Lumbo-Sacral Disease (Cauda-Equina Syndrome)
Lumbo-sacral disease is a syndrome in which instability between two vertebrae results in trapped nerves in the lower back.
Breeds at Risk: large breeds of dog, especially the German Shepherd, are especially at risk.
Trauma: heavy work, especially in young dogs, may predispose to the problem.
Age: most cases are in middle-aged to older dogs.
Other Factors: in some cases, abnormalities in the normal development of the spine can predispose to instability between the vertebrae.
Symptoms are associated with discomfort and/or loss of function in the the trapped nerves:
- Low back pain and/or stiffness on rising, especially after rest
- Difficulty in climbing stairs or jumping (eg. into the car)
- In some cases, there is a lameness in a single hind leg.
Loss of Function
- There may be weakness or unsteadiness in the back legs
- There may be loss of control of the bladder and/or bowel
- There may be an inability to wag the tail
Several other diseases may appear superficially similar to lumbo-sacral disease; these include orthopaedic diseases in the back legs, diseases of the nerves and other diseases that result in spinal instability and nerve entrapment. Xrays, and sometimes MRI scans, are needed to confirm the diagnosis of this disease.
Lumbo-sacral disease may be treated medically or surgically. Surgery is most likely in dogs with a severe or prolonged problem, especially if there is a poor response to medical treatment.
- Restriction of Activity >>> strict rest initially is followed by long-term moderation of exercise (eg. lead walks only, exercise on the flat, no jumping)
- Medication >>> painkilling anti-inflammatory drugs can give symptomatic relief
Several different surgical procedures have been described to treat this disease. All the procedures are complex, technically demanding and expensive. Referral to a specialist centre is usually required for this type of surgery.
The outlook is good for most dogs with early signs. Those not controlled by medical treatment may benefit from surgery. However, dogs with severe nerve dysfunction have a poor prognosis and euthanasia should be considered to alleviate suffering.