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Spirocercosis 933

NSTs often result in enlargement and Chronic Treatment ○ In dogs with intramedullary neoplasms:
■
abnormal contrast enhancement of the • Same as for acute general treatment median survival time is 20 days (range,
VetBooks.ir ○ CT may allow appreciation of bony lysis postoperative radiation therapy should be ○ Surgical resection and postoperative Diseases and Disorders
1-202 days).
• For incompletely excised neoplasms,
spinal nerves and roots and may extend
into the spinal cord.
radiation: in one report of 9 dogs (6 with
considered.
or proliferation.
• CSF analysis (pp. 1080 and 1323) Behavior/Exercise meningiomas), overall median survival was
510 days.
• Fluoroscopic-guided needle aspiration/biopsy • Postoperative exercise restriction; 3-4 weeks’ • Feline: lymphoma (p. 607)
of vertebral lesion duration
• Spinal lymphoma: further staging is required. • Controlled physical rehabilitation under PEARLS & CONSIDERATIONS
FeLV/FIV testing, cytologic evaluation of the guidance of trained personnel may be
bone marrow, ± kidney, lymph node, liver, beneficial. Comments
or spleen • MRI may help exclude other differential
• Presumptive diagnosis based on lesion loca- Possible Complications diagnoses and may provide insight into
tion and imaging characteristics Radiation myelopathy histologic type of neoplasm.
○ Vertebral: osteosarcoma, fibrosarcoma, • Definitive diagnosis requires histopathologic
hemangiosarcoma, plasma cell neoplasia, Recommended Monitoring evaluation.
lymphoma, metastatic neoplasia • Periodic neurologic exam • Long-term remission is possible regardless
○ Extradural: lymphoma, NST • Repeat imaging studies of completeness of excision.
○ Intradural/extramedullary: NST, menin- • Chemotherapy necessitates hematologic and
gioma, nephroblastoma (young dog) serum biochemical profile monitoring. Technician Tips
○ Intramedullary: neuroparenchymal tumors • Severely affected animals require intensive
(e.g., glial tumors), metastatic neoplasia, PROGNOSIS & OUTCOME nursing care.
hematopoietic neoplasms) ○ Animals may not be able to urinate and
• Definitive diagnosis: histopathologic exam • Variable based on tumor type, complete- therefore require manual bladder expres-
ness of resection, and severity of neurologic sion or maintenance of a urethral catheter
TREATMENT deficits and indwelling closed urinary collection
○ Patients lacking motor function and noci- system. Development of urinary tract
Treatment Overview ception (sensation) have a grave prognosis. infection is common.
In general, surgery is the basis for treatment of • Canine ○ Affected animals require soft, padded
most neoplasms. Complete resection is often ○ Surgical resection alone: in a study of dogs bedding and frequent changes in their
impossible, but cytoreduction enables decom- with various neoplasms, the overall median recumbency to prevent decubital ulcers.
pression of the spinal cord and allows return survival was 240 days. Passive range of motion of paralyzed limbs
of function. Adjunctive therapy may include ○ Meningioma with surgical resection alone: and other physical therapy exercises may
radiation therapy and/or chemotherapy. For median survival of 19 months; ranges from be performed to assist in recovery.
hematopoietic neoplasms, chemotherapy alone < 30 days to 1440 days; postoperative • Affected animals are often painful preopera-
or in conjunction with radiation therapy may radiation may prolong survival time tively and in the early postoperative period,
be used, depending on degree of compression ○ Vertebral tumors (osteosarcoma and necessitating analgesic therapy.
and neurologic function of the animal. Surgery fibrosarcoma): median survival of 135
should be performed by a board-certified days (range, 15-600 days) SUGGESTED READING
neurologist or surgeon. ○ NST: varies, depending on the proximity Levy MS, et al: Spinal tumors in 37 dogs: clinical
to the spinal cord outcome and long-term survival (1987-1994). J
Acute General Treatment ■ With surgery alone: median survival Am Anim Hosp Assoc 33:307-312, 1997.
• Hemilaminectomy/dorsal laminectomy for of 203 days (range, 120-300 days); AUTHOR: Marc Kent, DVM, DACVIM
decompression and cytoreduction proximal neoplasms have shorter EDITOR: Kenneth M. Rassnick, DVM, DACVIM
• Palliation with glucocorticoids and analgesics survival times
• Vertebral tumors: palliation with radiation, ■ In one study of 10 dogs treated with
bisphosphonate, glucocorticoids radiation alone, the mean progression-
• Spinal lymphoma: systemic chemotherapy, free survival was 240 days, whereas the
radiation therapy overall mean survival was time 371
• Plasma cell tumor/multiple myeloma: days.
systemic chemotherapy, radiation therapy

Spirocercosis Client Education
Sheet

Epidemiology GENETICS, BREED PREDISPOSITION
BASIC INFORMATION
SPECIES, AGE, SEX Medium- and large-breed dogs predisposed,
Definition • Primarily affects dogs but genetic and breed predisposition
A disease of dogs caused by the nematode • Young to middle-aged dogs overrepresented; unknown.
Spirocerca lupi and characterized by lesions dogs < 1 year old unlikely to develop
that can affect the esophagus (with potential disease CONTAGION AND ZOONOSIS
for transformation to esophageal malignancy), Not zoonotic
aorta, and vertebrae

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