“Polo”
Royal Von Tasz Classic The most significant finding on this report is the fact that there was a primary tumor (squamous cell carcinoma) of the right tonsil that had spread to the local lymph nodes and throughout the lungs (pulmonary metastasis.) There was atrophic gastritis evident on microscopic examination of the stomach, most likely secondary to the squamous cell carcinoma or medications that were used to treat it causing decreased appetite and/or upset stomach. There was a mild inflammation to the small intestine, which is not likely of significance. The remainder of the gastrointestinal tract appeared normal. There was arthritis in the left knee that was suggestive of patellar luxation. The articular surface of the knee joint and the cruciate ligament does not appear to have any pathology, but the portion of the femur that the patella glides along (medial trochlear ridge) was roughened/eroded, which could indicate that there was some luxation of the patella that occurred. The right hip had been replaced and the implant was in good working order. The left hip was normal; no evidence of hip dysplasia was noted. There is spondylosis present at the third thoracic and fourth lumbar vertebrae. The degree was mild, and it is uncertain whether or not this would have manifested in clinical disease. There was grossly no evidence of lumbosacral stenosis, but on microscopic examination there were changes in the spinal cord that could suggest some mild lumbar stenosis. If there were congenital LS stenosis, there would be bony changes evident grossly on examination of the spinal column, specifically the malformation of the dorsal arch of the L7-S1 vertebrae. This was not noted on the examination. Acquired lumbosacral stenosis, or lumbar stenosis, can be caused by bony and soft tissue degenerative changes leading to gradual progressive reduction in the spinal canal. There are degenerative changes consistent with narrowing of the lumbar spinal canal but not specifically the lumbosacral area, and there is no evidence to support a congenital condition. I would have to remove lumbosacral stenosis from the checklist provided by the pathologist based on this. The dural osseous metaplasia of the cauda equine noted can be relatively common in older dogs and may not have been of clinical significance, but in this case we have history that suggests that either the cauda equine syndrome or the degenerative changes in the lumbar spinal cord were causing neurological deficits (dead tail.) There was benign prostatic hypertrophy present which may have accounted for the bladder atony in this patient; however, given the history of neurological impairment it is more likely that the bladder atony was attributable to the same process that was causing the dead tail. There was some change noted in the mitral valve of the heart most likely age-related. There was no evidence of disease of the thyroid or adrenal glands, the cardiovascular system, immune system, skin, liver/pancreas or eyes. Judy’s notes: The MSU pathologist Ingrid L. Bergin, VMD, MS, CACLAM, indicated on Polo’s report that the findings were suggestive of mild lumbar stenosis. On our checklist, she checked off Lumbosacral Stenosis, and wrote in “mild.” Dr. Cardeccia, our consultant who interprets the reports for us, agreed there could be some mild lumbar stenosis, but not acquired lumbosacral stenosis. We sent the report to the neurologist, Dr. Michael Wolf, to get his opinion. He said: "Dear Judy, I read the report. Gross pathology: Mild spondylosis. Spondylosis is a common degenerative change to the vertebrae seen in older dogs. Spondylosis is not associated with compression of the nerve roots or spinal cord. It occurs at the bottom of the vertebral body. They (MSU) do not report a bulging disc or narrowing of the spinal canal (stenosis). Osseous metaplasia of the dura (membrane around the spinal cord) is an age related change and of no clnical significance. Microscopic exam: Mild multifocal chronic axonal and myelin degeneration. These changes are likely age related as stenosis or compressive issues were not seen in gross pathology. If you have further questions, please do not hesitate to contact me. Kind regards, Dr. Michael Wolf" |
