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General Back Pain
Overview
Due to their active nature, dogs can commonly injure their backs. Causes of back pain can be due to soft tissue injury (eg muscle tear) or spinal injury (eg intervertebral disc disease IVDD). Pain can be located anywhere from the neck, middle back, or lower back.
Milder injuries from muscle tears can be managed conservatively with rest and anti-inflammatory medications. However, spinal injuries can lead to more serious problems such as paralysis.
An intervertebral disc is a shock absorber that sits between each vertebra (spinal bone). When they deteriorate, they can no longer function as a good shock absorber and the pet can experience pain. IVDD can occur at any time and may be related to jumping on and off furniture, other high-impact activities, or genetic predisposition.
There are 2 types of degenerative processes:
| Chondrodystrophic | This occurs between 2-24 months of age. From 1 year of age, 75-100% of intervertebral discs have degenerated. |
| Non-chondrodystrophic | A slow aging process where clinical signs appear between 8-10 years of age. |
IVDD can occur in any dog breed, but more commonly in:
- American Cocker Spaniel
- Basset Hound
- Dachshund
- French Bulldog
- German Shepherd
- Labrador Retriever
- Pekingnese
- Shih Tzu
With IVDD, the degenerated disc contents spill into the spinal canal and push on to the spinal cord; and the longer the compression, the most severe the signs.
Signs
Clinical signs of back pain include:
- Pain eg not wanting to eat, tense abdomen, crying when moved or picked up, reluctance to go up or downstairs, reluctance to jump up on furniture, uninterested in walks, unable to turn their neck
- Loss of limb function e.g. wobbly legs, knuckling paws
- Paralysis
- Loss of feeling in hindlimbs
Diagnosis
- Physical and neurological examination
- Radiographs (X-rays)
- CT scan
- MRI
- Myelogram
Radiology is usually the first diagnostic test when investigating spinal problems. However, it can only confirm IVDD cases in 60% of cases. A CT or MRI is more accurate in confirming the diagnosis, but will require referral to a specialist facility to have this performed.
Management
Medical or surgical therapy may be recommended depending on your Veterinarian's findings from the physical examination. Here some possible recommendations (please note that your Veterinarian will advise what is suitable for your pet):
| Medical therapy | Indicated when there is only mild pain and / or mild loss of limb function. Medical advice ranges (depending on whether your Veterinarian suspects muscular or spinal injury) from: - low level activity (no jumping/running/ball chasing) for 2-4 weeks (if suspected muscle injury) - strict confinement for 4-6 weeks – crate only with leash walking to the toilet only. This is to allow the intervertebral disc to heal. - pain relief - anti-inflammatory medication - anti-anxiety medication - acupuncture therapy may assist with pain relief - expressing the bladder at least 3 times a day (if loss of ability to urinate) - soft bedding with a lot of absorbent padding |
| Surgical therapy | Indicated when the cord is compressed and there is severe pain, or loss of limb function. A referral specialty surgeon can perform surgery to remove a section of the vertebrae to relieve the pressure on the spinal cord. Pets are typically required to stay in the hospital following surgery until they have full control of their bladder and bowel function. This is usually a week. Ongoing physical therapy such as massage therapy and swimming can assist in recovery. |
Prognosis
- Early diagnosis offers the best chances for recovery.
- Pets with minimal neurological deficits with well-controlled pain have a fair to good prognosis with medical treatment.
- In pets with more severe spinal injury, surgery is usually required. Success rates after decompressive surgery are reported between 58.8-95%.
- Prognosis is poor if bleeding occurs within the spinal cord (myelomalacia).