Third Street Veterinary Hospital, PC
McMinnville, Oregon 97128
Office phone: (503) 472-9418
Lumbosacral
Stenosis
This
is a disease that occurs at the lumbosacral junction. The term “lumbo” refers to the lumbar vertebrae. These are the bones in the lower part of the
spinal column. The term “sacral” refers
to the sacrum, which is the part of the spine that joins the lumbar spine and the
pelvis. Changes that occur in the
vertebrae, supporting ligaments or adjacent disks can all contribute to this
pathologic narrowing of the spinal cord canal.
Prevalence
This
disorder is seen more commonly in adult dogs of large breeds. Males may be affected more often than
females. German Shepherd dogs appear
predisposed to the condition.
Causes/Transmission
Lumbosacral
stenosis occurs from one or more types of changes at this vertebral
junction: a congenital malformation,
proliferation of ligaments which support the joint, instability at the joint,
or compression from a protruding disk.
In
some dogs, abnormalities in the structure of the vertebrae may be present at
birth, but problems do not become apparent for a number of years.
Clinical Signs
When
instability exists along the spine, abnormal movement occurs. The onset of signs is usually gradual, with
continuous progression and worsening over time. Early signs can include pain and lameness. Gradually, with continued compression of the
spinal cord, affected dogs lose control of the back legs, tail, urinary bladder
and bowel.
Diagnosis
Radiographs
(x-rays) will generally reveal arthritic changes at the lumbosacral
junction. However, this is common in
many dogs and may not cause any clinical signs. As such, x-rays may offer only indirect evidence of the
disorder.
If
the clinical signs are correct and the initial radiographs are suggestive of
lumbosacral stenosis, a special radiographic study, called an epidurogram, may
be performed. This is the injection of
contrast material around the spinal cord so that pressure on the spinal cord
can be detected on subsequent radiographs.
This procedure is sometimes technically difficult and is not always performed. In some cases, a presumptive diagnosis is
made based on the dog’s breed, age, clinical signs and progression of disease.
Treatment
If
your dog is overweight, weight reduction will be an important part of the
treatment. Any disorder of the back is
aggravated by excessive body weight.
Strict
rest is also an important part of treatment for any back problem. Cage rest is preferable, but confinement in
a small fenced run or small room is acceptable.
Anti-inflammatory
drugs and pain relievers will often give temporary relief.
Although
infection in the disk is not a common cause, it should be treated with
appropriate antibiotics if it is present.
An infection of this nature usually requires 4-8 weeks of therapy.
Surgery
can be performed and is helpful in relieving compression on the spinal cord for
years to come. In some cases, surgery
is not indicated or desirable. This is
decided on an individual basis.
Prognosis
The
prognosis is variable depending upon the severity of the clinical signs and
response to treatment. Dogs who have
loss of bladder and bowel control have a more guarded prognosis for return to
normal function.