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Discospondylitis

Discospondylitis is due to infection of the intervertebral disc and adjacent vertebral endplates. If the infection is confined to the vertebral body, it is called vertebral osteomyelitis. Coagulase-positive Staphylococcus spp. (S. inter­medius or S. aureus) are the most common aetiological agents associated with canine discospondylitis. Other less commonly identified organisms include Streptococcus spp., Escherichia coli, Salmonella, Actinomyces spp, Aspergillus spp, and Brucella spp.

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Spinal decompression and stabilisation in a cat with lumbar vertebral pathological fracture and subluxation, following discospondylitis and spinal epidural empyema

This recently published paper details a young cat with spinal epidural empyema and discospondylitis that required surgical stabilisation. Most cases of discospondylitis in cats affect older patients causing hyperesthesia and frequently affect L7-S1 all of which differ in this case. The authors note that the decision of medical vs surgical treatment should be based on both imaging findings and neurological assessment and in addition, blood and epidural material cultures were essential for diagnosis.

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Clinical features, comparative imaging, treatment and outcome in dogs with discospondylitis

Obhectives were (i) to describe the signalment, clinical and imaging findings, etiologic agents, treatment, and outcome of dogs with discospondylitis, (ii) determine diagnostic agreement between radiographs, CT, and MRI with regard to the presence of discospondylitis and its location, and (iii) determine risk factors for relapse and progressive neurological deterioration.

Radiograph and MRI results were found to be discrepant in dogs with discospondylitis. Prior trauma and corticosteroids could respectively be associated with relapse and progressive neurological dysfunction.

Image by Louis Reed

C-reactive protein in dogs with suspected bacterial diskospondylitis: 16 cases (2010–2019)

Serum C-reactive protein (CRP) has already been shown to be a useful ancillary diagnostic test in multiple canine inflammatory disorders including steroid-responsive meningitis-arteritis but in this study, 14 of 16 dogs with discospondylitis had elevated CRP at the time of presentation and was suggested to be clinically more useful to screen dogs with back pain than pyrexia or leucocytosis alone.

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CT features of discospondylitis in dogs  

Forty-one dogs (63 affected discs) with MRI-identified discospondylitis were evaluated with CT. The most frequently found changes were: (1) endplate involvement with erosion and multifocal osteolysis (2) periosteal proliferation adjacent to the disc space and spondylosis; and (3) vertebral body involvement involving one-third of the vertebra with multifocal osteolysis.

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Brucella canis discospondylitis
This study looked at the clinical and imaging findings of 33 dogs from the southwestern USA with Brucella canis discospondylitis (BDS) with the aims of highlighting differences with dog with DS from other bacteria. Clinically, dogs affected with BDS were of a younger age at presentation and had a longer duration of clinical signs. Radiographically, identification of 'hole punch' lesions, and occasional presence of physitis or spondylitis without discitis and paravertebral changes without vertebral or intervertebral disc abnormality on MRI should increase the suspicion of BDS and prompt testing for that agent.

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Follow-up MRI using low-field MRI of dogs with discospondylitis

This retrospective study investigated the features of a follow-up MRI in a group of dogs treated for discospondylitis, and if these were associated with the presence or absence of clinical signs.

 The subjective classification of inactive discospondylitis was significantly associated with asymptomatic clinical status. However, there was no meaningful association between the clinical status of dogs treated for presumptive discospondylitis and follow up MRI results.

Image by National Cancer Institute

Use of C-reactive protein concentration in evaluation of diskospondylitis in dogs

This study looks at how C-reactive protein (CRP) can be used as an adjunctive diagnostic tool in the evaluation of suspected discospondylitis in dogs. In this study, CRP was more sensitive than neutrophilic or hyperglobulinemia in predicting discospondylitis. There was no association between CRP and positive bacterial culture. No difference in serum CRP concentration was found between dogs with single or multiple lesions, nor between dogs with or without empyema, muscular involvement or spinal cord compression. Overall CRP was considered a sensitive, but not specific biomarker for discospondylitis and may be useful in patients with suspicious clinical signs. Hopefully further studies will help to know if serial CRP may have utility in making treatment decisions on duration of antibiotic therapy  as well as predicting outcome.

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