| Signalment |
10 year-old male castrated Golden
Retriever |
| Chief Complaint |
Left fore limb lameness |
| Onset |
Six months |
| Course |
Initially dog would intermittently limp in
the left fore limb. Signs were initially mild and intermittent.
Dog was initially examined and mild elbow degenerative joint
disease was diagnosed on palpation and radiography. Carprofen
was initiated and there was mild improvement. The lameness progressively
got worse. The dog would refuse to go for long walks or play
ball. The Carprofen was increased but without response. Etodolac
was also tried without response. Five months after the initial
lameness the owner noted that there appeared to be mild muscle
atrophy of the limb. |
| Past Pertinent History |
None |
| Physical Exam |
The dog was found to be bright alert and responsive.
Physical exam was unremarkable except for grade 2 lameness of
the left fore limb, with moderate atrophy of the supraspinatus,
infraspinatus, and triceps muscles. |
| Neurologic Exam |
Normal except for a mild decreased position
sense in the left forelimb and a decreased withdrawal reflex
in the same limb. |
| Neuronatomic Diagnosis |
Brachial plexus/peripheral nerve (vs. orthopedic)
|
| Differential Diagnosis |
Nerve sheath tumor, neuritis - infectious/immune, degenerative (vs. neoplasia - osteosarcoma; degenerative joint disease, bicipital tendonitis, sesmoid disease)
|
| Neuroanatomic Diagnosis |
Brachial plexus/peripheral nerve r/o nerve sheath tumor,
neuritis - infectious/immune, degenerative. |
| Diagnostics |
LF radiographs, cervical radiographs, thoracic radiographs, complete blood count, chemistry panel, urinalysis and thyroid panel did not reveal any significant abnormalities. |
| MRI |
Hyperintense mass lesion located at the level
of the caudal cervical vertebral as the peripheral nerves course
through the brachial plexus on the axial T2WI. |
| Treatment |
Amputation |
| Outcome |
Guarded to good. The nerve sheath tumor was
removed completely with amputation. |
