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  • Author or Editor: Luc M. L. Van Ham x
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Abstract

Objective

To compare 2 types of narcotic-induced anesthesia for recording of transcranial magnetic motor evoked potentials (TMMEP) in dogs.

Design

The effect of different doses of sufentanil and midazolam and of sufentanil and nitrous oxide on onset latencies and peak-to-peak amplitudes of TMMEP was evaluated and compared.

Animals

18 neurologically normal dogs.

Procedure

Premedication with droperidol and fentanyl. Induction and maintenance of anesthesia either with sufentanil and midazolam or with sufentanil and nitrous oxide. Recording of TMMEP from the extensor carpi radialis muscle of the forelimb and from the cranial tibial muscle of the hind limb.

Results

Both types of narcotic anesthesia induced dose-dependent suppression of TMMEP; compared with baseline recordings, latencies increased, amplitudes decreased, and reproducibility became poorer with increasing dose of the anesthetics. Using surgical-depth doses of the anesthetics, TMMEP could still be recorded in all dogs with sufentanil and nitrous oxide, but not with sufentanil and midazolam anesthesia.

Conclusions

Sufentanil and nitrous oxide anesthesia was superior to sufentanil and midazolam anesthesia for TMMEP recording.

Clinical Relevance

In small animal medicine, and in dogs in particular, spinal cord diseases are among the most frequently encountered neurologic disorders. The development of techniques for recording TMMEP in anesthetized dogs allows noninvasive evaluation of transmission along descending motor pathways of the spinal cord.

Free access
in American Journal of Veterinary Research

Abstract

Objective—To determine the spectrum and frequency of abnormalities for low-field magnetic resonance imaging (MRI) examinations of clinically normal Doberman Pinschers and Foxhounds.

Animals—37 clinically normal dogs (20 Doberman Pinschers and 17 Foxhounds).

Procedures—For each dog, MRI of the cervical vertebrae (sagittal, dorsal, and transverse T1- and T2-weighted images) was performed. Variables assessed were intervertebral disk degeneration, disk-associated compression, compression of the dorsal portion of the spinal cord, vertebral body abnormalities, and changes in intraparenchymal signal intensity. Associations between these variables and age, breed, sex, and location of the assessed intervertebral disk spaces were evaluated.

Results—Severe MRI abnormalities were detected in 17 dogs, including complete disk degeneration (n = 4 dogs), spinal cord compression (3), or both (10). Vertebral body abnormalities were detected in 8 dogs, and hyperintense signal intensity was detected in 2 dogs. Severity of disk degeneration and disk-associated compression was significantly associated with increased age. There was a significant association between disk degeneration, disk-as-sociated compression, and compression of the dorsal aspect of the spinal cord and location of the assessed intervertebral disk space, with the intervertebral disk spaces in the caudal portion of the cervical region being more severely affected.

Conclusions and Clinical Relevance—Abnormalities were commonly seen on MRI examinations of the caudal portion of the cervical vertebral column and spinal cord of clinically normal Doberman Pinchers and Foxhounds. Such lesions were probably part of the typical spinal cord degeneration associated with the aging process of dogs.

Full access
in American Journal of Veterinary Research

Abstract

Objective—To determine magnetic resonance imaging (MRI) vertebral ratio values representing vertebral canal height, vertebral canal shape, and vertebral body shape in Doberman Pinschers with and without disk-associated cervical spondylomyelopathy (DACSM) and clinically normal English Foxhounds.

Animals—Doberman Pinschers with (n = 18) and without (20) DACSM and clinically normal English Foxhounds (18).

Procedures—All dogs underwent low-field MRI of the cervical vertebral column. From 5 specific measurements made at C3 through C7, 4 linear vertebral ratios were calculated and assessed for correlation: vertebral canal height-to-body height ratio (CBHR), vertebral canal height-to-body length ratio (CBLR), caudal canal height-to-cranial canal height ratio (CCHR), and vertebral body length-to-height ratio (BLHR). The CBHR and CBLR described vertebral canal height, CCHR described vertebral canal shape, and BLHR described vertebral body shape. A midvertebral canal-occupying ratio (mVCOR) for the spinal cord was calculated at C5.

Results—Compared with both groups of unaffected dogs, CBHR, CBLR, and BLHR for Doberman Pinschers with DACSM were significantly smaller. The C7 CCHR was significantly larger in DACSM-affected Doberman Pinschers, compared with clinically normal English Foxhounds. Ratios did not differ significantly between unaffected Doberman Pinschers and clinically normal English Foxhounds. Correlation coefficients between CBHR, CBLR, and mVCOR were low and not significant.

Conclusions and Clinical Relevance—Doberman Pinschers with DACSM had significantly smaller vertebral canal heights and more square-shaped vertebral bodies, compared with unaffected Doberman Pinschers, combined with a funnel-shaped vertebral canal at C7. Breed-specific differences were not evident. Linear MRI vertebral canal-to-body ratios do not appear to predict relative vertebral canal stenosis.

Full access
in American Journal of Veterinary Research

Abstract

Objective—To determine radiographic vertebral ratio values representing vertebral canal stenosis in Doberman Pinschers with and without clinical signs of caudal cervical spondylomyelopathy (CCSM).

Animals—Doberman Pinschers with (n = 81) and without (39) signs of CCSM.

Procedures—All dogs underwent lateral survey radiography of the cervical vertebral column. Five specific measurements were made at C3 through C7, and from those data, 3 ratios were calculated and analyzed for use in diagnosis of CSSM: canal height-to-vertebral body height ratio (CBHR), canal height-to-vertebral body length ratio (CBLR), and caudal vertebral canal height-to-cranial vertebral canal height ratio (CCHR). The CBHR and CBLR were considered indicators of vertebral canal stenosis, and CCHR described vertebral canal shape.

Results—Compared with Doberman Pinschers without CCSM, mean CBHR and CBLR values were significantly smaller for Doberman Pinschers with CCSM; for CBHR, this difference was evident at each assessed vertebra. The CCHR value for C7 was significantly larger in dogs with CCSM. Receiver operating characteristic statistics did not identify a threshold point that had combined high sensitivity and specificity sufficient to differentiate between Doberman Pinschers with and without CCSM.

Conclusions and Clinical Relevance—Doberman Pinschers with CCSM had vertebral canal stenosis combined with a funnel-shaped vertebral canal at C7 significantly more often than did Doberman Pinschers without CCSM. Despite these significant differences, no reliable threshold ratio values were identified to differentiate groups of dogs.

Full access
in American Journal of Veterinary Research

Abstract

Objective—To evaluate the evolution of clinical signs and their correlation with results of magnetic resonance imaging (MRI) and transcranial magnetic stimulation (TMS) and to assess potential prognostic variables after conservative medical treatment for disk-associated cervical spondylomyelopathy (DA-CSM) in dogs.

Design—Prospective cohort study.

Animals—21 client-owned dogs with DA-CSM.

Procedures—After neurologic grading, dogs underwent low-field MRI and TMS with measurement of onset latencies and peak-to-peak amplitudes from the extensor carpi radialis and cranial tibial muscles. Dimensions calculated from MRI images were remaining spinal cord area, spinal cord compression ratio, vertebral occupying ratio, vertebral canal height-to-body height ratio, vertebral canal height-to-body length ratio, and vertebral canal compromise ratio. Intraparenchymal signal intensity changes were graded. Dogs were reevaluated 1, 3, 6, 12, and 24 months after initial diagnosis.

Results—Outcome was successful in 8 of 21 dogs. Negative outcomes were characterized by rapid progression of clinical signs. All dogs with more severe clinical signs of DA-CSM 1 month after diagnosis had unsuccessful outcomes. Outcome was associated with the remaining spinal cord area and vertebral canal compromise ratio. Prognosis was not associated with severity of clinical signs or results of TMS. There were no significant correlations among clinical signs, MRI findings, and TMS results.

Conclusions and Clinical Relevance—Conservative medical treatment of DA-CSM was associated with a guarded prognosis. Selected MRI variables and clinical evolution 1 month after diagnosis can be considered prognostic indicators. The lack of correlation among clinical signs, results of diagnostic imaging, and results of electrophysiologic evaluation in dogs with DA-CSM warrants further investigation.

Full access
in Journal of the American Veterinary Medical Association

Abstract

Case Description—A 4-year-old sexually intact male mixed-breed dog was evaluated because of clinical signs of acute-onset pelvic limb ataxia, rapidly progressing to paraplegia with severe spinal hyperesthesia.

Clinical Findings—General physical examination revealed pyrexia, tachycardia, and tachypnea. Neurologic examination demonstrated severe spinal hyperesthesia and paraplegia with decreased nociception. Magnetic resonance imaging revealed extradural spinal cord compression at T13-L1 and hyperintense lesions on T1- and T2-weighted images in the epaxial musculature and epidural space.

Treatment and Outcome—Decompressive surgery, consisting of a continuous dorsal laminectomy, with copious lavage of the vertebral canal was performed. Cultures of blood, urine, and surgical site samples were negative. Histologic examination results for samples obtained during surgery demonstrated suppurative myositis and steatitis. These findings confirmed a diagnosis of sterile idiopathic inflammation of the epidural fat and epaxial muscles with spinal cord compression. The dog's neurologic status started to improve 1 week after surgery. After surgery, the dog received supportive care including antimicrobials and NSAIDs. The dog was ambulatory 1 month after surgery and was fully ambulatory despite signs of mild bilateral pelvic limb ataxia 3 years after surgery.

Clinical Relevance—Although idiopathic sterile inflammation of adipose tissue, referred to as panniculitis, more commonly affects subcutaneous tissue, its presence in the vertebral canal is rare. Specific MRI findings described in this report may help in reaching a presumptive diagnosis of this neurologic disorder. A definitive diagnosis and successful long-term outcome in affected patients can be achieved by decompressive surgery and histologic examination of surgical biopsy samples.

Full access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine interobserver and intraobserver agreement for results of low-field magnetic resonance imaging (MRI) in dogs with and without disk-associated wobbler syndrome (DAWS).

Design—Validation study.

Animals—21 dogs with and 23 dogs without clinical signs of DAWS.

Procedures—For each dog, MRI of the cervical vertebral column was performed. The MRI studies were presented in a randomized sequence to 4 board-certified radiologists blinded to clinical status. Observers assessed degree of disk degeneration, disk-associated and dorsal compression, alterations in intraspinal signal intensity (ISI), vertebral body abnormalities, and new bone formation and categorized each study as originating from a clinically affected or clinically normal dog. Interobserver agreement was calculated for 44 initial measurements for each observer. Intraobserver agreement was calculated for 11 replicate measurements for each observer.

Results—There was good interobserver agreement for ratings of disk degeneration and vertebral body abnormalities and moderate interobserver agreement for ratings of disk-associated compression, dorsal compression, alterations in ISI, new bone formation, and suspected clinical status. There was very good intraobserver agreement for ratings of disk degeneration, disk-associated compression, alterations in ISI, vertebral body abnormalities, and suspected clinical status. There was good intraobserver agreement for ratings of dorsal compression and new bone formation. Two of 21 clinically affected dogs were erroneously categorized as clinically normal, and 4 of 23 clinically normal dogs were erroneously categorized as clinically affected.

Conclusions and Clinical Relevance—Results suggested that variability exists among observers with regard to results of MRI in dogs with DAWS and that MRI could lead to false-positive and false-negative assessments.

Full access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine intraobserver, interobserver, and intermethod agreement for results of myelography, computed tomography-myelography (CTM), and low-field magnetic resonance imaging (MRI) in dogs with disk-associated wobbler syndrome (DAWS).

Design—Prospective cross-sectional study.

Animals—22 dogs with DAWS.

Procedures—All dogs underwent myelography, CTM, and low-field MRI. Each imaging study was interpreted twice by 4 observers who were blinded to signalment and clinical information of the patients. The following variables were assessed by all 3 techniques: number, site, and direction of spinal cord compressions; narrowed intervertebral disk spaces; vertebral body abnormalities; spondylosis deformans; and abnormal articular facets. Intervertebral foraminal stenosis was assessed on CTM and MRI images. Intraobserver, interobserver, and intermethod agreement were calculated by κ and weighted κ statistics.

Results—There was very good to good intraobserver agreement for most variables assessed by myelography and only moderate intraobserver agreement for most variables assessed by CTM and low-field MRI. There was moderate to fair interobserver and intermethod agreement for most variables assessed by the 3 diagnostic techniques. There was very good or good intraobserver, interobserver, or intermethod agreement for the site and direction of the worst spinal cord compression as assessed by all the imaging modalities; abnormal articular facets and intervertebral foraminal stenosis were the least reliably assessed variables, with poor interobserver agreement regardless of imaging modality used.

Conclusions and Clinical Relevance—There was considerable variation in image interpretation among observers and between use of various imaging modalities; these imaging techniques should be considered complementary in assessment of dogs with DAWS.

Full access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To evaluate the use of transcranial magnetic stimulation for differentiating between clinically relevant and clinically irrelevant cervical spinal cord compression on magnetic resonance imaging (MRI).

Design—Validation study.

Animals—Clinically normal Doberman Pinschers without (n = 11) and with (6) spinal cord compression on MRI and 16 Doberman Pinschers with disk-associated wobbler syndrome (DAWS).

Procedures—After dogs were sedated, transcranial magnetic motor evoked potentials were recorded from the extensor carpi radialis muscle (ECRM) and cranial tibial muscle (CTM). Onset latencies and peak-to-peak amplitudes were measured. Magnetic resonance imaging was performed to identify spinal cord compression.

Results—There were significant differences in ECRM and CTM onset latencies between Doberman Pinschers with DAWS and each of the 2 groups of clinically normal dogs, but there were no significant differences in ECRM and CTM onset latencies between the 2 groups of clinically normal dogs. There were significant differences in CTM peak-to-peak amplitudes between Doberman Pinschers with DAWS and each of the 2 groups of clinically normal dogs, but there were no significant differences in ECRM peak-to-peak amplitudes among groups or in CTM peak-to-peak amplitudes between the 2 groups of clinically normal dogs. There was a significant correlation between severity of spinal cord compression and ECRM onset latency, CTM onset latency, and CTM peak-to-peak amplitude.

Conclusions and Clinical Relevance—Results suggested that transcranial magnetic stimulation may be a useful diagnostic tool to differentiate between clinically relevant and clinically irrelevant spinal cord compression identified on MRI alone.

Full access
in Journal of the American Veterinary Medical Association