Aravindan Arajeane, Ferreira Alexandra
Veterinary Specialists Scotland, Part of Linnaeus Veterinary Ltd., Livingston, UK.
Vet Med Sci. 2025 Jan;11(1):e70148. doi: 10.1002/vms3.70148.
A 2-year-old female entire Golden Retriever with a history of being subdued was seen. Her physical and neurological examinations were initially unremarkable, but she acutely progressed to non-ambulatory paraparesis, with absent cervical or thoracolumbar hyperaesthesia. Magnetic resonance imaging of the vertebral column was performed, showing a well-defined, intradural-extramedullary mass at the level of the caudal aspect of L2 causing right-sided ventrolateral marked cord compression. The lesion was T2W hyperintense and mildly hyperintense on T1W images. The signal intensity pattern of this lesion suggested the presence of an early stage hyperacute hemorrhagic process. Cerebrospinal fluid (CSF) was collected from the cisterna magna. CSF analysis exhibited a marked mixed pleocytosis with a slight neutrophilic predominance and elevated protein content. Due to the dog going from being ambulatory to non-ambulatory paraparetic with absent postural reactions in her pelvic limbs, surgery was performed to allow decompression of the spinal cord. A hemilaminectomy with durotomy was performed. Over the course of the dog's hospitalisation, she had two episodes of left-sided epistaxis which resolved with local application of adrenaline. Seven days post-operatively, the dog was discharged being non-ambulatory paraparetic with voluntary movement in both pelvic limbs. Three months after discharge, the dog was ambulatory with no ataxia noted in the pelvic limbs. As there is no current definitive diagnostic test for steroid responsive meningitis-arteritis (SRMA) available, the diagnosis of it in this case is supported by the dog's signalment, bloodwork, CSF analysis and response to corticosteroid therapy. This report details a rare clinical presentation, including epistaxis, intradural-extramedullary haemorrhage and absence of cervical or thoracolumbar hyperaesthesia, in a dog diagnosed with suspected SRMA.
接诊了一只2岁的未绝育雌性金毛猎犬，它有被制服的病史。其体格检查和神经学检查最初并无异常，但随后病情急剧发展为非行走性双下肢轻瘫，颈部或胸腰椎无感觉过敏。对脊柱进行了磁共振成像检查，结果显示在L2尾侧水平有一个边界清晰的硬膜内髓外肿块，导致右侧腹外侧脊髓明显受压。该病变在T2加权像上呈高信号，在T1加权像上呈轻度高信号。此病变的信号强度模式提示存在早期超急性出血过程。从枕大池采集了脑脊液。脑脊液分析显示有明显的混合性细胞增多，中性粒细胞略占优势，蛋白质含量升高。由于这只狗从能够行走发展为非行走性双下肢轻瘫，且盆腔肢体姿势反射消失，遂进行了手术以解除脊髓压迫。实施了半椎板切除术并切开硬脑膜。在这只狗住院期间，它出现了两次左侧鼻出血，通过局部应用肾上腺素后出血停止。术后7天，这只狗出院时仍为非行走性双下肢轻瘫，但盆腔肢体有自主运动。出院3个月后，这只狗能够行走，盆腔肢体未发现共济失调。由于目前尚无针对类固醇反应性脑膜炎-动脉炎（SRMA）的确定性诊断测试，该病例中对SRMA的诊断是基于这只狗的特征、血液检查、脑脊液分析以及对皮质类固醇治疗的反应。本报告详细描述了一只被诊断为疑似SRMA的狗的罕见临床表现，包括鼻出血、硬膜内髓外出血以及颈部或胸腰椎无感觉过敏。
