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242 Section III: Spinal Procedures

on the specific case and situation, radiation will either definitively oncologist, and radiologist. Most importantly the owner/caregiver
control the tumor or palliate its growth. High‐dose radiation is needs to be well informed throughout the entire process.
usually good at killing tumor cells. Unfortunately, it can also dam-
age the surrounding healthy spinal cord. Radiation oncologists and Video clips to accompany this book can be found on
radiotherapy physicists are well‐informed resources for planning the companion website at:
therapies and intensity‐modulated radiation therapy is often used www.wiley.com/go/shores/neurosurgery
in treatment of spinal neoplasms. In infrequent cases of spinal
inflammation or necrosis, radiation therapy should be stopped as
soon as neurological deficits are noted. Transient demyelination,
known as Lhermitte’s syndrome in humans, is usually reversible. In References
animals it could manifest itself with the animal either licking at the 1 Levy MS, Mauldin G, Kapatkin AS, Patnaik AK. Nonlymphoid vertebral canal
tumors in cats: 11 cases (1987–1995). J Am Vet Med Assoc 1997;210:663–664.
radiation therapy site or turning and looking at this site. This syn- 2 Sama AA. Spinal tumors. Medscape. Available at http://Emedicine.Medscape.Com/
drome can resolve and is sometimes treated with steroids. It can be Article/1267223‐Overview (accessed May 15, 2012).
important to differentiate Lhermitte’s syndrome with recurrence of 3 Oliver JE, Lorenz MD. Handbook of Veterinary Neurological Diagnosis. Philadelphia,
disease [11]. Sometimes a follow‐up advanced imaging technique PA: WB Saunders, 1983.
such as MRI may be required to differentiate this from recurrent 4 National Institute of Neurological Disorders and Stroke, NINDS. Brain and spinal
tumors: hope through research. Available at https://www.ninds.nih.gov/Disorders/
disease. Chemotherapy is generally not recommended for primary Patient‐Caregiver‐Education/Hope‐Through‐Research/Brain‐and‐Spinal‐
treatment of nonhematopoietic spinal tumors. Lymphoma, leuke- Tumors‐Hope‐Through (accessed May 15, 2012).
mia, disseminated histiocytic sarcoma, multiple myeloma, and to 5 Bagley RS, Kornegay JM, Page RL et al. Central nervous system. In: Slatter D (ed.)
some extent osteosarcoma are responsive to chemotherapy. Textbook of Small Animal Surgery, 2nd edn. Philadelphia, PA: WB Saunders, 1993:
2137–2166.
Palliative therapy is often indicated in dogs with spinal neoplasia. 6 Smith AN. Overview of neoplasia of the nervous system. In: The Merck Veterinary
Corticosteroids may help alleviate peritumoral inflammation and Manual. Available at http://www.msdvetmanual.com/nervous‐system/neoplasia‐
edema. Steroids need to be considered based on the overall picture. of‐the‐nervous‐system/overview‐of‐neoplasia‐of‐the‐nervous‐system
They would likely not be indicated if the patient was Cushingoid or 7 Levy MS, Kapatkin AS, Patnaik AK, Mauldin GE. Spinal tumors in 37 dogs: clinical
had an undiagnosed lymphoma. Some controversy exists over the outcome and long‐term survival (1987–1994). J Am Anim Hosp Assoc
1997;33:307–312.
risk–benefit ratio of using steroids. Unwanted side effects such as 8 Morrison WB. Cancer in Dogs and Cats: Medical and Surgical Management, 2nd
polyuria/polydipsia, gastrointestinal ulceration, weight gain, inhi- edn. Jackson, WY: Teton NewMedia, 2002.
bition of tissue healing postoperatively, or higher risk of infection 9 Seguin B, Bagley R, Silver G. Diagnosis and treatment of spinal neoplasia in dogs
need to be weighed against the benefits of steroid use. Other medi- and cats. Waltham Focus 2000;10:4–9.
cations such as tramadol, nonsteroidal antiinflammatory drugs 10 South Texas Veterinary Specialists. Spinal cord tumors. Available at http://www.
stvetspecialists.com/index.php?option=com_content&task=view&id=23&Item
(NSAIDs), amantadine, and gabapentin should be considered. (accessed March 26, 2012).
Alternative therapies such as acupuncture might also help alleviate 11 Kent M, Northrup N. Spinal neoplasia. In: Tobias KM, Johnston SA (eds) Veterinary
some of the pain associated with spinal tumors. Surgery: Small Animal. St Louis, MO: Elsevier Saunders, 2012: 537–551.
Spinal tumors offer a challenging dilemma. Because the physical 12 Gilson SD. Neuro‐oncological surgery of the vertebral column and spinal cord. In:
Slatter D (ed.) Textbook of Small Animal Surgery, 3rd edn. Philadelphia, PA: WB
examination findings are often similar to less life‐threatening dis- Saunders, 2003: 1277–1286.
eases like intervertebral disc disease and degenerative myelopathy, 13 Petersen SA, Sturges BK, Dickinson PJ, Higgind RJ. Canine intraspinal meningi-
the clinician needs to be astutely aware of this on the differentials. omas: imaging features, histopathologic classification, and long‐term outcome in
Many times animals are sent home with palliative therapy on the 34 dogs. J Vet Intern Med 2008;22:946–953.
assumption of the more benign syndromes. As with most cancers, 14 Gottfried ON, Gluf W, Quinones‐Hinojosa A, Kan P, Schmidt MH. Spinal menin-
giomas: surgical management and outcome. Neurosurg Focus 2003;14(6):Article 2.
the sooner they are diagnosed and treated the better potential for a Available at http://thejns.org/doi/pdf/10.3171/foc.2003.14.6.2
more positive long‐term outcome. Patients with a chronic or recur- 15 LeCouter RA. Tumors of the nervous system. In: Withrow SJ, MacEwen EG
rent presentation or those not responding to traditional therapy (eds) Small Animal Clinical Oncology. Philadelphia, PA: WB Saunders, 2001:
500–531.
should be regarded as highly suspicious for the presence of spinal 16 National Canine Cancer Foundation. Spinal cord neoplasia. Available at http://
neoplasia. Thorough work‐ups are recommended. The best out- wearethecure.org/learn‐more‐about‐canince‐cancer/canine‐cancer‐library/spinal‐
come can often come when doctors work as a team, which should cord‐neoplasia/(accessed March 26, 2012).
consist of the primary veterinarian, a surgeon or neurologist with 17 Wright JA., The Pathological Features Associated with Spinal Tumours in 29 Dogs.
experience in neurosurgical oncology, the oncologist, radiation J.Comp. Path 1985; 95: 549–556.