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.

Brachial Plexus Mass – Nerve Sheath Tumor. Axial T2WI.