Severe seizures associated with traumatic brain injury managed by controlled hypothermia, pharmacologic coma, and mechanical ventilation in a dog

Abstract

Objective: To describe the management and outcome of a dog presenting with intractable seizures associated with traumatic brain injury.

Case summary: A spayed female Wheaten Terrier was presented to an emergency clinic with neurologic deficits (modified Glasgow coma scale of 10) shortly after a road traffic accident. Seizures were uncontrolled despite aggressive pharmacologic intervention. Controlled hypothermia to achieve a rectal temperature of 33-35 degrees C (91.4-95 degrees F) was initiated as a protective measure to reduce intracranial pressure and cerebral metabolic rate, and to assist with seizure control. Intubation and mechanical ventilation were required to protect the airway and manage hypercapnia associated with hypoventilation. The patient went on to make a full recovery, although behavioral changes were noted by the owners for an 8-week period following injury.

New or unique information provided: To the author's knowledge, this is the first instance of therapeutic hypothermia reported in the veterinary literature. A short review of this treatment modality is provided.