Adjunctive HBOT in the Management of Multifocal Traumatic CNS Lesions in a Canine
A 5-year-old male intact Boston Terrier was referred for adjunctive HBOT. The owner witnessed the patient run head on at full speed into a closed sliding glass door, at which point the dog lost consciousness and stopped breathing. The owner performed CPR measures and the dog began breathing again, regained consciousness, but remained laterally recumbent.
Neurologic examination revealed signs consistent with traumatic lesions in the forebrain, brainstem, and high cervical spinal cord. The patient remained laterally recumbent with upper motor neuron signs to all four limbs.
CT, CT myelogram, and MRI were performed after 48 hours of treatment, when the anesthetic risk was deemed more favorable. They revealed evidence of central nervous system hemorrhage in the high cervical spinal cord, with marked brainstem swelling. No fractures or luxations were found. A non-compressive mild disc herniation at C2-3 was noted.
The patient was treated with IV fluids, opiods, methocarbamol, Yunnan Baiyao, famotidine, and one hour HBOT sessions at 1.5 ATA TID initially (commencing prior to diagnostic imaging). At least 4 hours were maintained between each HBOT session. The patient was able to swallow and eat by day 2 of hospitalization. Passive range of motion exercises were begun 48 hours after admission. Rehabilitative exercises and underwater treadmill sessions were begun on day 7 after presentation. Progressive neurologic improvement was seen in hospital on a daily basis.
On day 9 of hospitalization, one hour HBOT sessions at 1.5 ATA were reduced to BID frequency. By discharge on day 12, the patient could stand with the support of a harness.
At recheck examination on day 16, the patient was able to stand up and walk on his own. Controlled studies on canines with complete global ischemia and spinal cord lesions have clearly demonstrated a beneficial effect when adjunctive HBOT is utilized.
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