Results of routine thoracic radiographic examinations rarely impact the plan to proceed with anesthetic procedures in dogs with presumed acute intervertebral disc herniation

Teiko Takedai Nicole Block Karina M. Pinal Steven W. Frederick

Background

The study explores the clinical utility of routine pre-anesthetic thoracic radiographic examinations in dogs with presumed acute thoracolumbar intervertebral disc herniation (IVDH). IVDH is a critical condition in dogs that can lead to severe neurological symptoms. The primary concern addressed is whether findings from routine thoracic radiography alter the management plan for dogs undergoing anesthesia for advanced spinal imaging and surgery.

Methods

This retrospective study reviewed medical records of dogs presented with presumed acute IVDH at a specialty veterinary hospital between July 2020 and July 2022. Dogs were included if they underwent routine thoracic radiographs prior to advanced spinal imaging as part of a pre-anesthetic screening. The primary variable of interest was the alteration of the treatment plan based on the radiographic findings. Statistical analyses were conducted using Fisher’s exact test and logistic regression.

Results

Among the 105 dogs included, only 2 had changes in their treatment plans attributable to thoracic radiographic findings, suggesting a minimal impact of these findings on clinical decision-making. Abnormal radiographic findings were identified in 16 dogs, with cardiomegaly, pneumonia, and various masses being the most common abnormalities. Despite these findings, most dogs proceeded with the planned diagnostic and therapeutic procedures.

Limitations

The study acknowledges several limitations, including its retrospective nature and the reliance on accurate medical record documentation. It also mentions the potential bias introduced by varying clinician recommendations and the generalizability of the results to other settings or populations.

Conclusions

Routine thoracic radiography in dogs with suspected acute IVDH rarely influences the clinical management plan. However, the study highlights that older dogs (aged 12 years and older) were more likely to have radiographic abnormalities that could influence clinical decisions, suggesting a potential area for further research. Despite the low impact on treatment alterations, the authors suggest that thoracic radiography might still hold clinical relevance, particularly in older dogs or those with specific risk profiles. Further studies are recommended to assess the universal applicability of these findings.

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