Use of physiatry as the sole treatment for three paretic or paralyzed dogs with chronic compressive conditions of the caudal portion of the cervical spinal cord.

Physiatry alone was used to treat 3 large (30- to 40-kg [66 to 88 lb]) mature (6- to 9-year-old) dogs that were tetraparetic or tetraplegic. All 3 dogs had myelographic evidence of multiple chronic compressive extradural lesions of the caudal portion of the cervical spinal cord. All dogs improved substantially after a course of intensive physical treatment. For 2 dogs, an abbreviated treatment regimen was continued by the owners after the dogs were discharged. Both of these dogs regained and retained normal neurologic function. The other dog improved but was treated infrequently at home. That dog's signs recurred, and the dog was euthanatized. Persistent use of physical treatment for paralysis that results from conditions affecting the cervical spinal cord may be useful even without concurrent surgical or pharmacologic treatments.

Fenestration. Pros and cons.

Fenestration of canine intervertebral discs is a time-honored, yet controversial, procedure used by veterinarians in the management of degenerative disc disease. It has been touted for both its supposed therapeutic effects and for its purported role in preventing future episodes of disc-related clinical signs. In spite of its long-standing reputation and wide use by many, fenestration may lack a firm scientific basis for its continued incorporation in the repertoire of the veterinary spine surgeon. This chapter will explore the key issues that impinge on the role fenestration plays and discuss the pros and cons attendant with its use. The author feels that, with the ability to diagnose and treat intervertebral disc prolapse in more sophisticated and scientific ways, fenestration should largely be abandoned. The evidence for this conclusion and the limited role that may still be reserved for fenestration are discussed.

Neuroradiographic diagnosis and surgical repair of tethered cord syndrome in an English bulldog with spina bifida and myeloschisis.

A 3-month-old English Bulldog had excretory incontinence and sensory deficits in the distribution of pudendal nerves. Noncontrast radiography, myelography, and computed tomography revealed spina bifida beginning at L7, an expanded subarachnoid space caudal to L7, and a taut, thick filum terminale. Microsurgical exploration of the lumbosacral spine confirmed the presence of a tethered cord, and the filum terminale was transected. The spinal cord immediately migrated cranially about 1 cm. Although some sensory improvement was evident during a 2-week postoperative period, the dog was euthanatized. Postmortem examination confirmed spina bifida and atrophy of sacral nerve roots and perineal muscles, thoracic hemivertebrae, and hydrocephalus.

Laminotomy of the axis for surgical access to the cervical spinal cord. A case report.

A cranially hinged laminotomy of vertebra C2 was used to expose the cervical spinal cord of a dog with a meningioma in the region of the atlantoaxial articulation. By preserving the dorsal atlantoaxial ligament, the technique seemed to result in greater and more physiologic stability between the atlas and axis than dorsal laminectomy and prosthetic replacement of the dorsal atlantoaxial ligament. The procedure allowed a dorsal approach, avoiding injury to the vertebral arteries and limited exposure, which are potential problems with hemilaminectomy of C1-C2. Further investigation is needed to evaluate long-term consequences of this procedure.

Late-onset regurgitation associated with persistent right aortic arch in two dogs.

Congenital persistent right aortic arch was diagnosed as the cause of weight loss and regurgitation in 2 dogs, aged 2.5 and 8 years, respectively. The first dog had 2 brief episodes of regurgitation that resolved spontaneously before the most recent onset of signs and diagnosis. The second dog had no clinical signs attributed to persistent right aortic arch until 2 months before the diagnosis was made. Dogs born with persistent right aortic arch typically have clinical signs of esophageal stenosis around the time of weaning. Evidence from the 2 dogs in this report indicate that clinical signs associated with vascular ring anomalies may not become evident until later in life. Veterinarians should consider the diagnosis of persistent right aortic arch in any age dog that is admitted because of regurgitation, weight loss, and dilatation of the cranial portion of the esophagus.

Spinal meningiomas in dogs: 13 cases (1972-1987).

Medical records of 13 dogs with spinal meningiomas were reviewed. Breed predilections were not found. Males outnumbered females 9 to 4, and most of the dogs were middle-aged. All dogs had motor deficits of various degrees, and approximately half of the dogs had clinical signs of mild to moderate spinal pain. The remainder had histories of clinical signs suggestive of chronic discomfort. There was a prolonged (greater than 3 months) delay between the onset of signs and diagnosis, except in 3 dogs. The neurologic courses usually were progressive. Results of noncontrast spinal radiography were normal in 10 dogs; in 3 dogs, the lamina appeared scalloped. Results of myelography contributed to the correct diagnosis in 10 of 12 dogs; however, in 2 dogs, intradural/extramedullary tumors were thought to be intramedullary lesions. A preponderance of cervical meningiomas was found, accounting for 10 of 13 tumors. Lumbar meningiomas were found in the remaining 3 dogs. Surgery was performed in 9 of the dogs, six of which improved after surgery. Poor results were correlated with tumors that involved spinal cord segments of an intumescence, ventrally located tumors, iatrogenic trauma, and tumor invasion into adjacent neural parenchyma. Four of 13 spinal meningiomas were found to be invasive into the spinal cord itself.