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Diskospondylitis ( spondylitis and vertebral osteomyleitis ). 7/27/09 Trisha J. Oura. Review of Definitions. Physitis Skeletally immature Possible collapse of vertebral body, spinal abnormalities Spondylitis Vertebral bone Direct innoculation Diskitis Intervertebral disk only

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Presentation Transcript
review of definitions
Review of Definitions
  • Physitis
    • Skeletally immature
    • Possible collapse of vertebral body, spinal abnormalities
  • Spondylitis
    • Vertebral bone
    • Direct innoculation
  • Diskitis
    • Intervertebral disk only
  • Diskospondylitis
    • Primary infection/inflammation of endplates
    • Secondary IVD involvement

* usually no differentiation between diskitis and diskospondylitis in vet med

pathophysiology
Pathophysiology
  • Hematogenous/iatrogenic/trauma/FB
  • Source

** Urogenital

    • Respiratory, oral, endocarditis, abscess
  • Bacterial > Fungal
    • S. aureus, S. intermedius
    • B. canis (ZOONOTIC)
    • Aspergillus sp.
    • Spirocerca lupi
  • Most common sites
    • Thoracolumbar, lumbosacral
    • Mobility  focal ischemia?
  • Neurologic effects

The ubiquitous plant awn!

www.bouldervet.com

signalment presentation
Signalment/Presentation
  • Signalment
    • Males
    • Giant/large breed
    • Older
  • Clinical signs
    • Non-specific  signs of sepsis
    • Neurologic deficits, pain
  • Recommendations for diagnostics:
    • MDB: leukocytosis, cystitis/bacteruria
    • Cultures: urine, blood, TTW, etc
    • BRUCELLA TESTING
    • Imaging!

Burkert BA, SC Kerwin, GL Hosgood, et al. Signalment and clinical features of diskospondytlitis in dogs: 513 cases (1980-2001). J Am Vet Med Assoc 2005;227:268-275.

www.my-pet-medicine.com

imaging
Imaging
  • Radiographic
    • Survey spinal radiographs
  • Nuc-med
  • CT/MR

Stern L, R McCarthy, R King, et al. Imaging diagnosis—discospondylitis and septic arthritis in a dog. Vet Radiol Ultrasound 2007;48:335-337.

Shamir MH, N tavor, T Aizenberg. Radiographic findings during recovery from discospondylitis. Vet Radiol Ultasound 2001;42:496-503.

radiography
Radiography
  • Early/active
    • Narrowing of IVD space
    • Loss of endplate margins
    • Rarefaction of bone
    • Bone lysis and/or proliferation
    • Sclerosis
  • Progression/resolution
    • Lack of lytic focus
    • Loss of sclerotic margins
    • Smoothing of lytic margins
    • Bridging

**Radiographic findings DO NOT correlated well with clinical disease**

slide8

6 yo FS Cocker Sp: lethargy, poorly localized pain

8 yo FS mix: previous acute lymphoplasmacytic hepatitis , now difficult rising, lethargic

slide9

5 m MN PitX: hind limb lame x 3 weeks after HBC & IM fixation of L femur fracture 3 mos prior

At presentation

3 months later

now what
Now what?
  • Good prognosis
  • Sequelae
    • Collapse of vertebrae, malformation, residual CNS deficits
  • Treatment
    • Long course antibiotics

(>6 weeks)

    • Based on culture results (e.g. B-lactam +/- fluorquinolone/ aminoglycoside
references
References
  • Bahr A. The vertebrae. In: Thrall DE, ed. Textbook of veterinary diagnostic radiology. 5th ed. St. Louis: Sauders Elsevier, 2007;179-193.
  • Textbook of veterinary internal medicine Website. Discospondylitis (spondylitis, vertebral osteomyelitis) . Available at: http://www.vetmedtext.com/content/default.cfm. Accessed Jul 26, 2009.
  • Burkert BA, SC Kerwin, GL Hosgood, et al. Signalment and clinical features of diskospondytlitis in dogs: 513 cases (1980-2001). J Am Vet Med Assoc 2005;227:268-275.
  • Stern L, R McCarthy, R King, et al. Imaging diagnosis—discospondylitis and septic arthritis in a dog. Vet Radiol Ultrasound 2007;48:335-337.
  • Shamir MH, N tavor, T Aizenberg. Radiographic findings during recovery from discospondylitis. Vet RadiolUltasound 2001;42:496-503.
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