Intermittent „greeting” due to Chiari-like malformation/syringomyelia (CM/SM) and occipital dysplasia in a Cavalier King Charles Spaniel

A. Bathen-Nöthen; C. Bull; M. Fehr; M. Fork; A. Tipold

doi:10.1055/s-0038-1622669

Tierärztliche Praxis Ausgabe K: Kleintiere / Heimtiere, Table of Contents

Tierarztl Prax Ausg K Kleintiere Heimtiere 2008; 36(02): 119-125
DOI: 10.1055/s-0038-1622669

Hund/Katze

Schattauer GmbH

Intermittierendes „Grüßen“ infolge Chiari-like Malformation/- Syringomyelia (CM/SM) und okzipitaler Dysplasie bei einem Cavalier King Charles Spaniel

Intermittent „greeting” due to Chiari-like malformation/syringomyelia (CM/SM) and occipital dysplasia in a Cavalier King Charles Spaniel

Authors

A. Bathen-Nöthen

¹Klinik für Kleintiere (Direktor: Prof. Dr. I. Nolte) der Stiftung Tierärztliche Hochschule Hannover

²Tierarztpraxis A. Bathen-Nöthen, Lindlar
C. Bull

¹Klinik für Kleintiere (Direktor: Prof. Dr. I. Nolte) der Stiftung Tierärztliche Hochschule Hannover
M. Fehr

¹Klinik für Kleintiere (Direktor: Prof. Dr. I. Nolte) der Stiftung Tierärztliche Hochschule Hannover
M. Fork

¹Klinik für Kleintiere (Direktor: Prof. Dr. I. Nolte) der Stiftung Tierärztliche Hochschule Hannover
A. Tipold

¹Klinik für Kleintiere (Direktor: Prof. Dr. I. Nolte) der Stiftung Tierärztliche Hochschule Hannover

Abstract

Zusammenfassung:

Gegenstand: Ein 5½-jähriger, männlicher Cavalier King Charles Spaniel wurde mit einer intermittierenden Gangstörung einer Vordergliedmaße vorgestellt. Während der Episoden winkelte der Hund je eine Vordergliedmaße für einige Minuten wie zum Gruß an. Dazwischen lagen normale Gangphasen. Material und Methoden: Anhand der neurologischen Untersuchung wurde die neuroanatomische Lokalisation vor allem im Bereich der oberen Halswirbelsäule vermutet. Als weiterführende bildgebende Diagnostik wurde eine Magnetresonanztomographie (MRT) von Gehirn, Halsund Brustmark durchgeführt. Ferner erfolgte eine Darstellung des Foramen magnum per Computertomographie. Ergebnisse: Bei dem Patienten wurde eine mittelgradige Kleinhirnherniation und hochgradige Syringohydromyelie des Halsund Brustmarks (Chiarilike malformation and syringomyelia; CM/SM) diagnostiziert. Das Foramen magnum war nach dorsal unphysiologisch schlüssellochförmig erweitert. Zur Therapie der Syringohydromyelie wurde eine dorsale Laminektomie mit Durafenestration im Bereich des ersten Halswirbels durchgeführt. Bei einer Kontrolluntersuchung nach acht Wochen zeigte der Hund trotz persistierender Syrinx das episodische „Grüßen“ nicht mehr. Schlussfolgerung: Zahlreiche neurologische Symptome sind im Zusammenhang mit einer Syrinx beschrieben. Dies ist der erste Fall eines Cavalier King Charles Spaniel mit intermittierendem „Grüßen“. Darüber hinaus liegen hier zwei angeborene Anomalien vergesellschaftet vor: Chiari-like malformation and syringomyelia (CM/SM) und okzipitale Dysplasie. Klinische Relevanz: Der Cavalier King Charles Spaniel sollte nicht nur wegen Kleinhirnherniation mit nachfolgender Syrinx im Hinblick auf die Zuchttauglichkeit untersucht werden, sondern auch wegen okzipitaler Dysplasie. Eine operative Druckentlastung des Liquorraums kann zur klinischen Heilung führen.

Summary

Objective: A 5.5-year-old male Cavalier King Charles Spaniel (CKCS) was presented with an intermittent gait abnormality of one front limb. During these episodes the dog flexed one front limb for some minutes like a kind of “greeting”. Between these episodes the dog’s gait was normal. Material and methods: On the basis of the neurological examination the neuroanatomical localisation was considered to be primarily in the upper motor neuron of the cervical spine. As a diagnostic imaging tool, a magnetic resonance imaging (MRI) of the brain, cervical and thoracic spinal cord was performed and the area of the foramen magnum was shown by computed tomography. Results: In this patient a moderate herniation of the cerebellum and severe syringohydromyelia of the cervical and thoracic spinal cord (Chiari-like malformation and syringomyelia; CM/SM) was diagnosed. The foramen magnum was dorsally widened in a keyhole shape. As therapy of the syringohydromyelia a dorsal laminectomy at the level of the first cervical vertebra with fenestration of the dura mater was performed. Up to a post surgery follow-up eight weeks later, the dog no longer showed“greeting”, although in a repeated MRI the dimensions of the syrinx still remained. Conclusion: Many neurologic signs are described in association with a syrinx. This is the first case report of a CKCS presenting intermittent “greeting”. Furthermore the dog showed a combination of two anomalies: Chiarilike malformation and syringomyelia (CM/SM) and occipital dysplasia. Clinical relevance: It is recommended that the CKCS should be screened for breeding purposes not only for occipital hypoplasia but also for occipital dysplasia. A surgical decompression of the cerebrospinal fluid-filled space can result in resolution of clinical signs, whereas MRI failed to demonstrate an improvement of the syrinx. Further studies with advanced MRI techniques would be necessary in the future to diagnose morphologic as well as functional options of the cerebrospinal fluid-filled space and -flow.

Schlüsselwörter

Syringohydromyelie - Anomalie - Chiari-like Malformation and Syringomyelia - CM/SM - okzipitale Dysplasie - Hund - Cavalier King Charles Spaniel

Key words

Syringohydromyelia - anomaly - Chiari-like Malformation and Syringomyelia - CM/SM - caudal occipital malformation syndrome - dog - Cavalier King Charles Spaniel

Full Text

References

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