Sedlacek Jordan, Rychel Jessica, Giuffrida Michelle, Wright Bonnie
Fort Collins Veterinary Emergency and Rehabilitation Hospital, Fort Collins, CO, United States.
Red Sage Integrative Veterinary Partners, Fort Collins, CO, United States.
Front Vet Sci. 2022 Jul 19;9:934789. doi: 10.3389/fvets.2022.934789. eCollection 2022.
Dachshunds are at significant risk of experiencing thoracolumbar intervertebral disk herniation (IVDH) during their lifetimes. Standard of care includes advanced imaging, surgical intervention, and postoperative rehabilitation. Conservative management is commonly recommended for cases where the standard of care is declined, and little is known about the prognosis of treatment with conservative management and rehabilitation (nonsurgical rehabilitation). This retrospective cohort study assessed 12-week functional outcome and recurrence of clinical signs in 40 dachshunds with T3-L3 myelopathy presumed to be due to Hansen's Type I disc herniation, treated with nonsurgical rehabilitation. The overall prognosis was good with 34 of 40 (85.0%, 95% CI 70.2-94.2) dachshunds achieving functional pet status by 12 weeks postinjury. Modified Frankel Score at presentation was significantly ( < 0.001) higher in dogs with a positive 12-week outcome compared to dogs that did not recover by 12 weeks. All 27 dogs with motor function at presentation had a positive outcome. Of the 9 dogs exhibiting paraplegia with intact deep nociception at presentation, 7 dogs (77.8%) had achieved a positive outcome by 12 weeks. None of the 4 dogs persistently lacking deep nociception had a positive outcome. Among 27 dogs with a positive outcome for whom follow-up records were available, the 1- and 2-year recurrence rates for T3-L3 myelopathy were 5 and 11%, respectively. Nonsurgical rehabilitation should be considered in dachshunds with mild to moderate T3-L3 myelopathy or in severe cases when advanced imaging and surgical intervention are not possible.
腊肠犬在其一生中患胸腰椎椎间盘突出症（IVDH）的风险很高。护理标准包括先进的影像学检查、手术干预和术后康复。对于拒绝接受护理标准的病例，通常建议采用保守治疗，而对于保守治疗和康复（非手术康复）的治疗预后知之甚少。这项回顾性队列研究评估了40只被认为是由于汉森I型椎间盘突出症导致T3-L3脊髓病的腊肠犬，接受非手术康复治疗后的12周功能结局和临床症状复发情况。总体预后良好，40只腊肠犬中有34只（85.0%，95%可信区间70.2-94.2）在受伤后12周达到功能性宠物状态。与12周未恢复的犬相比，12周结局为阳性的犬在就诊时的改良Frankel评分显著更高（<0.001）。所有就诊时具有运动功能的27只犬均有阳性结局。就诊时表现为截瘫且深部痛觉完整的9只犬中，7只（77.8%）在12周时达到阳性结局。4只持续缺乏深部痛觉的犬均无阳性结局。在27只结局为阳性且有随访记录的犬中，T3-L3脊髓病的1年和2年复发率分别为5%和11%。对于轻度至中度T3-L3脊髓病的腊肠犬，或在无法进行先进影像学检查和手术干预的严重病例中，应考虑非手术康复。
