1. Davis MJ, Dewey CW, Walker MA, et al. Contrast radiographic findings in canine bacterial discospondylitis: a multicenter, retrospective study of 27 cases. J Am Anim Hosp Assoc 2000; 36:81–85.
2. Reihsaus E, Waldbaur H, Seeling W. Spinal epidural abscess: a meta-analysis of 915 patients. Neurosurg Rev 2000; 23:175–205.
3. Curry WT Jr, Hoh BL, Amin-Hanjani S, et al. Spinal epidural abscess: clinical presentation, management, and outcome. Surg Neurol 2005; 63:364–371.
4. Zimmerer SME, Conen A, Muller AA, et al. Spinal epidural abscess: aetiology, predisponent factors and clinical outcomes in a 4-year prospective study. Eur Spine J 2011; 20:2228–2234.
5. Rigamonti D, Liem L, Sampath P et al. Spinal epidural abscess: contemporary trends in etiology, evaluation, and management. Surg Neurol 1999; 52:189–197.
6. Siddiq F, Chowfin A, Tight R, et al. Medical vs surgical management of spinal epidural abscess. Arch Intern Med 2004; 164:2409–2412.
7. Karikari IO, Powers CJ, Reynolds RM, et al. Management of a spontaneous spinal epidural abscess: a single-center 10-year experience. Neurosurgery 2009; 65:919–924.
8. Grieve JP, Ashwood N, O'Neill KS, et al. A retrospective study of surgical and conservative treatment for spinal extradural abscess. Eur Spine J 2009; 9:67–71.
9. Tang HJ, Lin HJ, Liu YC, et al. Spinal epidural abscess—experience with 46 patients and evaluation of prognostic factors. J Infection 2002; 45:76–81.
10. Connor DE, Chittiboina P, Caldito G, et al. Comparison of operative and nonoperative management of spinal epidural abscess: a retrospective review of clinical and laboratory predictors of neurological outcome. J Neurosurg Spine 2013; 19:119–127.
11. Mink JH, Gordon RE, Deutch AL. The cervical spine: radiologist's perspective. Phys Med Rehabil Clin N Am 2003; 14:493–548.
12. Nussbaum ES, Rigamonti D, Standiford H, et al. Spinal epidural abscess: a report of 40 cases and review. Surg Neurol 1992; 38:225–231.
13. De Stefani A, Garosi LS, McConnell FJ, et al. Magnetic resonance imaging features of spinal epidural empyema in five dogs. Vet Radiol Ultrasound 2008; 49:135–140.
14. Dewey CW, Kortz GD, Bailey CS. Spinal epidural empyema in two dogs. J Am Anim Hosp Assoc 1998; 34:305–308.
15. Granger N, Hidalgo A, Leperlier D, et al. Successful treatment of cervical spinal epidural empyema secondary to grass awn migration in a cat. J Feline Med Surg 2007; 9:340–345.
16. Jerram RM, Dewey CW. Suspected spinal epidural empyema and associated vertebral osteomyelitis (physitis) in a dog. J Vet Emerg Crit Care 1998; 8:216–221.
17. Schmiedt CW, Thomas WB. Spinal epidural abscess in a juvenile dog. Vet Comp Orthop Traumatol 2005; 18:186–188.
18. Carrera I, Sullivan M, McConnell F, et al. Magnetic resonance imaging features of discospondylitis in dogs. Ultrasound 2011; 52:125–131.
19. Friedmand DP, Hills JR. Cervical epidural spinal infection: MR imaging characteristics. AJR Am J Roentgenol 1994; 163:699–704.
20. Lavely JA, Vernau KM, Vernau W, et al. Spinal epidural empyema in seven dogs. Vet Surg 2006; 35:176–185.
21. Cherrone KL, Eich CS, Bonzynski JJ. Suspected paraspinal abscess and spinal epidural empyema in a dog. J Am Anim Hosp Assoc 2002; 38:149–151.
22. Holloway A, Dennis R, McConnell F, et al Magnetic resonance imaging features of paraspinal infection of the dog and cat. Vet Radiol Ultrasound 2009; 50:285–291.
23. Savage K, Holtom PD, Zalavras CG. Spinal epidural abscess: early clinical outcome in patients treated medically. Clin Orthop Relat Res 2005; 439:56–60.
24. Sutton A, May C, Coughlan A. Spinal osteomyelitis and epidural empyema in a dog due to migrating conifer material. Vet Rec 2010; 166:693–694.
25. Plessas IN, Jull P, Volk HA. A case of canine discospondylitis and epidural empyema due to Salmonella species. Can Vet J 2013; 54:595–598.
26. Jeffery ND, Levine JM, Olby NJ et al. Intervertebral disk degeneration in dogs: consequences, diagnosis, treatment, and future directions. J Vet Intern Med 2013; 27:1318–1333.
27. Feldenzer JA, McKeever PE, Schaberg DR, et al. The pathogenesis of spinal epidural abscess: a pathophysiological model in the rabbit. Neurosurgery 1987; 20:859–867.
28. Lasker BR, Harter DH. Cervical epidural abscess. Neurology 1987; 37:1747–1753.
29. Baker AS, Ojemann RG, Swartz MN, et al. Spinal epidural abscess. N Engl J Med 1975; 293:463–468.
30. Thomson CE, Kornegay JN, Stevens JB. Analysis of cerebrospinal fluid from the cerebellomedullary and lumbar cisterns of dogs with focal neurological disease: 145 cases (1985–1987). J Am Anim Hosp Assoc 1990; 196:1841–1844.
31. Duarte RM, Vaccaro AR. Spinal infection: state of the art and management algorithm. Eur Spine J 2013; 22:2787–2799.
32. Tompkins M, Panuncialman I, Lucas P, et al. Spinal epidural abscess. J Emerg Med 2010; 39:384–390.
33. Pradilla G, Nagahama Y, Spivak A, et al. Spinal epidural abscess: current diagnosis and management. Curr Infect Dis Rep 2010; 12:484–491.
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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.
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.