Felis ISSN 2398-2950

Diskospondylitis

Contributor(s): Paul Cuddon, Laurent Garosi, Michael Podell

Introduction

  • Reported in cats but not as common as in the dog.
  • Cause: infection of intervertebral disk with extension to the vertebral end plates and vertebral body usually hematogenous.
  • Signs: spinal pain, lethargy.
  • Diagnosis: radiography, advanced imaging, urine and blood culture.
  • Treatment: antibiotics, rest, analgesia.
  • Prognosis: fair to guarded depending on etiological agent.

Pathogenesis

Etiology

  • Hematogenous spread of infection from:
  • Direct inoculation of an organism into the region is uncommon, but can occur as a result of spinal surgery, penetrating wound, regional abscessation or migration of foreign material (eg plant awn).
  • Bite wound abscesses of the tail base can result in direct inoculation of bacterial organisms and potentially in diskospondylitis, meningitis or signs of lumbrosacral myelopathy.
  • May be bacterial or fungal.

Predisposing factors

General

Pathophysiology

  • Bacterial infection, eg S aureus, S intermedius, by hematogenous spread via urinary tract   →   infection of disk and end plate   →   intervertebral body   →   involves local meninges   →   inflammation   →   soft tissue swelling   →   vertebral instability   →   collapse of disk space with possible protrusion/extrusion of disk material (predilection for lumbosacral space)   →   pressure on canal   →   pain   →   clinical signs, eg pathological fracture, luxation.
  • Diskospondylitis infections usually start in the endplate of a vertebra, with subsequent spread to the intervertebral disk.
  • Blood supply within the vertebral endplates consists of capillary beds, which reduce blood flow velocity.
  • The reduced velocity allows for diffusion of nutrients into the nucleus pulposus of the plates. The pores also provide a route for organisms to diffuse into the nucleus pulposus, where infection harbors within the disk.
  • The minimal vascular supply of the intervertebral disk further perpetuates infection within the disk.
  • Clinical signs of myelopathy may occur with spinal cord compression from proliferative inflammatory tissue, secondary vertebral subluxation, or epidural abscesses.
  • Rarely may be associated with spinal epidural empyema.

Timecourse

  • Often weeks or months before diagnosis made.
  • Occasional acute deterioration with secondary pathological vertebral fracture, disk protrusion or spinal epidural empyema.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Packer R A, Coates J R, Cook C R et al (2005) Sublumbar abscess and diskospondylitis in a cat. Vet Radiol Ultrasound 46 (5), 396-399 PubMed.
  • Aroch I, Shamir M, Harmelin A (1999) Lumbar discospondylitis and meningomyelitis caused by Escherichia coli in a cat. Feline Pract 27 (6), 20-22 ResearchGate.
  • Watson E & Roberts R E (1993) Diskospondylitis in a cat. Vet Radiol 34 (6), 397-398 VetMedResource.
  • Moore M P (1992) Discospondylitis. Vet Clin North Am 22 (4), 1027-1034 PubMed.
  • Malik R, Latler M & Love D N (1990) Bacterial diskospondylitis in a cat. JSAP 31 (8), 404-406 Wiley Online Library.


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