So diskospondylitis occurs when there is
an infection that happens at the end plates
of the backbones or the vertebral bodies. They
sit right next to the disk space. The causes
of diskospondylitis are often bacterial in nature.
So things like E. coli, staphylococcus, and streptococcus
are the most common bacteria that we can culture.
Generally these bacteria can also be found
in the bloodstream or the urine of the patient.
We don't exactly know why this infection gets
into the these endplates but hematogenous or
kind of a blood-borne spread is the most likely
cause. Generally the young, large breed male
working-class dogs tend to be the most common
that we see develop diskospondylitis but
all genders breeds and ages can be affected.
The most common symptoms of diskospondylitis
in veterinary patients generally includes
pain along the spinal column so they can show
signs of pain in really different ways. So
sometimes they'll be vocal if you touch around
their back, they can have hiding behaviors,
they can be unwilling to move or walk or just
not willing to do their normal daily activity.
In cases where the diskospondylitis has
become more advanced, neurological signs
can be seen, most common being weakness in
the legs of the patient , incoordination
in the way the patients walking or in severe
cases, you can get paralysis of the limbs.
Patients that are suspected to have Diskospondylitis
should have full physical and neurological
evaluations. Sometimes evidence of fever can
be present, pain and varying neurological signs
depending on the location of the infection.
If diskospondylitis is suspected based on
the patient‘s signalment, exam and history, radiographs
or X-rays of the spine can be helpful in finding the lesions.
The full spinal column should be imaged because
diskospondylitis can be in multiple areas at once.
Evidence of diskospondylitis on the radiographs
or x-rays generally include collapsed disc
spaces or sometimes even widened disk spaces
and the end plates of the vertebrae are generally
destroyed or irregular instead of being sharply marginated.
Sometimes evidence of diskospondylitis
can't be seen on the x-rays or
radiographs alone. And this happens, especially
if you catch the disease early. In these cases
CT Imaging or even MRI imaging of the spine
would be needed to detect the more subtle changes.
After the imaging has been performed and diskospondylitis
is suspected, we have to try to
find which infectious organism is at fault.
So things like blood cultures, urine cultures,
CT or ultrasound guided biopsies can all be
performed to try and look for the bacteria or
the fungus that's causing the problem.
There are four big categories when we're treating
patients with diskospondylitis. The first
one is pain management. We want to make sure
that these patients receive either anti-inflammatory
or nerve pain medications to help cope with
the pain associated with the disease. Generally,
we can take the pain medications away over a
few weeks to months as the patient starts to recover.
The next big category is antibiotics or antifungal
medications. Depending on which infection
is actually causing the diskospondylitis
we want to make sure that we culture for bacteria
or perform blood tests so that we can pick the
right antibiotic or antifungal to treat.
Treatment process itself can take at least
up to six months, but generally up to a year of
treatment is needed because it's very hard
to clear the infection from the bone itself.
As we’re treating and we slowly start to remove
our medications, relapses of the infection
can also happen. The third major category is
rest and activity restriction. Patients that
have diskospondylitis may develop vertebral
fractures or spinal luxations and so we
want to keep them in a small enclosed area and
keep them rested at least for the next several
weeks to make sure we can avoid those complications.
The final is follow-up appointments with your
Veterinary neurologist. So patients diagnosed
with diskospondylitis are generally rechecked
fairly frequently to monitor for neurological
improvement, improvement in their pain and
sometimes repeat imaging and repeat cultures are needed
to make sure that we can clear the infection.
The prognosis for patients that are diagnosed
with diskospondylitis are generally fair to
good with long term treatment. Patients can
be fair to poor in their long-term prognosis,
especially if they're suffering from a fungal
infection, if they develop spinal luxations,
or if they have severe neurological signs such as paralysis.