Treating Low Back Problems
Low back problems occur more often in dogs than in cats. Degeneration of the bone of the low back can result from congenital deformities of the lower lumbar or sacral vertebrae (most commonly in German Shepherds). Low back problems also can be caused by disc problems (found in small and large breeds), infections or traumatic injuries. Arthritic symptoms generally result from these problems as they become chronic. As the arthritis progresses, the discs continue to degenerate. The nerves in the lower back can become pinched causing a disease called Cauda Equina Syndrome (figs. 1 and 2).
Affected animals are usually stiff in the morning and following exercise. Due to the associated pain, they are reluctant to stand on their hind legs, jump up or be patted on the lower back. They often experience lameness in one or both legs and may occasionally yelp out in pain. Some affected animals will lose muscle tone to the tail and will start inexplicably chewing their rump and tail areas. In severe cases, animals will lose control of their bowel and bladder function.
Diagnosis and Treatment
Medical treatment with steroids can lessen these clinical symptoms, however, there are side effects. Also, steroids cannot stop the progressive deterioration and further nerve damage. Surgery is usually the best option in cases of Cauda Equina Syndrome.
Signs such as tail chewing, lameness, pain over the back and incontinence are caused by nerve root pressure that occurs in Cauda Equina Syndrome. Other diseases such as allergies, orthopedic problems, and urinary tract infections can cause similar symptoms. Therefore, it is essential that a good physical examination, appropriate laboratory tests, and radiographic procedures are performed to determine the exact cause of your pet’s difficulty.
Standard radiographs of the lower back can be very useful in assessing the spine for congenital, arthritic, infectious or malalignment diseases. These studies are more accurately performed while your pet is under general anesthesia to allow exact positioning of the spine.
If a definitive cause of the low back problem cannot be seen on regular radiographs, an MRI or CT Scan (or both) may be recommended. These technologies provide a more detailed picture of the low back and include the spinal canal, discs, nerve roots etc. Usually this will pinpoint the cause of the problem and provide the information needed to medically or surgically treat the disease effectively.
Surgery for Cauda Equina Syndrome can be performed after appropriate testing has been conducted. The surgical procedure (laminectomy) opens the vertebrae (spinal canal) to reveal the spinal cord and nerves as they exit the spinal cord. Any bone spurs, ruptured disc, or scar tissue can be cut away to relieve pressure on the spinal cord or nerve roots. If necessary, the openings through which the nerves leave the vertebrae (foramina) can also be widened to eliminate pinching and pressure caused by arthritic spurs in these areas.
In some cases, animals experience a temporary set back in their neurologic abilities following surgery. This condition is related to a drop in spinal cord blood pressure, and spinal cord/nerve root manipulation occurring during surgery. If this occurs, you can usually expect your pet to be able to walk and gradually return to its preoperative status within 3-4 weeks.
As your pet gradually improves following successful surgery, the preoperative pain, lameness and incontinence should resolve. Some animals are markedly improved within 4-8 weeks, while others show a slow, gradual improvement over 6 or more months. Although no guarantees can be given with any medical or surgical treatment, most low back problems will respond favorably to proper treatment. The rate of recovery depends, in part, on the age and general health of your pet as well as the length of time the problem has occurred prior to surgery.
Veterinary Surgical Centers can make an accurate prognosis for the success of surgery only after a thorough medical, physical and neurologic examination of your pet. For an evaluation or further information about Cauda Equina Syndrome in pets or other neurological disorders, please call our offices to schedule a consultation appointment.