We spoke in a previous blog post about IVDD (disc disease) in dogs but let us take a closer look at a particular type called Lumbosacral Stenosis/Lumbosacral Instability. Unlike disc disease which is more prevalent in our smaller and longer breeds of dogs like Dachshunds and Shih Tzus; Lumbosacral Stenosis (LS) is more common in large breed dogs such as, Retrievers and Greyhounds.
We already spoke about the anatomy of the spine and the spinal cord. The area we are talking about with LS disease is the lower back, the last lumbar vertebrae and the start of the sacrum which the area of the spine that connects the lower lumbar region and the pelvis. In this area, the spinal cord becomes a bunch of individualized nerves that then travel to the back half of the body and the organs.
With LS Stenosis, there is motion at the end of the lumbar spine and sacrum that puts pressure on the nerves in that area and causes significant issues. Often the symptoms include; tripping when walking, standing on the tops of the hind feet, falling, wobbliness in the hind end, pain on palpation of that area, walking with the hind end lower than the rest of the body, and many other non-specific signs. LS disease can mimic the symptoms of hip arthritis so it is important to speak with your veterinarian about these issues.
Diagnosis of LS disease is done by a variety of methods starting with a good physical examination by your veterinarian. The next step is usually imaging of the lower back and hips. Radiographs can show some evidence of LS disease but, to confirm the diagnosis, we typically recommend advanced imaging such a CT or MRI scan.
Treating LS disease is a complex process that is best served by a multi-modal approach to include a combination of therapies to reduce pain, improve mobility, and preserve quality of life. The first phase of treatment is usually medications. Unlike arthritis, LS patients often need a bit more pain control that just standard anti-inflammatories. We will typically use a combination of pain medications. At the same time, we strongly recommend traction-aiding devices like PawFriction to reduce the risk of sliding and to keep muscle mass healthy; one fall can cause a significant flare up of LS pain.
There are some more advanced therapies for LS disease that can be performed including intra-spinal injections of steroids and some surgical possibilities. These should be discussed with your veterinarian or a specialist as they take some advanced training to perform.
While Lumbosacral Stenosis is a progressive disease, thankfully we can make many dogs extremely comfortable and mobile for many years in the future.