FASAVA Congress 2017

Spinal  cord disease is common in dogs (a little less so in cats)  and can be caused by abnormality of the surrounding tissue including vertebrae, intervertebral discs, tumour, haematoma or infection compressing the spinal cord  or can occur as a result of abnormalities of the meninges or disease of the spinal cord itself. All may be focal, multifocal or more diffuse depending on disease process.  
Early diagnosis and treatment of spinal cord disease is usually associated with a better prognosis and the early diagnosis and consideration of surgical options is critical for some (any cause of spinal cord compression - especially IV disc extrusion). “Seeing how things go” with empiric treatment is not appropriate for many spinal cord diseases. However, in some instances treatment can be instituted on a best guess based on clinical presentation. The prognosis associated with various neurologic diseases should also be considered prior to embarking on often expensive diagnostic testing however severe neurologic abnormality is not necessarily associated with the poorest prognosis.
Identification and localization of spinal cord abnormality is the first step. The likely causes should be considered prior to undertaking further diagnostic tests or treatment and this list may be narrowed based on signalment and likelihood of a particular diagnosis but in most cases it is not possible to identify a cause just based on neurologic findings. Radiography, advanced imaging (myelography, CT or MRI), serology and/or CSF analysis may be required to arrive at a more definitive diagnosis and enable appropriate treatment.
The indications for diagnostic testing, advantages, disadvantages and the likely information to be gained from these tests will be discussed.