Magnetic resonance imaging and management of suspected bilateral C2 hypertrophic ganglioneuritis in a Yorkshire Terrier dog: a case report

A 6-year-old intact male Yorkshire Terrier, weighing 5.8 kg, presented with progressive ataxia of the thoracic and pelvic limbs with a four-month duration. A physical examination revealed proprioceptive ataxia and neck pain, with neurological signs indicating a C1–5 lesion. The radiographs revealed mild narrowing of the disc spaces at C2–3, C4–5, and C5–6, suggesting cervical intervertebral disc disease (IVDD). Magnetic resonance imaging (MRI) revealed bilateral symmetrical enlargement of the C2 nerve roots, causing spinal cord compression and distortion. The post-contrast T1-weighted images showed pronounced contrast enhancement, suggestive of hypertrophic ganglioneuritis. Mild disc protrusions at C4–5, C5–6, and C6–7 were also observed with minimal spinal compression, suggesting a lesser role in the clinical presentation. Considering the MRI findings, high-dose immunosuppressive prednisolone was administered under the tentative diagnosis of hypertrophic ganglioneuritis, leading to significant improvement in mobility and postural reactions. Follow-up MRI performed three months post-treatment revealed a significant decrease in the hypertrophy of the C2 nerve roots and alleviated spinal cord compression. This case underscores the essential role of MRI in differentiating hypertrophic ganglioneuritis from other spinal cord pathologies such as IVDD or spinal nerve tumors.