Treatment of traumatic cervical myelopathy with surgery, prolonged positive-pressure ventilation, and physical therapy in a dog.
METHODS
A 9-year-old dog was evaluated for traumatic cervical myelopathy after a surgical attempt to realign and stabilize the C2 and C3 vertebrae.


RESULTS
The dog could not ventilate spontaneously and was tetraplegic; positive-pressure ventilation (PPV) was maintained. Myelography and computed tomography revealed spinal cord compression with subluxation of the C2 and C3 vertebrae and extrusion of the C2-3 intervertebral disk.


RESULTS
Surgically, the protruding disk material was removed and the vertebrae were realigned with screws and wire. For PPV, assist control ventilation in volume control mode and then in pressure control mode was used in the first 6 days; this was followed by synchronized intermittent mandatory ventilation until 33 days after the injury; then only continuous positive airway pressure was provided until the dog could breathe unassisted, 37 days after the injury. Physical therapy that included passive range of motion exercises, neuromuscular electrical stimulation, and functional weight-bearing positions was administered until the dog was discharged 46 days after injury; the dog was severely ataxic and tetraparetic but could walk. Therapy was continued at home, and 1 year later, the dog could run and had moderate ataxia and tetraparesis.


CONCLUSIONS
Hypoventilation with tetraparesis in traumatic spinal cord injury can be successfully treated with PPV exceeding 30 days, surgery, and physical therapy.
Smarick
Sean D
SD
Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.
Rylander
Helena
H
Burkitt
Jamie M
JM
Scott
Nancy E
NE
Woelz
Jacqueline S
JS
Jandrey
Karl E
KE
Aldrich
Janet
J
Sturges
Beverly K
BK
D000818:Animals; D002574:Cervical Vertebrae / Q000293:injuries / Q000601:surgery; D004283:Dog Diseases / Q000601:surgery / Q000628:therapy*; D004285:Dogs; D005260:Female; D007405:Intervertebral Disc Displacement / Q000601:surgery / Q000628:therapy / Q000662:veterinary; D026741:Physical Therapy Modalities / Q000662:veterinary*; D020127:Recovery of Function; D012121:Respiration, Artificial / Q000662:veterinary; D013117:Spinal Cord Compression / Q000601:surgery / Q000628:therapy / Q000662:veterinary; D013119:Spinal Cord Injuries / Q000601:surgery / Q000628:therapy / Q000662:veterinary*; D014057:Tomography, X-Ray Computed / Q000662:veterinary; D016896:Treatment Outcome