Introduction

• Cause: unknown.
• Signs: often clinically silent, can lead to spinal pain, stiffness and in advanced stages neurological signs.
• Diagnosis: spinal radiography, advanced imaging of the spine if neurological signs.
• Treatment: no known cure, analgesic if needed, surgical decompression of neural tissues may provide temporary remission.
• Prognosis: guarded.

Pathogenesis

Etiology

• Unknown.
• May be inherited in Boxers.
• Another hypothesis suggests that canine DISH may be secondary to other diseases including hypoparathyroidism Primary hypoparathyroidism and hypercalcitonism Hypercalcitonism.

Pathophysiology

• Systemic non-inflammatory disorder.
• Result in calcification and ossification of the soft tissues including the ventral longitudinal ligament and other attachments to bone such as ligaments, tendons and capsules (enthesis).
• Affects both the axial and appendicular skeleton.
• DISH in dogs is mostly characterized by generalized new bone formation that appears as flowing ossification due to their trabecular pattern, along the ventral and lateral aspects of the vertebral column.
• Most commonly in the thoracolumbar vertebral column, especially T6-T10 and L2-L6.
• Often remain clinically silent but can lead to spinal pain, stiffness and in advanced stages spinal cord or nerve root compression and neurologic deficits.
• Pain associated with DISH may be due to the involvement of the periosteum and the massive extension of the ossification into the surrounding soft tissues.
• Bony proliferation in the region of the exit zones of the intervertebral foramen can result in foraminal stenosis and nerve root irritation.
• An association between intervertebral disk herniation Intervertebral disk: type 1 herniation Intervertebral disk: type 2 herniation at sites adjacent to segments affected with DISH has been suggested but remains to be proven.

Diagnosis

Treatment