TY - JOUR
T1 - Lumbar hemilaminectomy for treatment of diskospondylitis in an aardvark (Orycteropus afer)
AU - Nevitt, Benjamin N.
AU - Adkesson, Michael J.
AU - Jankowski, Gwen
AU - West, Paula
AU - Langan, Jennifer N.
PY - 2018/2/15
Y1 - 2018/2/15
N2 - CASE DESCRIPTION A 17-year-old sexually intact male aardvark (Orycteropus afer) was evaluated because of hind limb proprioception deficits and ataxia. CLINICAL FINDINGS Results of examination and CT suggested a diagnosis of intervertebral disk disease and diskospondylitis at the L2-3 intervertebral space. Magnetic resonance imaging of the vertebral column also indicated intervertebral disk rupture with spinal cord compression and inflammation of the adjacent epaxial musculature TREATMENT AND OUTCOME Hemilaminectomy was performed according to the technique described for dogs. Anatomic variations encountered intraoperatively limited the ability to completely remove the affected disk material; however, adequate decompression of the spinal cord was achieved. Microbial culture and susceptibility testing of surgical biopsy specimens yielded a multidrug-resistant Enterococcus faecalis that was treated with a 10-week course of linezolid. Intensive postoperative care required constant rate infusions for adequate sedation, analgesia, and antimicrobial treatment. Dehiscence of the surgical site occurred 3 weeks after surgery and was treated with negative pressure wound therapy. Physical rehabilitation initiated 5 days after surgery progressed from passive range of motion to the use of an underwater treadmill. Despite initial improvement, acute deterioration occurred 5.5 months after surgery. Repeated CT revealed progression of diskospondylitis, which prompted euthanasia. CLINICAL RELEVANCE Postoperative hind limb paresis and paralysis in this species presented considerable challenges for care and rehabilitation. Patient demeanor, size, and anatomy required development of custom mechanical devices. Despite the inability to eliminate the multidrug-resistant bacterial osteomyelitis that resulted in the death of this aardvark, information gained may benefit treatment of subsequent patients.
AB - CASE DESCRIPTION A 17-year-old sexually intact male aardvark (Orycteropus afer) was evaluated because of hind limb proprioception deficits and ataxia. CLINICAL FINDINGS Results of examination and CT suggested a diagnosis of intervertebral disk disease and diskospondylitis at the L2-3 intervertebral space. Magnetic resonance imaging of the vertebral column also indicated intervertebral disk rupture with spinal cord compression and inflammation of the adjacent epaxial musculature TREATMENT AND OUTCOME Hemilaminectomy was performed according to the technique described for dogs. Anatomic variations encountered intraoperatively limited the ability to completely remove the affected disk material; however, adequate decompression of the spinal cord was achieved. Microbial culture and susceptibility testing of surgical biopsy specimens yielded a multidrug-resistant Enterococcus faecalis that was treated with a 10-week course of linezolid. Intensive postoperative care required constant rate infusions for adequate sedation, analgesia, and antimicrobial treatment. Dehiscence of the surgical site occurred 3 weeks after surgery and was treated with negative pressure wound therapy. Physical rehabilitation initiated 5 days after surgery progressed from passive range of motion to the use of an underwater treadmill. Despite initial improvement, acute deterioration occurred 5.5 months after surgery. Repeated CT revealed progression of diskospondylitis, which prompted euthanasia. CLINICAL RELEVANCE Postoperative hind limb paresis and paralysis in this species presented considerable challenges for care and rehabilitation. Patient demeanor, size, and anatomy required development of custom mechanical devices. Despite the inability to eliminate the multidrug-resistant bacterial osteomyelitis that resulted in the death of this aardvark, information gained may benefit treatment of subsequent patients.
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U2 - 10.2460/javma.252.4.464
DO - 10.2460/javma.252.4.464
M3 - Article
C2 - 29393738
AN - SCOPUS:85042129292
SN - 0003-1488
VL - 252
SP - 464
EP - 472
JO - Journal of the American Veterinary Medical Association
JF - Journal of the American Veterinary Medical Association
IS - 4
ER -