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

TL;DR

Routine chest X-rays before anesthesia for dogs with suspected spinal disc issues rarely change treatment plans, but may be more useful in older dogs.

Contribution

This study quantifies the limited impact of thoracic radiographs on anesthetic planning for acute canine disc herniation.

Findings

Only 2 out of 105 dogs had treatment plans changed based on chest X-ray results.

Older dogs (12+ years) were 4.6 times more likely to show relevant thoracic pathology.

Radiographic findings rarely altered diagnostic or surgical approaches in most cases.

Abstract

Acute thoracolumbar intervertebral disc herniation (IVDH) constitutes an emergency because associated neurological clinical signs can be progressive, with prognosis dependent on preoperative presence of deep pain perception. Pre-anesthetic thoracic radiographs are routinely performed to evaluate for potential pathology that could result in increased risk or change in overall prognosis. However, due to the emergent nature of this disease, the weight of thoracic radiographic findings on treatment plans for these dogs in unknown. The objective of this study was to investigate the clinical benefit of thoracic radiographs prior to advanced spinal imaging and surgery for acute non-ambulatory dogs with suspected T3-L3 myelopathy.

Consecutive dogs presented with presumed acute IVDH between July 2020-July 2022 were identified, and medical records were reviewed retrospectively. Age, body weight, and alteration of treatment plan were compared between the dogs with positive thoracic pathology identified on thoracic radiographs and those with negative thoracic pathology.

Only 2/105 dogs had their diagnostic and treatment plans changed due to thoracic radiographic findings. Dogs with radiographic pathology diagnosed (2/16) were more likely to have their treatment plans changed than dogs with no radiographic pathology (0/89) (p = 0.014). The odds of radiographic thoracic pathology were 4.6 times higher in dogs aged 12 years or older [OR 4.6 (95%CI 1.2–17, p = 0.026].

Performing routine thoracic radiography prior to advanced (anesthetized) diagnostic spinal imaging in presumed IVDH cases rarely resulted in a change to the treatment plan, thought eh practice may be clinically relevant in dogs 12 years of age or older.