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Medical management of spinal epidural empyema in five dogs

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  • 1 Department of Veterinary Medicine, University of Cambridge, Cambridge CB3 0ES, England.
  • | 2 Department of Veterinary Medical Sciences, University of Bologna, Via Tolara di Sopra, 50 40064 Ozzano dell'Emilia BO, Italy.
  • | 3 Department of Veterinary Medicine, University of Cambridge, Cambridge CB3 0ES, England.
  • | 4 Department of Veterinary Medicine, University of Cambridge, Cambridge CB3 0ES, England.
  • | 5 Department of Veterinary Medicine, University of Cambridge, Cambridge CB3 0ES, England.
  • | 6 Department of Veterinary Medical Sciences, University of Bologna, Via Tolara di Sopra, 50 40064 Ozzano dell'Emilia BO, Italy.
  • | 7 School of Veterinary Sciences, University of Bristol, Langford, Bristol BS40 5DU, England.
  • | 8 Department of Veterinary Medicine, University of Cambridge, Cambridge CB3 0ES, England.

Abstract

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.

Contributor Notes

Dr. Rousset's present address is Western Veterinary Specialist and Emergency Center, 1802 10 Ave SW, Calgary, AB T3C 0J8, Canada.

Dr. Ives' present address is Anderson Moores Veterinary Specialists, The Granary, Bunstead Barns, Poles Ln, Hursley, Winchester SO21 2LL, England.

Dr. Vanhaesebrouk's present address is Nuffield Department of Clinical Neurosciences, Level 6, West Wing, John Radcliffe Hospital, Oxford OX3 9DU, England.

Drs. Granger and Vanhaesebrouck contributed equally to this study.

Address correspondence to Dr. Monforte Monteiro (susanamonfortemonteiro@gmail.com).