Providing veterinarians a challenging case for brain storming every week ... A Case A Week a website for Vets prepared by Dr Mofya Saul and Dr Rajesh Banga.
A 4.5 year old neutered male large breed mix canine was presented to AcaseAweek Clinic with sudden onset of acute hind limbs weakness for 2 days. The patient is both indoor and outdoor and is current on all the vaccinations, deworming and heart worm prevention.
Physical Exam: T= 101.9 oF HR/PR=114 R=panting Weight= 37.8kg MM=moist and pink CRT=<2 sec
Neurological: Mild pain on palpation of spine in thoraco-lumber area. No other abnormalities noted at this time on P/E.
CBC and Biochemistry: All values within normal limits.
4Dx snap test: Negative.
Radiographs: Pelvic radiograph on this patient was normal. Lateral and VD view of thoraco-lumber area were taken and are as shown below (Click on the images to enlarge):
What are your radiographic findings? What is your tentative and differential diagnosis? What further diagnostic tests you will perform? What will be your treatment plan?
Radiographic findings: Intervertebral space between T13/L1/L2/L3/L4 is showing evidence of spondilosis and spur formations Tentative diagnosis: Intervertebral disc disease DDx: Discospondilytis, Trauma to spinal cord, Further diagnostic test: MRI Treatment: Cage rest, Prednisolone, Hydromorphine, Carprofen long term Management: Surgical decompression Prognsis: Since deep pain perception is still there, so prognosis is good
Radiographic findings: Intervertebral space between T13/L1/L2/L3/L4 is showing evidence of spondilosis and spur formations
Tentative diagnosis: Intervertebral disc disease
DDx: Discospondilytis, Trauma to spinal cord,
Further diagnostic test: MRI
Treatment: Cage rest, Prednisolone, Hydromorphine, Carprofen
long term Management: Surgical decompression
Prognsis: Since deep pain perception is still there, so prognosis is good