Lecture 14

Question 1

What are the characteristics of fibrocartilagenous embolism?

Answer 1

-ischemia of spinal cord
-caused by vascular occlusion with fibrocartilage
-neurons die due to lack of oxygen and glucose stemming from decreased blood flow

Question 2

What is the most likely source of the fibrocartilage seen in fibrocartilagenous embolism?

Answer 2

intervertebral disc

Question 3

What is shown in this image?

Answer 3

fibrocartilage occluding vessels of spinal cord

Question 4

How do the intervertebral discs typically receive nutrition?

Answer 4

from the vertebral end plates

Question 5

What is the typical presentation for fibrocartilagenous embolism?

Answer 5

-large to giant breed dogs
-schnauzers and shelties
-rare in cats

Question 6

What are the clinical signs of fibrocartilagenous embolism?

Answer 6

-sudden onset
-often associated with activity; not major trauma
-non-progressive
-deficits may be asymmetrical; worse on one side bc each side of spinal cord has an artery
-not painful

Question 7

How is fibrocartilagenous embolism diagnosed?

Answer 7

-signalment
-onset
-focal, non-painful spinal lesion
-excluding other causes

Question 8

Why are radiographs NOT used in FCE diagnosis?

Answer 8

patients will have normal spinal radiographs AND myelogram; only affects spinal cord, not the bone

Question 9

What signs of FCE can be seen on MRI?

Answer 9

swelling and edema of spinal cord

Question 10

What is the treatment and prognosis for FCE?

Answer 10

-nursing care and physical therapy
-no good method for dissolving or removing fibrocartilage
-nearly 85% of dogs improve spontaneously over 2 to 4 weeks

Question 11

What is a saddle thrombus?

Answer 11

aortic embolism at the distal aortic trifurcation

Question 12

Why are saddle thrombus cases often thought to be neuro. cases?

Answer 12

loss of blood flow and oxygen supply to the muscle and nerves in hind limbs can mimic neuro. signs

Question 13

What causes aortic embolism?

Answer 13

secondary to cardiomyopathy; myocardial hypertrophy and atrial thrombus

Question 14

What are the clinical signs of aortic embolism?

Answer 14

-acute onset
-paraparesis/paraplegia
-firm, painful muscles
-weak/absent reflexes
-weak/absent femoral pulses
-murmur, gallop rhythm, and/or pulmonary edema

Question 15

How is aortic embolism diagnosed?

Answer 15

typically based on clinical features

Question 16

What are the differentials for paraparesis in cats?

Answer 16

-aortic embolism
-spinal trauma
-spinal lymphoma
-FIP
-other causes of myelitis

Question 17

What are the chest rad. findings in cats with aortic embolism?

Answer 17

-cardiomegaly
-pulmonary edema

Question 18

What are the echocardiogram findings in cats with aortic embolism?

Answer 18

-myocardial hypertrophy
-decreased contractility
-thrombus

Question 19

What is the treatment for aortic embolism?

Answer 19

-clot dissolution with t-pa or streptokinase
-heparin, clopidogrel, or aspirin to prevent further thrombosis
-nursing care
-treatment of underlying heart disease

Question 20

What is the prognosis for aortic embolism?

Answer 20

-about 50% improve within several weeks
-recurrence is common (50%)
-can develop hemorrhage and die from bleeding

Question 21

Which diseases/injuries can mimic spinal cord disease?

Answer 21

-hip dysplasia
-bilateral CCL rupture (will still have proprioception)
-pelvic fractures
-polyarthritis
-prostatitis