Clinical findings and outcomes in canine ischemic neuromyopathy: neurologic status is associated with survival, and recovery is possible.

Recovery is possible in nonambulatory dogs with INM; ambulatory status and nociception alone should not determine prognosis.

This retrospective, multicenter study describes clinical findings and outcomes in 42 dogs diagnosed with ischemic neuromyopathy (INM) across five referral hospitals over a 10-year period (2013–2023). The majority of cases involved pelvic limb INM (90.5%), while thoracic limb INM was rare (9.5%). Comorbidities were present in 83.3% of dogs, with protein-losing nephropathy being most common (50.0%). All thoracic limb cases were ambulatory at presentation but were euthanized at owner request shortly after diagnosis. Among pelvic limb cases, 57.9% were ambulatory at presentation, 71.1% retained nociception, and 39.5% had a gradual onset exceeding 24 hours. Survival to discharge was achieved in 50.0% of pelvic limb cases. Ambulatory status, presence of nociception, and more gradual progression to peak clinical severity were significantly associated with survival to discharge. Of dogs with available long-term follow-up, 25.0% achieved full recovery, including 12.5% of initially nonambulatory dogs. These findings challenge the notion that nonambulatory status or absent nociception should preclude treatment, as a meaningful subset of severely affected dogs recovered. Clinicians are advised to use prognostic indicators such as ambulatory status and nociception to guide decision-making but not in isolation, as outcomes can be favorable even in neurologically severe cases. Underlying comorbidities, particularly protein-losing nephropathy, may influence overall prognosis and should be considered concurrently.

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