In today’s rapidly evolving world, case studies offer an invaluable method for examining real-life scenarios and gaining insights into practical applications of theories, strategies, and concepts.
We would like to share some of ours below
This large breed patient – a Ridgeback named Stella, presented with right hind lameness for 2 weeks, unresponsive to non-steroidal anti-inflammatory medications. The patient then acutely become paraplegic in both hindlimbs and had paresis of both front limbs. The cervical spine was stiff on manipulation. An MRI of the cervical spine was therefore performed.
The images revealed the following:
The C5-C6 intervertebral disc space was completely collapsed with loss of visualization of any normal intervertebral disc structures. The collapse had resulted in subtle step formation with C6 located ventrally to C5 which resulted in mild narrowing of the vertebral canal.
Severe STIR hyperintensity of most of the vertebral bodies of C5 and C6 was present, with an irregular region of paravertebral soft tissue [ventral cervical musculature and adjacent tissues/fascia] hyperintensity associated with these vertebral bodies and extending across the endplate.
There was marked contrast uptake of the abovementioned paravertebral tissues, with contrast uptake of the intervertebral disc space and contrast uptake extending into both intervertebral foramina. The contrast enhancement was broad-based along the floor of the canal and had a fusiform shape. The spinal cord parenchyma is dorsally displaced as a result with moderate cord compression of at least 20%.
The most likely differential diagnosis was discospondylitis, with extension into the vertebral canal resulting in mild cord compression. There is mild subluxation at this site.
Discospondylitis is infection of the intervertebral disk, which can spread to adjacent structures, and is most commonly bacterial in origin. Fungal infection or Brucellosis are much less common. Large breed dogs are commonly affected.
Hematogenous spread of bacteria or fungi is probably the most common cause of discospondylitis. Sources of infection may include bacterial endocarditis, sites of dental extraction, and urinary tract infections – many dogs with discospondylitis have concurrent urinary tract infection. Discospondylitis due to Brucella cants infection most likely results from spread from a genital infection.
Sagittal T2W sequence. The arrow indicates the collapsed intervertebral disk space, compared to normal ones for example at C3-4.
Dorsal STIR: The arrow indicates the abnormal disk space, but not eh hyperintensity [“white” or “bright” lesions] also extending into the vertebrae themselves.
Sagittal T1W plus contrast. The arrows indicate contrast uptake within the vertebral canal, indicating spread of infectious materials from the disk space into the canal.
Great images obtained from Pretoria Pet MRI.
This little terrier cross doggy, Bessie, presented with severe neck pain and muscle spasms, and underwent an MRI of the cervical spinal cord.
The MRI sequences the spinal cord are shown in 3 different planes, namely, dorsal, sagittal and transverse, as seen in the attached images. The extruded disc material, which is the round dark structure shown by the white arrows, is causing significant compression (40% – 50%) of the spinal cord.
Surgery is required for these cases, which was performed in this doggy, to alleviate the pressure and compression of the spine.
Dorsal FLAIR sequence
Sagittal T2W sequence
Transverse T2W sequence
This cute little Dachshund patient, named Milo, presented with absent right pelvic limb proprioception and acute onset of back pain.
On the MRI images at T12 to T13 intervertebral disk space, ventrally and slightly to the right of the midline, is a massive T2 weighted hypointense (dark) smoothly marginated extruded disc.
It results in displacement of the spinal cord towards the left of the midline and dorsally, with severe compression by at least 60% – this is a result of a Hansen type I disc.
A surgical lesion was demonstrated, and surgery was performed.
Transverse T2W sequence, left of the patient is to the right of the image.
Sagittal T2W sequence
Dorsal FLAIR sequence
This lovely 7 year-old-Mastiff, named Picolo, presented with unilateral epistaxis (nose bleeds).
On the images, which are of the back of the nasal passages at the level of the eyes, an infiltrative and destructive mass-lesion is seen within the right nasal cavity (the patient’s right is on the left of the image).
Biopsies demonstrated necrosis and neoplastic populations with the differentials of osteosarcoma or spindle cell sarcoma.
Tumours of the nasal cavity account for approximately 1% of all canine neoplasms. The median age is 10 years yet cases as young as 9 months have been reported. The most common tumours demonstrated are carcinomas (adenocarcinoma, squamous cell carcinoma, and undifferentiated carcinoma) followed by sarcomas (fibrosarcoma, chondrosarcoma, osteosarcoma and undifferentiated sarcomas).
These tumours demonstrate progressive local invasion and destruction, with a relatively low metastatic rate (which means they tend not to spread from the nasal cavity to other body parts or organs). Unfortunately, extensive nasal tumours are rarely cured but local disease control can be managed to varying degrees with radiation therapy, chemotherapy and palliative care.
Transverse T2W images. The arrows demonstrate a lobulated mass in the right nasal cavity.
Snuffles’ MRI Journey
Meet Snuffles, a lovely Pug type dog who recently experienced three frightening seizures. After ruling out several potential causes, the referring vet turned to MRI for more answers.
The MRI scan revealed that a part of Snuffles’ brain, particularly the right side of the cerebrum, was showing signs of extensive intensity changes (i.e. a generalised “white” or “bright” appearance) and swelling. The brain tissue in this area looked blurred and indistinct on the images.
A probable explanation for these changes is a condition called meningoencephalitis of unknown origin or MUO, which is an inflammation of the brain and its surrounding tissues. This could be caused by an immune mediated process, but further tests, like a spinal tap and analysis of the cerebrospinal fluids, are needed.
Thanks to advanced imaging, his vet has a much clearer idea of what’s going on inside his brain and how best to move forward.
MUO is most commonly seen in small-breed dogs, suggesting a possible genetic basis for the condition; a genetic risk for the condition has been identified in the Pug and Maltese breeds.
MRIs are invaluable in helping us understand what’s happening in the brain or spinal tissues in cases like these, giving pets like Snuffles the best possible chance for the right treatment and recovery!
Top right: Sagittal T2W to the right of the midline, bottom left – Transverse T2W, and bottom right Dorsal FLAIR images of the brain. The arrows indicate the affected inflamed and swollen right side of the cerebrum.
This dear little 3-year-old French bulldog, named Winston, presented with acute hindlimb paresis.
An MRI of the TL region was performed because we know these little guys are very prone to intervertebral disk disease.
The images revealed moderate extradural cord compression at T12 to T13 from left dorsolaterally because of a hypertrophied [meaning enlarged] articulation process joint – these are the joints that connect the individual vertebral bodies to form a long vertebral unit. There is focal spinal cord hyperintensity [whiteness of the cord] which may be most consistent with oedema.
The osseous malformation is considered a long-standing problem, probably since birth, with acute onset of clinical signs possible if there were any mild trauma on an already compromised/narrowed vertebral canal.
Sagittal T2W images: The arrow indicates a structure which is originating from dorsally and results in compression of the spinal cord at T12 to T13
Both these Transverse T2W images (the patient’s left side is on the right side of the image) shows the articular process joint, which is asymmetrical and abnormally formed on the left side, extending into the vertebral canal.
