Bernese mountain dog Lisa is a 9 year old, intact female, weighing 37 kg presented with a one day history of anorexia and intermittent vomiting and difficulties moving. 

History. Lisa doesn‘t find a comfortable position to sleep and is getting up and laying down and getting up again. Regularly vaccinated and dewarmed. Has had already 2 surgeries for intestinal obstruction, last time several years ago.

Physical examination.
Reduced general condition, heart rate 120 beats/minute, rectal temperature 40.8°C,pale mucous membranes,capillary refill time: 2 seconds,palpable lymph nodes unremarkable.
Abdominal palpation is not possible: Lisa is tensiong up on palpation, abdomen appears to be painful. Spinal palpation: focal  pain in the cranial lumbar spine.

List possible differential diagnoses:

1. Intestinal obstruction
2. Intestinal ulceration
3. Pancreatitis
4. Intervertebral disc disease
5. Discospondylitis

What would be your next diagnostic tests?

1. CBC
2. blood chemistry
3. abdominal ultrasound
4. abdominal radiographs
5. spinal radiographs

Question yourself!

1. Which vertebral bodies are radiographed?
2  Is that a well positioned laterolateral radiograph?
3. Describe the pathological changes on Lisa‘s spinal radiograms.
4. After doing a radiogram, what is your diagnosis?
       a. Spondylosis deformans
       b. Dissemanted idiopathic skeletal hyperostosis (DISH)
       c. Lytic end-plates L3-L4
       d. Discospondylitis
5. Which anatomical structures are involved in this pathology?
6. What is the etiology behind the lesion?
7. What is your diagnostic plan after radiography?
8. What is your treatment plan?
9. When is surgical treatment considered?