Mr. Smalls presented to our Neurology service for severe neck pain. He had episodes of crying out in pain and holding up his right front limb. Other than neck pain, he had no other neurological deficits on his examination at PVESC.

Cervical MRI revealed a severely lateralized foraminal disc herniation at C2-3 on the right. This was consistent with his clinical signs at home. Successful medical management was given a guarded prognosis due to the severe lateralization of the disc herniation.

Mr. Smalls was admitted for a cervical hemilaminectomy, as he had multiple recurrences of neck pain as oral prednisone was tapered. A cervical hemilaminectomy was performed by Dr. Eifler and Dr. Landry as a team, and Mr. Smalls was discharged several days later comfortable on oral medications for strict crate rest.

Mr. Smalls presented for his 6 week post-surgery recheck with a normal neurological examination off all oral medications.

The PVESC Neurology team is so happy for Mr. Smalls’ recovery, and are so thankful to have the dedicated team and quality facility to help pets with challenging neurological conditions.

T2-Weighted transverse cervical spine MRI image. There is extradural nerve root compression on the right.

The red arrow shows the small round hypointense disc material compressing the right nerve root.

The left nerve root appears normal (blue arrow).

The spinal cord is labeled with a star.

CLINICALLY REVELANT FACTS:

• Cervical disc herniations that involve the nerve root carry a more guarded prognosis for medical management alone (prednisone, rest, analgesic medications)
• A routine ventral slot surgery has little to no ability to reach disc and nerve root in the foramina
• Cervical hemilaminectomies require longer recovery (due to the dorsal approach) and carry higher risk due to the location of the vertebral artery
• Red oval below shows ideal surgical site margins

ABOUT PVESC NEUROLOGY

PVESC Neurology is here for you Monday – Friday for scheduled appointments, and 7 days a week for neurological emergencies. Our state-of-the-art MRI allows us to offer the gold standard care for our patients 24/7. Our goal is to continue to bring quality veterinary neurology to the state of Maine.

If you are looking to refer and quote a client for emergency advanced imaging +/- surgery, please see general guidelines below:

Bloodwork, brain MRI, +/- CSF tap – $3500 – 4000. Infectious CNS disease testing may be recommended at additional cost pending test results.
Bloodwork, spine MRI, surgical decompression, hospitalization – $7000 – 10,000.

Authored by: Dr. Landry, DVM, DACVIM, Neurology