Anal Sac Adenocarcinoma with Vertebromedullary Metastasis in a Cocker Spaniel

Background: Several neoplasms can affect the perianal region, being the hepatic adenoma and the anal sac adenocarcinoma (ASAC), which is considered the most frequent. The ASAC is a malignant neoplasm originating from the secretory epithelium of the perianal apocrine glands and is rarely seen in veterinary medicine. The ASAC occurs mainly in adult to elderly canines with high metastasis rates. Patients may be asymptomatic or manifest discomfort and behavioral changes. In the presence of metastasis, the most frequent clinical signs are inappetence, coughing, dyspnea, and colorectal obstruction. Given this scenario, this paper aims to describe the clinical presentation, diagnostic examination, and necropsy findings of a Cocker Spaniel with ASAC and metastasis in the vertebral body, spinal cord, and cauda equina. Case: A 8-year-old neutered male Cocker Spaniel (12 kg of body mass) with a clinical history of non-ambulatory paraparesis was evaluated. The patient also presented tenesmus, difficulty to defecate, and the presence of nodules in the anal sac area. On the neurological examination, asymmetrical changes compatible with injury between L4-S3 were found. A complete blood count, serum biochemistry, and imaging exams such as plain radiography, abdominal ultrasonography (US), and magnetic resonance imaging (MRI) were requested. Blood count revealed anemia and neutrophilic leukocytosis and hypercalcemia. The liver showed increased echogenicity and thickened pancreas in the abdominal US scan. A slightly heterogeneous, vascularized mass with irregular borders was identified in the topographic region of the sublumbar lymph nodes; MRI images demonstrated an expansile formation in the ventral region of the lumbosacral spine, corresponding to the sublumbar lymph nodes and interruption of the cerebrospinal fluid at L5, suggestive of compression of the spinal cord and cauda equina. A presumptive diagnosis of perianal neoplasm with metastasis was made based on the complementary exams. The dog was referred to necropsy, which revealed a 4 cm tumor in the perianal region that invaded the pelvic canal. Multifocal nodules were present on the lung surface, liver, and kidneys, suggesting metastasis. On the cross-section of the spine, one could note the presence of the tumor in the vertebral bodies, spinal cord, and cauda equina from L5 to S3. Even with histopathological evaluation of the tumor, only the immunohistochemical analysis allowed us to confirm the anal sac adenocarcinoma. Discussion: Adenomas and carcinomas are perianal gland neoplasms common in adult and elderly male dogs; the Cocker Spaniel breed is among the most affected. The clinical signs presented by the patient, such as tenesmus and difficulty in adopting the posture of defecation, are common, although neurological changes are rare. As for metastasis, carcinomas of the perianal region present high chances of metastasis to organs including the liver, kidneys, and lungs, both lymphatically and hematogenously, but few studies have related these factors to neurological alterations  due to metastasis. We concluded that metastases from carcinomas to the spine must be considered a possible differential diagnosis in cases of patients presenting clinical signs that are compatible with spinal cord compression and a history of previous neoplasm. Keywords: canine perianal carcinoma, neoplasm, spinal cord metastasis. Título: Adenocarcinoma de saco anal com metástase vertebro-medular em um Cocker Spaniel Descritores: carcinoma perianal canino, neoplasma, metástase medula espinhal.Introdução: Diversas neoplasias podem acometer a região perianal, sendo o adenoma hepático e o adenocarcinoma do saco anal (ASA), considerados os mais frequentes. O ASAC é uma neoplasia maligna originada do epitélio secretor das glândulas apócrinas perianais e raramente é visto na medicina veterinária. O ASA ocorre principalmente em cães adultos a idosos com altas taxas de metástase. Os pacientes podem ser assintomáticos ou manifestar desconforto e alterações comportamentais. Na presença de metástase, os sinais clínicos mais frequentes são inapetência, tosse, dispneia e obstrução colorretal. Diante desse cenário, este trabalho tem como objetivo descrever a apresentação clínica, exame diagnóstico e achados de necropsia de um Cocker Spaniel com ASAC e metástase no corpo vertebral, medula espinhal e cauda equina.Caso: Foi avaliado um macho castrado da raça Cocker Spaniel (12 kg de massa corporal) de oito anos de idade com história clínica de paraparesia não deambulatória. A paciente também apresentava tenesmo, dificuldade para defecar e presença de nódulos na região do saco anal. Ao exame neurológico, foram encontradas alterações assimétricas compatíveis com lesão entre L4-S3. Foram solicitados hemograma completo, bioquímica sérica e exames de imagem como radiografia simples, ultrassonografia (US) abdominal e ressonância magnética (RM). O hemograma revelou anemia e leucocitose neutrofílica e hipercalcemia. O fígado mostrou ecogenicidade aumentada e pâncreas espessado na US abdominal. Identificou-se massa pouco heterogênea, vascularizada e de contornos irregulares na região topográfica dos linfonodos sublombares; As imagens de RM demonstraram formação expansiva na região ventral da coluna lombossacral, correspondendo aos linfonodos sublombares e interrupção do líquido cefalorraquidiano em L5, sugestiva de compressão da medula espinhal e cauda equina. O diagnóstico presuntivo de neoplasia perianal com metástase foi feito com base nos exames complementares. A cadela foi encaminhada para necropsia, que revelou tumoração de 4 cm na região perianal que invadia o canal pélvico. Nódulos multifocais estavam presentes na superfície pulmonar, fígado e rins, sugerindo metástase. No corte transversal da coluna, notou-se a presença do tumor nos corpos vertebrais, medula espinhal e cauda equina de L5 a S3. Mesmo com a avaliação histopatológica do tumor, apenas a análise imuno-histoquímica permitiu confirmar o adenocarcinoma do saco anal.Discussão: Adenomas e carcinomas são neoplasias das glândulas perianais comuns em cães machos adultos e idosos; a raça Cocker Spaniel está entre as mais afetadas. Os sinais clínicos apresentados pelo paciente, como tenesmo e dificuldade em adotar a postura de defecar, são comuns, embora alterações neurológicas sejam raras. Quanto à metástase, os carcinomas da região perianal apresentam grandes chances de metástase para órgãos como fígado, rins e pulmões, tanto por via linfática quanto hematogênica, porém poucos estudos relacionam esses fatores às alterações neurológicas decorrentes da metástase. Concluímos que metástases de carcinomas para a coluna devem ser consideradas um possível diagnóstico diferencial em pacientes que apresentam sinais clínicos compatíveis com compressão medular e história de neoplasia prévia

Extradural Synovial Cyst of the Cervical Spine in a Saint Bernard

Background: Extradural synovial cysts (ESC) originate from an extrusion of the synovium in unstable or degenerated joints. In the spine, this condition can cause neurological signs such as hyperesthesia, proprioceptive ataxia and paresis. Since extradural presentations of synovial cysts are unusual in dogs, the aim of this manuscript is to report a case of extradural synovial cyst of the cervical spine, as well as the clinical findings, diagnosis, surgical treatment and clinical evolution after therapy.Case: A 3-year-old spayed Saint Bernard weighing 60 kg was presented to a Veterinary Medical Teaching Hospital with a history of acute paraparesis that evolved to non-ambulatory tetraparesis five days after the appearance of the first clinical signs. Neurological examination revealed non-ambulatory tetraparesis, normal muscle tone and segmental spinal reflexes in the thoracic and pelvic limbs, as well as cervical pain associated with limited neck movement. According to the neurological examination, the likely lesion location was the C1-C5 spinal cord segment. The differential diagnosis list included intervertebral disc disease, caudal cervical spondylomyelopathy, neoplasm, infectious or noninfectious inflammatory disease, and cystic diseases. Complete blood (cell) count and serum biochemistry tests were within reference limits. The cerebrospinal fluid analysis revealed 35 mg/dL of protein (< 30 mg/dL) and 27 cells (up to 5 cells/mm3) with a predominance of lymphocytes. In plain radiography, bone proliferations of the C4 (caudal) C5 (cranial) articular processes were observed and, in myelography, extradural spinal cord compression was evident between C4-C5 on the right side. The animal underwent dorsal laminectomy for spinal cord decompression. An extradural synovial cyst and proliferated articular processes were removed. At 1,281 days after surgery, the dog was clinically normal and presented no neurological deficits.Discussion: The etiology of synovial cysts has not been well established. However, it is believed that osteoarthritic degeneration associated with joint mobility could cause a rupture in the articular capsule, leading to a synovial membrane protrusion, which would fill with synovial fluid and compress spinal structures. ESC in the cervical region have been reported, often associated with cervical neoplasm. The case we report had no evidence of bone or intervertebral disc compression in myelographic and radiographic exams, abnormalities that would appear in cervical neoplasm. The patient underwent dorsal laminectomy to confirm the presumptive diagnosis and decompress the spine. In the histopathological exam, the cystic material consisted of connective fibrous tissue with a synovial cell lining layer, compatible with synovial cysts. The fluid drained during surgery was also analyzed, showing similarities to synovial fluid drained from other conventional joints. Cerebrospinal fluid analysis revealed mononuclear pleocytosis, a common finding in ESC. The ESC should be included in the differential diagnosis of dogs with cervical myelopathy, especially in young animals and large breeds. A myelographic exam is an important but not definitive auxiliary tool for diagnosis and the therapeutic plan. Dorsal laminectomy is an effective technique for treating ESC

Postoperative Analgesia with Transdermal Fentanyl or Intramuscular Methadone in Dogs Submitted to Thoracolumbar Hemilaminectomy

Background: Postoperative care after thoracolumbar hemilaminectomy in dogs generally includes rest, physical therapy, and analgesics such as opioids. Currently, there is no established standard for the management of postoperative pain in patients undergoing hemilaminectomy. Ideally, an analgesic protocol should provide adequate pain relief with limited sedation, low adverse effects, and postoperative patient comfort. Therefore, this study aimed to evaluate postoperative analgesia using transdermal fentanyl or intramuscular methadone in dogs undergoing thoracolumbar hemilaminectomy associated with intervertebral disc fenestration (HT) for the treatment of intervertebral disc extrusion (IVDE).Materials, Methods &amp; Results: Eight dogs from the Department of Neurology and Neurosurgery of a veterinary teaching hospital, submitted to HT for the treatment of IVDE, were included. The dogs were randomly distributed into two groups of equal numbers, namely the transdermal fentanyl (FT) group and the intramuscular methadone (IM) group. At the end of the surgical procedure, a fentanyl adhesive patch was applied to the animals in the FT group, which remained there for 72 h. In the IM group, analgesia was induced by intramuscular administration of methadone at intervals of 6 h until 72 h after surgery. The animals were evaluated using the short form of the Glasgow Composite Pain Scale (SF-GCPS). Evaluations of physiological parameters, side effects, and pain were performed by two assessors who had experience using the pain scale and were blinded to the analgesic protocol. Pain evaluations were performed every 2 h (from T4) until 24 h after the surgical procedure. Evaluations were performed every 4 h from 24 h to 48 h after the surgical procedure and at intervals of 24 h from 48 h to 72 h.Discussion: Transdermal fentanyl provided the lowest pain scores, when evaluated by the SF-GCPS, for both assessors. These data are presented as a function of time in Figure 1, which shows the variation in pain scores by SF-GCPS over time. It should be noted that, for both assessors, animals in the FT group had lower pain scores than animals in the IM group. There was also less variation in pain scores in the FT group, indicating better analgesic quality. This can be explained by the maintenance of the drug’s plasma concentrations in a stable manner, avoiding periods of greater or lesser pain throughout the evaluation period due to the absence of increases or decreases in plasma concentration. In the IM group, three analgesic rescues were required; in the FT group, there was no rescue. Although the data indicate that IM was responsible for a greater occurrence in the number of rescues, it is worth noting that this information is based on a small group of animals. One dog needed two rescues (at T4 and T8), regarding which both assessors agreed, while another required one rescue (at T18), but there was a difference of one point between the raters. However, pain scores in all of the cases were considered to be mild, not moderate or severe, with rescues occurring on scores of 5/20. Both fentanyl used by the transdermal route and intramuscular methadone promoted analgesia in the first three postoperative days in dogs undergoing HT. Better stability in postoperative pain scores without the need for analgesic rescue and less occurrence of adverse effects were observed in dogs treated with FT.Keywords: fentanyl patch, neurosurgery, dogs, analgesia, pain.Título: Analgesia pós-operatória com Fentanil transdérmico ou Metadona intramuscular em cães submetidos à hemilaminectomia toracolombar Descritores: adesivo fentanil, neurocirurgia, cães, analgesia, dor

Intradural Disc Extrusion in a Dog

Background: Intervertebral disc extrusion is an important cause of spinal cord dysfunction in dogs. Intradural localization of the extruded disc material is rare, and is generally associated with a traumatic event or with recurrence of disc extrusion at a previously affected site. We report the clinical presentation, diagnostic workup, and treatment of a dog with intradural intervertebral disc extrusion not preceded by a traumatic event.Case:  A 6-year-old male Dachshund was referred for neurological evaluation due to acute onset of hind-end paralysis preceded by claudication of the left hindlimb. The patient had been receiving conservative treatment to no effect. Neurological examination revealed asymmetric non-ambulatory paraparesis, absence of postural reactions and decreased muscle tone in both hindlimbs, a bilaterally diminished patellar reflex, and a hindlimb withdrawal reflex which was normal on the right and greatly diminished to absent on the left. The lower back was tender to epaxial palpation. Plain radiographs of the lumbar spine in the lateral projection showed calcified material within the spinal canal between the third and fourth lumbar vertebrae. Myelography was suggestively abnormal at the same level, with epidural leakage of contrast at L3-L4. Considering the clinical history, breed, age, neurological signs, and radiographic findings, intervertebral disc disease was suspected despite the inconclusive myelography findings. A dorsolateral lumbar hemilaminectomy was performed. Intraoperatively, the diagnosis was confirmed by visualization of a discolored spinal cord and absence of extradural material. The intradural space was accessed via durotomy. A firm, straw-yellow material was seen compressing the spinal cord and removed. Subsequent histopathological examination confirmed that this material consisted of extruded intervertebral disc contents. Postoperatively, the patient underwent physiotherapy and achieved a satisfactory recovery.Discussion: The most common cause of paraparesis in chondrodystrophic dog breeds is intervertebral disc extrusion. Intradural extrusion of the intervertebral disc is a rare phenomenon, often associated with vigorous exercise that causes laceration of the dura mater, allowing penetration of disc material into the intradural space. Although there were no classic signs of intervertebral disc disease on plain radiography, radiopaque material was visible within the spinal canal, which can occur in cases of calcified intervertebral disc extrusion. Myelography was inconclusive, but the decision was made to operate nevertheless, considering that the patient had not responded to conservative treatment and that surgicaltreatment is the most suitable approach for dogs with non-ambulatory paraparesis or paraplegia secondary to intervertebral disc extrusion. The surgical technique consisted of a hemilaminectomy and durotomy. Our diagnostic suspicion was confirmed intraoperatively, as in most cases of intradural disc extrusion in humans. Intradural disc extrusion is anuncommon phenomenon in dogs, and the diagnosis is usually only established intraoperatively. This unusual variant of intravertebral disc disease should be included in the differential diagnosis of spinal cord dysfunction in chondrodystrophic breeds, even in the absence of a history of trauma or preexisting intervertebral disc disease. Clinical treatment appears ineffective in these cases. Conversely, surgical treatment can yield good outcomes, and even functional recovery

Estudo Dinâmico em Mielografia de Cães com Extrusão de Disco Intervertebral Toracolombar

Background: Myelography is recommended for diagnosing thoracolumbar intervertebral disc extrusion (IVDE) in dogs. The authors of this study found that the images of myelograms obtained in the lateral radiographic view during the injection of contrast medium contained relevant information that assisted in determining the location of spinal cord compression in dogs with IVDE; however, no studies have reported a possible contribution of these images in the diagnosis of compression. This study aimed to evaluate the contribution of radiographic views acquired during contrast injection (dynamic study) to the location of spinal cord compression in dogs with thoracolumbar IVDE. Materials, Methods &amp; Results: Myelograms that defined extradural compression of the spinal cord in dogs with a definitive diagnosis of thoracolumbar or lumbar IVDE were included. In addition to conventional ventrodorsal, left and right oblique, and lateral radiographic views (obtained after contrast administration), lateral radiographic views acquired during the injection of at least 75% of the total calculated contrast volume in each patient (dynamic study). The examinations were evaluated by veterinary doctors, a radiologist, and a neurologist, all experienced in myelography assessments. In each radiographic view, the possibility of locating the affected intervertebral space (deviation or attenuation of the contrast column or absence of alteration) was observed. We analyzed which view, dynamic study, or conventional lateral study better demonstrated the compression site. The data were statistically analyzed. A total of 74 myelographic examinations were included in the study. Regarding the possibility of locating the affected intervertebral space in each radiographic view and the evaluators' perception of diagnostic evidence between the dynamic study and conventional lateral views, there was no statistical difference among the evaluators. Considering the total evaluations among the evaluators, the dynamic study identified the compression site in 75% of cases, while the conventional lateral view identified the compression site in 66.2%. The perceptions of the evaluators regarding the diagnostic evidence of the dynamic and conventional lateral views were 37.16% in favor of the dynamic study, 33.78% were indifferent, 8.78% in favor of the conventional lateral view, and 20.27% were not evident. There was a statistically significant difference in favor of the dynamic study for better diagnostic evidence compared to the conventional lateral view. In two patients, the dynamic study was crucial for determining the compression site, expediting the execution of decompressive surgeries and avoiding further diagnostic imaging interventions. Discussion: Myelography is an acceptable imaging modality for diagnosing IVDE in dogs when advanced imaging modalities are not available, especially in cases where dogs with severe neurological deficits need to undergo spinal decompression surgery as quickly as possible. Dynamic studies can assist in detecting ventral and dorsal compressive lesions, as well as the intervertebral space to be accessed, particularly in cases where conventional projections of the myelographic examination show subtle ventral or dorsal compressions or an extensive intramedullary pattern due to parenchymal edema, resulting in failure to fill the contrast columns for more than one intervertebral space. Considering that the dynamic study proved to be more effective in highlighting the compression site than the conventional lateral view, its inclusion in myelography examinations can contribute to improved diagnostic accuracy. In conclusion, dynamic myelography aids in determining lesion location, and its inclusion in conventional myelographic studies of dogs with suspected IVDE is recommended. Keywords: radiographic views, extradural compression, disc extrusion, spinal cord. Título: Cães com Extrusão de Disco Intervertebral Toracolombar - Estudo Dinâmico em Mielografia Descritores: projeções radiográficas, compressão extradural, extrusão de disco, medula espinhal.&nbsp;Myelography is recommended for diagnosing thoracolumbar intervertebral disc extrusion (IVDE) in dogs. The authors of this study found that the images of myelograms obtained in the lateral radiographic view during the injection of contrast medium contained relevant information that assisted in determining the location of spinal cord compression in dogs with IVDE; however, no studies have reported a possible contribution of these images in the diagnosis of compression. This study aimed to evaluate the contribution of radiographic views acquired during contrast injection (dynamic study) to the location of spinal cord compression in dogs with thoracolumbar IVDE. Myelograms that defined extradural compression of the spinal cord in dogs with a definitive diagnosis of thoracolumbar or lumbar IVDE were included. In addition to conventional ventrodorsal, left and right oblique, and lateral radiographic views (obtained after contrast administration), lateral radiographic views acquired during the injection of at least 75% of the total calculated contrast volume in each patient (dynamic study). The examinations were evaluated by veterinary doctors, a radiologist, and a neurologist, all experienced in myelography assessments. In each radiographic view, the possibility of locating the affected intervertebral space (deviation or attenuation of the contrast column or absence of alteration) was observed. We analyzed which view, dynamic study, or conventional lateral study better demonstrated the compression site. The data were statistically analyzed. A total of 74 myelographic examinations were included in the study. Regarding the possibility of locating the affected intervertebral space in each radiographic view and the evaluators' perception of diagnostic evidence between the dynamic study and conventional lateral views, there was no statistical difference among the evaluators. Considering the total evaluations among the evaluators, the dynamic study identified the compression site in 75% of cases, while the conventional lateral view identified the compression site in 66.2%. The perceptions of the evaluators regarding the diagnostic evidence of the dynamic and conventional lateral views were 37.16% in favor of the dynamic study, 33.78% were indifferent, 8.78% in favor of the conventional lateral view, and 20.27% were not evident. There was a statistically significant difference in favor of the dynamic study for better diagnostic evidence compared to the conventional lateral view. In two patients, the dynamic study was crucial for determining the compression site, expediting the execution of decompressive surgeries and avoiding further diagnostic imaging interventions. Myelography is an acceptable imaging modality for diagnosing IVDE in dogs when advanced imaging modalities are not available, especially in cases where dogs with severe neurological deficits need to undergo spinal decompression surgery as quickly as possible. Dynamic studies can assist in detecting ventral and dorsal compressive lesions, as well as the intervertebral space to be accessed, particularly in cases where conventional projections of the myelographic examination show subtle ventral or dorsal compressions or an extensive intramedullary pattern due to parenchymal edema, resulting in failure to fill the contrast columns for more than one intervertebral space. Considering that the dynamic study proved to be more effective in highlighting the compression site than the conventional lateral view, its inclusion in myelography examinations can contribute to improved diagnostic accuracy. In conclusion, dynamic myelography aids in determining lesion location, and its inclusion in conventional myelographic studies of dogs with suspected IVDE is recommended

Neurological and Orthopedic Diseases in Dogs and Cats Submitted to Physiotherapy

Background: The goals of physical therapy are to maximize functional recovery, improve mobility, and restore well-being and quality of life. In the veterinary literature, there is a dearth of data on physical therapy in small animal practice. Therefore, this study aimed to identify the main neurological and orthopedic diseases in canine and feline patients seen at the physical therapy service of an animal hospital. Concomitantly, we collected demographic and clinical information on patients, including sex, breed, physical therapy modalities, number and frequency of physical therapy sessions, duration of treatment, and rate of functional recovery.Materials, Methods & Results: The records of animals with neurological and orthopedic diseases seen at the Physical Therapy department of a university-affiliated animal hospital were reviewed. The animals were divided into two groups: I) dogs and cats with neurological diseases and II) dogs and cats with orthopedic diseases. Both groups were distributed according to species, age, sex and race. Dogs and cats were classified into three age groups: puppies (≤ 1 year old), adults (> 1 year and ≤ 10 years old) and elderly (> 10 years old). A total of 384 records were retrieved, of which 370 (96.4%) were of dogs and 14 (3.6%) of cats. Neurological cases accounted for 66% of the total (n = 253), with 243 cases in dogs (96%) and 10 in cats (4%). Among orthopedic cases (n = 131, accounting for the remaining 34%), 127 were in dogs (97%) and only 4 in cats (3%). In the neurological dysfunction group, intervertebral disc disease (72.4%) was the most common diagnosis. Among the orthopedic disorders, femur fracture (23.1%) was most prevalent. In group I (neurological), 66.7% of outcomes in canine patients and 44.4% in felines were considered satisfactory. In group II (orthopedic), 61% of outcomes in dogs and 66.7% in cats were considered satisfactory.Discussion: Physical therapy has many applications in small-animal practice. After spinal cord decompression surgery in dogs with IVDD, for instance, it helps maintain and recover motor and sensory function, and is considered safe and well-tolerated in dogs after thoracolumbar hemilaminectomy with disc fenestration. Physical therapy also plays an important role after surgical repair of fractures and dislocations, aiding recovery of range of motion and return to functional activity. The most probable explanation for the wide variation in number of physical therapy sessions can be explained by owners’ satisfaction with the level of recovery achieved by the animal, often leading to discontinuation of physical therapy. The high rate of unsatisfactory outcomes in feline patients can be explained by the type of injury (spinal trauma) and the degree of neurological dysfunction. Adult female dogs were most likely to be referred to the physical therapy sector, and the Dachshund and Poodle breeds were most prevalent. Patients in the neurological dysfunction group had the highest average duration and number of sessions. Massage, stretching, passive joint mobilization, and neuromuscular electrical stimulation (NMES) were the most commonly used modalities in all physical therapy protocols. Satisfactory functional recovery was achieved in more than 60% of cases in both groups. The absence of a control group and the lack of standardization of physical therapy modalities precluded a more definitive confirmation of the results obtained in terms of functional recovery

The need for opioid in the postoperative analgesia of dogs undergoing hemilaminectomy due to intervertebral disc extrusion

ABSTRACT: The aim of this study was to evaluate the postoperative analgesic effect of protocols with and without the opioid methadone in dogs with intervertebral disc extrusion undergoing decompressive surgery. Sixteen paraplegic dogs with preserved nociception underwent hemilaminectomy/disc fenestration and were randomly assigned to two groups. The analgesic protocol consisted of methadone, meloxicam and dipyrone in Group I (G1), and meloxicam and dipyrone in Group II (G2). The animals were blindly assessed by two observers, using the visual analogue scale (VAS) and the short-form Glasgow Composite Measure Pain Scale (CMPS-SF). Assessments occurred every 2 hours during first 24 hours post-surgery, and every 4 hours afterwards. There was no statistical difference among groups regarding pain scores or analgesic rescues. Both analgesic protocols provided analgesia in the initial 48 hours postoperatively, demonstrating that opioids are not necessary in the postoperative period of dogs undergoing hemilaminectomy and disc fenestration

Anal Sac Adenocarcinoma with Vertebromedullary Metastasis in a Cocker Spaniel

Background: Several neoplasms can affect the perianal region, being the hepatic adenoma and the anal sac adenocarcinoma (ASAC), which is considered the most frequent. The ASAC is a malignant neoplasm originating from the secretory epithelium of the perianal apocrine glands and is rarely seen in veterinary medicine. The ASAC occurs mainly in adult to elderly canines with high metastasis rates. Patients may be asymptomatic or manifest discomfort and behavioral changes. In the presence of metastasis, the most frequent clinical signs are inappetence, coughing, dyspnea, and colorectal obstruction. Given this scenario, this paper aims to describe the clinical presentation, diagnostic examination, and necropsy findings of a Cocker Spaniel with ASAC and metastasis in the vertebral body, spinal cord, and cauda equina. Case: A 8-year-old neutered male Cocker Spaniel (12 kg of body mass) with a clinical history of non-ambulatory paraparesis was evaluated. The patient also presented tenesmus, difficulty to defecate, and the presence of nodules in the anal sac area. On the neurological examination, asymmetrical changes compatible with injury between L4-S3 were found. A complete blood count, serum biochemistry, and imaging exams such as plain radiography, abdominal ultrasonography (US), and magnetic resonance imaging (MRI) were requested. Blood count revealed anemia and neutrophilic leukocytosis and hypercalcemia. The liver showed increased echogenicity and thickened pancreas in the abdominal US scan. A slightly heterogeneous, vascularized mass with irregular borders was identified in the topographic region of the sublumbar lymph nodes; MRI images demonstrated an expansile formation in the ventral region of the lumbosacral spine, corresponding to the sublumbar lymph nodes and interruption of the cerebrospinal fluid at L5, suggestive of compression of the spinal cord and cauda equina. A presumptive diagnosis of perianal neoplasm with metastasis was made based on the complementary exams. The dog was referred to necropsy, which revealed a 4 cm tumor in the perianal region that invaded the pelvic canal. Multifocal nodules were present on the lung surface, liver, and kidneys, suggesting metastasis. On the cross-section of the spine, one could note the presence of the tumor in the vertebral bodies, spinal cord, and cauda equina from L5 to S3. Even with histopathological evaluation of the tumor, only the immunohistochemical analysis allowed us to confirm the anal sac adenocarcinoma. Discussion: Adenomas and carcinomas are perianal gland neoplasms common in adult and elderly male dogs; the Cocker Spaniel breed is among the most affected. The clinical signs presented by the patient, such as tenesmus and difficulty in adopting the posture of defecation, are common, although neurological changes are rare. As for metastasis, carcinomas of the perianal region present high chances of metastasis to organs including the liver, kidneys, and lungs, both lymphatically and hematogenously, but few studies have related these factors to neurological alterations  due to metastasis. We concluded that metastases from carcinomas to the spine must be considered a possible differential diagnosis in cases of patients presenting clinical signs that are compatible with spinal cord compression and a history of previous neoplasm. Keywords: canine perianal carcinoma, neoplasm, spinal cord metastasis. Título: Adenocarcinoma de saco anal com metástase vertebro-medular em um Cocker Spaniel Descritores: carcinoma perianal canino, neoplasma, metástase medula espinhal.Introdução: Diversas neoplasias podem acometer a região perianal, sendo o adenoma hepático e o adenocarcinoma do saco anal (ASA), considerados os mais frequentes. O ASAC é uma neoplasia maligna originada do epitélio secretor das glândulas apócrinas perianais e raramente é visto na medicina veterinária. O ASA ocorre principalmente em cães adultos a idosos com altas taxas de metástase. Os pacientes podem ser assintomáticos ou manifestar desconforto e alterações comportamentais. Na presença de metástase, os sinais clínicos mais frequentes são inapetência, tosse, dispneia e obstrução colorretal. Diante desse cenário, este trabalho tem como objetivo descrever a apresentação clínica, exame diagnóstico e achados de necropsia de um Cocker Spaniel com ASAC e metástase no corpo vertebral, medula espinhal e cauda equina.Caso: Foi avaliado um macho castrado da raça Cocker Spaniel (12 kg de massa corporal) de oito anos de idade com história clínica de paraparesia não deambulatória. A paciente também apresentava tenesmo, dificuldade para defecar e presença de nódulos na região do saco anal. Ao exame neurológico, foram encontradas alterações assimétricas compatíveis com lesão entre L4-S3. Foram solicitados hemograma completo, bioquímica sérica e exames de imagem como radiografia simples, ultrassonografia (US) abdominal e ressonância magnética (RM). O hemograma revelou anemia e leucocitose neutrofílica e hipercalcemia. O fígado mostrou ecogenicidade aumentada e pâncreas espessado na US abdominal. Identificou-se massa pouco heterogênea, vascularizada e de contornos irregulares na região topográfica dos linfonodos sublombares; As imagens de RM demonstraram formação expansiva na região ventral da coluna lombossacral, correspondendo aos linfonodos sublombares e interrupção do líquido cefalorraquidiano em L5, sugestiva de compressão da medula espinhal e cauda equina. O diagnóstico presuntivo de neoplasia perianal com metástase foi feito com base nos exames complementares. A cadela foi encaminhada para necropsia, que revelou tumoração de 4 cm na região perianal que invadia o canal pélvico. Nódulos multifocais estavam presentes na superfície pulmonar, fígado e rins, sugerindo metástase. No corte transversal da coluna, notou-se a presença do tumor nos corpos vertebrais, medula espinhal e cauda equina de L5 a S3. Mesmo com a avaliação histopatológica do tumor, apenas a análise imuno-histoquímica permitiu confirmar o adenocarcinoma do saco anal.Discussão: Adenomas e carcinomas são neoplasias das glândulas perianais comuns em cães machos adultos e idosos; a raça Cocker Spaniel está entre as mais afetadas. Os sinais clínicos apresentados pelo paciente, como tenesmo e dificuldade em adotar a postura de defecar, são comuns, embora alterações neurológicas sejam raras. Quanto à metástase, os carcinomas da região perianal apresentam grandes chances de metástase para órgãos como fígado, rins e pulmões, tanto por via linfática quanto hematogênica, porém poucos estudos relacionam esses fatores às alterações neurológicas decorrentes da metástase. Concluímos que metástases de carcinomas para a coluna devem ser consideradas um possível diagnóstico diferencial em pacientes que apresentam sinais clínicos compatíveis com compressão medular e história de neoplasia prévia

Complications after cerebrospinal fluid collection in dogs with brain neoplasm

ABSTRACT: Cerebrospinal fluid (CSF) collection in dogs with brain neoplasms (BN) may be associated with complications owing to increased intracranial pressure caused by expansive lesions. Although this procedure has been performed in dogs with BN, no data regarding complications after CSF tap in these animals is available. Thus, this retrospective study aimed to identify the rate and types of complications observed after CSF taps in dogs with BN. Thirty dogs with BN were included in the study. In 83% (25/30) of the cases, clinical recovery after CSF tap was considered normal, and in 17% (5/30) the recovery was abnormal. The main clinical and neurological signs observed in dogs with abnormal clinical recovery were apnea (5/5), absence of pupillary photomotor reflex (3/5), coma (2/5), and stupor (1/5). In 40% (2/5) of the dogs, herniation of the cerebellum through the foramen magnum was observed on necropsy. In conclusion, the rate of complications after CSF taps was 17%, and was characterized by apnea, absent pupillary photomotor reflex, altered level of consciousness, and encephalic herniation

Clinical management of dogs with presumptive diagnosis of thoracolumbar intervertebral disc disease: 164 cases (2006-2017)

ABSTRACT: This study aimed to identify dogs with presumptive diagnosis of cervical intervertebral disc disease (IVDD) submitted to clinical management and to evaluate the outcomes. Data were obtained from the medical records of patients with neurological dysfunction assisted at a University Veterinary Hospital from 2006 to 2017. In addition to the patients’ records, dog owners responded to a questionnaire on the success of therapy. Four hundred and thirteen neurological records were evaluated, and 164 met the inclusion criteria of the study. The most common breed was Dachshund, followed by mongrels. Classification of neurological dysfunction in the study sample was as follows: 15.9% with grade I, 25.6% with grade II, 26.8% with grade III, 8.5% with grade IV, and 23.2% with grade V. Outcome was satisfactory in 71.6% of the dogs and unsatisfactory in 28.4% of them. Recurrence was observed in 27.7% of those with satisfactory outcomes. The clinical treatment of dogs with thoracolumbar IVDD is satisfactory, particularly for animals with milder disease grades (I, II, and III). There is possibility of recurrence with conservative therapy and clinical signs may be more severe