OBJECTIVE: To examine associations between CSF biomarkers, initial neurologic dysfunction,
and long-term ambulatory outcome in dogs with acute intervertebral disk herniation (IVDH).
DESIGN: Prospective clinical study.
ANIMALS: 54 dogs with acute thoracolumbar IVDH and 16 clinically normal dogs.
PROCEDURES:For each dog, variables, including CSF myelin basic protein (MBP), lactate,
calcium, glucose, and total protein concentrations; nucleated cell count; and creatine kinase
(CK) and aspartate aminotransferase activities, were measured. For dogs with thoracolumbar
IVDH, initial neurologic function was characterized by use of a modified Frankel
score (MFS; determined on a scale of 0 to 5, where 0 represented paraplegia with no deep
nociception and 5 represented paraspinal hyperesthesia only). Long-term follow-up was
RESULTS: Among dogs with thoracolumbar IVDH, those with CSF CK activity ≤ 38 U/L had
a 35-fold increase in the odds of long-term ambulation, compared with the odds in dogs
with CSF CK activity > 38 U/L, adjusting for neurologic functioning at the evaluation. The
CSF lactate, calcium, and glucose concentrations and aspartate aminotransferase activity
were not predictive of long-term ambulatory outcome. Data analysis revealed that longterm
functional recovery was > 98% for affected dogs, regardless of their initial MFS, when
CSF CK activity was ≤ 38 U/L and MBP concentration was ≤ 3 ng/mL.
CONCLUSIONS AND CLINICAL RELEVANCE: In dogs with acute thoracolumbar IVDH, CSF CK
activity and MBP concentration appeared to be prognostic indicators and, along with initial
MFS, can be used to predict long-term ambulatory outcome. (J Am Vet Med Assoc
Presented as a poster at the American College of Veterinary Surgeons Symposium, Washington, DC, October 2009.