Case Study

RAD – Spondylosis, spondylarthrosis, and maldigestion/enteritits pattern in a 12 year old FS dog

The patient is a 12 year old FS dog with pain of unknown origin. Suspect exacerbation of arthritic joint or joints vs gastroenteritis. Presented for acute weakness and lethargy.

Physical exam: temperature 103.8 CRT 1 second. CBC/chem wnl, revealing a mild stress leukogram. Radiographs of the abdomen were also largely normal, possibly consistent with a mild gastroenteritis and revealing severe spondylosis deformans of L1-4. Blood pressure was 176, although excited/anxious. A recheck temperature was 103.4. Mabel was discharged on oral Carprofen, tramadol, and famotidine.

The patient is a 12 year old FS dog with pain of unknown origin. Suspect exacerbation of arthritic joint or joints vs gastroenteritis. Presented for acute weakness and lethargy.

DX

Spondylosis, spondylarthrosis, and maldigestion/enteritis pattern

Image Interpretation

RADs- VD thorax, lateral and VD abdomen – Osseous structures:
Overall moderate degenerative changes were associated with the axial skeleton including severe endplate spondyloses at L1/2, L3/3, L3/4 with mild narrrowing of the disc spaces. Both coxofemoral joints reveal severe osteophyte formations with irregular joint space width and subchondral bone sclerosis on the lateral views. The cervicothoracic transition and mid thoracic spine. The left facet joint at T13/L1 presented moderate osteoarthritic changes.
Intrathoracic structures:
The degree of lung inflation was fair. The pleural space was within normal limits. Mild focal widening of the caudal mediastinum was noted and was continuous with the contour of the caudal thoracic esophagus and cardia. The lung revealed a mild generalized bronchointerstitial pattern which may be regarded an incidental age related finding.
The cardiac silhouette was within normal limits for size and shape. The major vessels and pulmonary vasculature were within normal limits. There was no sign of vascular congestion.

Intraabdominal structures:
The serosal detail was within normal limits.
The liver extended beyond the costal arch, but the liver margins were pointed.
The kidneys and urinary bladder were within normal limits.
The stomach was contracted and contained a mild amount of gas. The duodenum was rigid in appearance with an “inverted 7 shape“ and contained a mild amount of gas. The small intestinal loops were non dilated and of even diameter, but presented a maldigestion pattern with varying degrees of corugation. The cecum was filled with gas. The colon contained mild amounts of gas and fecal matter.

Outcome

Spondyloses L1 to L4, spondylarthrosis T13/L1 leftsided.
Severe bilateral coxofemoral osteoarthritis.
Maldigestion/enteritis pattern with rigid appearance of the duodenum – primary intestinal disease such as gastroenteritis as well as pancreatitis are potential underlying causes. Check cPLI and consider abdominal ultrasound in case of lacking response to symptomatic treatment or abnormal cPLI.
Possible “sliding“ hiatal hernia versus reflux esophagitis – obtain lateral view of thorax for further definition.