Department of Neurology/Neurosurgery, Centre for Small Animal Studies, Animal Health Trust, Newmarket, Suffolk, UK.
Neurology/Neurosurgery Service, Willows Veterinary Centre and Referral Services, Solihull, UK.
J Vet Intern Med. 2019 Nov;33(6):2693-2700. doi: 10.1111/jvim.15626. Epub 2019 Oct 31.
Urinary (UI) and fecal (FI) incontinence occur in up to 7.5% and 32% of dogs, respectively, after thoracolumbar acute noncompressive nucleus pulposus extrusion (ANNPE).
HYPOTHESES/OBJECTIVES: To investigate clinical, diagnostic, and therapeutic predictors of UI and FI in dogs with ANNPE affecting the T3-L3 spinal cord segments.
Hundred and eighty-seven dogs with T3-L3 ANNPE diagnosed based on clinical and MRI findings.
Multicenter retrospective study. Data were obtained from medical records and telephone questionnaires and analyzed by logistic regression.
UI and FI were reported in 17 (9.1%) and 44 (23.5%) dogs, respectively. Paraplegic dogs were 3 times (95% CI = 1.25, 10.87) more likely to develop UI (P = .018) and 4 times (95% CI = 1.94, 12.56) more likely to develop FI (P = .001) compared to nonparaplegic dogs. Dogs with an intramedullary hyperintensity greater than 40% of the cross-sectional area of the spinal cord at the same level on transverse T2-weighted MRI images were 4 times more likely to develop UI (95% CI = 1.04, 21.72; P = .045) and FI (95% CI = 1.56, 10.39; P = .004) compared to dogs with smaller lesions. FI was 3 times (95% CI = 1.41, 7.93) more likely in dogs that were not treated with nonsteroidal anti-inflammatory drugs (NSAIDs) after diagnosis compared to dogs administered NSAIDs (P = .006) and 2 times (95% CI = 1.12, 5.98) more likely in dogs presented with clinical signs compatible with spinal shock compared to dogs without (P = .026).
The identification of clinical, diagnostic, and therapeutic predictors of UI and FI in dogs with T3-L3 ANNPE can help to approach these autonomic dysfunctions occurring after spinal cord injury.
犬胸腰段急性非压迫性髓核突出(ANNPE)后,分别有高达 7.5%和 32%的犬出现尿失禁(UI)和粪便失禁(FI)。
假设/目的:本研究旨在探讨影响 T3-L3 脊髓段的 ANNPE 犬发生 UI 和 FI 的临床、诊断和治疗预测因素。
187 只被诊断为 T3-L3 ANNPE 的犬。
多中心回顾性研究。数据来自病历和电话问卷调查,并通过逻辑回归进行分析。
UI 和 FI 分别在 17 只(9.1%)和 44 只(23.5%)犬中被报道。与非截瘫犬相比,截瘫犬发生 UI 的可能性高 3 倍(95%CI=1.25,10.87;P=.018),发生 FI 的可能性高 4 倍(95%CI=1.94,12.56;P=.001)。与脊髓内横断 T2 加权 MRI 图像上同一水平脊髓截面积大于 40%的高信号相比,脊髓内横断 T2 加权 MRI 图像上脊髓截面积大于 40%的犬发生 UI 的可能性高 4 倍(95%CI=1.04,21.72;P=.045)和 FI 的可能性高 4 倍(95%CI=1.56,10.39;P=.004)。与诊断后未接受非甾体抗炎药(NSAIDs)治疗的犬相比,接受 NSAIDs 治疗的犬发生 FI 的可能性高 3 倍(95%CI=1.41,7.93;P=.006),与无脊髓休克临床症状的犬相比,有脊髓休克临床症状的犬发生 FI 的可能性高 2 倍(95%CI=1.12,5.98;P=.026)。
识别 T3-L3 ANNPE 犬发生 UI 和 FI 的临床、诊断和治疗预测因素,有助于处理脊髓损伤后出现的这些自主神经功能障碍。