Progress on Tricky Issues in Spinal Cord Injury

Spinal cord injury is an extremely common problem and while dogs with incomplete injuries do well, dogs with complete injuries have a much less predictable recovery. This raises problems that we still struggle to solve. Central to the challenges we encounter is the limitation of clinical quantification of injury in animals that present with paraplegia and no pain perception. These animals have clinically complete injuries but, as reflected by the excellent recovery of approximately 50% of them, their underlying lesions are extremely variable in severity. In other words, we encounter a very limiting floor effect in our scoring. This has numerous consequences, including difficulty in providing an accurate prognosis for owners and the necessity for large treatment groups in clinical trials.
This presentation will describe methods of quantifying injury severity using MRI techniques, including diffusion tensor imaging (DTI). The issue of group size for clinical trials can be addressed by running multicenter basis working with private practices.  This presentation will describe the issues that must be addressed to collaborate effectively with private practices. Finally, the issue of the variability of injury severity in deep pain negative dogs, and factors that influence recovery of ambulation will be discussed.