{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T18:25:10Z","timestamp":1787682310494,"version":"build-2784847793"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"vor","delay-in-days":55,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Linnaeus Veterinary Limited"},{"name":"Mars Veterinary Health"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hydrated nucleus pulposus extrusion (HNPE) is associated with favorable outcome after conservative or surgical treatment. However, optimal management for dogs with severe neurologic deficits remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Hypothesis\/Objectives<\/jats:title>\n                    <jats:p>Compare conservative vs surgical treatment in nonambulatory paretic or plegic dogs with HNPE, focusing on recovery of unassisted ambulation and voluntary urination, and identify prognostic factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Animals<\/jats:title>\n                    <jats:p>Eighty-six dogs with severe neurologic impairment and a presumptive magnetic resonance imaging (MRI) diagnosis of HNPE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective multicenter study. Signalment, neurologic grade, neurolocalization, MRI findings, and treatment were recorded. Outcome was assessed at 1 week, 4 weeks, and 6 months. Satisfactory outcome was defined as recovery of voluntary urination and independent ambulation. Recovery time was defined as days to regain unassisted ambulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sixty dogs were treated conservatively and 26 surgically. Hydrated nucleus pulposus extrusion was cervical in 71\/86 (83%) dogs and thoracolumbar in 15\/86 (17%). At presentation, 62\/86 (72%) dogs were nonambulatory paretic, 22\/86 (26%) were plegic with intact nociception, and 2\/86 (2%) were plegic without nociception. At 1 week, neurologic status was better in the conservative group than in the surgical group, whereas no differences were observed at later follow-up. Satisfactory outcome was achieved in 85% of conservatively treated and 100% of surgically treated dogs. Median recovery time was 7 days with conservative treatment and 9 days with surgery. Non-chondrodystrophic breed, MRI intramedullary T2-weighted hyperintensity, and physical therapy were associated with longer recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and clinical importance<\/jats:title>\n                    <jats:p>Conservative treatment represents a valid option for nonambulatory dogs with HNPE. Signalment and MRI features should guide treatment selection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jvimsj\/aalag178","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T17:54:19Z","timestamp":1787680459000},"source":"Crossref","is-referenced-by-count":0,"title":["Acute hydrated nucleus pulposus extrusion in dogs with severe neurologic status: comparison between conservative and surgical treatment"],"prefix":"10.1093","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0529-2616","authenticated-orcid":false,"given":"Martin","family":"Di Tosto","sequence":"first","affiliation":[{"name":"Clinic for Small Animal, University of Veterinary Medicine Hannover , Hannover ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8003-1784","authenticated-orcid":false,"given":"Cristina","family":"Toni","sequence":"additional","affiliation":[{"name":"Neurology Department, Willows Veterinary Centre and Referral Service (part of Linnaeus Veterinary Limited, which is part of Mars Veterinary Health), Solihull,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6586-5035","authenticated-orcid":false,"given":"Barbara","family":"Contiero","sequence":"additional","affiliation":[{"name":"Department of Animal Medicine, Productions and Health, University of Padua , Padua ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3180-8788","authenticated-orcid":false,"given":"Francesca","family":"Cozzi","sequence":"additional","affiliation":[{"name":"Neurology Referral, Clinica Neurologica Veterinaria - NVA , Milan,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4177-5131","authenticated-orcid":false,"given":"Katia","family":"Marioni-Henry","sequence":"additional","affiliation":[{"name":"Neurology Department, Fitzpatrick Referrals , Godalming,","place":["United Kingdom"]},{"name":"Royal (Dick) School of Veterinary Studies and the Roslin Institute, The University of Edinburgh , Edinburgh ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7213-1005","authenticated-orcid":false,"given":"Marika","family":"Menchetti","sequence":"additional","affiliation":[{"name":"Neurology Department, San Marco Veterinary Clinic , Veggiano,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4405-8428","authenticated-orcid":false,"given":"Barbara","family":"Betti","sequence":"additional","affiliation":[{"name":"Neurology Department, AniCura Istituto Veterinario di Novara , Novara,","place":["Italy"]},{"name":"Neurology Department, Clinica Veterinaria Croce Blu , Alessandria,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0550-2574","authenticated-orcid":false,"given":"Federica","family":"Tirrito","sequence":"additional","affiliation":[{"name":"Neurology Department, AniCura Istituto Veterinario di Novara , Novara,","place":["Italy"]},{"name":"Department of Veterinary Medicine, University of Bari \u201cAldo Moro\u201d , Strada Provinciale 62 per Casamassima Km 3, Valenzano 70010 ,","place":["Italy"]},{"name":"Department of Veterinary Medicine and Animal Sciences, University of Milan , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"key":"2026082513541018700_ref1","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1111\/j.1748-5827.2011.01166.x","article-title":"Clinical and magnetic resonance imaging features of canine compressive cervical myelopathy with suspected hydrated nucleus pulposus extrusion","volume":"53","author":"Beltran","year":"2012","journal-title":"J Small Anim Pract"},{"key":"2026082513541018700_ref2","doi-asserted-by":"publisher","first-page":"579025","DOI":"10.3389\/fvets.2020.579025","article-title":"Classification of intervertebral disc disease","volume":"7","author":"Fenn","year":"2020","journal-title":"Front Vet Sci"},{"key":"2026082513541018700_ref3","doi-asserted-by":"publisher","first-page":"1989","DOI":"10.1111\/jvim.15304","article-title":"Comparison of surgical and conservative treatment of hydrated nucleus pulposus extrusion in dogs","volume":"32","author":"Nessler","year":"2018","journal-title":"J Vet Intern Med"},{"key":"2026082513541018700_ref4","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1016\/j.cvsm.2017.08.004","article-title":"Acute herniation of nondegenerate nucleus pulposus: acute noncompressive nucleus pulposus extrusion and compressive hydrated nucleus pulposus extrusion","volume":"48","author":"De Decker","year":"2018","journal-title":"Vet Clin North Am Small Anim Pract"},{"key":"2026082513541018700_ref5","doi-asserted-by":"publisher","first-page":"588338","DOI":"10.3389\/fvets.2020.588338","article-title":"Diagnostic imaging in intervertebral disc disease","volume":"7","author":"Da Costa","year":"2020","journal-title":"Front Vet Sci"},{"key":"2026082513541018700_ref6","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1016\/j.tvjl.2014.12.027","article-title":"Hydrated nucleus pulposus herniation in seven dogs","volume":"203","author":"Manunta","year":"2015","journal-title":"Vet J"},{"key":"2026082513541018700_ref7","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1136\/vr.104528","article-title":"Comparison of medical and surgical treatment for acute cervical compressive hydrated nucleus pulposus extrusion in dogs","volume":"181","author":"Borlace","year":"2017","journal-title":"Vet Rec"},{"key":"2026082513541018700_ref8","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1186\/s13028-015-0151-x","article-title":"Hydrated nucleus pulposus extrusion in dogs: correlation of magnetic resonance imaging and microsurgical findings","volume":"57","author":"Dolera","year":"2015","journal-title":"Acta Vet Scand"},{"key":"2026082513541018700_ref9","doi-asserted-by":"publisher","first-page":"1438300","DOI":"10.3389\/fvets.2024.1438300","article-title":"Clinical presentation, magnetic resonance imaging findings, and outcome of 80 dachshunds with cervical intervertebral disc extrusion","volume":"11","author":"Violini","year":"2024","journal-title":"Front Vet Sci"},{"key":"2026082513541018700_ref10","volume-title":"Small Animal Spinal Disorders: Diagnosis and Surgery","author":"Sharp","year":"2005","edition":"2nd"},{"key":"2026082513541018700_ref11","doi-asserted-by":"publisher","first-page":"588338","DOI":"10.3389\/fvets.2020.588338","article-title":"Diagnostic imaging in intervertebral disc disease","volume":"7","author":"Da Costa","year":"2020","journal-title":"Front Vet Sci"},{"key":"2026082513541018700_ref12","doi-asserted-by":"publisher","first-page":"210","DOI":"10.2460\/javma.256.2.210","article-title":"Agreement of surgeon's perception of the effectiveness of spinal cord decompression with findings on postoperative magnetic resonance imaging for dogs surgically treated for intervertebral disk extrusion","volume":"256","author":"Tirrito","year":"2020","journal-title":"J Am Vet Med Assoc"},{"key":"2026082513541018700_ref13","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1055\/s-0041-1740608","article-title":"Hydrated nucleus pulposus extrusion in dogs: thoracolumbar compared to cervical cases","volume":"35","author":"Kristiansen","year":"2022","journal-title":"Vet Comp Orthop Traumatol"},{"key":"2026082513541018700_ref14","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1111\/vru.13178","article-title":"MRI features can help to confirm a diagnosis of progressive myelomalacia, but may not be accurate in dogs lacking characteristic clinical signs at the time of imaging","volume":"64","author":"Cordle","year":"2023","journal-title":"Vet Radiol Ultrasound"},{"key":"2026082513541018700_ref15","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1016\/j.tvjl.2013.04.003","article-title":"Correlations between severity of clinical signs and histopathological changes in 60 dogs with spinal cord injury associated with acute thoracolumbar intervertebral disc disease","volume":"198","author":"Henke","year":"2013","journal-title":"Vet J"},{"key":"2026082513541018700_ref16","doi-asserted-by":"publisher","first-page":"2693","DOI":"10.1111\/jvim.15626","article-title":"Predictors of urinary or fecal incontinence in dogs with thoracolumbar acute non-compressive nucleus pulposus extrusion","volume":"33","author":"Mari","year":"2019","journal-title":"J Vet Intern Med"},{"key":"2026082513541018700_ref17","doi-asserted-by":"publisher","first-page":"1454","DOI":"10.2460\/javma.2005.227.1454","article-title":"Prognostic value of magnetic resonance imaging in dogs with paraplegia caused by thoracolumbar intervertebral disk extrusion: 77 cases (2000\u20132003)","volume":"227","author":"Ito","year":"2005","journal-title":"J Am Vet Med Assoc"},{"key":"2026082513541018700_ref18","doi-asserted-by":"publisher","first-page":"596059","DOI":"10.3389\/fvets.2020.596059","article-title":"Prognostic factors in canine acute intervertebral disc disease","volume":"7","author":"Olby","year":"2020","journal-title":"Front Vet Sci"},{"key":"2026082513541018700_ref19","doi-asserted-by":"publisher","first-page":"e70135","DOI":"10.1111\/jvim.70135","article-title":"Exercise restriction does not change outcome in dogs after diagnosis of acute non-compressive nucleus pulposus extrusion, fibrocartilaginous embolism, or hydrated nucleus pulposus extrusion","volume":"39","author":"Phillips","year":"2025","journal-title":"J Vet Intern Med"},{"key":"2026082513541018700_ref20","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1111\/j.1532-950X.2007.00296.x","article-title":"Evaluation of the success of medical management for presumptive cervical intervertebral disk herniation in dogs","volume":"36","author":"Levine","year":"2007","journal-title":"Vet Surg"},{"key":"2026082513541018700_ref21","doi-asserted-by":"publisher","first-page":"e17284","DOI":"10.1111\/jvim.17284","article-title":"Clinical characteristics associated with cervical hydrated nucleus pulposus extrusion in dogs","volume":"39","author":"Lin","year":"2025","journal-title":"J Vet Intern Med"},{"key":"2026082513541018700_ref22","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1016\/j.tvjl.2016.12.008","article-title":"Proportion recovery and times to ambulation for non-ambulatory dogs with thoracolumbar disc extrusions treated with hemilaminectomy or conservative treatment: a systematic review and meta-analysis of case-series studies","volume":"220","author":"Langerhuus","year":"2017","journal-title":"Vet J"}],"container-title":["Journal of Veterinary Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jvim\/article-pdf\/40\/4\/aalag178\/70787160\/aalag178.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jvim\/article-pdf\/40\/4\/aalag178\/70787160\/aalag178.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T17:54:20Z","timestamp":1787680460000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jvim\/article\/doi\/10.1093\/jvimsj\/aalag178\/8770644"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,1]]},"references-count":22,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,7,1]]}},"URL":"https:\/\/doi.org\/10.1093\/jvimsj\/aalag178","relation":{},"ISSN":["1939-1676"],"issn-type":[{"value":"1939-1676","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,7]]},"published":{"date-parts":[[2026,7,1]]},"article-number":"aalag178"}}