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

Ultrasound-guided perineural glucocorticoid injections may relieve refractory cervical pain from vertebral venous plexus abnormalities in dogs.

This case report describes a 2-year-old neutered male Greyhound presenting with chronic, progressive right forelimb lameness and cervical pain consistent with a right thoracic limb nerve root signature. Initial cervical MRI revealed moderate right-sided C6 internal venous plexus enlargement. Following failure of conservative medical management and physiotherapy, repeat MRI demonstrated progression to right-sided C5-T1 internal vertebral venous plexus enlargement with associated radiculopathy and possible dynamic spinal cord compression. Given the refractory nature of the condition and the unusual underlying etiology, three ultrasound-guided perineural glucocorticoid injections were performed using methylprednisolone acetate (1 mg/kg per site) targeting the right C5-C6, C6-C7, and C7-T1 nerve roots. Following the injections, the patient demonstrated notable improvement in both lameness severity and cervical discomfort, with no procedure-related adverse effects documented. This case illustrates an uncommon cause of cervical radiculopathy in a dog—vertebral venous system abnormality—and introduces ultrasound-guided perineural corticosteroid injection as a minimally invasive, potentially viable therapeutic option when standard medical management fails. The technique may offer targeted anti-inflammatory effect at affected nerve roots without the systemic risks associated with prolonged oral corticosteroid use. Further studies are warranted to evaluate the safety, efficacy, and long-term outcomes of this approach in dogs with similar presentations.

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