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Fred . . .
Case Study submitted by Peter Brofman, DVM, DACVIM (Neurology)
Veterinary Specialty Care, Mount Pleasant, SC.
Fred is a 9yr old MC Labrador mix who presented to the internal medicine service at Veterinary Specialty Care for evaluation for weight loss (10#), abdominal pain, stiff gait, and fever. Diagnostics included abdominal, thoracic, and spinal radiographs; abdominal ultrasound; CBC, chemistry analysis, urinalysis, Lyme titer, PCR for Anaplasma, Babesia, Bartonella, Ehrlichia, Mycoplasma, Neorickettsia, and Rickettsia; and urine and blood cultures. All testing was negative.
Fred was treated for 6 days with intravenous fluids; intravenous ampicillin/sublactam, enrofloxacin, and doxycycline; NSAID therapy; and opioids for pain. Despite diagnostics and therapy, an underlying cause for the fever could not be determined and the fever persisted between 103.5 to 105.5 degrees F throughout the week. He was
then referred to me for a neurological evaluation. No neurological abnormalities were noted but there was a stiff gait and generalized pain.
Joint taps were negative and a CK was normal. MRI of the thoracolumbar spine demonstrated findings consistent with diskospondylitis present at both T12-13 and the lumbosacral space. At T12-13 there was also evidence of some lateral involvement along the nerve roots, as well with likely compression and edema of the spinal cord. Following MR diagnosis of diskospondylitis and recovery from anesthesia, Fred was administered hyperbaric oxygen therapy at 2ATA for 60 minutes. Medical treatment was unchanged otherwise. Fred’s fever resolved within 3 hours post-treatment. He was treated with the same regimen daily for 3 more days then once weekly for 3 weeks. He was then treated every 2 weeks for a total of 13 treatments. At that point he had gained 10 pounds, was “like a puppy again,” and he remained afebrile.
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