Foramen Magnum Decompression with Adipose Tissue Grafting for Caudal Occipital Malformation Syndrome in a Maltese Dog

A 7-year-old intact female Maltese dog was referred to the hospital with a history of paresis in the hind limbs, left head turn, and a loss of balance that persisted for 2 weeks. Her condition was initially managed with steroids, prescribed by the referring veterinarian, but her neurological symptoms were not alleviated. Physical and neurological examinations, radiography, computed tomography, and magnetic resonance imaging were performed. Based on the findings on these examinations, caudal occipital malformation syndrome (COMS) with syringohydromyelia was diagnosed. Medical treatment was not effective in the previous trial; therefore, foramen magnum decompression, durotomy, and free autogenous adipose tissue grafting were performed. After 3 days, an improvement was observed in the clinical symptoms and was maintained for 8 months postoperatively. Based on the results, it is suggested that the decompression method with a fat graft may be considered an effective surgical treatment for the management of COMS that did not respond well to previous medical treatment.