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Payton

Payton's Spine
Pre-operative x-ray showing deviation of Payton's spine at the level of the fracture.

       An 8-month-old female German shorthair pointer dog, Payton, presented to ISU-LVMC on September 10th, 2009. The previous night, she was found unable to walk after a loud yelp was heard in the yard. She was taken to her local veterinarian, who found that she did not have any motor function in her hind limbs. She took a spinal radiograph that revealed a fractured lumbar vertebra. Payton was able to feel a pinch on her toes, and therefore surgery offered the possibility of allowing her to walk again. After consultation with the ISU Orthopedic Service, she was stabilized and transported to ISU for further evaluation and treatment.

        On presentation to ISU, Payton was evaluated by the emergency service and transferred immediately for additional imaging and surgery. Chest and spinal radiographs were taken which revealed a comminuted fracture of her L4 vertebral body. A CT scan was performed which identified severe spinal cord compression and bony fragments within the spinal canal itself. Payton was then taken to surgery where Dr. Bergh and Dr. Kraus performed a right L4
Payton's Vertebrae
CT scan of Payton's fractured vertebrae showing deviation and compression of the spinal canal.
hemilaminectomy and removed pieces of fragmented bone from the vertebral canal. The fractured vertebra was realigned and stabilized with four threaded pins and hard methyl-methacrylate bone cement. Post-operative radiographs showed good alignment and decompression at the fracture site. She recovered overnight in the intensive care unit with a continuous intravenous pain medication.
Payton post operation
Post-operative x-ray showing repair of the fracture with four pins and polymethyl methacrylate, a hard plastic.
          The following morning, Payton still had deep pain present in both hind limbs. She appeared to be recovering well, but developed a fever and had an increased respiratory effort. Blood work showed low white blood cells, anemia, and low protein. Her blood oxygen level was also low.
        Chest radiographs (x-rays) confirmed the suspicion of aspiration pneumonia. She was treated aggressively with oxygen supplementation and broad-spectrum antibiotics. Nebulization and chest coupage were performed frequently to loosen up the fluid in her lungs. Fortunately, Payton responded to this therapy and was eventually able to breathe well without oxygen supplementation, but she could still not move her hind legs.
        Twelve days after surgery, Payton moved out of ICU into the ISU Rehabilitation Program. In rehab, Payton had passive range of motion exercises to her rear limbs. She also worked on the physio-roll, had warm compresses applied to a fluid pocket which had developed over her incision site. Payton began to swing her left hind limb when sling walking or while in a cart. She was placed in the cart 2-3 times daily where she learned to move herself around
Payton photo 1
After surgical decompression and stabilization of Payton's spinal fracture and intensive physical therapy post-operatively, she regained the ability to walk.
easily with her forelimbs. She also began to use the underwater treadmill and eventually the pool to increase her strength and mobility. She showed increased motor activity in both limbs while swimming, and was able to kick both hind legs. However, progress in the right hind leg continued to lag behind the left leg. Eventually, she was able stand for short periods of time. Five weeks after surgery, she was discharged for some rest and continued rehabilitation with her owner.
          Payton returned for more rehabilitation after a couple of weeks at home and had made remarkable progress. She regained the ability to stand and support herself as well as walk by herself on good footing. Proper initial treatment by her referring veterinarian, the Emergency clinicians, residents, technicians, and students have all played a very important role in the success of her recovery!

Payton photo 2
Click on the above picture to see a video of Payton.

 

 

 

 

 

 

 

 

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