dodgy L5-L6 space?

Re: dodgy L5-L6 space?

Mark Lowrie — Thu, 23 Jan 2014 09:20:22 GMT

I would echo that the C5-6 disc space narrowing is an artefact and I wouldn‘t be concerned about it.

In a young large breed dog such as this then hindlimb ataxia may relate to a caudal cervical lesion though the forelimbs would be expected to have some involvement, most likely a short strided ‘choppy’ gait. However, I would not rule out a lesion caudal to T2 based on the history you have given – therefore other causes may be considered.

However, cervical spondylomyelopathy (wobblers) is divided into disc-associated and bone-associated disease. Disc-associated disease in a dog this age would seem extremely unlikely (and hence another reason for dismissing the finding on the radiograph) although a bone-associated cervical spondylomyelopathy would remain a possibility. Other causes of cervical lesions in young dogs are common and I certainly wouldn’t exclude discospondylitis or congenital anomalies e.g. arachnoid diverticulum.

Bottom line – as others have said – further imaging is indicated.

Re: dodgy L5-L6 space?

Beats — Wed, 22 Jan 2014 12:20:13 GMT

Thanks everyone for advice and suggestions.

Don't think there'll be any follow-up from this one to share, I'm afraid.

Checked the clinical notes and had done same typo on them so have added a note as Francsico suggests so if/when history gets requested form new vet won't be so confusing!

Re: dodgy L5-L6 space?

Anthony Dennison — Wed, 22 Jan 2014 09:14:16 GMT

IME Wobblers don't tend to be painful, just all over the place, though I await to be corrected. I agree with what's already been said, an MRI to evaluate the degree of spinal cord compression would be the next best step, depending on this there could be decompression surgery or stabilisation.

Physiotherapy would be a good idea as well I would have thought.

Re: dodgy L5-L6 space?

Francisco Gomez — Tue, 21 Jan 2014 22:21:16 GMT

So if it isn't me, it would be a good idea that it is corrected or the referral end in london phoned (just in case it is also written in the clinical hx as L instead of C). Im only saying because some clinical hxs are faxed and images don't go through, with the potential of making another vet looking at the wrong place I guess...

Re: dodgy L5-L6 space?

John Flynn — Tue, 21 Jan 2014 22:13:58 GMT

[quote user="Francisco Gomez"]Are these things not called C5-C6?[/quote]

I must have copied and pasted to replicate such a basic error *cough*

Re: dodgy L5-L6 space?

Francisco Gomez — Tue, 21 Jan 2014 22:05:53 GMT

Are these things not called C5-C6? Am i looking at the wrong xrays here? Im confused ...

Re: dodgy L5-L6 space?

Yantha Smyth — Tue, 21 Jan 2014 22:04:25 GMT

I'm wondering what the calcium tablets were for?!

Re: dodgy L5-L6 space?

John Flynn — Tue, 21 Jan 2014 22:02:09 GMT

I'll stick my neck out (hehe) and say that I think in all probability a thorough examination and an MRI would lead to the conclusion that this dog's a 'wobbler'.

I don't think the lesion (narrowed disc space) you see is artifactual, and while it could be incidental to the clinical presentation, a description of ataxia on the hindlimbs sounds might suspicious...

The vertical canal does not look even between [EDIT] C5 and C6 to me either. [I can't see L5-L6 as Francisco points out below, but I'm guessing this was a typo?]

I'm sure some bright spark in London will sort it out!

DISCLAIMER: i'm no neurologist and since the demise of the doberman, I've not seen a wobbler for years, and have never seen one in a rhodesian ridgeback, but i gather the breed can be affected.

Re: dodgy L5-L6 space?

Beats — Tue, 21 Jan 2014 12:29:45 GMT

OK, spoke to owner on phone yesterday and described both hindlimb ataxia AND pain trying to sit down, so not totally clear but does sound like could be a wobbler?

I guess would have to do an actual physical exam when the patient was not drugged up and maybe some fancy imaging to look for spinal cord compression to know whether that lesion is significant or not...

Anyway, went home on steroids and calcium tablets (from the vet that had ararnged the xray) and is apparently emigrating to London, so someone reading this might see it if I'm right and it is a progressive caudal cervical spondylomyelopathy...

Still intesrested in any thoughts if anyone has them, but I guess perhaps can't say much really just from the xrays i've posted.