Case: Spinal tumour, unfortunately leading to euthanasia
20th December 2015
A 13 year old male Jack Russel terrier presented unable to walk with paralysed hind quarters. We were able t0 localise the pathology affecting the spine to somewhere between the 3rd thoracic vertebra and the 3rd lumbar vertebra from the clinical signs. The owner thought that the dog’s mobility may have been below par for 4-5 weeks, but the loss of the ability to stand occurred suddenly within the previous 24 hours to presentation. The possibility of neoplasia (cancer) in this geriatric patient was discussed and we raised the option of euthanasia on the balance of probabilities, but the owner was keen for investigation.
We checked kidney function and then gave a general anaesthetic. We inserted a needle into the spinal canal allowing the injection of x-ray contrast medium into the fluid that surrounds the spinal cord. This makes that spinal fluid appear white on x-rays. This is myelography, and the white “tramlines” demarcate the extent of the spinal cord, and show if it is being squeezed anywhere. This myelogram indicated dorsal extradural compression (compression within the spinal canal, but outside the spinal fluid sac) over the first lumbar vertebra which is the first one after the last rib. The compression lateralised to the left. There was also a mild lateral (side) extradural compression at L2-3. This had no ventral component and this was presumed to be a chronic/longstanding sign.
The compression above the spinal cord was almost certainly neoplastic, or hemorrhage associated with neoplasia.
Euthanasia was advised and this was done under general anaesthetic.
A sad outcome, but at least the case with a hopeless prognosis was resolved promptly, alleviating further suffering.