References

Bloor C The use and management of closed urinary catheters. The Veterinary Nurse. 2013; 4:(5)264-75

Bubenik L, Hosgood G Urinary Tract Infection in Dogs with Thoracolumbar Intervertebral Disc Herniation and Urinary Bladder Dysfunction Managed by Manual Expression, Indwelling Catheterization or Intermittent Catheterization. Vet Surg. 2008; 37:(8)791-800

Campbell C, Parish L The decubitus ulcer: facts and controversies. Clinics in Dermatology. 2010; 28:(5)527-32

Coates J Paraparesis. In: Platt S, Olby N Gloucester: British Small Animal Veterinary Association; 2004

Crompton S, Hill P Post-operative recovery of the surgical patient. The Veterinary Nurse. 2011; 2:(4)190-8

Connell L, Monk M Small animal post-operative orthopaedic rehabilitation. The Veterinary Nurse. 2010; 1:(1)12-21

Daniels L Pelvic fractures-nursing considerations. Veterinary Nursing Journal. 2010; 25:(11)23-5

Davies T How to prevent perioperative hypothermia in the dog and cat: causes and consequences. The Veterinary Nurse. 2012; 3:(1)42-7

Dodd L Postoperative care of spinal patients.Gloucester: British Small Animal Veterinary Association; 2011

Drum M Physical Rehabilitation of the Canine Neurologic Patient. Vet Clin North Am Small Anim Pract. 2010; 40:(1)181-93

Iveson A Multimodal therapy beyond NSAIDs: diet, physical therapy, rehabilitation. Veterinary Times. 2011; 41:(46)14-16

Kazakos G, Polizopoulou S, Patsikias M, Tsimopoulous G, Roubies N, Dessiris A Duration and Severity of Clinical Signs as Prognostic Indicators in 30 Dogs with Thoracolumbar Disk Disease After Surgical Decompression. J Vet Med. 2005; 52:147-52

Lumbis R A practical approach to caring with patients with appetite reduction. The Veterinary Nurse. 2012; 3:(2)90-100

McKee M Intervertebral disc disease in the dog 2. Management options. In Practice. 2000; 22:458-71

Olby N, Thrall D Neuroradiology. In: Platt S, Olby N Gloucester: British Small Animal Veterinary Association; 2004

Olby N, MacKillop E, Cerda-Gonzalez S Prevalence of urinary tract infection in dogs after surgery for thoracolumbar intervertebral disc extrusion. J Vet Intern Med. 2010; 24:1106-11

Oosthuizen C How to place and manage indwelling urinary catheters. The Veterinary Nurse. 2011; 2:(5)266-71

Park E, White G, Tieber L Mechanisms of injury and emergency care of acute spinal cord injury in dogs and cats. J Vet Emerg Crit Care. 2012; 22:(2)160-78

Sherman J, Olby N Nursing and rehabilitation of the neurological patient. In: Platt S, Olby N Gloucester: British Small Animal Veterinary Association; 2004

Stiffler K, McCrackin Stevenson Prevalence and Characterization of Urinary Tract Infections in Dogs with Surgically Treated Type 1 Thoracolumbar Intervertebral Disc Extrusion. Vet Surg. 2006; 35:330-6

Thomas C A care report of a feline sacroiliac coxofemoral luxation following a road traffic accident. The Veterinary Nurse. 2012; 3:(3)174-9

Whitfield S MRI: applications in small animal practice. Veterinary Nursing Times CPD. 2010; 4:(4)1-4

Young A, Tivers M Advanced surgical nursing. In: Hotston A., Moore P, Rudd S Gloucester: British Small Animal Veterinary Association; 2008

A patient care report of a dog that had hemilaminectomy surgery to decompress the spinal cord

02 March 2016

Patient Report

11 mins read

02 March 2016

Volume 7 · Issue 2

ISSN (print): 2044-0065

ISSN (online): 2052-2959

Figure 1. Thoracolumbar radiograph to localise marker pre surgery.

Abstract

This article describes the nursing care involved in caring for a spinal patient from the time of admission, pre, peri and post operatively. It highlights the importance of nursing care and treating each patient as an individual. Nursing interventions discussed include monitoring under anaesthesia, post-operative monitoring, bladder management and rehabilitation. An understanding of the importance of postoperative monitoring and rehabilitation is required to promote the patient's recovery in addition to being confident in different bladder management techniques.

The patient presented with per acute onset paraparesis, with no known history of trauma. Due to the patient's breed predisposition and previous history of an intervertebral disc (IVD) extrusion at T13–L1 which required surgical intervention, she was referred to the hospital as an emergency out of hours patient.

Neurological examination revealed paraparesis with very weak lower motor neuron function demonstrated by delayed proprioception in the hindlimbs. The patient was deep pain (DP) positive and spinal reflexes were normal. The veterinary surgeon (VS) localised T3–L3 to be the most likely area of compression. General examination revealed no other concerns.

The patient was admitted and a blood sample was obtained for manual packed cell volume (PCV), total solids (TS) and in-house biochemistry. Intravenous access was gained in the right forelimb cephalic vein.

The patient was pre-medicated with 0.02 mg/kg of acepromazine (Calmivet 5 mg/ml, Vetoquinol) and methadone 0.3 mg/kg (Comfortan 10 mg/ml, Dechra) prior to receiving the blood results, which later revealed no abnormalities. The patient was anaesthetised using 4 mg/kg propofol (PropoFlo Plus 10 mg/ml, Zoetis) and maintained on isoflurane (Zoetis) inhalation agent once intubated for diagnostic imaging and possible surgery. Magnetic resonance imaging (MRI) is the ideal imaging technique for investigating spinal cord problems (Whitfield, 2010). However, due to the patient presenting out of hours the VS decided to use computed tomography (CT) which shows good detail when imaging thoracolumbar vertebrae (Olby and Thrall, 2004). The CT imaging revealed Hansen type I (disc extrusion) at the disc space L1–L2 which was lateralised to the left hand side. The patient was moved through to the radiography room where clipping and surgical preparation for a marker took place (Box 1). A marker was placed in L1 spinal vertebra and a lateral thoracolumbar spinal radiograph was taken to confirm this (Figure 1).

Register now to continue reading

Thank you for visiting The Veterinary Nurse and reading some of our peer-reviewed content for veterinary professionals. To continue reading this article, please register today.

Or continue by

Signing in with your registered email address