Open spina bifida characterisation in a dog foetus.

BACKGROUND: Open spina bifida is an uncommon malformation in animals, and there is a lack of imaging, clinical, and pathological characterisation of this condition in dogs. OBJECTIVE: Open spina bifida is rarely observed in animals due to high levels of perinatal mortality and frequent euthanasia. To the best of our knowledge, we present the first case of spina bifida in a dog was diagnosed in-utero and then followed post-partum. METHODS: A 3-year-old Poodle was presented with twin pregnancy. Radiographic and ultrasonographic findings were suggestive of vertebral malformation and open spina bifida with myelomeningocele in one foetus. Conservative treatment was given but the puppy died 3 days after birth. Thereafter, anatomical and histopathological analysis of several organs was performed to characterise the disease. RESULTS: When the twins were born, one puppy had a linear dorsal midline cutaneous defect extending from the level of vertebrae L2-L6. R Radiographic examination showed several congenital vertebral malformations involving the thoracic segment, lumbar segment, sacrum and scapula. Histopathological examinations confirmed the presence of open spina bifida and identified additional abnormalities in several internal organs. CONCLUSIONS: This case presents a complete characterisation of open spina bifida, before birth and after death, using imaging and histopathology techniques.

Surgical outcomes of six bulldogs with spinal lumbosacral meningomyelocele or meningocele.

OBJECTIVE: To report the surgical treatment and outcome of six bulldogs with spina bifida (SB) and meningocele (MC) or meningomyelocele (MMC). STUDY DESIGN: Case series. ANIMALS: Five French bulldogs and one English bulldog with MC or MMC. METHODS: Medical records of dogs with spinal MC or MMC diagnosed by MRI at two institutions between 2013 and 2016 were reviewed for surgical treatment and outcomes. RESULTS: Meningocele was diagnosed in two dogs, and MMC was diagnosed in four dogs. A lumbosacral dimple was noted in all dogs along with neurological deficits most commonly consisting of urinary and fecal incontinence (n = 6) and mild/moderate paraparesis (n = 3). Dorsal laminectomy was performed in all dogs to allow dissection of the meningeal sac to the vertebral column defect. In dogs with MMC, nerves were repositioned and protruded meninges were removed prior to suturing remaining meninges. Adhesions and filum terminale were resected in two dogs with suspected tethered cord syndrome. Urinary and fecal incontinence improved in two dogs and remained unchanged in four. Paraparesis improved in two dogs. CONCLUSION: Surgical treatment resulted in partial improvement of the urinary and fecal incontinence (2/6 dogs) and paraparesis (2/3 dogs) or stable neurological condition (3/6 dogs), with only minor temporary complications. CLINICAL SIGNIFICANCE: In the absence of published data comparing surgical and conservative treatment of puppies affected by SB and MC or MMC, early surgical treatment can be considered to prevent deterioration of neurological signs and, eventually, facilitate improvement of neurological signs.

Development of a locomotor rating scale for testing motor function in sheep.

BACKGROUND/PURPOSE: Research to cure paralysis associated with myelomeningocele (MMC) is ongoing using the fetal sheep model of MMC. Despite decades of research using this model, no standardized motor function assessment exists. The purpose of this study is to develop a sensitive and reliable locomotor scale for assessing the functional status of sheep. METHODS: Twenty lambs were used to develop and validate the locomotor scale. Lambs (n=15) underwent a surgically created MMC defect at gestational age (GA) 75 days, followed by repair with various methods at GA 100. One lamb underwent a sham operation (n=1). Normal lambs (n=4) served as controls. All lambs were born via spontaneous vaginal delivery, and motor function was assessed for 24 hours. A locomotor rating scale was developed based on behavioral observations of lambs. Inter-rater reliability testing was performed to determine if the scale could be reliably applied by different raters. RESULTS: Observations led to the definition of 7 categories of locomotor recovery. A scoring system was developed to rank these categories. The scale captured a wide variety of neurologic outcomes. Inter-rater reliability revealed minimal variability between examiners (average standard deviation ±0.431). The average score for all raters was within 1 point of the consensus score 100% of the time. CONCLUSIONS: The sheep locomotor rating scale is capable of capturing subtle differences in neurologic function with minimal inter-rater variability. We propose a standardized rating scale for neurologic outcomes and believe this is a critical component for assessing the validity of experimental treatments to cure paralysis in MMC.

[Spina bifida aperta in a sheep lamb]. / Spina bifida aperta bei einem Schaflamm.

The case report describes the symptoms and diagnostic methods of a spina bifida aperta in a new born lamb. The most relevant clinical findings were recumbency immediately after birth with normal consciousness and suckling reflexes, alterations of the skin and coat in the lumbosacral region as well as dysuria. The biochemical and haematological screening of the blood indicated no abnormalities. While the radiological examination of the spine showed no clear evidence of the cause of the clinical sings the ultrasound and computed tomography examination revealed an incomplete closure of the vertebral arch between the 4th lumbar and the 3rd sacral vertebrae. Additionally, a hernia with similar density to the spinal cord was present in the same region of the spine. Based on the findings the lamb was euthanized. The pathological examination confirmed the incomplete closure of the vertebral arch and moreover a myelomeningocele has been diagnosed. In the histopathological examination the white and grey matter were separated in the area of the macroscopic visible lesions. Due to non-specific clinical symptoms imagining diagnostics can be crucial to confirm the diagnosis of this rare syndrome.

Surgical correction of a sacral meningomyelocele in a dog.

A 15 wk old male unilateral cryptorchid German shepherd dog weighing 18 kg was referred for a nonhealing cutaneous lesion dorsally at the level of the sacrum, urinary incontinence, and a deviated tail. MRI revealed spina bifida and meningomyelocele continuous with the skin surface. Surgical correction of the meningomyelocele involved closure of the open meningeal defect, transection of the abnormal spinal nerves to the skin surface, and closure of the skin defect with a good outcome. Histopathology confirmed a meningomyelocele. This case report describes the MRI findings, surgical procedure, and proposed pathogenesis of spina bifida and meningomyelocele in a dog.

Myelomeningocoele and a dermoid sinus-like lesion in a French bulldog.

A 2-year-old male French bulldog was presented for investigation of lumbosacral pain and hindlimb ataxia associated with urinary and fecal incontinence. Survey radiography, myelography, and computed tomography images were suggestive of a dermoid sinus with associated spina bifida. Surgical intervention led to a resolution of pain and neurological deficits. Histopathological analysis of the excised tissue was compatible with a myelomeningocoele of the 7th lumbar vertebra.

Méningo-myélocèle et lésion dermoïde s'apparentant à un sinus chez un Bouledogue français. Un Bouledogue français mâle âgé de deux ans a été présenté pour faire enquête sur une douleur lombo-sacrée et une ataxie des jambes postérieures associée à une incontinence urinaire et fécale. La radiographie, la myélographie et les images par tomodensitométrie pour faire enquête sur les symptômes suggéraient un sinus dermoïde avec spina-bifida connexe. L'intervention chirurgicale a donné lieu à une résolution de la douleur et des autres déficits neurologiques. L'analyse histopathologique du tissu excisé était compatible avec un méningo-myélocèle de la 7e vertèbre lombaire.(Traduit par Isabelle Vallières).

MRI findings, surgical treatment and follow-up of a myelomeningocele with tethered spinal cord syndrome in a cat.

A 7-month-old male neutered cat was referred for paraparesis and painful sensation at the level of T13 vertebra where a dermal cyst was observed. Spine radiographs and magnetic resonance imaging (MRI) showed a well-encapsulated cyst communicating with the meninges and spinal cord, suggestive of hydromyelia and myelodysplasia. Dorsal laminectomy was performed and the cyst was completely removed. The day after surgery, the cat was ambulatory paraparetic. Involuntary defecation was observed for only a few days. The surgical specimen was cystic and covered by skin. Microscopic examination revealed a hollow hemispheric mass of glial fibrillary acidic protein (GFAP)-positive neural tissue lined by ependyma and formed of glia and vascular structures consistent with myelomeningocele (MMC). Only anecdotal descriptions of MMC have been published in the veterinary literature, mainly in the lumbosacral spinal cord. To the authors' knowledge, this is the first report of a MMC with tethered spinal cord syndrome in a cat successfully treated surgically.

Imaging diagnosis--cerebellar displacement and spina bifida in a calf.

Herein, we describe a calf affected by cerebellar displacement and spina bifida, diagnosed by ultrasonography. A full-term, newborn female calf with paralysis of the pelvic limbs was examined. The dorsal skin at the sacral level contained a circular defect; this was subsequently diagnosed as spina bifida. Cerebellar displacement into the cervical vertebral canal was suspected because of the frequent association of these anomalies. Spinal ultrasound examination carried out at the level of the craniocervical junction allowed identification of herniation of the cerebellum, the caudal part of brain stem, and part of an occipital lobe into the cervical vertebral canal. The ultrasonographic diagnosis was confirmed as post mortem examination. This type of brain defect, associated with spina bifida, resembles the Arnold-Chiari malformation in humans.

Priapism in dogs.

Priapism is a persistent penile erection lasting longer than 4 hours, without sexual stimulation. Priapism is categorized as either nonischemic (arterial, high flow) or ischemic (veno-occlusive, low flow). Ischemic priapism is considered an emergency in people. Reports of priapism in dogs are uncommon. This report describes 3 dogs with priapism; the first was considered idiopathic, the second was due to acute disc extrusion and subsequent T12-T13 hemilaminectomy, and the third was secondary to a lumbar meningomyelocoele. All 3 cases were suspected to be nonischemic priapism. The pathophysiology of the canine erection and a review of priapism in dogs and cats are discussed. Distinguishing ischemic versus nonischemic priapism and identifying and treating the underlying cause are important. Aspiration to obtain blood gas analysis may help classify the priapism and may provide pain relief. Ultrasonography aids in evaluation for vascular abnormalities and identifying etiology. If determined to be ischemic, then aspiration with the patient under sedation or anesthesia with or without irrigation should be done. Intracavernosal injections of phenylephrine and lubrication of the exposed penis are also recommended. If intracavernosal drainage and injections are not successful, or significant tissue damage has occurred, then penile amputation and perineal urethrostomy may become necessary. Systemic therapy could be considered if the priapism is not considered an emergency, and if intracavernous injections or surgical treatment are declined.

Computer tomography diagnosis of meningoencephalocele in a calf.

A 24-day-old female Holstein calf had a soft, painless fluctuating swelling on the median plane in the frontal region, but did not show any clinical symptoms including neurological signs. Computer tomography (CT) distinctly showed the cyst filled with fluid and part of the encephalon. Hence, this swelling was diagnosed as meningoencephalocele, but not meningocele. The meningoencephalocele was successfully repaired surgically. Meningoencephalocele can thus be easily recognised by CT in a calf.

Incomplete caudal duplication in a puppy: gross and radiological observations.

Caudal duplication is a rare type of conjoined twinning. The aim of this case report is to describe a case of caudal duplication in a male crossbreed puppy. The puppy was macroscopically and radiographically examined after death. External features included a supernumerary limb projecting from the perineum, complete lack of tail, anal atresia, double penis and absence of scrotal sacs. Internal examination showed anomalies involving the intestine and the urinary system. At x-ray examination, the supernumerary limb showed features similar to that of the normal right hindlimb but showed absence of fibula and tibia and presence of three metatarsi and phalanges. The authors discuss the pathogenic mechanisms of this condition, infrequently reported in veterinary practice, pointing out the importance of embryonic duplications commonly associated with dystocia.

Ventral meningomyelocele in a German warmblood foal.

A ventral meningomyelocele was found in a five week old, male German warmblood foal which exhibited central nervous symptoms. This rare malformation in horses may be caused by absent or defective fusion of vertebral bodies leading to herniation of the spinal cord and meninges with subsequent degenerative alterations of the spinal cord.

Cervical meningomyelocele associated with spina bifida in a hydrocephalic miniature colt.

Cervical meningomyelocele, spina bifida, and hydrocephalus were diagnosed in a newborn miniature colt that was unable to stand and had a cystic mass in the caudal portion of the dorsal cervical region. Results of physical examination and ultrasonographic imaging of the brain supported the diagnosis of hydrocephalus. Results of radiographic evaluation of the vertebral column were consistent with spina bifida at C5-C6. Fluid aspirated from the cervical mass resembled CSF. Radiography of the cervical region after injection of iohexol into the mass revealed herniation of the spinal cord through a large bony defect, supporting the diagnosis of spina bifida and meningomyelocele. Meningomyelocele, spina bifida, and hydrocephalus are interrelated congenital anomalies in other species. Meningomyelocele should be suspected in foals that have neurologic abnormalities, especially if they have other congenital anomalies and a fluid-filled mass along the dorsal midline.

Sodium chloride depletion in a cat with fistulated meningomyelocele.

Decreased serum and CSF chloride concentrations were documented in a 5-year-old Manx cat referred for evaluation of anorexia. Inadequate chloride intake coupled with chloride loss through a fistulated meningomyelocele probably caused chloride deficiency. The inciting cause of anorexia was not determined. The cat was treated with 0.9% NaCl solution. Normal serum and CSF chloride concentrations were restored. Lumbar myelography was performed to delineate the meningocutaneous tract, which then was dissected surgically and was ligated. The cat's body attempted to maintain normal CSF chloride concentration even though the serum chloride concentration was decreased markedly. Calculations made on the basis of rate of CSF production, CSF chloride concentration, and duration of anorexia provided supportive evidence for an active transport system for chloride from plasma to CSF.