Extrusão de disco intervertebral intradural em um cão / Intradural disc extrusion in a dog

Background: Intervertebral disc extrusion is an important cause of spinal cord dysfunction in dogs. Intradural localizationof the extruded disc material is rare, and is generally associated with a traumatic event or with recurrence of disc extrusionat a previously affected site. We report the clinical presentation, diagnostic workup, and treatment of a dog with intraduralintervertebral disc extrusion not preceded by a traumatic event.Case: A 6-year-old male Dachshund was referred for neurological evaluation due to acute onset of hind-end paralysispreceded by claudication of the left hindlimb. The patient had been receiving conservative treatment to no effect. Neurological examination revealed asymmetric non-ambulatory paraparesis, absence of postural reactions and decreased muscletone in both hindlimbs, a bilaterally diminished patellar reflex, and a hindlimb withdrawal reflex which was normal onthe right and greatly diminished to absent on the left. The lower back was tender to epaxial palpation. Plain radiographsof the lumbar spine in the lateral projection showed calcified material within the spinal canal between the third and fourthlumbar vertebrae. Myelography was suggestively abnormal at the same level, with epidural leakage of contrast at L3-L4.Considering the clinical history, breed, age, neurological signs, and radiographic findings, intervertebral disc disease wassuspected despite the inconclusive myelography findings. A dorsolateral lumbar hemilaminectomy was performed. Intraoperatively, the diagnosis was confirmed by visualization of a discolored spinal cord and absence of extradural material.The intradural space was accessed via durotomy. A firm, straw-yellow material was seen compressing the spinal cord andremoved. Subsequent histopathological...

Extrusão de disco intervertebral intradural em um cão / Intradural disc extrusion in a dog

Background: Intervertebral disc extrusion is an important cause of spinal cord dysfunction in dogs. Intradural localizationof the extruded disc material is rare, and is generally associated with a traumatic event or with recurrence of disc extrusionat a previously affected site. We report the clinical presentation, diagnostic workup, and treatment of a dog with intraduralintervertebral disc extrusion not preceded by a traumatic event.Case: A 6-year-old male Dachshund was referred for neurological evaluation due to acute onset of hind-end paralysispreceded by claudication of the left hindlimb. The patient had been receiving conservative treatment to no effect. Neurological examination revealed asymmetric non-ambulatory paraparesis, absence of postural reactions and decreased muscletone in both hindlimbs, a bilaterally diminished patellar reflex, and a hindlimb withdrawal reflex which was normal onthe right and greatly diminished to absent on the left. The lower back was tender to epaxial palpation. Plain radiographsof the lumbar spine in the lateral projection showed calcified material within the spinal canal between the third and fourthlumbar vertebrae. Myelography was suggestively abnormal at the same level, with epidural leakage of contrast at L3-L4.Considering the clinical history, breed, age, neurological signs, and radiographic findings, intervertebral disc disease wassuspected despite the inconclusive myelography findings. A dorsolateral lumbar hemilaminectomy was performed. Intraoperatively, the diagnosis was confirmed by visualization of a discolored spinal cord and absence of extradural material.The intradural space was accessed via durotomy. A firm, straw-yellow material was seen compressing the spinal cord andremoved. Subsequent histopathological...(AU)

Infiltrative lipoma causing lumbar nerve root compression in a dog

Background: Lipomas are benign soft tissue mesenchymal neoplasms composed of adipose cells and are usually foundin the subcutaneous tissue. Occasionally, lipomas may invade muscles or grow between them, in which case they arecharacterized as infiltrative lipomas. Clinical signs resulting from an intermuscular lipoma compressing peripheral nervesare rarely encountered in dogs. This case report aims to describe the neurological signs, diagnosis, and clinical evaluationof a dog diagnosed with infiltrative lipoma compressing a lumbar spinal nerve root.Case: A 12-year-old neutered male Fox Paulistinha, weighing 10.5 kg, was presented with difficulties in walking for thepast 15 days with no previous history of trauma. On physical examination, the presence of three cutaneous nodules wasnoted in the ventral thoracic region, with onset of one year and slow and progressive growth. A cytological evaluation ofthe nodules was performed, and lipoma was diagnosed. At the neurological examination, the patient presented ambulatoryparaparesis with marked motor deficit and atrophy of the quadriceps muscles of the left pelvic limb. Conscious proprioceptive deficit, the absence of patellar reflex, and diminished withdrawal reflex were observed in the left hind limb, in additionto diffuse pain on epaxial palpation of the lumbar region. Electroneuromyography showed increased insertion activity inthe left gastrocnemius muscle and moderate spontaneous activity (fibrillation). Persistence of 10% was observed in theF-wave study of the left tibial nerve. These findings indicate partial involvement of the roots of the left sciatic-tibial nerve.Magnetic resonance imaging (MRI) showed the presence of a mass measuring 3.18 × 1.04 × 1.4 cm, interspersed withthe paravertebral muscles, and located adjacent to the L2 and L3 spinous processes...

Infiltrative lipoma causing lumbar nerve root compression in a dog

Background: Lipomas are benign soft tissue mesenchymal neoplasms composed of adipose cells and are usually foundin the subcutaneous tissue. Occasionally, lipomas may invade muscles or grow between them, in which case they arecharacterized as infiltrative lipomas. Clinical signs resulting from an intermuscular lipoma compressing peripheral nervesare rarely encountered in dogs. This case report aims to describe the neurological signs, diagnosis, and clinical evaluationof a dog diagnosed with infiltrative lipoma compressing a lumbar spinal nerve root.Case: A 12-year-old neutered male Fox Paulistinha, weighing 10.5 kg, was presented with difficulties in walking for thepast 15 days with no previous history of trauma. On physical examination, the presence of three cutaneous nodules wasnoted in the ventral thoracic region, with onset of one year and slow and progressive growth. A cytological evaluation ofthe nodules was performed, and lipoma was diagnosed. At the neurological examination, the patient presented ambulatoryparaparesis with marked motor deficit and atrophy of the quadriceps muscles of the left pelvic limb. Conscious proprioceptive deficit, the absence of patellar reflex, and diminished withdrawal reflex were observed in the left hind limb, in additionto diffuse pain on epaxial palpation of the lumbar region. Electroneuromyography showed increased insertion activity inthe left gastrocnemius muscle and moderate spontaneous activity (fibrillation). Persistence of 10% was observed in theF-wave study of the left tibial nerve. These findings indicate partial involvement of the roots of the left sciatic-tibial nerve.Magnetic resonance imaging (MRI) showed the presence of a mass measuring 3.18 × 1.04 × 1.4 cm, interspersed withthe paravertebral muscles, and located adjacent to the L2 and L3 spinous processes...(AU)

AVALIAÇÃO SENSITIVA E MOTORA DE CÃES COM LESÃO MEDULAR AGUDA, SUBMETIDOS À DESCOMPRESSÃO CIRÚRGICA E TRANSPLANTE DE CÉLULAS-TRONCO MESENQUIMAIS

Paraparesia e paraplegia são sinais clínicos comuns em cães, sendo que a principal causa é a hérnia discal, que promove compressão da medula espinhal. Esta é considerada emergência neurológica. Não existe terapia farmacológica eficaz para a lesão medular primária e a terapia farmacológica para lesão medular secundária é questionável quanto a sua eficácia. Quando há compressão medular evidente na mielografia, tomografia computadorizada e/ou ressonância magnética a descompressão cirúrgica o mais breve possível é indicada. Apesar de diversas terapias medicamentosas ou celulares bem-sucedidas ainda não foi observado a recuperação total das lesões do parênquima medular lesionado. O transplante de células-tronco tem sido considerado opção promissora para o tratamento de distúrbios neurológicos, incluindo lesões medulares agudas e crônicas, devido seu efeito anti-inflamatório, potencial angiogênico, ação parácrina e eventual transformação neuronal. Este estudo tem como objetivo avaliar 22 cães com paraplegia aguda, devido a hérnia discal toracolombar, nos graus IV e V e os efeitos da descompressão cirúrgica associada ou não ao transplante de células-tronco mesenquimais (CTMs) de forma epidural no momento da cirurgia.

Paraparesis and paraplegia are common in dogs. The main cause is herniated disc, which promotes compression of the spinal cord and is considered a neurological emergency. There is no effective pharmacological therapy for primary spinal cord injury and pharmacological therapy for secondary spinal cord injury is questionable regarding it is efficacy. When there is evident spinal compression in myelography, computed tomography and/or magnetic resonance image, surgical decompression as soon as possible is indicated. Despite several successful drug or cellular therapies, full recovery of lesions of the injured medullary parenchyma has not yet been observed. Stem cell transplantation has been considered a promising option for the treatment of neurological disorders, including acute and chronic spinal cord injury because anti-inflammatory effect, angiogenic potential, paracrine action and eventual neuronal transformation. This study aims to evaluate dogs with acute paraplegia due to thoracolumbar disc herniation in degrees IV and V and the effects of surgical decompression associate or not to the transplantation of mesenchymal stem cell (MSC) in an epidural manner at the time of surgery.