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strength make this a poor long-term
choice for our canine athletes. One
therapy that is quite popular in human
medicine is injection of a steroid at the
site of compression, giving the patient
the benefits of a potent anti-inflammatory while minimizing the systemic side
effects. While this seems to be an effective modality in some dogs, efficacy
data in veterinary medicine is limited.
Surgical
There are quite a few surgical procedures described for the lumbosacral
junction depending on the nature of
the compression and degree of instability. The most common decompressive
procedure is called a Dorsal Laminectomy, in which a window is created in the
roof of the vertebral canal. This window
allows access to remove protruding intervertebral disc, compressive bone, or
soft tissues. Once the nerve roots have
been adequately decompressed, the
procedure is complete. In dogs with
significant instability of the lumbosacral junction, stabilization or fusion
may be elected. If necessary, stabilization is achieved through the use of implants to prevent movement across the
lumbosacral junction.
Rehabilitation Therapy
Rehabilitation therapy is an extremely
useful adjunctive therapy which can
be an important part of any conservative or surgical management plan.
Rehabilitation therapy can consist of
manual therapies and hydrotherapy
to improve conditioning and resolve
muscle imbalances. Some therapeutic
modalities such as acupuncture, cold
laser, and transcutaneous electrical
nerve stimulation (TENS) can also provide non-medication pain relief. As a
part of rehabilitation therapy, a home
exercise plan is also mapped out, allowing a dog owner to take an important
role in their dog's recovery process.

Prognosis

dogs, likely due to the fact that any nerve root compression does not spontaneously resolve, as well as the dynamic nature of the lumbosacral junction. In particular, dogs returning to a high level of activity like agility and other sports are
predisposed to exacerbations or "flare-ups" of their discomfort. Because the nature
of lumbosacral disease is such that it tends to progress gradually, a trial of medical
therapy may be elected as a first option with minimal risk, with more aggressive
therapies pursued if the patient does not respond sufficiently.
Surgical Therapy
Overall, the prognosis with surgical therapy tends to be fairly good with success
rates of between 75-90% reported in veterinary literature. Addressing any nerve
root compression often leads to a rapid return to comfort once post-surgical discomfort has resolved. Neurologic deficits (weakness, incoordination) often
do take weeks (occasionally months)
to see the full extent of improvement,
as nerve healing can take quite some
time. The one scenario where the
prognosis is more guarded, even with
a successful surgical decompression,
is in dogs that have developed urinary
and fecal incontinence. The overall reBob, one of Dr. Gallagher's patients, had a dorsal
covery rate for these dogs is guarded,
laminectomy for a lumbosacral disc protrusion in March
with approximately 50% achieving re2014. Bob is active in sheep herding and has now
turn to continence.
returned to full function and competition.

Conclusion
Lower back pain can be an intimidating concern in agility and sporting dogs. There
are often subtle changes in performance, such as unexplained decreased performance or hind limb lameness, which will warrant a visit to your veterinary specialist.
Through a thorough examination and possible advanced diagnostics, your veterinary specialist will be able to get a better picture of your canine competitor's cause
of injury. While canine back pain can be daunting, it is important to remember that
advances in veterinary medicine are continuing to provide better patient outcomes
over time, and your veterinary specialist is a key resource in your athlete's return to
competition. D

References and Continued Reading
Danielsson, F., Sjostrom, L. (1999) Surgical treatment of degenerative lumbosacral stenosis in
dogs. Veterinary Surgery 28, 91-98.
De Risio L (2001) Predictors of outcome after dorsal decompressive laminectomy for
degenerative lumbosacral stenosis in dogs: 69 cases( 1987-1997). J Am Vet Med Assoc
219:624-8
Janssens L (2009) Lumbosacral degenerative stenosis in the dog. The results of epidural
infiltration with methylprednisolone acetate: a retrospective study. Vet Comp Orthop
Traumatol. 2009;22(6):486-91.
Meij BP (2010) Degenerative lumbosacral stenosis in dogs. Vet Clin North Am Small Anim
Pract. 2010 Sep;40(5):983-1009

Nonsurgical Therapy

Ness, M.G. (1994) Degenerative lumbosacral stenosis in the dog: a review of 30 cases. Journal
of Small Animal Practice 35, 185-190

Unfortunately, nonsurgical therapy is
only effective in approximately 50% of

Suwankong N(2008). Review and retrospective analysis of degenerative lumbosacral stenosis
in 156 dogs treated by dorsal laminectomy. Vet Comp Orthop Traumatol 21:285-93.

Dr. Ryan Gallagher completed his undergraduate degree in biology at Sonoma State University and then earned his Doctor of Veterinary Medicine at the University of California
Davis School of Veterinary Medicine. Dr. Gallagher then completed a rotating internship at the University of Pennsylvania and a three-year residency program in neurology at
North Carolina State University, after which he earned diplomate status from the American College of Veterinary Internal Medicine in neurology. Dr. Gallagher currently practices
at The Spine Center at VOSM, partnered with Veterinary Orthopedic & Sports Medicine Group in Annapolis Junction, Maryland. For more information, visit www.vosm.com.
June 15

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http://www.vosm.com

Clean Run - June 2015

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