Not too long ago, Leah, a 4-year-old female Border Collie, got loose from her owner and went missing for the night. When a local veterinary facility found her the next day, the staff immediately called her owner and informed her that Leah had been injured. She had a facial laceration that might have been from a deer kick. Otherwise, she appeared normal, and so her wound was repaired, and Leah was on her way home. Two days later, however, Leah became acutely non-ambulatory. She had minimal motor function in all four limbs, and was unable to sit up on her own. Leah was then hospitalized with a suspected case of tetanus. She was treated with an anti-toxin and other supportive care and monitored. Her severe tetraparesis did not improve for three weeks. Leah’s veterinarians no longer suspected tetanus and were much more concerned that she might have a spinal cord injury. That was when they referred her to the William R. Pritchard Veterinary Medical Teaching Hospital at the University of California, Davis. Once at UC Davis, specialists in the Neurology/Neurosurgery Service performed a CT scan and an MRI to determine the cause of Leah’s condition. She was diagnosed with an atlanto-occipital luxation (dislocation of the skull from the spine) and fractures of the first vertebra and the back of the skull. These injuries were compromising her spine, causing temporary paralysis. Neurologists Drs. Pete Dickinson and Karen Vernau, along with neurology resident Dr. Devin Ancona, attempted to reduce the luxation via both non-surgical and surgical approaches. Both attempts were unsuccessful, however, due the amount of fibrous tissue that had built up in the three weeks of healing since the initial injury. Therefore, surgery to decompress Leah’s spinal cord was necessary. An incision was made behind Leah’s skull to allow the neurosurgeons access to her skull and vertebrae. They drilled away the top of Leah’s first vertebrae and a small area of the back of her skull, necessary to open that area and decompress the spinal cord. Following the successful surgery, Leah recovered for the night in the hospital’s Intensive Care Unit. She was then moved to the Intermediate Care Ward (ICW) after an uneventful night of rest and recovery. After two days of recovery in the ICW, where she showed voluntary motor function in her limbs, Leah was transferred to the neurology ward where she continued to improve. By the time Leah was discharged the following day, she was able to support herself lying sternally. Leah’s owner took her home with instructions of strict cage rest and a physical rehabilitation plan once Leah was neurologically stable. At Leah’s one-month recheck appointment, she had improved significantly and was able to stand without support and take a few steps. She was still considered non-ambulatory given her inability to remain standing and walk without falling, but her improvement over the previous four weeks was suggestive of a positive prognosis for return to ambulation. She was “green lighted” to begin physical rehabilitation with the Integrative Medicine Service at U.C. Davis. Following two weeks of physical rehabilitation, Leah was walking on her own. She gradually improved with continued rehabilitation over the next month, and is now rehabbing at a facility closer to home.
