Fitzpatrick Referrals Ltd, Halfway ln, Godalming, UK.
North Downs Specialist Referrals, part of Linnaeus Veterinary Limited, Bletchingley, UK.
J Vet Intern Med. 2023 May-Jun;37(3):1129-1138. doi: 10.1111/jvim.16694. Epub 2023 Apr 24.
Non-traumatic spinal cord hemorrhage (NTSH) is an uncommon cause of myelopathy in dogs.
Describe the clinical characteristics, concurrent medical conditions and underlying causes, magnetic resonance imaging (MRI) findings and outcome in dogs with NTSH.
Dogs diagnosed with NTSH using gradient echo T2-weighted (GRE) sequences with or without histopathological confirmation of hemorrhage were included. Dogs with a traumatic cause were excluded, including those with compressive intervertebral disc extrusion.
Retrospective descriptive study; the databases of 2 referral hospitals were searched between 2013 and 2021.
Twenty-three dogs met inclusion criteria. The onset of signs was acute and progressive in 70% of cases; spinal hyperesthesia was variable (48%). Hemorrhage was identified in the thoracolumbar spinal segments in 65% of dogs. An underlying cause was identified in 65% of cases. Angiostrongylus vasorum represented 18% of the total cohort, followed by steroid-responsive meningitis arteritis (SRMA; 13%). Overall, 64% of dogs had a good or excellent outcome, regardless of cause; which was increased to 100% for SRMA, 75% for A. vasorum and 75% for idiopathic NTSH. Outcome was not associated with neurological severity. Recovery rate was 67% and 50% for nociception-intact and nociception-negative dogs, respectively.
Larger prospective studies would be required to define prognostic factors for dogs with NTSH, but outcome appeared to be most influenced by the underlying cause, as opposed to neurological severity at presentation.
非外伤性脊髓出血(NTSH)是犬脊髓病的一种不常见病因。
描述 NTSH 犬的临床特征、合并症及潜在病因、磁共振成像(MRI)表现和转归。
使用梯度回波 T2 加权(GRE)序列诊断为 NTSH 的犬,无论是否有出血的组织病理学证实,均包括在内。排除外伤性病因的犬,包括有压迫性椎间盘突出的犬。
回顾性描述性研究;检索了 2 家转诊医院的数据库,检索时间范围为 2013 年至 2021 年。
23 只犬符合纳入标准。70%的病例出现急性和进行性症状发作,脊柱过敏程度不同(48%)。65%的犬在胸腰段脊髓中发现出血。65%的病例确定了潜在病因。血管圆线虫占总队列的 18%,其次是类固醇反应性脑膜血管炎(SRMA;13%)。无论病因如何,64%的犬预后良好或极好;SRMA 的预后为 100%,血管圆线虫为 75%,特发性 NTSH 为 75%。预后与神经严重程度无关。有痛觉和无痛觉犬的恢复率分别为 67%和 50%。
需要更大的前瞻性研究来确定 NTSH 犬的预后因素,但与发病时的神经严重程度相比,预后似乎主要受潜在病因的影响。