Klebsiella sp.-related infectious spondylitis in a bearded dragon (Pogona vitticeps).

BACKGROUND: Spondylitis is an inflammation of the vertebrae that leads to a destructive process with exuberant new bone formation. Osteomyelitis can produce a distortion of the bone architecture, degenerative joint changes and ankyloses of adjacent vertebrae. In reptiles, intervertebral discs are absent, so the term discospondylitis is not used. In lizards, vertebral lesions have not been well studied. The present paper describes the first case of Klebsiella sp.-related spondylitis in a pet lizard (Pogona vitticeps). CASE PRESENTATION: A 2-year-old, female bearded dragon (Pogona vitticeps) was presented for clinical examination due to a decreased activity level, decreased appetite and constipation. Blood tests showed no remarkable alterations. The haemogram showed normal parameters with relative lymphocytosis, although the absolute number of lymphocytes did not differ from the reference values. A computed tomography scan revealed a mixed osteolytic-proliferative bone lesion diffusing to the first and last tracts of the pre-sacral vertebrae together. A small amount of material obtained from the spinal swelling was sampled with an aseptic technique for bacterial culture, which was positive for Klebsiella sp. The antibiogram revealed sensitivity to enrofloxacin, marbofloxacin, and chloramphenicol and intermediate sensitivity to gentamicin. Complete return to spontaneous feeding was achieved 15 days after the beginning of antibiotic and anti-inflammatory therapy. CONCLUSIONS: In veterinary medicine, spondylitis represents a well-known disease in small companion animals. In mammals, the most common aetiologic agents are fungi and bacteria. Antibiotic therapy was set based on the antibiogram, and marbofloxacin was chosen at a dosage of 10 mg/kg subcutaneously (SC) once per day (SID). After only 7 days of antibiotic therapy, the clinical condition improved significantly; the patient started feeding and drinking spontaneously and gained weight. This case should remind clinicians of the importance of always performing antibiograms before choosing any antibiotic therapy. Considering reptiles, there have been few papers about spinal diseases, mostly regarding snakes and a few about Iguana iguana. Relative to other species of saurians, the literature remains lacking.

Pathogenesis of Enterococcal Spondylitis Caused by Enterococcus cecorum in Broiler Chickens.

Enterococcal spondylitis (ES) is a disease of commercial broiler chickens, with a worldwide distribution. Symmetrical hind limb paralysis typical of ES results from infection of the free thoracic vertebra (FTV) by pathogenic strains of Enterococcus cecorum . To determine the pathogenesis of ES, birds with natural and experimental ES were studied over time. In natural disease, case birds (n = 150) from an affected farm and control birds (n = 100) from an unaffected farm were evaluated at weeks 1-6. In control birds, intestinal colonization by E. cecorum began at week 3. In case birds, E. cecorum was detected in intestine and spleen at week 1, followed by infection of the FTV beginning at week 3. E. cecorum isolates recovered from intestine, spleen, and FTV of case birds had matching genotypes, confirming that intestinal colonization with pathogenic strains precedes bacteremia and infection of the FTV. Clinical intestinal disease was not required for E. cecorum bacteremia. In 1- to 3-week-old case birds, pathogenic E. cecorum was observed within osteochondrosis dissecans (OCD) lesions in the FTV. To determine whether OCD of the FTV was a risk factor for ES, 214 birds were orally infected with E. cecorum, and the FTV was evaluated histologically at weeks 1-7. Birds without cartilage clefts of OCD in the FTV did not develop ES; while birds with OCD scores ≥3 were susceptible to lesion development. These findings suggest that intestinal colonization, bacteremia, and OCD of the FTV in early life are crucial to the pathogenesis of ES.

Use of linezolid to treat MRSP bacteremia and discospondylitis in a dog.

A 1.5 yr old male German shepherd dog was evaluated for recurrent intermittent episodes of fever and lethargy. Clinicopathologic abnormalities were suggestive of a discospondylitis at the seventh and eighth thoracic vertebrae. Blood and urine cultures yielded growth of methicillin-resistant Staphylococcus pseudintermedius (MRSP) that was resistant to all commonly used antibiotics. Extralabel antibiotic susceptibility testing demonstrated susceptibility of both blood and urine isolates to linezolid. The prescribed dose was extrapolated from pharmacokinetic (PK) studies and the isolate's plasma minimum inhibitory concentration (MIC). Linezolid was administered for 23 wk and resulted in successful resolution of bacteremia, bacteriuria, and discospondylitis. When justified, linezolid should be considered to treat methicillin-resistant infections.

Outcome of dogs diagnosed with concurrent intrahepatic portosystemic shunts and vertebral lesions: six cases (2016-2022).

OBJECTIVES: To describe the clinical outcome of dogs diagnosed with concurrent discospondylitis/vertebral physitis and congenital intrahepatic portosystemic shunts. MATERIALS AND METHODS: Medical records from two academic institutions were searched for dogs diagnosed with discospondylitis and/or vertebral physitis, and a concurrent intrahepatic portosystemic shunt. Dogs were excluded if they did not undergo attenuation of their shunt, did not have a single congenital intrahepatic shunt and did not have at least 90 days of follow-up. RESULTS: Six dogs met the inclusion criteria and were included in the study. Discospondylitis alone was diagnosed in four dogs, vertebral physitis alone in one dog and both discospondylitis and vertebral physitis in one dog. Three dogs had a right divisional intrahepatic portosystemic shunt, and three dogs had a left divisional intrahepatic portosystemic shunt. Median duration of antimicrobial therapy was 112 days (range 14 to 240 days). Clinical resolution of discospondylitis and vertebral physitis was noted in all dogs. Endovascular attenuation was performed in all dogs a median of 82 days after presentation (range 1 to 317 days). No perioperative or postoperative complications occurred. All dogs were alive at the last available follow-up a median of 513 days after presentation (range 224 to 1504 days) and free of clinical signs associated with discospondylitis or vertebral physitis, as well as their portosystemic shunt. CLINICAL SIGNIFICANCE: Dogs with intrahepatic portosystemic shunts may concurrently develop discospondylitis and vertebral physitis. With antimicrobial therapy and endovascular embolisation of their portosystemic shunt, all dogs in this study had a good outcome with clinical resolution of both disease processes. However, long-term follow-up was not obtained in all cases.

Clinical findings and outcome in goats with discospondylitis and vertebral osteomyelitis.

BACKGROUND: Vertebral infections, including vertebral osteomyelitis, septic physitis, and discospondylitis, are rarely reported in goats, and when reported, have been largely limited to necropsy case reports. OBJECTIVE: Describe clinical findings and outcome in goats with vertebral infections evaluated by computed tomography (CT). ANIMALS: Five goats with vertebral osteomyelitis, septic physitis, and discospondylitis evaluated by CT. METHODS: Retrospective case series. RESULTS: The most common presenting complaints were progressive weakness, paresis and recumbency. Three goats were tetraparetic and 2 goats had pelvic limb paraparesis. Clinicopathologic findings included leukocytosis, mature neutrophilia, and hyperfibrinogenemia. The most common vertebrae affected were C7-T1. All 5 goats had discospondylitis with or without vertebral osteomyelitis and septic physitis. Computed tomographic evidence of spinal cord compression was present in 4/5 goats. Medical management (antimicrobials, physical therapy, analgesia, supportive care) was attempted in 4 goats, and 1 goat was euthanized at the time of diagnosis. All 4 goats that were treated regained ambulatory ability and survived to hospital discharge. CONCLUSIONS AND CLINICAL IMPORTANCE: Despite severity of CT imaging findings, goats with discospondylitis, septic physitis, and vertebral osteomyelitis can successfully return to ambulatory function. Additional studies are required to determine ideal treatment regimens.

Bacterial diskospondylitis in juvenile mink from 2 Ontario mink farms.

Nine juvenile mink with hind-limb paresis/paralysis from 2 Ontario farms were submitted for necropsy. Diagnostic tests revealed spinal compression and severe thoracic diskospondylitis with intralesional Gram-positive coccoid bacterial colonies. Streptococcus canis, Streptococcus dysgalactiae subsp. equisimilis, and hemolytic Staphylococcus spp. were isolated from vertebral lesions.

Discospondylite bactérienne chez des jeunes visons provenant de 2 fermes de visons de l'Ontario. Neuf jeunes visons atteints d'une parésie/paralysie des membres postérieurs provenant de 2 fermes de l'Ontario ont été soumis à une nécropsie. Les tests diagnostiques ont révélé une compression médullaire et une discospondylite thoracique grave avec des colonies de bactéries coccoïdes à Gram positif. Les bactéries Streptococcus canis, Streptococcus dysgalactiae subsp. equisimilis, et Staphylococcus spp. hémolytiques ont été isolés des lésions vertébrales.(Traduit par Isabelle Vallières).

A case of canine discospondylitis and epidural empyema due to Salmonella species.

A case of canine discospondylitis and epidural empyema due to Salmonella species is reported. The history, clinical signs, and magnetic resonance imaging were suggestive of discospondylitis and empyema, which was subsequently confirmed by blood cultures. To the authors' knowledge, this is the first reported case of canine discospondylitis due to Salmonella species.

Cas de discospondylite canine et d'empyème épidural causé par l'espèceSalmonella. Un cas de discospondylite canine et d'empyème épidural causé par l'espèce Salmonella est présenté. L'anamnèse, les signes cliniques et l'imagerie par résonance magnétique suggéraient une discospondylite et l'empyème, ce qui a été subséquemment confirmé par des hémocultures. À la connaissance des auteurs, il s'agit du premier cas signalé de discospondylite canine causée par l'espèce Salmonella.(Traduit par Isabelle Vallières).

Clinical and diagnostic imaging findings in an Italian wolf (Canis lupus italicus) with discospondylitis.

An adult male Italian wolf (Canis lupus italicus) was presented with an abnormal gait. Neurologic examination showed thoracic kyphosis, paraparesis, decreased proprioception in the pelvic limbs, and normal spinal reflexes. Neurologic symptoms suggested a thoracolumbar spinal cord lesion. Pathologic findings included leukocytosis. Spinal radiographs revealed ventral spondylosis of T4/T5/T6, a poorly defined intervertebral disc space, and mild lysis of the vertebral margins. Multiple metallic foreign bodies were seen in the thoracic wall. Magnetic resonance imaging of the spine detected increased signal intensity on fluid sensitive sequences of the vertebral bodies, the intervertebral disc, and surrounding soft tissues. These findings were interpreted as active discospondylitis at T4/T5. Medical therapy included antibiotic and analgesic treatment as well as movement restriction. Follow-up at 4 wk showed significant clinical and radiologic improvement. Discospondylitis should be included in the differential diagnosis in wolves with paresis.

Molecular epidemiology of Enterococcus cecorum isolates recovered from enterococcal spondylitis outbreaks in the southeastern United States.

Enterococcus cecorum, a normal intestinal inhabitant, is increasingly responsible for outbreaks of arthritis and osteomyelitis in chickens worldwide. Enterococcal spondylitis (ES) is a specific manifestation of E. cecorum-associated disease in which increased flock morbidity and mortality result from chronic infection involving the free thoracic vertebra. In this study the genetic relatedness and antimicrobial resistance of isolates recovered from ES-affected flocks in the southeastern United States were determined. ES outbreaks from 2007 to 2011 were investigated in North Carolina (15 flocks, 13 farms, four integrators), South Carolina (one flock, one farm, one integrator) and Alabama (six flocks, six farms, one integrator). From these 22 epidemiologically distinct outbreaks, 326 isolates of E. cecorum were recovered. Isolates from spinal lesions and caeca of affected birds (cases) and caeca of unaffected birds (controls) were genotyped using pulsed-field gel electrophoresis; phenotyped using both GenIII MicroPlate™ (Biolog; Hayward, CA, USA) microbial identification plates and antimicrobial sensitivity testing; and compared with each other. Isolates from spinal lesions were incapable of mannitol metabolism and the majority of these isolates were genetically clonal. In contrast, caecal isolates from control birds varied in their ability to metabolize mannitol and were genetically diverse. Isolates from both case and control birds had high levels of antimicrobial resistance. These findings indicate that the increase in E. cecorum-associated disease in the southeast United States is due to the emergence of new clones with increased pathogenicity and multidrug resistance.

An outbreak and source investigation of enterococcal spondylitis in broilers caused by Enterococcus cecorum.

Enterococcus cecorum was isolated from spondylitis lesions in broilers from two flocks in North Carolina that were experiencing increased mortality. Affected birds showed paresis and paralysis, clinical signs characteristic of enterococcal spondylitis (ES). Affected birds rested on their hocks and caudal abdomens with legs extended forward and were unable to stand or walk. Necropsy examination of affected birds revealed firm to hard inflammatory masses involving the vertebral bodies at the level of the free thoracic vertebra that bulged dorsally and compressed the spinal cord. When opened, lesions contained pale, tan to yellow caseonecrotic material. Microscopically, necrosis and fibrinoheterophilic spondylitis with intralesional gram-positive bacteria were seen. Heavy growth of E. cecorum recovered from vertebral lesions confirmed the diagnosis of ES. To investigate possible sources of the organism for one of the flocks bacterial cultures were made from the environment, water lines, mice trapped on the farm, cecal/cloacal swabs from one of the parent broiler breeder flocks, egg residue, hatching eggs, and the hatchery environment. Except for cecal/cloacal swabs from the breeders, E. cecorum was not isolated from any of these samples. When compared phenotypically and genotypically, cecal/cloacal isolates of E. cecorum from the breeders differed from isolates from spondylitis lesions in the broilers. The source of E. cecorum for the broiler flocks was not determined, but vertical transmission appears unlikely.

Cervical discospondylitis in 2 Great Dane puppies following routine surgery.

Two Great Dane puppies developed cervical discospondylitis following routine surgery for sterilization. One animal was affected at C4-C5 and the other at C6-C7 intervertebral discs. Pseudomonas aeruginosa was obtained in pure culture from ultrasound-guided disc aspiration in 1 case. Both animals were successfully treated with long-term antibiotics.

Discospondylitis caused by Staphylococcus aureus in an African black-footed penguin (Spheniscus demersus).

A 22-year-old female African black-footed penguin (Spheniscus demersus), housed indoors with other African and rockhopper penguins, was presented acutely with lethargy, ataxia, and hind limb weakness after a molt. The penguin would assume a hunched position and, when resting, sat on its hocks or lay on its keel. Physical and neurologic examination revealed hind limb paraparesis, proprioceptive deficits, and tiptoe walking. Results of a complete blood cell count and biochemical analysis revealed mild heterophilic leukocytosis, anemia, mild hypoalbuminemia, hypokalemia, and hyperuricemia. Results of whole-body radiographs and coelioscopy were unremarkable. Two computed tomographies of the spine at a 3-month interval revealed a lesion at the mobile thoracic vertebra proximal to the synsacrum with associated spinal cord compression. The penguin was treated with itraconazole, doxycycline, and meloxicam, and it initially improved with return to near normal gait and behavior. However, 5 months after the onset of clinical signs, the penguin was euthanatized after a relapse with worsening of the neurologic signs. Postmortem and histopathologic examination revealed focal granulomatous discospondylitis at the penultimate mobile thoracic vertebra, with intralesional bacteria from which Staphylococcus aureus was cultured.

Experimental reproduction of enterococcal spondylitis in male broiler breeder chickens.

There has been a recent emergence of epidemic spinal infections with necrosis causing lameness and mortality in male broilers and broiler breeders. Mortality in affected flocks may be as high as 15%. The disease has been called enterococcal spondylitis (ES), based on the frequent isolation of Enterococcus cecorum from the lesions and necrosis and inflammation observed in the free thoracic vertebrae (FTV) of affected birds. Male broiler breeders in an experimental setting were challenged with pure E. cecorum isolates obtained from ES-affected commercial flocks. Challenge routes included oral gavage (10(8)), intravenous (i.v.; 10(3)), and air sac (AS; 10(3)). Half the study birds in each group were chemically immunosuppressed with dexamethasone. Spinal lesions were observed grossly in birds challenged intravenously (2.9%) and birds challenged orally (6.1%). Microscopic spinal lesions consistent with ES were more frequently identified compared with gross lesions in the orally challenged group (30.3%). Chemical immunosuppression with dexamethasone was not associated with a greater incidence of ES in this study. By recreating the disease experimentally, the study design reported here may help in the further development of an experimental challenge model for future studies on risk factors, prevention, and therapeutic intervention of ES.

Hypertrophic scar in a dog: histological and clinical features.

An adult male bullmastiff dog was treated for paraparesis and ataxia due to discospondylitis and disc herniation. At this time, the dog had a nonhealing ulcer between the pads of the left hindfoot. At re-evaluation, the dog had developed a large exophitic mass in the previously ulcerated area. Cytological examination revealed occasional spindle cells with mild atypia, and a soft tissue tumour was suspected. The mass was excised and submitted for histology. The lesion was characterized by superficial ulceration, an intermediate layer of granulation tissue and a deep portion containing vertically orientated capillaries and perpendicularly arranged fibroblasts and collagen. The histological features led to a diagnosis of hypertrophic scar. Eight weeks after surgery, the lesion recurred and was treated with an intralesional injection of methylprednisolone acetate. The lesion regressed in 10 days, but recurred after 3 months following severe self-trauma. Hypertrophic scars and keloids are two types of exuberant scarring reported in human beings, the pathogenesis of which is still unclear but seems to involve several cytokines, growth factors and inflammatory cells. The histological features identified in this case paralleled those reported in hypertrophic scars in humans. In this case, intralesional corticosteroid therapy was useful in the management of the lesion, but the severe self-trauma could have influenced the recurrence. Even if uncommon, hypertrophic scar should be included among the differential diagnoses of spindle cell tumours in dogs.

Discospondylitis in a yellow-eyed penguin (Megadyptes antipodes).

A 1-year-old female yellow-eyed penguin (Megadyptes antipodes) was diagnosed with chronic discospondylitis on the basis of clinical signs and results of hematologic tests, radiography, and computed tomography. Despite significant destruction of the affected vertebral bodies and gross malformation of the spine, neurologic function was unaffected. Treatment with antibiotics, antifungals, and swimming physiotherapy was attempted, but the bird died after 40 days of hospitalization. Histopathologic lesions observed at necropsy were severe chronic discospondylitis, chronic granulomatous tracheitis, proventricular ulceration, and adrenal hemorrhage. The suspected inciting cause of the discospondylitis was a reported population-wide oral stomatitis that affects yellow-eyed penguin chicks.

Osteomyelitis and discospondylitis due to Scedosporium apiospermum in a dog.

A 6-year-old, 30-kg, female German Shepherd Dog, living in a leishmaniasis enzootic area, was presented with a severe rear limb motor disorder and a medical history of acute onset of fever. Routine hematology indicated neutrophilia. Spinal survey radiographs were consistent with osteomyelitis and discospondylitis. Because of the poor clinical prognosis and the painful nature of the lesions, the dog was euthanized at the owners' request. At necropsy, T13-L1 vertebrae had large areas of necrosis within the vertebral bodies. Histopathological findings were consistent with chronic, severe, fungal osteomyelitis and discospondylitis. Polymerase chain reaction identified Scedosporium apiospermum, a eutrophic filamentous fungus now recognized as an emerging agent of severe infections in immunosuppressed human patients.

Two dogs with iatrogenic discospondylitis caused by meticillin-resistant Staphylococcus aureus.

Two dogs developed discospondylitis caused by meticillin-resistant Staphylococcus aureus following thoracolumbar hemilaminectomy. Diagnoses were established by magnetic resonance imaging and radiography, respectively, in conjunction with culturing of microbial swabs. Treatment with beta-lactam antibiotics was first initiated. As soon as culturing results, confirming meticillin-resistant Staphylococcus aureus infection, and antibiograms became available, antimicrobial therapy was changed to gentamicin and trimethoprim/sulphadiazine. One dog, however, deteriorated further and was euthanased. The other dog improved on appropriate therapy. The first attempt to discontinue drug therapy four months after surgery led to a relapse. Antimicrobial therapy with chloramphenicol was then initiated and maintained for an additional four months. This dog is free of any relapses for 2.5 years. The veterinary surgeon should be aware of the possible involvement of meticillin-resistant Staphylococcus aureus in postsurgical discospondylitis when choosing an antibiotic for initial antimicrobial therapy while culturing results are still pending.

Pseudomonas-associated discospondylitis in a two-month-old llama.

A 2-month-old female llama with a history of tetraparesis was presented for necropsy. This cria was apparently normal until it became ataxic during its second week of life. It had diminished flexor reflexes of the left forelimb and both hind limbs. Hematology and serum biochemistry revealed neutrophilia, elevated alkaline phosphatase, elevated phosphorus, and modest hyperglycemia. Radiography of the cervical spine demonstrated an abnormal C3-C4 intervertebral disc and bony proliferation of the vertebral end plates. The llama was treated with antibiotics and corticosteroids but failed to respond. Postmortem examination revealed cervical intervertebral disc disease and vertebral exostosis. Microscopically, there was necrosis of intervertebral connective tissue and focal malacia of the spinal cord. Pseudomonas aeruginosa was isolated from the intervertebral disc space and from cerebrospinal fluid. To the authors' knowledge, this is the first description of Pseudomonas-associated discospondylitis in a llama.

Diagnostic Imaging of Discospondylitis.

Discospondylitis can affect dogs of any age and breed and may be seen in cats. Although radiography remains the gold standard, advanced imaging, such as CT and MRI, has benefits and likely allows earlier diagnosis and identification of concurrent disease. Because discospondylitis may affect multiple disk spaces, imaging of the entire spine should be considered. There is a lengthening list of causative etiologic agents, and successful treatment hinges on correct identification. Image-guided biopsy should be considered in addition to blood and urine cultures and Brucella canis screening and as an alternative to surgical biopsy in some cases.

Spondylitis in a humpback whale (Megaptera novaeangliae) from the southeast Pacific.

A 7.25 m long male humpback whale (Megaptera novaeangliae) with spondylitis was found beached on August 13, 1994 at Ancon, Ecuador (2 degrees 23' S, 80 degrees 47' W). The condition involved at least 11 vertebrae, 7 lumbar (L4 to L11) and 4 caudal (Ca1 to Ca4). Partial fusion of vertebrae was observed as a result of intervertebral bony proliferation, likely impeding full motion. The relatively young age of this specimen and the severity of the deformities suggest an infectious, rather than degenerative, process. The gross findings are most consistent with some type of spondyloarthritis. Although this condition has previously been identified in a number of cetacean species, the pathogenesis, population impact and ecologic implications have not been fully assessed. This is the third case described for humpback whales and the first for a humpback whale from the SE Pacific.