Likely radiation-induced sciatic neuropathy in a dog.

Radiation-induced peripheral neuropathy should be considered in dogs developing delayed neuropathy within prior radiotherapy fields.

This case report describes the first documented occurrence of radiation-induced peripheral neuropathy (RIPN) in a companion animal. An 11-year-old spayed female beagle developed progressive left sciatic neuropathy approximately 19 months following stereotactic radiotherapy (20 Gy) administered as adjuvant treatment after excision of a grade 2 soft tissue sarcoma on the proximal caudal left thigh. RIPN is a recognized late adverse effect of radiotherapy in human medicine, typically presenting months to years post-treatment, but had not previously been reported in veterinary patients. Diagnostic workup included computed tomography and magnetic resonance imaging of the sciatic nerve, which yielded findings consistent with RIPN, including perineural fibrosis and nerve enlargement. Histopathological examination confirmed severe nerve fiber loss, supporting the diagnosis. Conservative management with an anti-inflammatory course of corticosteroids failed to produce clinical improvement. Due to the progressive and non-responsive nature of the neuropathy, limb amputation was ultimately performed. This case highlights that RIPN should be considered as a differential diagnosis in dogs presenting with peripheral neuropathy following regional radiotherapy, particularly when clinical signs develop in a delayed fashion within a previously irradiated field. Clinicians should be aware of this potential late-onset complication when counseling owners about the long-term risks of radiotherapy, especially when nerves lie within or near the radiation field.

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