Species: dog
Breed: Tatra Sheperd
Sex: m, neutered
Weight: 48.6 kg
Birth date: 2021-07-01 00:00:00
Primary diagnosis: Spinal cord atrophy and disc extrusion with dynamic component at level of C5-6 intervertebral space, multiple facet joint cyst associated with left C6 spinal nerve compressive radiculopathy
Situation: emergency initial
Medical history: The dog was presented to our clinic on 03.12.2024. On 02.12 evening Rumianek wanted to walk back into the house when he suddenly swayed, straddled the back and then fell over. He didn't scream or cry. He couldn't get up after that. No trauma was observed before. They went to the private vet, were the dog got Dexamethason and Meloxicam. The private vet heard a slight heart murmur. At night he did not seem to be in much pain. The morning of presentation Rumianek was able to move his legs a little better and got Meloxicam from the owner. He has not passed any urine or faeces since this incident. At our clinic the dog was hospitalized and the day after an MRI was done. MRI report (04.12): Cervical myelopathy, affecting predominantly the grey matter; Spinal cord atrophy and disc extrusion with dynamic component at the level of C5-6 intervertebral space; Multiple facet joint cyst associated with left C6 spinal nerve compressive radiculopathy --> The myelopathy likely represents spinal cord contusion and/or edema as a consequence of FCE/ANNPE/myelitis. On 06.12 the dog went into surgery (ventral slot). The dog stayed hospitalized until 12.12 and was then transferred to a rehabilitation center. That day the dog still couldn't walk himself but he started putting himself in a sternal position. The dog is apparently deaf.
Medication: Evening before presentation (02.12): Dexamethadon and meloxicam. The morning of presentation (03.12): Meloxicam. No medication before and between observations 1 & 2. 04.12: Gabapentin 10 mg/kg PO TID started at 18, Furosemid 2 mg/kg IV at 23. 05.12 (nothing given before observation 4): Meloxicam 0.1 mg/kg IV SID. 08.12: Meloxicam 0.1 mg/kg IV SID, Gabapentin 20 mg/kg PO TID, Buprenorphin 0.02 mg/kg IV TID, Trazodon 3 mg/kg PO at 11 & 17, Pro-Kolin PO BID, Acepromazin 0.001 mg/kg IV at 05 (09.12). 09.12: Buprenorphin 0.02 mg/kg IV TID, Ondansetron 0.3 mg/kg IV TID, Gabapentin PO TID 10 mg/kg at 09 then 5 mg/kg at 17, Acepromazin 0.001 mg/kg IV at 18 and 23, Trazodon 3 mg/kg PO at 18. 10.12 (nothing given before observation 5): Ondansetron 0.3 mg/kg IV TID, Buprenorphin 0.015 mg/kg IV 1x at 24, Acepromazin 0.002 mg/kg IV at 02 and 05 (11.12), Gabapentin 5 mg/kg PO at 09 and 24, Paracetamol 10 mg/kg IV TID. 11.12 (nothing given before observation 6): Ondansetron 0.3 mg/kg IV, Gabapentin 5 mg/kg PO TID (but only given at 17 and 24), Paracetamol 10 mg/kg PO TID, Pro-Kolin according to weight PO TID. 12.12 (nothing given before observation 7): Ondansetron & Gabapentin & Paracetamol & Pro-Kolin same as 11.12.
Neurologic exam: Performed on 03.12.2024 by emergency team. Mentation: normal. Posture: sternal recumbency, unable to stand without support. Gait: Tetraparesis with knuckling on all 4 limbs. Cranial nerves: unremarkable, only swallowing movement is partially very pronounced Postural reactions: highly reduced on all 4 limbs, deficit on the right more pronounced. Spinal reflexes: Flexor unremarkable on all 4 limbs; Anal tone and tail tone present, increased panniculus reaction on the right side at thoracolumbar level. Sensitivity: no pain can be triggered. Neuroanatomical localisation: C1-C5.
Pain type: acute, nociceptive, somatic
Pain origin: neck
Pain duration: Less than 24 hours
Estimated pain severity: 48