Aberrant migration of Spirocerca lupi to the spinal cord in dogs: Association of clinical signs, CSF analysis, preventive treatment, and outcome

Spirocerca lupi is a nematode typically targeting the esophageal wall but may also migrate to the spinal cord. This study aimed to characterize the clinical presentation, cerebrospinal fluid (CSF) findings, prognostic factors, and outcomes of dogs with spinal S. lupi (SSL) aberrant migration, and to evaluate prophylactic treatment efficacy. Medical records from 2016 to 2022 were reviewed, including 284 study and 280 control dogs. Complete recovery occurred in 130/284 dogs (46 %) at 1 month, and in 214/284 dogs (75 %) at 3 months and was associated with the clinical grade at presentation (P < 0.001). Of the 162 non-ambulatory dogs, 59 % became ambulatory at 1 month, and 79 % at 3 months. Dogs with urinary incontinence were less likely to fully recover (P = 0.04). Protein CSF concentration was lower at presentation in dogs who completely recovered at 1 month and 3 months (344 mg/dL [15-1297] vs. 732 mg/dL [34-1291], P = 0.006, and 366 mg/dL [15-1297] vs. 769 mg/dL [83-1262], P = 0.025, respectively). A higher proportion of control dogs received prophylactic treatment compared to the SSL group (216/280 [77 %] vs. 168/284 [59 %], respectively, P < 0.001, OR 0.43, CI 0.30-0.62) however, prophylactic treatment did not significantly impact recovery rates. Our findings suggest that SSL is associated with a favorable prognosis; however, full recovery may take several months, and dogs presenting with urinary incontinence and higher neurological severity grades are less likely to recover. Finally, our findings suggest that prophylactic treatment against S. lupi may have a protective effect against SSL and is therefore recommended in endemic regions.