Presumptive Acute Post-Hypoxic Myoclonus Following Return of Spontaneous Circulation in a Cat and a Dog.

Acute post-hypoxic myoclonus can occur in dogs and cats after CPR and carries a grave prognosis.

This case report describes the occurrence of presumptive acute post-hypoxic myoclonus (APHM) in two companion animals—one cat and one dog—following cardiopulmonary arrest (CPA) and successful cardiopulmonary resuscitation (CPR) with return of spontaneous circulation (ROSC). APHM is a well-recognized neurological complication in human medicine, characterized by transient focal, multifocal, or generalized rhythmic myoclonic activity arising from global hypoxic-ischemic brain injury, with origins that may be cortical or subcortical (brainstem-generated). In humans, APHM typically manifests within 48 hours of CPA while patients remain comatose and has historically carried a poor prognosis, though contemporary literature advocates for combined clinical and electroencephalographic evaluation before drawing prognostic conclusions. In both veterinary cases presented, APHM developed within 24 hours of resuscitation. Neither animal responded to antiseizure medications or sedative drugs, and both were ultimately euthanized. This report is significant as it represents one of the first descriptions of APHM in veterinary patients, drawing parallels to the human medical literature and highlighting an important post-resuscitation neurological complication. Clinicians managing post-CPA patients in veterinary practice should be aware of APHM as a potential sequela, recognize its refractory nature to standard pharmacological intervention, and consider its implications for neurological prognostication in dogs and cats following ROSC.

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