A Controlled Clinical Study of Intensive Neurorehabilitation in Post-Surgical Dogs with Severe Acute Intervertebral Disc Extrusion

Ângela Martins; Débora Gouveia; Ana Cardoso; Carla Carvalho; Tiago Coelho; Cátia Silva; Inês Viegas; Óscar Gamboa; António Ferreira

doi:10.3390/ani11113034

A Controlled Clinical Study of Intensive Neurorehabilitation in Post-Surgical Dogs with Severe Acute Intervertebral Disc Extrusion

Animals (Basel). 2021 Oct 22;11(11):3034. doi: 10.3390/ani11113034.

Authors

Ângela Martins^{1

2

3

4}, Débora Gouveia^{2

4}, Ana Cardoso², Carla Carvalho², Tiago Coelho², Cátia Silva², Inês Viegas², Óscar Gamboa⁵, António Ferreira^{3

5}

Affiliations

¹ Faculty of Veterinary Medicine, Lusófona University, Campo Grande, 1300-477 Lisboa, Portugal.
² Animal Rehabilitation Center, Arrábida Veterinary Hospital, Azeitão, 2925-583 Setúbal, Portugal.
³ CIISA-Centro Interdisciplinar-Investigação em Saúde Animal, Faculdade de Medicina Veterinária, Av. Universidade Técnica de Lisboa, 1300-477 Lisboa, Portugal.
⁴ Superior School of Health, Protection and Animal Welfare, Polytechnic Institute of Lusophony, Campo Grande, 1300-477 Lisboa, Portugal.
⁵ Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisboa, Portugal.

Abstract

This retrospective controlled clinical study aimed to verify if intensive neurorehabilitation (INR) could improve ambulation faster than spontaneous recovery or conventional physiotherapy and provide a possible therapeutic approach in post-surgical paraplegic deep pain perception-positive (DPP⁺) (with absent/decreased flexor reflex) and DPP-negative (DDP^-) dogs, with acute intervertebral disc extrusion. A large cohort of T10-L3 Spinal Cord Injury (SCI) dogs (n = 367) were divided into a study group (SG) (n = 262) and a control group (CG) (n = 105). The SG was based on prospective clinical cases, and the CG was created by retrospective medical records. All SG dogs performed an INR protocol by the hospitalization regime based on locomotor training, electrical stimulation, and, for DPP^-, a combination with pharmacological management. All were monitored throughout the process, and measuring the outcome for DPP⁺ was performed by OFS and, for the DPP^-, by the new Functional Neurorehabilitation Scale (FNRS-DPP^-). In the SG, DPP⁺ dogs had an ambulation rate of 99.4% (n = 167) and, in DPP^-, of 58.5% (n = 55). Moreover, in DPP⁺, there was a strong statistically significant difference between groups regarding ambulation (p < 0.001). The same significant difference was verified in the DPP^- dogs (p = 0.007). Furthermore, a tendency toward a significant statistical difference (p = 0.058) regarding DPP recovery was demonstrated between groups. Of the 59 dogs that did not recover DPP, 22 dogs achieved spinal reflex locomotion (SRL), 37.2% within a maximum of 3 months. The progressive myelomalacia cases were 14.9% (14/94). Therefore, although it is difficult to assess the contribution of INR for recovery, the results suggested that ambulation success may be improved, mainly regarding time.

Keywords: 4-aminopyridine; acute dogs; functional electrical stimulation; locomotor training; neurorehabilitation; spinal cord injury; transcutaneous electrical SC stimulation.