The Role of Fenestration in Management of Type I Thoracolumbar Disk Degeneration.

Fenestration offers the advantages of prophylaxis without the need for specialized instrumentation and imaging. Currently there is a lack of equipoise regarding the efficacy of fenestration relative to decompression for treatment of acute canine intervertebral disk herniation; most veterinary spinal surgeons do not consider the 2 procedures equivalently efficacious. Therapeutic fenestration should perhaps be given greater consideration, especially if advanced imaging shows only mild to moderate spinal cord compression or there are restrictions on the duration of surgery, when it might be better to spend the time on fenestration rather than decompression.

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.

Electrophysiologic evidence of polyneuropathy in a cat with signs of bilateral brachial plexus neuropathy.

CASE DESCRIPTION: A 2-year-old spayed female domestic shorthair cat was examined because of bilateral thoracic limb weakness of acute onset. CLINICAL FINDINGS: Clinical signs included muscle atrophy, paresis, depressed spinal reflexes, hyperesthesia of the thoracic limbs, and reduced jaw muscle tone. Pelvic limb reflexes were normal. Results of a neurologic examination were suggestive of multifocal lesions involving both brachial plexuses and the trigeminal nerves. Abnormal nerve conduction across the brachial plexus and delayed late potentials were found on electrodiagnostic testing, and diffuse subclinical involvement of other regions of the peripheral nervous system was confirmed on the basis of abnormal electromyographic findings for the masticatory muscles and conduction block of the peroneal nerve. TREATMENT AND OUTCOME: No specific treatments were given, and neurologic signs resolved within a month. A relapse occurred 2 months after the first episode, with clinical signs affecting both the pelvic and the thoracic limbs on this occasion. Again, the condition resolved without specific treatment, and 13 months after the initial episode, the cat reportedly was normal. CONCLUSIONS AND CLINICAL RELEVANCE: Findings suggested that brachial plexus neuropathy can be a multifocal disease in cats, even if clinically apparent neurologic deficits are initially subtle or absent, and that electrodiagnostic techniques can be used to identify subclinical involvement of the peripheral nerves.