CASE OF THE MONTH
This handsome young chap is Milo. Ten month old Milo presented to see Dr Lisa with a two day history of lethargy and pain which localised to his thoracic spine. He was started on anti-inflammatories, however after two days he failed to show any improvement and was still in pain. X-rays of his spine were taken however no abnormalities were detected. Dr Lisa felt Milo seemed in too much pain for a straightforward muscle injury, so blood and urine testing were undertaken to determine if a more serious disease process such as an infectious or immune mediated disease could be the cause. Milo’s blood tests revealed a significant inflammatory process and his urine showed the presence of bacteria. These results lead Dr Lisa to suspect Milo had a disease called discospondylitis.
Discospondylitis is an infection of the intervertebral discs and adjacent vertebrae of the spine, either by bacteria or fungi. It is the result of spread of infection from other areas of the body via the blood stream (eg – urinary tract, heart valves, prostate, foreign bodies such as grass awns etc). Affected dogs typically have back or neck pain and are reluctant to walk or rise and have a decreased appetite. X-rays in the early stages of the disease often show no abnormalities however within a month bone damage can be seen.
Milo’s extreme back pain and the presence of bacteria in his urine are what lead Dr Lisa to suspect discospondylitis. Milo was placed on a course of antibiotics and given additional pain relief. He was monitored closely over the next few weeks. Later, we repeated Milo’s spinal x-rays and severe damage was detected in his thoracic spine (due to the bacteria eating away at the bone) consistent with discospondylitis (see images). Due to the severity of damage to the vertebrae Milo was referred to a specialist for further imaging and testing.
Milo is a regular at the clinic at the moment as we monitor him closely, but he is improving beyond our expectations – in fact his owners are struggling to keep this energetic boy quiet! Milo is likely to be on antibiotics for the next several months and will need a CT scan in a few weeks to ensure there is no further bone loss, which could result in spinal instability, however we are very hopeful he will make a good recovery.