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Dennis gets his wobble fixed!

Dennis is a young Yorkshire terrier referred to us in October 2013 with a one month history of progressive hindlimb weakness and incoordination.

He was wobbly on his backlegs and this was interfering with his ability to run about and have a normal life. Clinical examination suggested that his spinal cord was abnormal midway along his back; his head and forelimbs were normal but his hindlimbs were not fully under the control of his brain. In an older animal this would most commonly occur due to a slipped disc pressing on the spinal cord, but at just one year of age, Dennis was a bit too young for a slipped disc.

The best way of investigating brain and spinal cord disease is with an MRI scan. We are one of a handful of practices in the Northwest that has a regular visit from a mobile MRI unit and Dennis had an MRI scan performed at the next visit of the MRI unit.

The MRI scan clearly showed a fluid bleb at the level of the 10th thoracic vertebra which was compressing his spinal cord and causing the hindlimb weakness. This is a very unusual developmental disorder called an arachnoid cyst caused by incomplete separation or adhesions of the meningeal membranes around the spinal cord. The problem could be treated with spinal surgery, although the surgery is technically difficult and around a third of dogs can have recurrence of the problem in the future.

Longitudinal slice through Dennis’s spine on MRI showing a white pear-dropped shaped fluid bleb (*) just above his spinal cord at the 10th thoracic vertebra (T10) causing compression of the dark spinal cord.

Dennis’ owners were aware of the risks of surgery but could see he was getting worse on his back legs each week. Surgery involved removal of part of the bone around the spinal cord using a high speed surgical burr, an incision into the dural envelope around the spinal cord and marsupialisation of the arachnoid cyst to decompress the spinal cord. Dennis was such a small dog that his spinal cord in this location was around 4mm in diameter so there was no room for error. Fortunately surgery went extremely well and Dennis was ambulatory the day after surgery and discharged home two days after surgery. One week later Dennis was already showing signs of improvement as he was no longer falling over when he tried to cock his back leg to urinate.

Transverse slice though Dennis’s spine at the level of T10. The spinal cord (*) is usually circular in cross section but is being squashed by the white arachnoid cyst from top left.

When his skin sutures were removed he started a program of hydrotherapy to assist his rehabilitation. The hydrotherapy allows him to improve neuromuscular coordination, build up his hindlimb muscles and most dogs really enjoy the underwater treadmill.

Little Dennis looks tiny on our hydrotherapy treadmill...

..but he's soon enjoying his underwater exercise!

 

It is now  several months since surgery and we are pleased to report that Dennis is having a normal life again.

Thanks to Dennis' owners for allowing us to share his story.

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