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Nonsurgical treatment of atlantoaxial subluxation in dogs
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Surgical intervention and stabilisation has been the gold standard in the treatment of atlantoaxial subluxation, a genetic defect in certain small breeds. Is there really no nonsurgical effective treatment? There is another option, especially in young dogs, as this study on 19 dogs illustrates.
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The objective of this retrospective study was to evaluate long-term neurologic outcome in dogs with atlantoaxial subluxation (AAS) that were treated nonsurgically with a cervical splint. 19 dogs with AAS and managed with a cervical splint were included.
Medical records from 2 university hospitals were reviewed. Information pertaining to trauma, duration of clinical signs prior to admission, medical treatments prior to admission, results of neurologic and physical examinations at the time of admission, results of laboratory testing, results of diagnostic imaging, neurologic status at the time of discharge, duration of time the cervical splint was used for treatment, and neurologic status at the time of splint removal and at a final reexamination was extracted from the medical records.
Long-term outcome was defined as neurologic status greater than or equal to 1 year after splint removal.
Factors associated with a good or poor long-term outcome were determined. RESULTS: A good final outcome was reported in 10 of 16 dogs.
Median duration of clinical signs prior to referral was 30 days; dogs that were affected < or = 30 days were significantly more likely to have a good long-term outcome, compared with dogs affected > 30 days.
The neurologic grade at admission, radiographic appearance of the dens, age at onset of clinical signs, and history were not associated with outcome.
CONCLUSIONS AND CLINICAL RELEVANCE: Nonsurgical management of AAS by use of a cervical splint is a viable treatment modality for young dogs with a first episode of acute-onset clinical signs, regardless of the severity of neurologic deficits at admission.
Source: Havig ME, Cornell KK, Hawthorne JC, McDonnell JJ, Selcer BA. (2005): Evaluation of nonsurgical treatment of atlantoaxial subluxation in dogs: 19 cases (1992-2001). In: J Am Vet Med Assoc. 2005 Jul 15;227(2):257-62.
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