Successful surgical management of an Escherichia coli epidural-subdural abscess secondary to sino-rhinotomy.

OBJECTIVE: To describe a case of successful management of epidural-subdural abscess and severe meningitis with secondary brain herniation in a dog. CASE SUMMARY: A rhino-sinusotomy was performed in a 3-year-old mixed-breed dog for management of refractory sinonasal aspergillosis. Initial recovery was good, but the dog became acutely stuporous 36 hours after surgery. Evidence of increased intracranial pressure with brain herniation and midline shift secondary to an epidural abscess was observed on magnetic resonance imaging. Decompressive craniectomy and drainage of the abscess was performed. Intensive nursing care and physiologic support was performed with consciousness returning 7 days after initial stupor. The dog was discharged 14 days after craniectomy and was ambulatory with support. NEW/UNIQUE INFORMATION PROVIDED: Intracranial abscesses are rarely described in dogs and few had a successful outcome reported. All previous reports have been of brain abscesses or empyema, rather than a combination of epidural and subdural abscessation. Additionally, the process of sino-rhinotomy for management of aspergillosis has not been previously linked to intracranial abscess formation. To the authors' knowledge, this is the first report of successful management of an epidural-subdural abscess and suggests that even with cases with low modified Glasgow Coma Scale scores outcome may be positive.

The potential role of MRI in veterinary clinical cardiology.

Over the last decade, magnetic resonance imaging (MRI) has become established as a useful referral diagnostic method in veterinary medicine that is widely used in small animal brain and spinal diseases, aural, nasal and orbital disorders, planning soft tissue surgery, oncology and small animal and equine orthopaedics. The use of MRI in these disciplines has grown due to its unparalleled capability to image soft tissue structures. This has been exploited in human cardiology where, despite the inherent difficulties in imaging a moving, contractile structure, cardiac MRI (CMRI) has become the optimal technique for the morphological assessment and quantification of ventricular function. Both CMRI hardware and software systems have developed rapidly in the last 10 years but although several preliminary veterinary CMRI studies have been reported, the technique's growth has been limited and is currently used primarily in clinical research. A review of published studies is presented with a description of CMRI technology and the potential of CMRI is discussed along with some of the reasons for its limited usage.

Association of clinical and magnetic resonance imaging findings with outcome in dogs with presumptive acute noncompressive nucleus pulposus extrusion: 42 cases (2000-2007).

OBJECTIVE: To assess associations of severity of neurologic signs (neurologic score), involvement of an intumescence, and findings of magnetic resonance imaging (MRI) with interval to recovery and outcome in dogs with presumptive acute noncompressive nucleus pulposus extrusions. DESIGN: Retrospective case series. ANIMALS: 42 dogs with presumptive acute noncompressive nucleus pulposus extrusions. PROCEDURES: Medical records and magnetic resonance (MR) images of dogs evaluated from 2000 through 2007 were reviewed. Inclusion criteria were acute onset of nonprogressive myelopathy following trauma or strenuous exercise, MRI of the spine performed within 7 days after onset, MRI findings consistent with acute noncompressive nucleus pulposus extrusions, and complete medical records and follow-up. RESULTS: Clinical neuroanatomic localization of lesions was to the C1-C5 (n = 6), C6-T2 (6), T3-L3 (28), and L4-S3 (2) spinal cord segments. Median neurologic score was 3.5. Median duration of follow-up was 804 days (range, 3 to 2,134 days) after onset of neurologic signs. Outcome was successful in 28 (67%) dogs and unsuccessful in 14 (33%) dogs. Severity of neurologic signs, extent of the intramedullary hyperintensity on sagittal and transverse T2-weighted MR images, and detection of intramedullary hypointensity on GRE images were all associated with outcome on univariate analysis. Results of multivariate analysis suggested that maximal cross-sectional area of the intramedullary hyperintensity on transverse T2-weighted MR images was the best predictor of outcome. CONCLUSIONS AND CLINICAL IMPORTANCE: Clinical and MRI findings can help predict outcome in dogs with acute noncompressive nucleus pulposus extrusions.

Association of clinical and magnetic resonance imaging findings with outcome in dogs suspected to have ischemic myelopathy: 50 cases (2000-2006).

OBJECTIVE: To determine whether clinical signs or magnetic resonance imaging findings were associated with outcome in dogs with presumptive ischemic myelopathy. DESIGN: Retrospective case series. ANIMALS: 50 dogs. PROCEDURES: Medical records and magnetic resonance images were reviewed. A neurologic score from 1 (normal) to 5 (most severe degree of dysfunction) was assigned on the basis of neurologic signs at the time of initial examination. Follow-up information was obtained from the medical records and by means of a telephone questionnaire completed by owners and referring veterinarians. RESULTS: Median neurologic score at the time of initial examination was 3 (range, 2 to 5). Median follow-up time was 584 days (range, 4 to 2,090 days). Neurologic score at the time of initial examination and extent of the lesion seen on magnetic resonance images (quantified as the lesion length-to-vertebral length ratio and as the percentage cross-sectional area of the lesion) were significantly associated with outcome. Sensitivity of using a lesion length-to-vertebral length ratio > 2.0 or a percentage cross-sectional area of the lesion > or = 67% to predict an unsuccessful outcome was 100%. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that severity of neurologic signs at the time of initial examination and extent of the lesions seen on magnetic resonance images were associated with outcome in dogs with ischemic myelopathy.

Magnetic resonance imaging features of spinal epidural empyema in five dogs.

Spinal epidural empyema is defined an accumulation of purulent material in the epidural space of the vertebral canal. Spinal epidural empyema should be considered as a differential diagnosis in dogs with pyrexia, spinal pain, and rapidly progressing myelopathy. Magnetic resonance (MR) imaging is the imaging test of choice in humans. Here, we describe the MR imaging features of five dogs with confirmed spinal epidural empyema. The epidural lesions appeared as high or mixed signal masses in T2-weighted (T2W) images. Increased signal within the spinal cord gray matter at the site of the lesion was detected in T2W images in all dogs. Two patterns of enhancement were detected on postcontrast T1-weighted (T1W) images. Mild to moderate peripheral enhancement was seen in three dogs and a diffuse pattern of enhancement was seen in one. Discospondylitis was identified in three dogs on T1W postcontrast images. Decompressive spinal surgery was performed in all dogs. Bacteria isolated from the abnormal epidural tissue were Enterobacter cloacae, coagulase-positive Staphylococci, Pasteurella multocida, and Escherichia coli. In one dog bacteria were not isolated. These MR imaging features, along with appropriate clinical signs, can allow prompt diagnosis and appropriate treatment planning.