Lifespan and Causes of Death in the Irish Wolfhound - Vetsuisse ...

3.7.1.3 Diagnosis
The definite diagnosis of FCE can only be made post-mortem through
histopathological examination of the spinal chord, combined with special staining
techniques to demonstrate the presence of cartilaginous material inside medullary
blood vessels (Junker, van den Ingh et al. 2000). Nevertheless, FCE can be strongly
suspected in vivo if the following diagnostic criteria are met:
Neurological examination reveals spinal injury of widely varying location and severity.
Diagnostic criteria include acute onset, absence of pain, usually (though not always)
asymmetrical neurological signs, a history of trauma and/or exercise shortly before
the onset, and non-progressive symptoms after 12-24 hours at most. If the symptoms
continue to progress after this time, other causes of neuromalacia should be
considered.
Spinal radiographs are usually normal. Myelography often shows focal intramedullary
swelling in the acute stage. Later on, it can be normal or indicate focal medullary
atrophy. MRI is currently the best available diagnostic technique, with the responsible
disc showing a decreased and the infarcted medullary area showing an increased
signal intensity on T2 images. However, its limited availability and the need for fast
action in acute cases can limit its practical use.
Furthermore, a cerebrospinal fluid analysis can be performed. In the acute stage, it
may show a high RBC and mildly high neutrophile count; later on, only mildly
elevated protein may be observed. Normal results are also possible at all stages,
however.
Differential diagnoses include other forms of spinal injury such as fractures and
luxations, which are usually associated with pain and visible on a spinal radiography;
or spinal tumours (Vaughan-Scott, Goldin et al. 1999), where signs can be expected
to be slowly progressive rather than acute. Furthermore, medullary haemorrhage due
to ingestion of rodenticides, thrombocytopenia or DIC should be considered and
excluded through a haematological exam. Last, focal myelitis is also a possibility, but
can be differentiated by its progressive symptoms and characteristic changes in the
cerebrospinal fluid (Sisson and Parent 2004).
Sex Age (wks) Trauma? Clinical Diagnosis
Pathology
m 9 yes (play) Tetraparesis/-plegia; problem C1-C6 FCE C5-C7
m 12.5 yes (slid) Monoparesis; left hind limb FCE T1-T7
m 8 unknown Hemiparesis/-plegia FCE C6-C7
m 10 unknown Hemiparesis FCE C5-T3
f 8 no Paresis posterior FCE
m 11 no Monoparesis/-plegia; left hind limb recovered
m 10 yes (walk) Monoparesis; left hind limb recovered
m 11 no Paresis posterior; problem T2-L3 recovered
Table 3.5: Summary of clinical presentation data from 8 Irish Wolfhound puppies
diagnosed or suspected with FCE over a 16-month period between 1996-1997 at
Utrecht university; taken from Junker, van den Ingh et al. (2000). Note that the
definition of "trauma" is to be interpreted generously, which could interfere with the
cases where no trauma was reported.
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