Haematomyelia and myelomalacia following an inadvertent thoracic intraspinal injection in a cat.

Dutil, Guillaume F; Schweizer, Daniela; Oevermann, Anna; Stein, Veronika M; Maiolini, Arianna (2021). Haematomyelia and myelomalacia following an inadvertent thoracic intraspinal injection in a cat. JFMS open reports, 7(1), p. 2055116921995394. Sage 10.1177/2055116921995394

[img]
Preview
Text
2055116921995394.pdf - Published Version
Available under License Creative Commons: Attribution-Noncommercial (CC-BY-NC).

Download (676kB) | Preview

Case summary

A 4-month-old cat was presented with acute paraplegia after the referring veterinarian performed a subcutaneous injection (cefovecin and dexamethasone) in the caudodorsal thoracic area, during which the cat suddenly became uncooperative. A complete neurological examination performed 1 day after the injection revealed paraplegia without deep pain perception and reduced segmental spinal reflexes in the pelvic limbs. Findings were consistent with either an L4-S3 myelopathy or a T3-L3 myelopathy with subsequent spinal shock. MRI showed swelling of the spinal cord from T1 to L1 with heterogeneous T2-weighted intramedullary hyperintensity and no contrast enhancement. A centrally located intraspinal signal void was visible in T2*-weighted images. These changes were compatible with a suspected traumatic intraspinal injection. Despite intensive supportive care over 4 days, neurological status did not improve and the cat was euthanased. Gross pathology findings revealed severe intramedullary haemorrhage and myelomalacia in the T10-L1 spinal cord segments. Histopathology of the spinal cord after haematoxylin and eosin staining revealed a severe intramedullary space-occupying haemorrhage with focal malacia. A trajectory-like, optically empty cavity containing some eosinophilic droplets at the edges was detected. Although no further evidence of trauma was noted in the surrounding structures, the spinal cord changes were compatible with a perforating trauma.

Relevance and novel information

To our knowledge, this is the first report of thoracic intraspinal injection causing myelomalacia defined by an ante-mortem MRI and confirmed post mortem by histopathology. The traumatic myelopathy appeared to be most compatible with an intraspinal injection causing vascular rupture.

Item Type:

Journal Article (Further Contribution)

Division/Institute:

05 Veterinary Medicine > Department of Clinical Veterinary Medicine (DKV) > DKV - Clinical Neurology
05 Veterinary Medicine > Department of Clinical Research and Veterinary Public Health (DCR-VPH) > Experimental Clinical Research
05 Veterinary Medicine > Department of Clinical Veterinary Medicine (DKV) > DKV - Clinical Radiology
05 Veterinary Medicine > Department of Clinical Veterinary Medicine (DKV)
05 Veterinary Medicine > Department of Clinical Research and Veterinary Public Health (DCR-VPH)

UniBE Contributor:

Dutil, Guillaume Fabien; Schweizer, Daniela Esther; Oevermann, Anna; Stein, Veronika Maria and Maiolini, Arianna

Subjects:

600 Technology > 610 Medicine & health
600 Technology > 630 Agriculture

ISSN:

2055-1169

Publisher:

Sage

Language:

English

Submitter:

Anna Oevermann

Date Deposited:

26 Apr 2021 13:03

Last Modified:

02 May 2021 03:07

Publisher DOI:

10.1177/2055116921995394

PubMed ID:

33796326

Uncontrolled Keywords:

MRI haemorrhage intramedullary paraplegia perforating trauma spinal cord injury

BORIS DOI:

10.48350/155980

URI:

https://boris.unibe.ch/id/eprint/155980

Actions (login required)

Edit item Edit item
Provide Feedback