An 8-year old spayed golden retriever was presented for ataxia, dull mentation, cervical pain, inappetence, and an episode of collapse. On examination, the dog was febrile with cervical pain. A CBC revealed a mature neutrophilia, and cerebrospinal fluid (CSF) analysis revealed nondegenerative neutrophilic pleocytosis with no infectious agents. A working diagnosis of steroid-responsive meningitis-arteritis was made; immunosuppressive doses of steroids were administered. After a temporary response, the dog deteriorated and experienced an apparent vestibular episode.
Magnetic resonance imaging revealed an epidural abscess in the cervical vertebral canal. Drainage of the abscess revealed filamentous, branching organisms. Treatment with clindamycin, ampicillin, cefotaxime, and trimethoprimsulfa was initiated. Oral prednisone was discontinued and IV dexamethasone sodium phosphate was administered at anti-inflammatory doses once a day for 3 days. Enrichment broth cultures of CSF revealed a gram-positive bacterial organism. PCR identified the organism as Actinomyces spp, and cefotaxime and trimethoprim-sulfa were discontinued. After 9 days in the hospital, the patient was discharged with oral amoxicillin, clindamycin, omeprazole, and gabapentin. Oral antibiotics were continued for 8 to 10 weeks. Eight months after drainage of the epidural abscess, the dog was reportedly normal.