Poliomyelomalacia in three dogs that underwent hemilaminectomy for intervertebral disk herniation.

CASE DESCRIPTION: 3 dogs were examined because of a sudden onset of signs of pain (1 dog) or paraparesis (2 dogs). CLINICAL FINDINGS: Neurologic findings consisted of myelopathy affecting the lumbar intumescence (1 dog) and T3-L3 myelopathy (2 dogs). In all dogs, MRI revealed spinal cord compression caused by L3-4 disk herniation. All dogs underwent routine surgical decompression of the intervertebral disk herniation. During MRI and decompressive surgery, physiologic variables were monitored. Immediately after surgery, all dogs were paraplegic with pelvic limb neurologic dysfunction consistent with myelopathy affecting the L4 through caudal spinal cord segments. TREATMENT AND OUTCOME: Within 24 hours after surgery, repeated MRI in all dogs revealed hyperintensity in the spinal cord gray matter of the lumbar intumescence on T2-weighted images. In the absence of neurologic improvement, dogs were euthanized at 3, 91, and 34 days after surgery. Postmortem microscopic examination of each dog's spinal cord at the lumbar intumescence revealed necrosis of the gray matter with relative white matter preservation suggestive of an ischemic injury. CLINICAL RELEVANCE: Dramatic neurologic deterioration following decompressive surgery for intervertebral disk herniation in dogs may be associated with the development of poliomyelomalacia secondary to ischemia. In these 3 dogs, ischemia developed despite probable maintenance of normal spinal cord blood flow and perfusion during anesthesia. To exclude other causes, such as compression or hemorrhage, MRI was repeated and revealed hyperintensity of the spinal cord gray matter on T2-weighted images, which microscopically corresponded with ischemic neurons and neuronal loss.

Computed tomographic and ultrasonographic diagnosis with successful excision of a lipoma in a shusui koi (Cyprinus carpio).

CASE DESCRIPTION: A client-owned 12-year-old 10.3-kg (22.7-lb) female shusui koi (Cyprinus carpio) was evaluated because of an ulcerated mass on the left body wall, hyporexia, and decreased activity. CLINICAL FINDINGS: The patient was anesthetized with a solution of eugenol in water for all examinations and procedures. An approximately 7 × 5-cm smooth, raised, ulcerated, and firm mass was present ventral and lateral to the dorsal fin on the left body wall. Whole-body CT images obtained before and after contrast administration revealed an encapsulated, homogeneous, fat-opaque mass within the muscle. The mass was fat echoic with poor vascularity on ultrasonographic examination. Histologic evaluation of an ultrasound-guided needle biopsy specimen was suggestive of a lipoma. TREATMENT AND OUTCOME: The mass was excised, and the fish was placed in water with 0.3% salinity for 3 weeks after surgery. Postoperative antimicrobial administration was not indicated, and additional postoperative analgesic administration was considered impractical. The patient had noticeable improvement in appetite and activity with no indication of discomfort immediately following surgery. Five weeks after surgery, the incision site had healed with minimal scarring, and evaluation of CT images revealed no evidence of mass regrowth or regional osteomyelitis. CLINICAL RELEVANCE: Antemortem evaluation and diagnosis of a lipoma in a teleost with subsequent excision was described. This report highlighted the logistic challenges associated with anesthesia, advanced diagnostic imaging, and surgery in fish and showed that they can be successfully overcome so that high-level medical care can be provided to such patients.