Gutierrez Quintana, Rodrigo
Factors affecting the prognosis following thoracolumbar spinal cord disease in the dog.
MVM(R) thesis, University of Glasgow.
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Thoracolumbar spinal cord disease is common in dogs, with numerous processes affecting the T3 to L3 spinal cord segments. Being able to accurately predict the outcome is of critical importance for clinicians and owners, in order to inform the clinical decision making process. A large number of variables, including the signalment, findings of the clinical examination, the choice of diagnostic techniques and choice of therapy could potentially have an influence on the outcome. Although there are a large number of reports detailing the use of magnetic resonance imaging (MRI) in the investigation of canine thoracolumbar spinal diseases, little is known about the historic trends in the choice of imaging technique for investigating thoracolumbar spinal cord diseases in dogs and whether this altered choice has affected prognosis. In Chapter III, I demonstrate that the choice of myelography or MRI as diagnostic imaging modality does not significantly affect either the grade or speed of recovery in dogs with thoracolumbar spinal cord diseases. I also describe that the historical trend has been for MRI to progressively replace other diagnostic imaging techniques for investigation of spinal cord diseases. The age and weight of the patient on presentation are two variables that are easy to obtain and could have an influence on the outcome of dogs with thoracolumbar spinal cord diseases. In chapter IV, I show that neither age nor weight of the patient at presentation affects the neurological recovery, and that there is no significant difference even when comparing extreme groups of age or weight. The neurological examination remains an indispensable tool to localise and grade lesions affecting the spinal cord and is essential for accurate planning and interpretation of diagnostic imaging techniques and formulating the prognosis. In Chapter V, I demonstrate that the presence of a cutaneous trunci reflex is useful in further localising the maximal level of spinal cord lesion within the T3 to L3 spinal cord segments to an accuracy of up to four vertebrae. In addition the cutaneous trunci reflex can be used to rapidly segregate dogs with an ambulatory paresis into less and more severely affected populations on the basis of clinical severity.
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