UMN: Intervertebral disc disease

41 UMN


Intervertebral disc disease




INITIAL PRESENTATION



• Pain

• Proprioception deficits

• Paresis/paralysis.


INTRODUCTION


The anulus fibrosis of the intervertebral disc may rupture or bulge, and compress the adjacent spinal cord, nerve root, or both. Normal activity is sufficient to precipitate IVDD in a degenerate disc (Figs 41.1 and 41.2 and see Table 41.1).


image

Figure 41.1 Cross-section through disc space.


image

Figure 41.2 Type I and type II disc disease.


Table 41.1 The nature of the anulus pathology has been categorized as type I or type II















  Type I Type II
Pathology Tear, rupture Bulge, prolapse
Breed
Chondrodystrophoid (2–7 year olds)

Non-chondrodystrophoid (8–10 year olds)

Cat
Non-chondrodystrophoid

Cat

Signs may occur suddenly or gradually. They can resolve with time and rest, or progressively worsen. Pain is a common sign, occurring in 60–70% of affected dogs (Table 41.2).


Table 41.2 Signs of disc disease























  Cervical Thoracolumbar
Location All, except C1–2 Caudal to T9–10
Common presentation
Neck pain

Forelimb lameness
Back pain

Non-ambulatory paraparesis

Paraplegia
Pain perception Intact May be absent
Respiration ± Hypoventilation Unaffected

Cats are also affected by spontaneously occurring Type I disc disease. Type II is found as an incidental finding at post-mortem. The range of clinical presentations is similar to the dog. Pain may or may not accompany feline IVDD. The age range for feline IVDD is wide: 4–17 years, with most affected before 8 years of age.


The following cases of two dogs with hindlimb ataxia illustrate the differences in localizing lesions between large and small breed dogs.



SIGNALMENT 1


A 6-year-old neutered female rottweiler.



CASE PRESENTING SIGNS


Hindlimb ataxia.



CASE HISTORY


The dog suddenly became depressed, lethargic and developed hindlimb ataxia.



CLINICAL EXAMINATION


Clinical examination showed a quiet but mentally responsive ambulatory dog with an arched back, lowered head posture, hindlimb ataxia and a shortened stride in both forelimbs. While sitting, the dog was seen to knuckle the right fore and not correct this abnormal posture. Hindlimb hopping was decreased. Spinal reflexes were increased in the hindlimbs and normal in the forelimbs. No thoracic, lumbar, or lumbosacral pain could be elicited. The abdomen was relaxed. The neck was tense but the dog was muzzled and this may have been a pain response or a behavioural response to being handled.

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Sep 3, 2016 | Posted by in SMALL ANIMAL | Comments Off on UMN: Intervertebral disc disease

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