A 6-year-old, neutered male Dachshund was presented for severe cervical pain. Medical management, including tramadol, methocarbamol, and prednisone, was attempted for 2 weeks prior to presentation. Physical and neurological examinations identified lameness in the left forelimb and cervical pain. Mild postural reaction deficits and decreased spinal reflexes were noted in the left forelimb. Orthopedic examination was normal.\nMagnetic resonance imaging of the cervical spine was performed. At C6–C7, there was an aggregation of material in the left ventral aspect of the vertebral canal and interverterbral foramen that was hypointense on T2W and STIR sequences with mild contrast enhancement on T1W sequence (Figure ). This material resulted in mild left sixth spinal nerve root compression and minimal extradural spinal cord compression. Additionally, there was mild broad-based dorsal protrusion of the annulus fibrosis throughout the remainder of the cervical vertebral column, without spinal cord or nerve root compression.\nTreatment options were discussed and the client elected fluoroscopically guided perineural injection of 5 mg methylprednisolone (1 mg/kg) at the C6–C7 foramen. Anesthetic recovery was uneventful.\nOnly mild improvement in pain was noted during hospitalization. The patient was discharged with gabapentin 50 mg (10 mg/kg) q8–12 h, tramadol 12.5 mg (2.5 mg/kg) q8–12 h, and prednisone 2.5 mg (1 mg/kg) q12 h the following day. The owner reported that over the next couple of months the patient continued to improve at home and both the tramadol and prednisone were discontinued by the owner and family veterinarian. Six months later, the clients were contacted by phone and reported that they administered gabapentin only as needed after intense exercise.
An 11-year-old, neutered male mixed breed dog was presented for evaluation of an acute onset of severe neck pain and left forelimb lameness that worsened the week prior to presentation. He had received no treatment prior to presentation. Physical and neurological examinations identified mild tetraparesis and ataxia with left thoracic root-signature signs. Left forelimb lameness was noted with mild proprioceptive deficits in the left thoracic and pelvic limbs. The right forelimb was normal. Pain was apparent on cervical but not thoracolumbar manipulation. Orthopedic examination was normal. Findings were consistent with a lesion affecting the C6–T2 spinal nerves or spinal cord segments and T3–L3 spinal cord segments.\nMagnetic resonance imaging of the cervical spine revealed that the nucleus of the intervertebral disk at C6–C7 was hypointense on all sequences, and there was mild broad-based dorsolateral protrusion of the C6–C7 intervertebral disk toward the left intervertebral foramen, compressing the left sixth nerve root. No spinal cord compression was noted.\nTreatment options were discussed with the client. The client elected fluoroscopically guided perineural injection of methylprednisolone (1 mg/kg) into the area of the intervertebral foramen of C6–C7. Anesthetic recovery was uneventful.\nIncreased willingness to ambulate and improved voluntary range of motion of the head and neck were noted on exam the following morning; lameness was still present. The patient was subsequently discharged with gabapentin (5.9–11.8 mg/kg PO BID), prednisone on a tapering dose beginning at 1.2 mg/kg q12 h and tramadol (3–4.4 mg/kg PO q8 h). At the 2-week follow-up evaluation, the patient showed only mild pain during range of motion. Forelimb weakness and lameness were no longer evident. Prioprioception was improved in the left forelimb. T3–L3 signs were unchanged. Prednisone and tramadol were discontinued at this visit. Further telephone follow-up with the owner revealed that gabapentin was continued as needed for pain for 2–3 months then discontinued. The patient remained free from clinical signs of radicular pain but had succumbed to lymphoma 18 months later.