Transcript Animal Spine Diseases

 Intervertebral
 Wobblers
Disc Disease (IVDD)
Syndrome
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Small breed dogs with short,
thick legs such as the
Dachshund, Bassett Hound
and Beagle are at the highest
risk of IVDD.
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IVDD is a premature
hardening of the center of the
disc, and weakening of the
outer layer of the disc.
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As the outer layer of the disc
ruptures, the inner material is
displaced upwards against
the spinal cord. This herniated
disc material injures the spinal
cord and results in cord
swelling and compression.
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Consequentially, the nerves
within the spinal cord traveling
to the legs and urinary
bladder become
damaged. This in turn results
in loss of limb function that
can range from weakness to
paralysis, and loss of bladder
control.
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Small animals with IVDD tend
to have the degeneration of
the discs begin to occur within
the first few months of life, but
the actual disc herniation
typically occurs without
warning at around 3 to 6 years
of age versus other dogs
(ages 8 to 10).
Prognosis
Treatment options
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Early treatments for IVDD may be simple cage rest in which the dog is
restricted from jumping.
Treatment with corticosteroids, NSAIDS, muscle relaxers, and analgesics
alleviate spinal cord pain, but can be dangerous because dogs that are
pain-free tend to become more active (instead of rest) with the chance
of additional intervertebral discs that can herniate and irreversibly
compress the already damaged spinal cord.
Surgical management of dogs with IVDD is often required to alleviate
cord compression and resolve clinical signs. Surgery should be
performed immediately if signs of paralysis are present. If a dog
suffering paralysis from a compressed or slipped disc goes without
surgery for more than 24 hours, the damage may become permanent.
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With all treatment options the healing of the disc is accomplished only
through time. If a dog is allowed too much freedom too soon the disc
will leak again and dog can be back where they started or worse.
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Over 80% of dogs will regain function, if they are operated before they
loose sensation. Many dogs will be ambulatory within 2 to 4 weeks after
surgery.
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The most common complication is recurrence of signs, usually due to
extrusion of another disk.
The spinal column is made up of four major vertebral regions: cervical
(neck), thoracic (mid back), lumbar (low back) and sacral (pelvic).
 Because disc material and the spinal cord itself are
not visible on plain X-Rays, further imagining is necessary
to definitively diagnose the location of the disc rupture.
 In some cases, a dye is injected along the spinal cord
(myelogram) to allow the DVM to see the compression
of the spinal cord on the radiographs.
Lateral view of the lumbar spine
Beam Center: Over level of fourth lumbar vertebral body.
Measurement: At level of first lumber vertebral body.
X-ray of the ventrodorsal view of the
thoracic spine
Beam Center: Over level of caudal
border of scapula (T-6)
Measurement: At highest point of
sternum
X-ray of the
ventrodorsal view of the
cervical spine
Beam Center: Over C4-5
intervertebral space
Measurement: C5-6
intervertebral space
X-ray of the lateral view of the thoracic
spine
Beam Center: Over seventh thoracic
vertebral body
Measurement: At level of seventh rib
Intervertebral disks are located between the vertebral bodies starting
at the second and third cervical vertebrae (C2-3) and extending to
the seventh lumbar and first sacral vertebrae (L7-S1).
The three sacral vertebrae are fused and therefore do not have disks.
Intervertebral disks are present between the coccygeal vertebra as well,
but are of little clinical significance.
When a disk herniates into the spinal canal, the meningeal
nerves become compressed and inflamed causing the animal a
great deal of pain. In addition, the nerve roots themselves are
often compressed, resulting in a great deal of pain for the affected
animal and affecting the area that these nerves supply.
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Wobblers disease is a
condition of the cervical
vertebrae that causes an
unsteady (wobbly) gait and
weakness in dogs.
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If left untreated, Wobblers
disease may result in chronic
pain and difficulty standing
or moving.
X-Ray image of a spinal cord compression in a dog
(Rhodesian Ridgeback), caused by congenital
malformation of os axis (arrows). 1:skull 2:humerus
X-ray of the flexed lateral view of the cervical spine
Beam Center: C3-4 intervertebral space
Measurement: Over level of C-7 (thoracic inlet)
 The term wobblers disease refers to a
number of different conditions of the
cervical (neck) spinal column that all cause
similar symptoms.
 The causes of wobblers disease include:
cervical intervertebral disk disease,
abnormalities of the cervical vertebrae,
and malformation of the cervical vertebrae
due to poor nutrition.
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Great Dane
Doberman
St. Bernard
Weimaraner
German Shepherd Dog
Boxer
Basset Hound
Rhodesian Ridgeback
Dalmatian
Samoyed
Old English Sheepdog
Bull Mastiff
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Clinical signs vary widely depending on the amount of spinal
cord compression caused by the cervical vertebral instability.
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Signs may have a rapid and sudden onset or they may
progress slowly.
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The signs may or may not worsen.
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The dog may have neck pain, difficulty rising to a standing
posture, wasting of the muscles (especially in the forelimbs),
worn toenails, unsteady gait, and general difficulty in
maintaining normal postures.
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Diagnosis is made through X-rays of the spinal column.
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Myelograms (injecting a contrast agent around the
spinal cord) may be needed to evaluate the spinal
cord.
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Additionally, an analysis of the cerebrospinal fluid may
be performed.
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X-rays of the vertebra in the neck followed by a
myelogram allow the DVM to see where and how many
lesions exist there.
Treatment
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The prognosis for dogs with wobblers
disease is variable.
 The earlier in the course of disease that
surgery is performed, the better the
outcome.
 Paralysis is always a possibility in dogs with
wobblers disease and frequently these
dogs cannot be helped.
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Prognosis
In mild cases steroids and bed or cage
rest may help.
In more severe cases, surgery for the dog
with wobblers will need to be performed.
In the most serious cases, no treatment
may be possible.
 X-rays
can be taken to view the areas of
main compression in the neck.
Generally three views of the neck are
taken. All 3 views are from lateral position in
which the dog is on its side while it is shot.
One lateral is shot with the neck in its
normal position, and the second view is of
the neck flexed toward the toes of the dog,
and the third is of the dog with its neck
poised as if looking to the sky.
X-ray of the lateral view of the
cervical spine
Beam Center: Intervertebral
space of C-4 and C-5
Measurement: Over level of C7 (thoracic inlet)
X-ray of the hyperextended
lateral view of the cervical
spine
Beam Center: C3-4
intervertebral space
Measurement: Over level of
T-1 (thoracic inlet)
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http://www.spineuniverse.com/displayarticle.php/article4029.html. Retrieved 11/28/09
Bagley RS., Tucker RL. Specialty Board Review, Neuroradiology. Prog Vet Neuro 7:62,
1996. Retrieved 11/29/09
Cauzinille L, Kornegay JN: Wobbler disease in a dog. J Am Vet Med Assoc 201:1225,
1992. Retrieved 11/29/09
http://www.caninechiro.com/id7.html Retrieved 11/30/09
Bagley, Rodney S. (2006). "Acute Spinal Disease" (PDF). Proceedings of the North
American Veterinary Conference.
http://www.ivis.org/proceedings/navc/2006/SAE/247.pdf?LA=1. Retrieved 11/30/09
Jeffery N, McKee W (2001). "Surgery for disc-associated wobbler syndrome in the dog-an examination of the controversy". J Small Anim Pract 42 (12): 574–81 Retrieved
11/30/09
Sumano H, Bermudez E, Obregon K (2000). "Treatment of wobbler syndrome in dogs with
electroacupuncture". Dtsch Tierarztl Wochenschr 107 (6): 231–5. Retrieved 12/01/09
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What breeds of dogs are at highest risk for IVDD?
What symptoms of IVDD are an emergency and requires
immediate treatment by a DVM?
With IVDD what is the percent of dogs that will regain
function, if they are operated on before they loose
sensation?
What is a myelogram?
Generally how many views of the neck are taken to diagnose
wobblers disease?
In what position are all the views taken?
1. Small breed dogs with short, thick legs such as the Dachshund,
Bassett Hound and Beagles are at the highest risk of IVDD
2. Inability to move real legs. Loss of bladder and bowel control.
3. 80%
4. Injecting a contrast agent around the spinal cord
5. 3
6. Lateral