title: Evolution of clinical signs and predictors of outcome after conservative medical treatment for disk-associated cervical spondylomyelopathy in dogs.
abstract: OBJECTIVE
  To evaluate the evolution of clinical signs and their correlation with results of magnetic resonance imaging (MRI) and transcranial magnetic stimulation (TMS) and to assess potential prognostic variables after conservative medical treatment for disk-associated cervical spondylomyelopathy (DA-CSM) in dogs.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  21 client-owned dogs with DA-CSM.
  
  
  METHODS
  After neurologic grading, dogs underwent low-field MRI and TMS with measurement of onset latencies and peak-to-peak amplitudes from the extensor carpi radialis and cranial tibial muscles. Dimensions calculated from MRI images were remaining spinal cord area, spinal cord compression ratio, vertebral occupying ratio, vertebral canal height-to-body height ratio, vertebral canal height-to-body length ratio, and vertebral canal compromise ratio. Intraparenchymal signal intensity changes were graded. Dogs were reevaluated 1, 3, 6, 12, and 24 months after initial diagnosis.
  
  
  RESULTS
  Outcome was successful in 8 of 21 dogs. Negative outcomes were characterized by rapid progression of clinical signs. All dogs with more severe clinical signs of DA-CSM 1 month after diagnosis had unsuccessful outcomes. Outcome was associated with the remaining spinal cord area and vertebral canal compromise ratio. Prognosis was not associated with severity of clinical signs or results of TMS. There were no significant correlations among clinical signs, MRI findings, and TMS results.
  
  
  CONCLUSIONS
  Conservative medical treatment of DA-CSM was associated with a guarded prognosis. Selected MRI variables and clinical evolution 1 month after diagnosis can be considered prognostic indicators. The lack of correlation among clinical signs, results of diagnostic imaging, and results of electrophysiologic evaluation in dogs with DA-CSM warrants further investigation.
authors.affiliation: Department of Medicine, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium. Sdedecker@rvc.ac.uk
authors.forename: Steven
authors.initials: S
authors.lastname: De Decker
authors.forename: Ingrid M V L
authors.initials: IM
authors.lastname: Gielen
authors.forename: Luc
authors.initials: L
authors.lastname: Duchateau
authors.forename: Anna
authors.initials: A
authors.lastname: Oevermann
authors.forename: Ingeborgh
authors.initials: I
authors.lastname: Polis
authors.forename: Iris
authors.initials: I
authors.lastname: Van Soens
authors.forename: Henri J J
authors.initials: HJ
authors.lastname: van Bree
authors.forename: Luc M L
authors.initials: LM
authors.lastname: Van Ham
mesh_terms: D000818:Animals; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D004283:Dog Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy*; D004285:Dogs; D005260:Female; D008297:Male; D011239:Prednisolone / Q000627:therapeutic use*; D011859:Radiography; D055009:Spondylosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000662:veterinary*; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D011239:Prednisolone