Newsletter

August 2017

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BACK WEEK: 4 to 9 SEPTEMBER

In the words of Mother Teresa:

“I alone cannot change the world, but I can cast a stone across the waters to create many ripples”

Let each one of us “cast a stone” by teaching our clients to look after their animal’s backs, and therefor create the ripple effect of having happy animals with healthy backs.

We will be sending out information to our members that you can pass on to your clients.

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CSW2

We had a very successful clinical skills workshop from the 17th to the 20th August, held at Grey Hare Farm in JHB. The delegates were treated to some amazing lecturers and got to work on some very special horses, who were all FULL of personality.

 

We will be updating the website shortly with photos taken at the event.

 

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NEWSFLASH!

CSW 3 to be held later this year.

Details to follow.    

And then the exam…. 1-3 Dec 2017.  All physios having done PACE, this is your last chance to write exams.

DON'T MISS OUT!  

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Are you recognizing signs of spinal cord disease in your canine patient?

                                                                       By Ansi van der Walt MScPhysio (WITS)

Disorders of the spinal column and cord include congenital defects, degenerative diseases, inflammatory and infectious diseases, tumours, nutritional diseases, injury and trauma, toxic disorders, and vascular diseases. It is important to recognize the possible differential diagnoses that may be a cause of pain and gait dysfunction in your canine patients, so that you can plan your management of the patient appropriately.

1.      Spinal Dysraphism

 

Definition:

"Spinal Dysraphism" is a broad term.

It refers to developmental disorders of spinal cord leading to various structural defects. It may be progressive or non-progressive in nature. Spinal Dysraphism has been reported in English bulldogs, Samoyeds, Dalmatians, English setters, golden retrievers, rottweilers and Cavalier King Charles Spaniels.

 RED FLAGS!

• Postural abnormalities

• Limb weakness

• Imbalance

• Uncoordinated walk

 

2.        Atlantoaxial Instability in Dogs

 

Definition:

Atlantoaxial instability results from a malformation in the first two vertebrae in the neck of an animal. This causes the spinal cord to compress and results in pain or even debilitation for the pet. The disorder is uncommon in older dogs and larger breeds of dogs. It is generally found in smaller, toy breeds. Yorkshire Terriers are commonly affected. To ensure the best possible chance for a full recovery, it is important to treat the animal once an occurrence or sign of distress is observed.

The condition can affect both dogs and cats.

RED FLAGS!

• Small breed dog

• Young dogs

• Severe neck and back pain

• Lack of desire to exercise.

• Collapsing/paralysis

 

 3.        Degenerative Myelopathy

 

Definition:

Degenerative myelopathy is the general medical term that refers to the disease of the dog's spinal cord or bone marrow. The condition does not have specific cause and may remain unidentified. While the disease can affect any breed and any age of dog, older animals are most often afflicted with the disease. Prognosis of this disease is not positive, as it is the degeneration of the animal's spinal cord, leading to loss of numerous bodily functions.

RED FLAGS!!

Lesions are often present on the spinal cord. Neurons in the brain stem may also be affected by the disease. Here are some common signs of this disease:

• Breed: German Shepherds, Pembroke and Cardigan Welsh Corgi's, Chesapeake Bay Retrievers, Irish Setters, Boxers, Collies, Rhodesian Ridgebacks, and Poodles

• Increased muscle atrophy and the inability to maintain posture

• A loss of the ability to control defecation and urination

• Exaggerated spinal reflexes

 

 4.        Degenerative lumbosacral stenosis in dogs

 

Degenerative lumbosacral stenosis is a common cause of cauda equina syndrome in dogs. If this condition is recognized early, treatment may help alleviate significant morbidity.

The term ‘lumbosacral disease’ encompasses any pathologic condition that affects the region of the spinal cord segments that contribute to the sciatic nerve and sacral and caudal nerves. Cauda equina syndrome implies pathologic conditions that affect the last several pairs of spinal nerve roots. Thus, lumbosacral disease and cauda equina syndrome are not specific conditions. Instead, they are the clinical manifestations of a variety of diseases that result in dysfunction of either the lumbosacral spinal cord segments or spinal nerve roots, respectively. Consequently, these two syndromes can result in similar clinical signs.

RED FLAGS:

• Older dogs

• Long-term history of pelvic limb weakness

• Pain at the lumbosacral articulation.

• Crouched stance with overflexion of the hip, stifle, and hock joints.

• Incontinence

• Paresis of the tail , self-mutilation of tails.

 

 5.        Spondylosis Deformans in Dogs

 

Definition:

Spondylosis deformans (or just ‘spondylosis’) is a degenerative, non-inflammatory condition of the spinal column characterized by the production of bone spurs along the bottom, sides, and upper aspects of the vertebrae of the spine.

In dogs, spondylosis deformans occurs most often inthe caudal thoracic and cranial lumbar regions of the spine.

RED FLAGS:

• Older dogs

• Centralisation of pain, disproportionate to exercise 

 

INTERVERTEBRAL DISC DISEASE (IVDD)

The intervertebral discs are subject to a number of degenerative conditions and forces that predispose them to bulge or rupture over time.

Disk rupture leads to compressive and/or concussive damage to the spinal cord:

RED FLAGS:

• Chondrodystrophic dogs

• Acute onset hind limb paralysis/paresis

• Urinary incontinence

• Apparent abdominal discomfort (cries when lifted or abdomen compressed)

 

FCE

 

Definition:

Fibrocartilagenous Embolism (FCE) is a sudden, paralytic condition of the spinal cord of dogs. It occurs with no prior warning and causes paralysis of the hind legs, and occasionally of the front legs as well. The paralysis is reversible in most cases with good supportive care, but the recovery period is very variable.

A small amount of intervertebral disk material detaches spontaneously and blocks a nearby artery, interrupting blood supply to a spinal cord segment. This results in inflammation and nerve damage. The cause of this disease is poorly understood. It can occur at any age, but is seen more commonly in large breed dogs.

The condition occurs suddenly and is sometimes preceded by an episode of physical exertion. Initially there may be some pain, but this normally resolves within a short space of time. Symptoms develop within the first few hours or onset, but do not progress after the first day.

Symptoms depend on the severity and location of the spinal cord injury. Signs may range from ataxia to complete paralysis.

RED FLAGS:

• Acute

• Non-painful

• Asymmetric

• Non-progressive

Typical history is that the dog was playing, suddenly yelped and immediately collapsed.

Bacterial Diseases:

Diskospondylitis is inflammation of the disk between 2 vertebrae (bones in the spinal column). The vertebrae can also be inflamed without infection of the disk. Causes include a bacterial or fungal infection in the bloodstream or a weakened immune system that allows infections to develop. Diskospondylitis occurs more often in larger breeds.

The most common sign of diskospondylitis is pain. Some dogs also have fever, depression, and weight loss. Neurologic signs can develop due to pressure on the spinal cord or, rarely, spread of infection to the spinal cord. Blood and urine samples can identify the underlying infection. Signs usually disappear within 5 days of treatment with an appropriate antibiotic, but treatment should be continued for at least 8 weeks.

Rickettsial Diseases: Dogs that develop an infection of rickettsia or related bacteria sometimes show signs of spinal cord dysfunction. These bacteria cause disorders such as Rocky Mountain spotted fever and ehrlichiosis, which can lead to swelling in the spinal cord. Blood and cerebrospinal fluid samples can help identify the infection. Antibiotic treatment is given for 2 to 3 weeks. The outlook for a full recovery is good with early treatment, although the neurological signs occasionally worsen despite treatment.

Viral Diseases:

Canine distemper encephalomyelitis, a viral infection that causes swelling of the brain and spinal cord, remains one of the most common central nervous system disorders in dogs worldwide. Neurological signs may appear suddenly or may worsen slowly and progressively, depending on the location of the swelling. Adult dogs can have fever and pain, and animals sometimes lose motor control or develop paralysis. Definitive diagnosis is difficult without a necropsy. There is no specific treatment, and the outlook for recovery is poor for dogs with severe signs.

Rabies is caused by a viral infection that spreads to the central nervous system from the peripheral nerves. Rabies is common throughout the world except in Japan and some other islands, including New Zealand, Iceland, and Hawaii. Initial signs are extremely variable, and rabies should be considered a possibility in any unvaccinated animal with severe neurologic dysfunction. Signs that the infection has reached the spinal cord include a loss of motor control and progressive paralysis, usually with a loss of reflexes. Affected animals typically, but not invariably, die within 2 to 7 days of when signs begin. There is no treatment.

Other infections:

Fungal Diseases

Cryptococcus neoformans is the most common fungus to cause a central nervous system infection in dogs.. Signs of spinal cord infection include partial or total paralysis and spinal pain. Blood or cerebrospinal fluid tests are necessary to diagnose an infection and identify the organism. Treatment and the outlook for recovery depend on the specific fungus involved.

Protozoal Diseases

• Neosporosis is caused by Neospora caninum, a microorganism that can cause inflammation of the brain and spinal cord. Infection in young puppies typically causes paralysis with muscle rigidity in one or both hind legs. Other organs, including muscle, liver, and lungs, can also be affected. A blood test or tissue sample can be used to diagnose the infection. Early drug treatment may be effective, but the chances of recovery are poor.

• Toxoplasmosis is caused by a protozoan called Toxoplasma gondii, which can occasionally cause inflammation of the brain and spinal cord. Dogs with toxoplasmosis often also have other diseases, such as canine distemper. A blood test or tissue sample can be used to diagnose the infection. Various drugs are recommended for treatment.

Parasitic Diseases

• Verminous myelitis is inflammation of the spinal cord caused by a parasite. The most common such parasite in dogs is a roundworm called Baylisascaris procyonis. Signs of spinal cord inflammation strike suddenly and severely, often affecting one side of the body more than the other, and may progressively worsen over time. This condition is difficult to diagnose except by examination of tissues after death. Drug treatment can be beneficial, but a full recovery is uncertain.

Tumours

Tumours that affect the spinal column and cord in dogs include cancers of the bone, connective tissue, meninges, and nerve sheath, in addition to metastatic cancers, which are cancers that have spread from other parts of the body. A specific tumor called a nephroblastoma can affect young dogs (from 5 to 36 months of age), with German Shepherds affected most commonly. This tumor is frequently in the middle or lower back, causing progressively worsening partial paralysis in the hind legs. Imaging (including x-rays, myelography, computed tomography, magnetic resonance imaging) and surgical biopsy are used to identify and confirm a diagnosis of spinal cancer. Surgery is possible in some cases.

Injury and Trauma

Spinal cord injuries usually occur as a result of a spinal fracture or dislocation. Common causes in dogs include automobile accidents, bite wounds, and gunshot wounds. The injury not only causes initial damage to the spinal cord, but also causes secondary damage from swelling, bleeding, destruction of the nerve sheath, and tissue decay. Signs of spinal trauma typically have a sudden and severe onset, and may progressively worsen. Severe spinal cord injury to the middle or lower back may cause a rigid paralysis, or a limp paralysis that spreads to the entire body over several days and leads to death from respiratory paralysis. Fractured or dislocated vertebrae can often be seen on x‑rays. Drug treatment can be helpful if started within the first few hours of injury. Animals with mild neurological signs from injury often recover after 4 to 6 weeks of cage rest. Surgery is necessary for some types of injuries that cause severe neurological signs. In dogs that have lost the ability to feel pain at locations below the spinal injury, the outlook for recovery is poor.

Poisoning and Toxic Disorders

Delayed organophosphate intoxication can be seen after ingestion or skin contact with insecticides or pesticides that contain organophosphates. In addition to the signs of severe exposure, delayed paralysis can develop 1 to 4 weeks after exposure. Partial paralysis of the hind legs worsens progressively, and occasionally all 4 legs become paralyzed. A veterinarian will need a history of the dog's possible chemical exposure to make the correct diagnosis. The outlook for recovery is poor for animals with severe signs.

Tetanus is caused by toxins produced by Clostridium tetani bacteria that usually enter the body at the site of a wound. Dogs are fairly resistant to tetanus, but cases do sometimes occur. Signs usually develop within 5 to 10 days of infection and include muscle stiffness and rigid leg extension, inability to swallow, protruding eyelids, and locking of the jowl and facial muscles. In severe cases, the animal may be unable to stand as a result of muscle spasms. Treatment consists of wound care, antibiotics to kill any remaining organisms, and tetanus antitoxin. In mild cases, a dog may recover completely with early treatment. In severe cases, death may occur due to respiratory paralysis.

 

 References:

1. Handbook of Veterinary Neurology 3rd Ed.(2007) Lorenz, ED and Kornegay MD. WB Saunders Company. ISBN13 9781416053903

2. Handbook of Small Animal Orthopedics and Fracture Repair, 5th Ed. (2016) DeCamp CE. WB Saunders Company ISBN: 978-1-4377-2364-9

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CLASSIFIEDS

• Exciting job opportunities exist in Auckland, New Zealand, with Vetphysio Limited and VSA Physio!  We are in urgent need of an animal/veterinary physiotherapist to join our lovely teams, and have enough work for a full-time position.

Currently, Vetphysio Limited offers a mobile equine physiotherapy service, and sees dogs and cats out of rented rooms in 2 veterinary clinics. We also run an in-patient and outpatient physio and rehab service out of a small animal referral hospital (VSA, or Veterinary Specialists Auckland), where we have an underwater treadmill and physio room.

We have great connections with referring vets, and we cover a huge area! We are also interested in expanding both the equine and small animal practices further, but we are struggling to keep up with the work we have, already! We can offer a job tailored to the individual interested in joining our team: either predominantly small animal, or mixed practice. We are also keen to expand our rider clinics.

We welcome applications from physiotherapists with post-graduate qualifications or learning in animal/veterinary physiotherapy. Please contact me via email, and feel free to explore our website and Facebook pages. Assistance can be given with visa applications and on registering with the NZ Physio Board.

Helen Robartes
Veterinary Physiotherapist
Vetphysio Limited
Mobile: 0226390254
Email: helen@vetphysio.co.nz
Web: www.vetphysio.co.nz

MSc with Merit (Vet Physio, Royal Veterinary College of London), BSc (Physio, South Africa) ACPAT Cat A, HCPC registered, NZPB registered, MPNZ, MNZAVPA

 

•  We are are looking for an energetic small animal physiotherapy graduate who might be interested in joining a well established small animal veterinary practice in Bryanston. Independent business opportunity available as well.

Please contact us at 011 706 2590 or 0605060190 or send contact information or cv to bpvet@mweb.co.za

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Laugh A Little!

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Our penultimate newsletter for the year should be reaching your inboxes at the end of October.

 

Your committee: Glenda Francis (Chair), Adri Mentz (Secretary), Kim Reitz (Treasurer)