An 8-year-old spayed female German shepherd was presented with a 2-week history of severe neck pain, lameness of the left forelimb, followed by progressive pelvic limb proprioceptive ataxia and ambulatory paresis. Neurological examination showed left lateralized C6-T2 myelopathy. Blood exams revealed a mild inflammation. MRI showed multiple lytic changes in the intervertebral discs and a left ventrolateral C6-C7 compressive myelopathy due to a suspected empyema. A mycotic discospondylitis was suspected. Urinalysis showed fungal hyphae and a definitive diagnosis of Aspergillosis was determined by urine culture. Fluconazole 5 mg/kg twice daily and analgesic therapies was started. Clinical signs significantly improved, and follow-up urinalysis showed no fungal hyphae. Three months later, hematuria was detected. Urinalysis showed fungal hyphae. Antimicogram was performed and revealed a high minimal inhibitory concentration for fluconazole and low for itraconazole. A therapy with itraconazole at 5 mg/kg BID was then started while the therapy with fluconazole was suspended. The condition of the dog significantly improved with almost complete disappearance of pain and ataxia. After 16 months from presentation, the dog presented a severe non-deambulatory paraparesis. Antifungal therapy had been discontinued two weeks earlier by the own decision of the owner without any medical indication. MRI revealed severe right side compressive T11-T13 myelopathy caused by high contrast enhancement material. Euthanasia was performed due to a rapid worsening of neurological signs. In conclusion, urine culture and antimicogram may represent a useful tool to guide the clinician in the choice of the correct antifungal therapy in dogs diagnosed with fungal discospondylitis.
Okonji S., D.F.M. (2022). MYCOTIC DISCOSPONDYLITIS IN A GERMAN SHEPHERD: CLINICAL PRESENTATION AND USEFULNESS OF ANTIMICOGRAM.
MYCOTIC DISCOSPONDYLITIS IN A GERMAN SHEPHERD: CLINICAL PRESENTATION AND USEFULNESS OF ANTIMICOGRAM
Okonji S.;Dini F. M.;Del Magno S.;Cola V.;Gandini G.
2022
Abstract
An 8-year-old spayed female German shepherd was presented with a 2-week history of severe neck pain, lameness of the left forelimb, followed by progressive pelvic limb proprioceptive ataxia and ambulatory paresis. Neurological examination showed left lateralized C6-T2 myelopathy. Blood exams revealed a mild inflammation. MRI showed multiple lytic changes in the intervertebral discs and a left ventrolateral C6-C7 compressive myelopathy due to a suspected empyema. A mycotic discospondylitis was suspected. Urinalysis showed fungal hyphae and a definitive diagnosis of Aspergillosis was determined by urine culture. Fluconazole 5 mg/kg twice daily and analgesic therapies was started. Clinical signs significantly improved, and follow-up urinalysis showed no fungal hyphae. Three months later, hematuria was detected. Urinalysis showed fungal hyphae. Antimicogram was performed and revealed a high minimal inhibitory concentration for fluconazole and low for itraconazole. A therapy with itraconazole at 5 mg/kg BID was then started while the therapy with fluconazole was suspended. The condition of the dog significantly improved with almost complete disappearance of pain and ataxia. After 16 months from presentation, the dog presented a severe non-deambulatory paraparesis. Antifungal therapy had been discontinued two weeks earlier by the own decision of the owner without any medical indication. MRI revealed severe right side compressive T11-T13 myelopathy caused by high contrast enhancement material. Euthanasia was performed due to a rapid worsening of neurological signs. In conclusion, urine culture and antimicogram may represent a useful tool to guide the clinician in the choice of the correct antifungal therapy in dogs diagnosed with fungal discospondylitis.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
