Referring Back Emergencies: Things to Know
The referral process for a back fracture, paraplegic dog +/- negative deep pain perception:
- During the day (8am-6 pm), call our rDVM Direct Line at 443-584-3413 to set up a transfer. As always, you can also call into the main line at 410-224-0121 ext 5, but may have to wait on hold.
- Outside of normal hours, please refer the patient directly to AAVEC (Annapolis) or Pet+E.R. (Towson), where we can facilitate a direct transfer first thing in the morning.
- The neurologist will examine the patient and review any previous work-up prior to meeting with owner, and will be able to expand on the prognosis and process from that point on.
How urgent is urgent? Surgical priorities and prognostications:
- Paraplegia with absent sensation should be worked-up within 12-24 hours.
- Paraplegia with intact sensation should be given the option to treat medically or proceed with work-up and surgery within 24-48 hours.
- Ambulatory paraparesis or tetraparesis with normal sensation needs to be seen by a neurologist as soon as scheduling allows.
- Dogs with signs consistent with FCEs, dogs with hemivertebrae associated disease and old large breed dogs should be treated medically until advanced imaging can be arranged.
Treatment prior to referral:
- Note type, dose and duration animal has been treated with corticosteroids or NSAIDs.
- Note if any side-effects are reported by owner.
- Run serum chemistry analysis and CBC prior to work-up.
- Radiographs can be useful to identify bony lesions such as fracture, bony neoplasia or discospondylitis. We recommend three view chest radiographs of all dogs prior to MRI to rule out cardiothoracic pathology.