Use of ultrasound-guided percutaneous perineural corticosteroid injections for refractory cervical pain secondary to vertebral venous system abnormality in a dog.

A 2-year-old neutered male Greyhound was presented for evaluation of chronic, progressive right forelimb lameness and cervical pain. On presentation, the dog was ambulatory with mild to moderate right thoracic limb lameness and pain on cervical palpation with a right thoracic limb nerve root signature. Cervical magnetic resonance imaging (MRI) identified moderate right-sided C6 internal venous plexus enlargement. Medical management and physiotherapy did not result in clinical improvement. Repeat cervical MRI identified right-sided C5-T1 internal vertebral venous plexus enlargement with associated radiculopathy and possible dynamic spinal cord compression. Three ultrasound-guided perineural glucocorticoid injections (methylprednisolone acetate, 1 mg/kg per site) were performed at right C5-C6, C6-C7, and C7-T1 with improvement noted in lameness and cervical discomfort. No adverse effects were associated with the injections. This case highlights use of ultrasound-guided perineural glucocorticoid injections as a potential option for improving refractory cervical pain secondary to vertebral venous system abnormalities in a dog.