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Differential Diagnosis of Conditions Mimicking Intervertebral Disc Disease in the Canine Phil Olson Iowa State University

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Differential Diagnosis of Conditions Mimicking Intervertebral Disc Disease in the Canine Phil Olson Iowa State University Volume 44 | Issue 2 Article 1 1982 Differential Diagnosis of Conditions Mimicking Intervertebral Disc Disease in the Canine Phil Olson Iowa State University Robert W. Carithers Iowa State University Follow this and additional works at: https://lib.dr.iastate.edu/iowastate_veterinarian Part of the Veterinary Medicine Commons Recommended Citation Olson, Phil and Carithers, Robert W. (1982) "Differential Diagnosis of Conditions Mimicking Intervertebral Disc Disease in the Canine," Iowa State University Veterinarian: Vol. 44 : Iss. 2 , Article 1. Available at: https://lib.dr.iastate.edu/iowastate_veterinarian/vol44/iss2/1 This Article is brought to you for free and open access by the Journals at Iowa State University Digital Repository. It has been accepted for inclusion in Iowa State University Veterinarian by an authorized editor of Iowa State University Digital Repository. For more information, please contact [email protected]. Differential Diagnosis of Conditions Mimicking Intervertebral Disc Disease In the Canine by Phil Olson, DVM* Robert W. Carithers, DVM, MS, PhD** Many abnormal conditions ofthe canine can Ataxia and paresis along with forced exercise produce clinical signs that in some way mimic is likely to cause falling and greater subluxa­ those associated with intervertebral disc tion. Anesthesia eliminates support of muscle disease. This oftentimes leads to unnecessary tone, increasing the danger further. 5.7 confusion and frustration in the diagnosis and "Wobbler Syndrome" is another common subsequent treatment of these cases by prac­ cervical problem. The condition most common­ ticing veterinarians. The purpose of this paper ly occurs in Great Danes and Doberman is to summarize the signs associated with those Pinschers, and clinical signs are due to com­ seen most commonly and thereby to clarify the pression of the cervical spinal cord caused by manner in which these can be most readily vertebral malformation-malarticulation of C 5 , 2 5 6 differentiated in a clinical situation. This paper C 6 , and C 7 • • • is not intended to be an in-depth analysis ofall Clinical signs are usually seen at less than canine spinal cord problems, but only to pro­ one year of age, often by two, and occasional­ vide a review of clinical signs, pathogenesis, ly later. Owners generally recognize ataxia of and diagnosis of certain conditions which pre­ the pelvic limbs. The onset is usually insidious sent in a similar manner. but sometimes acute, with signs normally pro­ gressive. The pelvic limbs are seen to cross each CERVICAL VERTEBRAL other, abduct or collapse on walking and INSTABILITY especially on turning. The hind quarters sway Atlanto-axial subluxation occurs in awkwardly. The dog may knuckle over. The miniature and toy breeds, resulting from frac­ impression given is that the animal doesn't ture, degeneration, or malformation of the know where the limbs are because of a pro­ dens. The pathogenesis of absence of the dens prioceptive deficit. Thoracic limb signs, if pre­ is unknown, although some speculation exists sent, are similar but less marked. Occasional­ 2 5 6 that the mechanism is similar to femoral head ly, limb cro~sing and knuckling over occur. • • 5 6 necrosis of Legg-Perthes Disease. • Neurological exam reveals abnormal Luxation most commonly occurs at six to postural reactions present, especially hopping eight months of age. Absence of the dens or and proprioceptive positioning. Manipulation fracture allows the cranial aspect of the body of the neck usually does not elicit pain. Blood, of the axis to rotate dorsally into the vertebral urine and CSF parameters are normal (possibly canal, with subluxation sometimes a result. slightly elevated protein in the CSF). There is Clinical signs include severe neck pain, spastic involvement of ascending proprioceptive and tetraparesis, and recumbency. Thoracic limb descending motor tracts.2,5.6 paresis often is the most profound sign. The Intervertebral disc protrusion may be animal walks with a short stiff stride.5,6,7 associated with the condition. Unrelated cer­ Handling should be done with extreme care, vical disc extrusion occurs in older dogs and with no manipulation ofthe atlantoaxial region. may be readily identified on plain radiographs. Cervical pain in this case is prominent. The *Dr. Olson is a 1982 graduate of the College of primary neurological disease to differentiate Veterinary Medicine at Iowa State University. **Dr. Carithers is a Professor in Veterinary Clinical from in young dogs is canine distemper Sciences at Iowa State University. myelitis .. Neurological exam reveals other ab- 60 Iowa State Veterinarian normalities not explained by a localized lesion, CANINE DISTEMPER as distemper lesions are usually disseminated. Signs of this disease may present due to pre­ For example, the examiner may see paraplegia dominant action ofthe virus on the spinal cord, with mild thoracic limb deficit, suggesting \vith no history of systemic illness. Dogs less separate lesions, one thoraco-Iumbar, and one than one year old are especially suspect ofhav­ cervical. Head tilt, tremor, and abnormal ing the disease. The history should be of signs nystagmus may be present, suggesting a of segmental myelopathy, with progressive 5 6 16 cerebello-vestibular lesion. Also, with worsening. • • distemper, the CSF is often abnormal. 5.6 Information helping to differentiate this etiology from a focal thoraco-Iumbar spinal cord lesion, such as intervertebral disc disease, often is neurological deficits at multifocal areas. NEOPLASIA An example is mild thoracic limb deficit in a Neoplasia may occur as extramedullary ex­ paraplegic dog. This suggests a mild cervical pansive masses, compressing the spinal cord to spinal cord lesion and a severe thoraco-Iumbar 5 6 produce an ischemic myelopathy. lesion. • Classification is either of vertebral or spinal Most often additional signs are present which cord neoplasia. Vertebral neoplasia character­ make diagnosis much easier. Head tilt, abnor­ istically shows compression myelitis of the mal nystagmus and head tremor suggest cere­ spinal cord due to invasive bony growth. It may bellovestibular dysfunction. Nasal or ocular be primary or metastic. Osteosarcoma, chon­ discharge, harsh lung sounds, hyperkeratosis drosarcoma, and fibrosarcoma are most com­ ofthe nose and foot pads and chorioretinopathy mon. Spinal cord or meningeal neoplasms are may be seen. Myoclonus is a nearly pathog­ seen in the dog, most often in the thoracic cord. nomonic sign. Diffuse lesion distribution and Meningiomas are most common. Medullary progressive nature suggest inflammatory neoplasms are rare and when present, are disease. The CSF is many times normal, but usually neurofibromas or neurofibro­ may show a mild increase in mononuclear cells, 6 7 5 6 16 sarcomas. • protein or both. • • Typical signs of neoplastic spinal cord com­ pression are slow in onset and progression. TOXOPLASMOSIS However, they often show acute signs and can Toxoplasmosis can produce unlimited progress rapidly. Necropsies have shown a neurological clinical signs. It is much less com­ mass may grow slowly a considerable time, mon than canine distemper. As with distemper, with the spinal cord adapting. Suddenly a signs may manifest as segmental myelopathy. 5 critical point is reached, where spinal cord cir­ Possible clinical signs include seizures, blind­ culation is compromised, resulting in lesions ness, tremor, hemi- or paraparesis and hind­ and clinical signs. Adaptation can be phe­ quarter paralysis. Spinal reflexes may be ab­ nomenal, showing an amazing decrease in cord sent and extensor rigidity present in one or both diameter on necropsy. Often the neoplasm is hindlimbs. The history is usually of a dog less lateral, therefore initial signs are likely to be than one year of age, showing gradual pro­ asymmetrical, with paresis and ataxia more gressive paralysis. Some common signs that pronounced ipsilaterally. Signs later progress when present with CNS signs are suggestive of to bilateral.2.5.6 toxoplasmosis include abortions, stunted Plain radiographs are normal unless young, iritis, retinitis, recurrent fever, lym­ vertebral invasion or origination has occurred. phadenopathy, diarrhea, pneumonia, myocar­ 5 6 A myelogram usually demonstrates the lesion. ditis, and icterus. • A thorough physical exam and thoracic radio­ Positive diagnosis is difficult. Serum titers graphs are important to diagnose metastasis.2.5 can be taken but interpretation is uncertain, Neoplasia may be confused with vertebral in­ although rising titers are suggestive. Systemic fection as a slowly progressive lesion. If signs mycoses may also produce CNS signs and appear acutely, then an intervertebral disc retinitis. 6 problem, vascular accident and others must be included in the initial ruleouts. The fact that POLYRADICULONEUROPATHY­ neoplasia generally occurs in older animals filay COONHOUND PARALYSIS also aid in the initial analysis of the case. The etiology of Coonhound Paralysis IS Vol. 44, No. 2 61 unknown. The functional lesion is apparently this condition is not completely understood. on the ventral nerve roots and peripheral Clinical signs depend on the location of the le­ nerves. The disease is initiated by coon bites sion, with trauma more easily causing injury one to two weeks before signs appear. Hall­ to the spinal cord becasue of lack of bony pro­ marks are pain without motor function. Nine­ tection. Diagnosis is by radiography of the ty percent show paresis and hyporeflexia in the spine, myelography,
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