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Evolution of clinical signs and predictors of outcome after conservative medical treatment for disk-associated cervical spondylomyelopathy in dogs

Steven De Decker (UGent) , Ingrid Gielen (UGent) , Luc Duchateau (UGent) , Anna Oeverman, Ingeborgh Polis (UGent) , Iris Van Soens (UGent) , Henri van Bree (UGent) and Luc Van Ham (UGent)
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Abstract
Objective-To evaluate the evolution of clinical signs and their correlation with results of magnetic resonance imaging (MRI) and transcranial magnetic stimulation (TMS) and to assess potential prognostic variables after conservative medical treatment for disk-associated cervical spondylomyelopathy (DA-CSM) in dogs. Design-Prospective cohort study. Animals-21 client-owned dogs with DA-CSM. Procedures-After neurologic grading, dogs underwent low-field MRI and TMS with measurement of onset latencies and peak-to-peak amplitudes from the extensor carpi radialis and cranial tibial muscles. Dimensions calculated from MRI images were remaining spinal cord area, spinal cord compression ratio, vertebral occupying ratio, vertebral canal heightto-body height ratio, vertebral canal height-to-body length ratio, and vertebral canal compromise ratio. Intraparenchymal signal intensity changes were graded. Dogs were reevaluated 1, 3, 6, 12, and 24 months after initial diagnosis. Results-Outcome was successful in 8 of 21 dogs. Negative outcomes were characterized by rapid progression of clinical signs. All dogs with more severe clinical signs of DA-CSM 1 month after diagnosis had unsuccessful outcomes. Outcome was associated with the remaining spinal cord area and vertebral canal compromise ratio. Prognosis was not associated with severity of clinical signs or results of TMS. There were no significant correlations among clinical signs, MRI findings, and TMS results. Conclusions and Clinical Relevance-Conservative medical treatment of DA-CSM was associated with a guarded prognosis. Selected MR1 variables and clinical evolution 1 month after diagnosis can be considered prognostic indicators. The lack of correlation among clinical signs, results of diagnostic imaging, and results of electrophysiologic evaluation in dogs with DA-CSM warrants further investigation.
Keywords
SURGICAL-TREATMENT, CANAL DIAMETER, MOTOR-EVOKED-POTENTIALS, MAGNETIC-RESONANCE IMAGES, SPINAL-CORD, SPONDYLOTIC MYELOPATHY, WOBBLER SYNDROME, COMPRESSIVE MYELOPATHY, DOBERMAN-PINSCHERS, FOLLOW-UP

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Citation

Please use this url to cite or link to this publication:

Chicago
De Decker, Steven, Ingrid Gielen, Luc Duchateau, Anna Oeverman, Ingeborgh Polis, Iris Van Soens, Henri van Bree, and Luc Van Ham. 2012. “Evolution of Clinical Signs and Predictors of Outcome After Conservative Medical Treatment for Disk-associated Cervical Spondylomyelopathy in Dogs.” Javma-journal of the American Veterinary Medical Association 240 (7): 848–857.
APA
De Decker, Steven, Gielen, I., Duchateau, L., Oeverman, A., Polis, I., Van Soens, I., van Bree, H., et al. (2012). Evolution of clinical signs and predictors of outcome after conservative medical treatment for disk-associated cervical spondylomyelopathy in dogs. JAVMA-JOURNAL OF THE AMERICAN VETERINARY MEDICAL ASSOCIATION, 240(7), 848–857.
Vancouver
1.
De Decker S, Gielen I, Duchateau L, Oeverman A, Polis I, Van Soens I, et al. Evolution of clinical signs and predictors of outcome after conservative medical treatment for disk-associated cervical spondylomyelopathy in dogs. JAVMA-JOURNAL OF THE AMERICAN VETERINARY MEDICAL ASSOCIATION. 2012;240(7):848–57.
MLA
De Decker, Steven, Ingrid Gielen, Luc Duchateau, et al. “Evolution of Clinical Signs and Predictors of Outcome After Conservative Medical Treatment for Disk-associated Cervical Spondylomyelopathy in Dogs.” JAVMA-JOURNAL OF THE AMERICAN VETERINARY MEDICAL ASSOCIATION 240.7 (2012): 848–857. Print.
@article{1999530,
  abstract     = {Objective-To evaluate the evolution of clinical signs and their correlation with results of magnetic resonance imaging (MRI) and transcranial magnetic stimulation (TMS) and to assess potential prognostic variables after conservative medical treatment for disk-associated cervical spondylomyelopathy (DA-CSM) in dogs. 
Design-Prospective cohort study. 
Animals-21 client-owned dogs with DA-CSM. 
Procedures-After neurologic grading, dogs underwent low-field MRI and TMS with measurement of onset latencies and peak-to-peak amplitudes from the extensor carpi radialis and cranial tibial muscles. Dimensions calculated from MRI images were remaining spinal cord area, spinal cord compression ratio, vertebral occupying ratio, vertebral canal heightto-body height ratio, vertebral canal height-to-body length ratio, and vertebral canal compromise ratio. Intraparenchymal signal intensity changes were graded. Dogs were reevaluated 1, 3, 6, 12, and 24 months after initial diagnosis. 
Results-Outcome was successful in 8 of 21 dogs. Negative outcomes were characterized by rapid progression of clinical signs. All dogs with more severe clinical signs of DA-CSM 1 month after diagnosis had unsuccessful outcomes. Outcome was associated with the remaining spinal cord area and vertebral canal compromise ratio. Prognosis was not associated with severity of clinical signs or results of TMS. There were no significant correlations among clinical signs, MRI findings, and TMS results. 
Conclusions and Clinical Relevance-Conservative medical treatment of DA-CSM was associated with a guarded prognosis. Selected MR1 variables and clinical evolution 1 month after diagnosis can be considered prognostic indicators. The lack of correlation among clinical signs, results of diagnostic imaging, and results of electrophysiologic evaluation in dogs with DA-CSM warrants further investigation.},
  author       = {De Decker, Steven and Gielen, Ingrid and Duchateau, Luc and Oeverman, Anna and Polis, Ingeborgh and Van Soens, Iris and van Bree, Henri and Van Ham, Luc},
  issn         = {0003-1488},
  journal      = {JAVMA-JOURNAL OF THE AMERICAN VETERINARY MEDICAL ASSOCIATION},
  keyword      = {SURGICAL-TREATMENT,CANAL DIAMETER,MOTOR-EVOKED-POTENTIALS,MAGNETIC-RESONANCE IMAGES,SPINAL-CORD,SPONDYLOTIC MYELOPATHY,WOBBLER SYNDROME,COMPRESSIVE MYELOPATHY,DOBERMAN-PINSCHERS,FOLLOW-UP},
  language     = {eng},
  number       = {7},
  pages        = {848--857},
  title        = {Evolution of clinical signs and predictors of outcome after conservative medical treatment for disk-associated cervical spondylomyelopathy in dogs},
  url          = {http://dx.doi.org/10.2460/javma.240.7.848},
  volume       = {240},
  year         = {2012},
}

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