Three-year-old cocker spaniel Luna was involved in a distressing incident when she was attacked by two dogs in her garden one Saturday morning, sustaining head trauma and bite wounds to her forelimbs.
Initially seen by her local vet, she had a general anaesthetic, radiographs and the wounds on her right forelimb were debrided and closed, before being transferred to Fitzpatrick Referrals.
Diagnosis
On arrival, Luna had a thorough physical and neurological examination by Specialist Neurologist Dr Carina Black. Luna was showing signs of severe head trauma, especially affecting the left side of her brain, leaving her blind in her right eye, unable to walk and with signs of increased pressure within her skull. Given the compromised situation that Luna was in, a conscious CT scan of her head, neck and chest was performed, showing a depressed skull fracture, with bony fragments being pushed into the brain tissue.
In light of the delicate condition with profound neurological signs and multiple body contusions, a systemic stabilisation and intense care therapy to reduce her brain oedema and haemorrhage was prioritised before further actions. Luna was hospitalised and received intensive care and continuous monitoring by our dedicated vets and patient care team.
Over the following days, Luna’s neurological examination became more responsive, and she was brighter and responding more to external stimuli. Carina discussed with Luna’s family the pros and cons of the treatment options, and the choice was made to remove the depressed skull fragment, but it was not without risks. An alternative option was to continue with conservative management and leave the depressed fracture in situ, with the possibility of this causing issues in the future. After taking some time to carefully consider the options, Luna underwent surgical decompression.
Surgery
Luna’s brain surgery was performed by Neurology Registrar Dr Marc Pérez Soteras, who removed the two large bone fragments from her brain. A post-op CT scan showed a successful removal of the bone fragments, with good decompression and no signs of post-operative haemorrhage. However, a tear on her brain was found during the surgery, and Luna might remain with ongoing neurological deficits.
Recovery & rehabilitation
Following surgery, Luna showed no signs of neurological deterioration, and four days later was referred to our in-house physiotherapy team.
Our physiotherapist’s initial assessment revealed that Luna could stand independently but was circling to the left. She had some sensory deficits, which meant she “knuckled” her paw or stumbled on occasion. She displayed signs of right-sided ‘neglect’ which meant she was unable to move to the right past her midline, nor acknowledge that side of her.
The aims of her physiotherapy treatment were to encourage proprioceptive awareness to past the midline to the right, improve the quality of her walking, prevent compensatory muscular tightness and weakness, and promote normal function as far as possible. To achieve these goals, various techniques were employed, including sensory stimulation and awareness, aligned postural work and gait re-education.
Luna continued to improve and was bright and alert when she was reunited and returned home with her family, six days after surgery. At the time of discharge, she was able to walk unaided, though she still had some right forelimb weakness and continued to circle to the left, but she was able to hold a correct standing posture for longer periods of time.
Sadly, however, Luna did lose her eyesight and hearing on her right side as a result of the accident, though she compensated those deficits and is back to living a happy life with her family.
Luna’s family share their story
Luna is three years old and has been with us since she was a pup, she is the centre of our family life and is my baby girl. The whole family and friends adore her; she was always friendly and loved everyone and always wanted to be the centre of attention. Luna is slowly recovering but the incident has changed her, she is quieter and not as playful, she still cannot pick up her toys as she did before and want to do tug of war. We hope with time she will recover. It is sad that she is blind and deaf on one side, but we hope that her other senses will make up the deficit.
It has been amazing to see how she is slowly recovering from such a horrid incident in our own back garden, I would say it is a “miracle” how she has recovered from all her injuries and skull fragments removed from her brain. The team’s help and support not only to Luna but to us as a family with regular calls and updates to help cope was really supportive and kind.
We would like to say a big thank you and are eternally grateful to Marc and the Fitzpatrick Referrals team for helping her recover and bring her back to our family.
Six months after surgery
We were delighted to receive this update from Luna’s family:
Luna’s doing so well. She’s managing to get around and adjusting to her injuries. She’s such a happy little girl. Her hair is growing back nicely now, so she’s starting to look like she used to do.
As she can now only see out of one eye, I bought her a ball with a bell inside and she loves chasing after it, even though we end up looking for it more than she does 🙂
We honestly can’t thank Marc and everyone at Fitzpatricks for all their help and support.
We’re delighted that Luna has adapted so well and is living life to the full as best as she can.
