Traumatic atlantoaxial subluxation in dogs: 8 cases (2009-2016)

Abstract

Objective: To demonstrate the utility of advanced imaging in dogs with traumatic atlantoaxial subluxation (TAAS), and to report the presentation, treatment, and outcome for these dogs.

Design: Retrospective study (2009-2016).

Setting: University teaching hospital.

Animals: Eight dogs diagnosed with TAAS with magnetic resonance imaging (MRI), computed tomography (CT), or both.

Interventions: None.

Measurements and main results: Eight dogs met criteria for inclusion. Of these, 6 were male, median age was 4 years (range, 1.5-11 years), and median body weight was 4.9 kg (range, 3.0-25.0 kg). On presentation, 6/8 (75%) dogs were nonambulatory tetraparetic and the most common injury was trauma inflicted by another animal 5/8 (62.5%). Diagnosis of TAAS was made using a combination of imaging modalities including vertebral column radiographs in 7/8 (87.5%) (of which 71.4% were suspicious for TAAS), CT in 7/8 (87.5%), and MRI in 7/8 (87.5%). In 7/8 (87.5%) dogs, CT and/or MRI offered additional information regarding the extent of injuries. Vertebral fractures were identified in 62.5% (5/8) of dogs. The majority of dogs underwent surgical repair (7/8 [87.5%]). The most common complication was aspiration pneumonia (3/8 [37.5%]). All 8 dogs survived to discharge. At the time of discharge, 4/8 (50%) were ambulatory tetraparetic. The 4 dogs that were nonambulatory tetraparetic at discharge progressed to being ambulatory within 2 months of surgery.

Conclusions: Although TAAS is an uncommon occurrence it should be considered a differential for any trauma patient that is presenting with signs of a cranial cervical myelopathy. CT and MRI have been shown to be useful to identify the extent of injuries and to facilitate surgical planning. With appropriate care, these dogs can have an excellent prognosis.

Keywords: cervical; instability; trauma.