Veterinary Teaching Hospital care helps puppy ‘run like the wind’

When Sharon Harrell named her puppy Sing a Brave Song — her call name is Miryam — she had no idea how appropriate the name would be.

Miryam would brave spinal surgery before she turned a year old. 

Bred for sport, the border collie/Papillon mix has been with Harrell since she was 4 months old. Harrell noticed a couple things that made Miryam a little different than other puppies. She was difficult to housetrain — she didn’t understand when she needed to “go” — but it was her gait that raised the most red flags for Harrell.

"From the beginning, there was something just a little off about her rear end. She had a wonderful temperament and she ran and ran, but there was always something just a little bit off  — at a walk, she would pace rather than an ordinary walk,” Harrell said. 

A veterinarian confirmed Harrell’s suspicions and referred Miryam to the Virginia-Maryland College of Veterinary Medicine’s Veterinary Teaching Hospital, where Miryam underwent an MRI.

Miryam was diagnosed with subarachnoid diverticulum, a rare condition in which a pocket of fluid sits between the spinal column and the spinal cord. The fluid’s compression on the spinal cord causes neurological problems, such as the incontinence and limb problems Miryam experienced. Those neurological signs get worse with time. 

Subarachnoid diverticulum seems to occur randomly, though it is more common in some breeds like pugs. Treatment options are limited — neither medical management nor surgery guarantee a full recovery. Veterinarian Richard Shinn and Harrell balanced risk, reward, and the commitment of post-operative care to come up with a plan. 

“Ultimately, we decided to move forward with surgery because even though there's not a great prognosis, it's a better prognosis compared to just doing medical management,” said Shinn, assistant professor of neurology at the college.

In February, Shinn worked with another surgeon during a four-hour surgery. They removed bone to access the spinal cord, then opened the dura — the tissue that surrounds and protects the spinal cord — so that spinal fluid could flow better, relieving pressure on the spinal cord.

After three days, Miryam returned home to begin the road to recovery. The surgical site takes about six weeks to heal, after which the dog can slowly work up to normal activity. Activity restrictions offer a huge challenge for an active young dog, but Miryam took it in stride. 

However, about 2 1/2 weeks after the surgery, Harrell took Miryam out in the early morning, and the puppy fell flat on the ground. 

"I called to get her in, honestly thinking I was going to be making a euthanasia decision, because I wasn't going to put her through it again,” Harrell said. “It happened at 5:30, I was there at 5:45, a resident had hands on her before 6, and Dr. Shinn had hands on her before 8."

It was determined that the problem stemmed from tapering prednisone too quickly, causing swelling at the surgical area. Miryam left the same day, and with careful management and physical therapy, she has made progress. 

"With neurological issues, progress is slow,” said Harrell. "Unlike orthopedic issues, neurological rehab is not linear, so there will be bad days and good days as the nerves rebuild. I think of it as the spinal cord, which was compressed, is having to stretch its wings and fill out the spinal column again." 

Five months after the surgery, Miryam is living a sporty pup’s dream, training in agility and flyball. 

“She runs like the wind in the woods. She chases her leggy border collie brothers up the mountain every morning,” said Harrell.