TECHNOLOGY & INNOVATION

From Dramatic Decline to Rapid Recovery

May 20,2021
4-year old Pointer mix suffers sudden weakening in his limbs and is rushed to emergency care. Diagnosed with an acute hydrated disc extrusion, the neurology team springs into action.
On Dec. 23, 2020, Gunther, a beloved four-year-old Pointer mix, was admitted for emergency care at VCA Alameda East Veterinary Hospital in Denver, Colorado. He had suddenly begun to suffer neck pain and weakness in his legs. And he seemed to be declining fast. 

The team admitted Gunther for emergency care and made sure he stayed stable overnight. Besides offering 24-hour emergency care, VCA Alameda East Veterinary Hospital offers primary veterinary care and 12 specialty departments, including surgery, internal medicine, oncology, dermatology, and neurology. The hospital has over two dozen board-certified veterinary specialists on staff to provide the most advanced veterinary care in their areas of expertise

“Many emergency hospitals in the area don’t offer neurology as a specialty, and that’s really what Gunther needed,” says Dr. Samantha Emch, a veterinary neurologist at VCA Alameda East. Every morning the hospital team reviews cases that were admitted the previous day and assigns the appropriate doctor for each of those patients. This assures that each pet gets the best possible care. That meant Gunther had the distinct advantage of seeing a neurology specialist right away.

When Dr. Emch took over Gunther’s care first thing on Christmas Eve, he was completely paralyzed. “When we supported him, he couldn’t move any of his legs,” she says. “That’s a frighteningly fast progression for a pet owner to witness: normal to paralyzed in 24 hours.” 

Dr. Emch’s exam of Gunther indicated a problem affecting his cervical spinal cord, and she recommended an MRI. Magnetic resonance imaging (MRI) is an imaging technique that gives doctors detailed images of organs, tissues and the skeletal system. MRI is the most frequently used imaging technique of the brain and spinal cord. 

The MRI showed an acute hydrated disc extrusion, which means that the inner core of a disc that acts as a shock absorber between two vertebrae of the neck broke through the outer disc layer and leaked into the spinal canal, compressing the spinal cord. “More often in these cases the disc has degenerated, and the core that breaks through is solid and chalky. In Gunther’s case, the inner core was still gel-like, which is less common,” Dr. Emch says.
4 year old Pointer mix dog
The next step was an important conversation with Gunther's owners. Dr. Emch shared the findings of a 2018 medical paper published in the Journal of Veterinary Internal Medicine that compared the outcomes of dogs with Gunther’s condition. The study showed that dogs treated with both medication and surgery had the same results as dogs who received only medication.  

“Gunther’s dad is a human physician, so he really understood the potential pros and cons of moving forward with the surgery,” Dr. Emch says. “Because Gunther’s condition was so severe and happened so quickly, I recommended that we perform the surgery, and the clients agreed.  They wanted to be as aggressive as possible.”

Dr. Emch performed the delicate surgery, called a ‘ventral slot,’ to remove the disc core material and allow Gunther’s spinal cord to return to its normal position. And by the day after surgery, he had a little movement in his legs. Gunther was discharged from the hospital on Dec. 26. While he could not yet walk on his own, with his weight supported, Gunther was moving all four legs. 

Just like a physical therapist would work with a human patient after surgery, a rehabilitation specialist at VCA Alameda East worked with Gunther to assess his current abilities and suggest exercises his owners could do at home to help him get stronger. Gunther had to relearn how to walk and where his feet should be to keep himself stable. 

“I saw Gunther two weeks after his surgery for a re-check appointment; at that point his exam was almost normal,” says Dr. Emch. “He was walking strongly, he was comfortable, he was very happy—and so were his owners. When I saw him four weeks after surgery he was completely back to normal.” 

“Although Gunther was a large dog with severe neurological signs, he had a very good outcome. It was great that he got better so quickly. And it was key that he saw a neurologist so soon and we could take action to relieve the compression of his spinal cord so quickly,” Dr. Emch says. “The clients clearly love Gunther very much. He is so cute and sweet, and his owners were so grateful. I used to have a Pointer, myself. Gunther reminded me so much of him.”

Ohio native Samantha Emch, DVM, MS, DACVIM, is a veterinary neurology specialist at VCA Alameda East Veterinary Hospital in Denver. She says completing neurologic exams is a bit like piecing together a puzzle to identify the problem. Her neurology interests include intervertebral disc disease, managing canine epilepsy, and central nervous system neoplasia.  
 
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When I saw him [Gunther] four weeks after surgery he was completely back to normal.
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