Austin Veterinary Emergency & Specialty (AVES)

Patient Information

Signalment: 11-week-old intact male Irish Wolfhound

History

The patient presented with a peracute onset of hindlimb weakness (paresis). There was no travel history, no known concurrent medical conditions, and no prior medications except Rimadyl, which was started the night prior to presentation.

Physical Examination

• Temperature: 102.1°F

• Pulse: 156 bpm

• Respiratory rate: Panting

• Weight: 16.1 kg

No significant abnormalities were noted on general physical exam.

Neurologic Examination

• Mentation: Appropriate

• Gait/Posture: Ambulatory paraparesis with strong motor function in the left hind limb and minimal motor function in the right hind limb

• Cranial Nerves: Normal

• Postural Reactions:

  • Forelimbs: Normal bilaterally

  • Hindlimbs: Mildly reduced on left, absent on right

• Spinal Reflexes:

  • Forelimbs: Normal

  • Hindlimbs: Reduced, especially on right

  • Patellar reflexes: Reduced bilaterally

• Muscle Tone:

  • Forelimbs: Normal

  • Hindlimbs: Reduced on right

• Pain: None detected

• Nociception: Intact in right hind limb

Neurolocalization

Findings localized to a right-sided L4-S3 spinal cord lesion.

Differential Diagnoses

Based on the peracute onset, asymmetry of deficits, and early improvement, a vascular event such as fibrocartilaginous embolism (FCE) was considered most likely. Other differentials included inflammatory, infectious, or neoplastic disease but were considered less likely. Juvenile Irish Wolfhounds may have a higher incidence of FCE.

Diagnostics

• Blood Pressure: 100 mmHg

• PCV/TS: 36/6.2

• CBC: Hematocrit 31

• Chemistry: Mild abnormalities noted (Cr 0.4, P 8.2, ALP 452, GGT 15)

• Spinal Radiographs: No significant abnormalities

Treatment Plan

MRI was discussed as the gold standard for diagnosis. However, due to clinical improvement and high suspicion for FCE, advanced imaging was deferred. Supportive care and physical therapy were recommended. Rimadyl was discontinued, and no medications were continued.

Outcome

At 8-day follow-up, the owners reported continued improvement in mobility.

Conclusion

This case highlights a classic presentation of presumptive fibrocartilaginous embolism in a young, large-breed dog. Early improvement and asymmetry of neurologic deficits supported the clinical diagnosis, and conservative management resulted in a favorable outcome.