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Risk factors associated with progressive myelomalacia in dogs with complete sensorimotor loss following intervertebral disc extrusion: a retrospective case-control study.
BMC Vet Res. 2019 Dec 03; 15(1):433.BV

Abstract

BACKGROUND

Progressive myelomalacia (PMM) is a usually fatal complication of acute intervertebral disc extrusion (IVDE) in dogs but its risk factors are poorly understood. The objective of this retrospective case-control study was to identify risk factors for PMM by comparing dogs with complete sensorimotor loss following IVDE that did and did not develop the disease after surgery. We also investigated whether any risk factors for PMM influenced return of ambulation. Medical records of client-owned dogs with paraplegia and loss of pain perception that underwent surgery for IVDE from 1998 to 2016, were reviewed. Dogs were categorized as PMM yes or no based on clinical progression or histopathology. Walking outcome at 6 months was established. Signalment, onset and duration of signs (categorized), steroids, non-steroidal anti-inflammatory drugs (yes or no), site of IVDE (lumbar intumescence or thoracolumbar) and longitudinal extent of IVDE were retrieved and their associations with PMM and walking outcome were examined using logistic regression.

RESULTS

One hundred and ninety seven dogs were included, 45 with and 152 without PMM. A 6-month-outcome was available in 178 dogs (all 45 PMM dogs and 133 control dogs); 86 recovered walking (all in the control group). Disc extrusions at the lumbar intumescence were associated with PMM (p = 0.01, OR: 3.02, CI: 1.3-7.2). Surgery performed more than 12 h after loss of ambulation was associated with PMM (OR = 3.4; CI = 1.1-10.5, p = 0.03 for 12-24 h and OR = 4.6; CI = 1.3-16.6, p = 0.02 for the > 24 h categories when compared with the ≤12 h category). Treatment with corticosteroids was negatively associated with PMM (OR: 3.1; CI: 1.3-7.6, p = 0.01). The only variable to affect walking outcome was longitudinal extent of IVDE (OR = 2.6; CI = 1.3-5.3, p = 0.006).

CONCLUSION

Dogs with lumbar intumescence IVDE are at increased risk of PMM. Timing of surgery and corticosteroid use warrant further investigations. PMM and recovery of walking are influenced by different factors.

Authors+Show Affiliations

Department of Small Animal Clinical Sciences, University of Tennessee Veterinary Teaching Hospital, College of Veterinary Medicine, Knoxville, TN, 37966-4544, USA.Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA. njolby@ncsu.edu. Comparative Medicine Institute, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA. njolby@ncsu.edu.Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA.Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA. Comparative Medicine Institute, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA.Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA. Comparative Medicine Institute, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA.Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31796017

Citation

Castel, Aude, et al. "Risk Factors Associated With Progressive Myelomalacia in Dogs With Complete Sensorimotor Loss Following Intervertebral Disc Extrusion: a Retrospective Case-control Study." BMC Veterinary Research, vol. 15, no. 1, 2019, p. 433.
Castel A, Olby NJ, Ru H, et al. Risk factors associated with progressive myelomalacia in dogs with complete sensorimotor loss following intervertebral disc extrusion: a retrospective case-control study. BMC Vet Res. 2019;15(1):433.
Castel, A., Olby, N. J., Ru, H., Mariani, C. L., Muñana, K. R., & Early, P. J. (2019). Risk factors associated with progressive myelomalacia in dogs with complete sensorimotor loss following intervertebral disc extrusion: a retrospective case-control study. BMC Veterinary Research, 15(1), 433. https://doi.org/10.1186/s12917-019-2186-0
Castel A, et al. Risk Factors Associated With Progressive Myelomalacia in Dogs With Complete Sensorimotor Loss Following Intervertebral Disc Extrusion: a Retrospective Case-control Study. BMC Vet Res. 2019 Dec 3;15(1):433. PubMed PMID: 31796017.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factors associated with progressive myelomalacia in dogs with complete sensorimotor loss following intervertebral disc extrusion: a retrospective case-control study. AU - Castel,Aude, AU - Olby,Natasha J, AU - Ru,Hongyu, AU - Mariani,Christopher L, AU - Muñana,Karen R, AU - Early,Peter J, Y1 - 2019/12/03/ PY - 2019/05/06/received PY - 2019/11/22/accepted PY - 2019/12/5/entrez PY - 2019/12/5/pubmed PY - 2020/3/20/medline KW - Ascending-descending myelomalacia KW - Intervertebral disk disease KW - Paraplegia KW - Spinal cord injury SP - 433 EP - 433 JF - BMC veterinary research JO - BMC Vet. Res. VL - 15 IS - 1 N2 - BACKGROUND: Progressive myelomalacia (PMM) is a usually fatal complication of acute intervertebral disc extrusion (IVDE) in dogs but its risk factors are poorly understood. The objective of this retrospective case-control study was to identify risk factors for PMM by comparing dogs with complete sensorimotor loss following IVDE that did and did not develop the disease after surgery. We also investigated whether any risk factors for PMM influenced return of ambulation. Medical records of client-owned dogs with paraplegia and loss of pain perception that underwent surgery for IVDE from 1998 to 2016, were reviewed. Dogs were categorized as PMM yes or no based on clinical progression or histopathology. Walking outcome at 6 months was established. Signalment, onset and duration of signs (categorized), steroids, non-steroidal anti-inflammatory drugs (yes or no), site of IVDE (lumbar intumescence or thoracolumbar) and longitudinal extent of IVDE were retrieved and their associations with PMM and walking outcome were examined using logistic regression. RESULTS: One hundred and ninety seven dogs were included, 45 with and 152 without PMM. A 6-month-outcome was available in 178 dogs (all 45 PMM dogs and 133 control dogs); 86 recovered walking (all in the control group). Disc extrusions at the lumbar intumescence were associated with PMM (p = 0.01, OR: 3.02, CI: 1.3-7.2). Surgery performed more than 12 h after loss of ambulation was associated with PMM (OR = 3.4; CI = 1.1-10.5, p = 0.03 for 12-24 h and OR = 4.6; CI = 1.3-16.6, p = 0.02 for the > 24 h categories when compared with the ≤12 h category). Treatment with corticosteroids was negatively associated with PMM (OR: 3.1; CI: 1.3-7.6, p = 0.01). The only variable to affect walking outcome was longitudinal extent of IVDE (OR = 2.6; CI = 1.3-5.3, p = 0.006). CONCLUSION: Dogs with lumbar intumescence IVDE are at increased risk of PMM. Timing of surgery and corticosteroid use warrant further investigations. PMM and recovery of walking are influenced by different factors. SN - 1746-6148 UR - https://www.unboundmedicine.com/medline/citation/31796017/Risk_factors_associated_with_progressive_myelomalacia_in_dogs_with_complete_sensorimotor_loss_following_intervertebral_disc_extrusion:_a_retrospective_case_control_study_ L2 - https://bmcvetres.biomedcentral.com/articles/10.1186/s12917-019-2186-0 DB - PRIME DP - Unbound Medicine ER -