Oh my Aching Back: Back Issues

I have a dear client & friend that commented how lucky my dog, Taco Belle, was to have a 24/7 Vet-Nanny. For 8 years, until this weekend, she historically has had zero health problems. Normally, when I arrive home from work, she greets me with adoring eyes (or perhaps it is just dinner time). Two days ago, that pattern was broken. Taco did not come to the door or when called. I found her hiding under an end table, oblivious to the time of day. Her routine that day was a Friday Spa day at the clinic, ride home in the truck with my husband, and a good snooze on the sofa. Unfortunately, veterinarians tend to think of all the possible worst case options: trauma, toxin, and foreign body; none of which seemed to fit her pattern. The sad eyes, lack of appetite, shivering without a fever, tended to indicate pain; however, no obvious area could be localized.

The next day, I left for work after walking her outside. It is a common statement that healthy dogs can go two weeks without eating (unlike cats that go into liver failure). The reality is, that like most pet owners, I am concerned when my dog misses 2 meals as that is very unusual for her pattern. When returning from work I pet her and she let out a blood curdling “scream” when I touched her mid-section. Taco demonstrated significant back pain. Fortunately, with significant exercise restriction and medications she is resting comfortably this evening...and eating. This is the topic of the moment: back pain.

What is the most common cause of back pain in small dogs?

Intervertebral Disk Disease is instability of the cushioning disk(s) between the back bones (which is important in those areas of the neck/cervical and lower back/lumbar). Anatomically there are 7 cervical, 13 thoracic, and 7 lumbar vertebrae in dogs.  There is a longitudinal ligament/band with a rich nerve supply that runs above (dorsal) the disk.  When a suspected minor misstep occurs, the disk shoots upward, pressing up on the ligament. As this continues in a process called Disk Herniation, it compresses the spinal column, creating inflammation, swelling, and pain.

Are small dogs more at risk?

Yes, Dachshund, Lhasa Apso, Shih Tzu, Cocker Spaniels, Beagles, and Pekingese breeds have frequent flyer miles in this area.

Where are the most common herniation sites?

 It is most commonly reported between the Thoracic vertebrae T11-T12 and Lumbar vertebrae L1-L2. In the neck it is between Cervical Vertebrae C2-C3.

What types of signs are noted by owners with suspected spinal column /disk issues?

Initially the first sign is pain over the disk site. As the inflammation spreads in the cord. Additional signs include neurological weakness and abnormal knuckling of the feet (proprioception). In neck problems involving disks, the only sign is maybe pain. Then as the compression continues on the spinal cord, paralysis may develop due to interruption of the signal from the brain to the leg(s).

What other causes of back pain need to be ruled out with ongoing signs? Why is that important to determine?

Degenerative conditions such as Spinal cord deterioration, vertebral fracture/dislocation, tumor, fibrocartilaginous emboli, or spinal cord/disk infection are possibilities. It is important to determine the difference as degenerative conditions will not respond to surgery.

What are the steps of testing? Will some need back surgery ?

The steps are Physical exam, followed by radiographs, and then Magnetic Resonance Imaging (MRI) for those not responding to treatment or with rapid deterioration. Some patients may need a neurological surgical procedure to remove the offending disk material putting pressure on the spinal cord as identified by the radiographs/MRI.

For dogs such as Taco Belle showing only pain, what are the treatments?

Strict cage rest for 3 to 4 weeks, traditional pain medications (metacam), medication for neuropathic pain (gabapentin), muscle relaxants (methocarbamol), and occasionally sedatives (trazodone). This means no steps, no jumping on furniture, no free play, and crating when unsupervised.

What percent of dogs require no additional treatment other than strict rest and pain meds?

Greater than 70% with proper pain meds and true exercise restriction for 3 to 4 weeks will fully recover.

Betsy Sigmon DVM, Diplomate American Board of Veterinary Practitioners, Canine & Feline Hospital Director, Creature Comforts Animal Hospital

Boothbay Harbor Coastline in Maine