Double Cervical Adjacent Hydrated Nucleus Pulposus Extrusion (HNPE) in a Yorkshire Terrier

Simple Summary Hydrated nucleus pulposus extrusion (HNPE) is a well-known pathological condition in veterinary neurology. Any breed of middle-aged or older dogs (median 9 years old) can be affected; it has an acute spontaneous onset, is rarely exercise-associated, and commonly affects the cervical region, causing tetraparesis or tetraplegia and mild cervical hyperesthesia. This study presents the first documented case of double cervical adjacent HNPEs in a small breed dog. A 9-year-old 6 Kg intact male Yorkshire terrier was referred for an acute onset of non-ambulatory tetraparesis. MR examination of the cervical spine showed two concurrent HNPEs at sites C3-C4 and C4-C5. The dog had a remission of symptoms with conservative therapy and physiotherapy.Abstract A 9-year-old Yorkshire terrier was brought to the emergency department for inability to maintain the correct station with acute onset. Neurological examination showed a non-ambulatory tetraparesis, spontaneous proprioceptive deficit in all limbs, and decreased flexor reflex in the forelimbs. The neurological symptoms suggested a cranial cervical spinal cord with suspicion of spinal shock. The clinical differential diagnoses included degenerative (intervertebral disc extrusion), vascular, inflammatory, or neoplastic disease. No pathological findings were evident in the hematobiochemical tests or in the radiograph examination. MRI examination of the cervical spine showed the presence of two adjacent hydrated nucleus pulposus extrusions at C3-C4 and C4-C5 tracts. Treatment included analgesic and non-steroidal anti-inflammatory therapy; movement restriction was initially necessary, followed by physiotherapy. Follow-up at 4 weeks showed complete recovery. A telephone follow-up after 3 months with the owner confirmed the absence of symptoms. This article reports the first double cervical HNPE case in a dog, adding the possibility that the disease may present in this form and the success of conservative treatment as described in the literature.