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CAUDA EQUINA NEURITIS IN A DOG

CAUDA EQUINA NEURITIS IN A DOG. CASE HISTORY. Welsh springer spaniel , 6 years , neutered Referred to the hospital with 4 days history of urinary + faecal incontinence with tenesmus Acute onset without progression. CLINICAL EXAMINATION. Clinical ex.: no abnormalities

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CAUDA EQUINA NEURITIS IN A DOG

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  1. CAUDA EQUINA NEURITIS IN A DOG

  2. CASE HISTORY Welsh springer spaniel, 6 years, neutered Referred to the hospitalwith 4 dayshistory of urinary + faecalincontinencewithtenesmus Acute onset without progression

  3. CLINICAL EXAMINATION Clinical ex.: noabnormalities Distended rectum and open anus Large, atonic bladder Hematological + biochemical ex.: normal Alert, nofever RX +echo: normal (distended bladder)

  4. NEUROLOGICAL EXAMINATION Absent anal reflex Decreasedtone + abnormalpositiontail No cranialnerve deficits/gaitabnormalities /proprioceptive deficits/spinalhyperesthesia Posturalreactions front + hindlegsnormal  Sacralspinal and/orcaudaequinalesion

  5. DIFFERENTIAL DIAGNOSIS AM Congenitalcauses (age ! ) Inflammatory/infectiouscauses *discospondylitis: common *myelitisviral/fungal/bacterial: rare *granulomatousmeningoencephalitis: female,small, progressivecervicalsigns Neoplasia Degenerativecauses (no pain) Spinalcord trauma

  6. NECROPSY Mild mitralendocardiosis Unilateralchronickidney infarct Mild cystitis (sondage) Mild unilateralpurulentotitis media No abnormalitiesseencentral/peripheralnervous system

  7. HISTOLOGICAL EXAMINATION 5th-6th-7th lumbarspine: smallperivascularinfiltrates Caudaequina: nerverootsextensivemononuclearcellinfiltration Swelling multiple roots Loss of axons (NF), degeneration of axons (Syn)

  8. IMMUNOHISTOCHEMICAL EXAMINATION T lymphocytes 45% B lymphocytes 35% Macrophages 20%

  9. HISTOLOGICAL EXAMINATION Nerverootscaudaequina HE CD3 immunostaining

  10. PCR PCR was performedonparaffin-embeddedbrain and spinal tissue *negativeforToxoplasmagondii *positiveforNeosporacaninum

  11. DIFFERENTIAL DIAGNOSIS PM Sacral/coccygeal trauma Acute idiopathicpolyradiculoneuritis Polyradiculoneurits post vaccination Infectious/protozoalpolyradiculoneuritis

  12. ACUTE IDIOPATHIC POLYRADICULONEURITIS =coonhoundparalysis Infiltration of ventral nerveroots and ventral components of peripheralnerves Sometimespost-vaccinal Adultdogs, Acute onset, ascending: paralysis/paresis/tetraplegia, oftencranialnerve deficits and dyspnea Peracute cases: neutrophilsmainly Chronic cases: mainlymononuclears

  13. PNE IN HORSES =polyneuritisequi=caudaequinaneuritis Maturehorses and ponies Chronicinflammationnerve roots,cranial + peripheral nerves Unknownetiology Auto immune process? Guillainbarrésyndrome Caudaequinasyndrome

  14. GRIFFITHS ET AL. 1983 Two cases of polyradiculoneuritis presenting as caudaneuritis Cranialnerve deficits, gaitabnormalities, proprioceptive defects Intact bladder function and anal reflex

  15. PROTOZOAL POLYRADICULONEURITIS Toxoplasmagondii / Neosporacaninum Combinedpolyradiculoneuritis-myositis in pups (transplacentalinfection): hindlimbparesis and ataxia, extensorrigidity Neosporaprimarypathogen <->toxoplasma

  16. NEOSPOROSIS Dogscanbedefinitive and intermediate host Adultdogs: neosporosis is rare, typicaldisseminateddisease: multifocal CNS/multiorgan/polymyositis Few reports of neosporosis in olderdogs: severe, necrotisingcerebellitis

  17. IN OUR CASE Adult dog withnodisseminateddisease, signs and lesionsrestricted to LS-caudaequina No cysts/tachyzoites No clinicalsigns of neosporosis No myositis / cerebellitis Prevalenceserology + PCR of neospora is high (33%) in clinicallyhealthydogs

  18. CONCLUSION First case of caudaequinaneuritiswithtypicalclinical and histologicallesionsrestricted to the caudaequinaregion Infiltratesimilarcomposition PNE (Van Galen 2008) The role of neospora in this case is unclear

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