic appearance of epidural empyema in a dog.

The computed tomographic (CT) appearance of epidural empyema in a 5.5-month-old, intact male boxer dog is described. Epidural empyema was diagnosed by means of CT, surgery, and bacterial culture. The imaging and pathogenesis of epidural abscesses and the pitfalls of differentiating caudal fossa lesions from severe cranial cervical lesions are discussed.