MAGNETIC

RESONANCE IMAGING
D I A G N O S I N G I N T E RV E RT E B RA L D I S C D I S E A S E ( I V D D )
R E B E C C A E N G L A N D , RV T
TA R L E T O N S TAT E U N I V E R S I T Y

MEET TULIP

PATIENT HISTORY
Tulip is a 2-year-old black and white Border collie pit mix
She was spayed at 4 months of age and adopted from the shelter
thereafter
She is current on all of her vaccinations and has had consistent
veterinary care as needed no major previous medical history
During the process of moving into a new house, she bolted out the
door into the street and was hit by a car going approximately 35 mph
She was taken to the nearest veterinarian for evaluation and
treatment
Her injuries appeared to be only superficial, with road rash on her
face and limbs she was in shock, but no major injuries were
apparent

ASSESSMENT
Initial examination:
General appearance lateral recumbency, stressed, wide eyes, shivering
EENT WNL
Integument road rash abrasions on lateral face, neck, shoulders, and all 4 limbs
Musculoskeletal difficult to assess, but patient cried out when neck was shifted
Abdominal palpation WNL
Respiratory increased rate and effort, no nasal discharge or bleeding
Cardiovascular tachycardic, pale mucous membranes
Nervous PLRs intact, deep pain present in all 4 limbs, rectal tone WNL, unable to
assess gait or CP

TPR: 101.2F, 168, 54

Weight: 39.9 lbs., BCS 5/9

SUPPORTIVE CARE
Stabilization
18g IVC was placed in her Left cephalic vein
A bolus of 500 ml of LRS was given IV, then given at 2x maintenance for the first hour
(100ml/hr)
TPR and MM/CRT was monitored continuously every 5 minutes during fluid administration
Butorphanol was administered IV and IM to provide pain management as well as sedation

Initial Treatments
Her entire body was mapped for wounds and abrasions
All noted areas were clipped of hair
Dilute chlorhexidine was used to clean those areas
Wet-to-dry bandages were placed on all 4 limbs temporarily for removal of dirt and road
debris
Cefazolin was given IV to provide initial antibiotic therapy
Carprofen was given SQ to provide pain control as well as anti-inflammatory action
Abrasions not covered by bandages were treated with a layer of Quadritop to reduce pain
and inflammation

DIAGNOSTICS
Bloodwork
Blood was obtained from her Left hind lateral saphenous vein to run a Chem 10, CBC,
and Electrolyte panel
A manual PCV/TP was also run
All blood tests were within normal parameters

Other Diagnostics
Survey radiographs were taken of her chest, abdomen, spine, and hips
All radiograph appeared to be WNL
All limbs were palpated, and no obvious fractures were noted
When the patient was able, she was assessed for CP deficits, ataxia, ROM, and gait
abnormalities
No abnormalities were present
A brief ultrasound was performed to assess possible trauma to the abdomen
No signs of bleeding found, organs appeared WNL

FURTHER TREATMENT
Tulip was continuously observed, remained on IV fluids, and her TPR
was monitored every 30 minutes
She received additional doses of cefazolin, carprofen, and Quadritop
Since sedation was no longer required, her pain management
regimen was changed to include the use of hydromorphone
At the end of the day, her IVC was removed and a temporary
bandage was placed to prevent bleeding
Upon release to the owner, she was sent home with an e-collar to
prevent excoriation (self-trauma) to her wounds, an oral antibiotic
(cephalexin), an oral anti-inflammatory (carprofen), and additional
pain management (tramadol)
A recheck was recommended and scheduled in 48 hours

ANESTHETIC RECOVERY

RECHECK EXAMINATION
The owner presented Tulip for her recheck as directed
Per the owner, she was taking all medications as directed
The owner did have a major concern:
Her neck seems to be bothering her
She holds her head lower in position than normal
She wont jump up on the couch or play like she normally does
She has trouble eating because she cant lower her head enough to reach to food bowl
She cries at random times when she attempts to move her head

Upon exam, she had significantly decreased ROM and pain was
elicited especially when her neck was extended and flexed
laterally
Her wet-to-dry bandages were removed and all the abrasion
wounds appeared to be healing well

REFERRAL
Radiographs were repeated, only this time focusing specifically on
the cervical vertebrae
No abnormalities were visualized
Options for further diagnostics and treatment were discussed with
the owner
A. Treat the clinical signs with rest and pain / anti-inflammatory management
B. Seek advanced imaging to assess the neck for possible spinal injury

The owner discussed the options with her family and elected to have
advanced imaging performed to determine the cause of Tulips pain
Due to the nature and characteristics of the injury, Tulip was referred
to an advanced veterinary imaging center where an MRI could be
performed
The MRI was scheduled to occur in 72 hours

CERVICAL
RADIOGRAPHS

Retrieved from Lavins Radiography for Veterinary Technicians, 5th ed.

PREPARATION
The owner was instructed to discontinue all anti-inflammatory
medications 48 hours in advance of the procedure, so that the scan
could provide unaltered, accurate anatomical images
MRI procedures in pets require heavy sedation or full anesthesia to
prevent any movement while images are being created
Tulip was fasted 12 hours before the procedure to reduce the
possibility of regurgitation while under anesthetic water was not
withheld
A 20g IVC was placed in her Right cephalic vein, so that anesthetic
drugs and fluids could be administered
When ready to start the scan, she will be anesthetized with
propofol IV and maintained on isoflurane gas this drug choice will
allow her to recover quickly

MAGNETIC
RESONANCE IMAGING
(MRI)
Was first utilized in the 1980s
Is becoming increasingly popular, especially in the veterinary
field
Provides better subject contrast than that of computerized
tomography (CT) and standard radiography
Superior demonstration of the brain, spinal cord, and soft
tissues such as ligaments and cartilage
DOES NOT utilize ionizing radiation to create images, and
therefore doesnt pose risks associated with radiation exposure
to staff or patients
Non-invasive

MRI MACHINE

Retrieved from Lavins Radiography for Veterinary

Technicians, 5th ed.

INDICATIONS FOR AN
MRI
Intracranial disease or seizures
Cranial nerve disorders
Chronic nasal discharge
Cervical or thoracolumbar disk disease, lumbosacral disorders
Spinal cord dysfunction
Suspected spinal tumors
Orthopedic disorders associated with soft tissue injuries
Chronic shoulder or elbow lameness
Cardiac or abdominal masses
Mapping vessels
Radiation therapy planning and tumor staging

HOW THE
PROCEDURE WORKS
The animal is placed into the magnet machine
All of the patients molecules align based on polarity and become magnetized
When ready to perform the scan, a radio frequency is applied and tuned to the
frequency of hydrogen atoms
The hydrogen atoms in the patient respond by resonating into a higher energy
state their angle of magnetization is also changed and they wobble together
The molecules then return to their normal energy state when the radio
frequency is removed
This gives off a radio frequency that is then calculated into an image
Images created are thin, cross-sectional slices of the anatomy being imaged
Scanning takes approximately 30 to 60 minutes, depending on the area being
imaged and complexity of the case

SAFETY FIRST!
The MRI machine is extremely dangerous, especially to those
who are untrained
The magnet is always on! So anyone going into the magnet
room must be screened for unsafe metal objects (implants, etc.)
The Projectile Effect launching of metallic objects into the
magnet by magnetic force can cause serious injury or death
Only magnetically safe objects are permitted!
There are specialized pieces of equipment that are designed for
use in the MRI room these must be utilized!
These include stretchers, monitors, oxygen tanks, anesthetic
machines, etc.

EXAMPLES OF SAFETY
SIGNS

Retrieved from Lavins Radiography for Veterinary

Technicians, 5th ed.

TULIPS MRI
She was anesthetized as per the protocol previously discussed
She was continuously monitored during the procedure, by hand and
with the use of a plastic esophageal stethoscope
When the procedure was finished, she recovered well and was sent
home with her owner
Based on her scan, she was diagnosed with intervertebral disc
disease, with a herniation noted at the C2-C3 junction of the cervical
vertebrae
She will need surgical correction to remove the disc contents that are
pressing onto the spinal cord, causing her pain and thus decreased
ROM and quality of life
The owner has scheduled surgery for later this week, and a surgical
report and update will follow

MRI RESULTS

Retrieved from www.google.com search

REFERENCES
Bassert, J. M. and McCurnin, D. M. (2010). McCurnins
Clinical Textbook for Veterinary Technicians, 7th ed. St.
Louis, MO: Saunders Elsevier.
Brown, M. and Brown, L. (2014). Lavins Radiography for
Veterinary
Technicians, 5th ed. St. Louis, MO: Saunders
Elsevier.
Vaden, S. L., Knoll, J. S., Smith Jr., F. W. K., and Tilley, L. P.
(2009).
Blackwells Five-Minute Veterinary Consult:
Laboratory Tests and
Procedures, Canine and Feline.
Ames, IA: Wiley-Blackwell.
Images without a source listed are from personal
photography library