Non-ambulatory tetraparesis due to paraspinal abscessation and spinal epidural empyema caused by Streptococcus canis in Australia: a case report

Authors: Graham M, King J, Corfield G
Publication: Australian Veterinary Practitioner, Volume 54, Issue 4, pp 178-185, Dec 2024
Publisher: Australian Veterinary Association

Animal type: Dog
Article class: Clinical Article

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Abstract:

Case report: A two year 8-month-old male neutered Staffordshire Bull Terrier Cross was referred for investigation of a C1-C5 myelopathy resulting in non-ambulatory tetraparesis. Abnormalities detected on routine haematology and biochemistry included a leukocytosis characterised by neutrophilia, mild hypoalbuminaemia, mild hyperglycaemia and mild increase in ALT. Contrast-enhanced computed tomographic (CT) scans revealed multifocal fluid accumulation and evidence of intralesional gas dorsal and ventral to C1-2, consistent with abscessation, with evidence of cervical Spinal Epidural Empyema (SEE), extradural spinal cord compression and severe regional cellulitis. A lumbar cistern cerebrospinal fluid sample was collected and there was a mild neutrophilic pleocytosis with increased protein. Ultrasound-guided aspiration of the dorsal cranial cervical abscess revealed a dark brown, opaque, viscous exudate; with heavy growth of Streptococcus canis. Initial medical therapy involved multimodal analgesia, broad spectrum intravenous antibiotic coverage and intensive supportive nursing care. Significant neurological improvement occurred following treatment. By day 8 the dog had improved to ambulatory tetraparesis and was discharged from hospital. Antibiotic therapy was continued for 10 weeks following discharge. At the 15-month follow-up examination there had been a complete neurological recovery. A repeat contrast-enhanced CT scan performed at that time showed moderate to severe bony remodelling of C1-C2 but no spinal cord compression.

Conclusions: This is the first report detailing long-term complete neurological recovery of a non-ambulatory tetraparetic patient with paraspinal abscessation and spinal epidural empyema caused by S canis treated medically in Australia.

Keywords: Spinal epidural empyema, paraspinal abscessation, Streptococcus canis, dog

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