Case: Fixed price surgery helps a 5 month old Bulldog pup with a congenital spinal problem

One of our referring practices contacted us about George, a 5 month old Bulldog pup that had developed progressive hind limb neurological problems over the previous two weeks. At presentation to us the forelimbs were working fine, but the pup was unable to stand on the hind limbs. We discussed the possibility of referral to a specialist centre with MRI facilities, but the owner had inadvertently fallen into a gap in insurance cover and cost was an issue.

 

A lumbar-puncture myelogram was performed. This involved the placement of a needle between the vertebrae at the base of the back to allow injection of a contrast agent into the fluid that surrounds the spinal cord. This agent outlined compression of the spinal cord in the region of the fourth and fifth thoracic vertebrae on the left hand side. The arch of the vertebral column and the articulations between the vertebrae were pressing on the adjacent spinal cord and interfering with the communication between the brain and the areas lower than the compression. Surgery on this area is tricky because of the depth and the peculiar local anatomy of the vertebrae in this region. We discussed this case with a good friend of ours who is a specialist in neurology. Again, referral to him with his greater experience of these cases was discussed but the estimated costs of specialist referral were just too much for the owner to consider.

 

So we operated on the pup at Burton on Trent, removing the areas of the vertebral column that were pressing on the spinal cord. The surgery was challenging because the anatomy of the thoracic vertebrae is not as straightforward for surgery as that of, for example, the lumbar spine.

 

However George did well and was able to stand on his hind limbs the day after surgery. The prognosis is a little guarded but with rehabilitation we hope that George will go on to make a functional recovery.