Back and neck pain in dogs PDF Print E-mail
News - Rubrieke
Saturday, 18 June 2016 14:14
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Dr Liesel van der Merwe is a small animal medicine specialist. Send her your questions: This e-mail address is being protected from spambots. You need JavaScript enabled to view it .


Dr Liesel van der Merwe

Most of us at some time have suffered from a pinched nerve in the neck. Some also have had to have surgery for a ‘slipped’ disc. Dogs can suffer from these very same things.

Smaller breed dogs and larger breeds have different conditions which cause these symptoms.

Daschunds and Pekingese dogs are very prone to getting a disc prolapse (slipped disc).

What happens in dogs, especially those with very short twisty legs (chondrodystrophic breeds) is that the disc ages prematurely. The disc is a gel cushion between the vertebrae and is a shock absorber.

In these breeds the gel becomes hard and thick and can eventually calcify from the age of two years onwards. This places pressure on the ligament holding the disc in place. When this ligament ruptures or tears, the disc material moves up into the space next to the spinal cord.

How much neurological damage occurs depends on how fast (explosive) the rupture is. Very explosive ruptures will cause a lot of damage and bruising and swelling whereas slow ‘leaks’ may cause minimal signs until a lot of material is compressing the cord.

It also makes a difference where the disc prolapse occurs. There is more space around the spinal cord in the neck. So, if a prolapse occurs there it doesn’t always cause severe nerve damage, but rather just pain as it entraps nerves and presses on the meninges, which causes pain. 

These animals often present with limited neck movement or just yelping when touched. They will also not lift their heads. Sometimes they are lame in one of the front legs if specific limb nerves are pinched. Although painful, these dogs are not a surgical emergency. Pain medication and antispasmodics will help while a diagnosis or treatment decision is made.

In the lower back, however, there is very little space around the spinal cord and any prolapsed tissue will almost immediately put pressure on the nerves. These areas are a little more serious.

These dogs will present with non-specific pain. They may present with sudden onset paralysis, dragging their back legs, or they may present somewhere in-between with weak legs which have poor feeling and walk wobbly.

The more severe cases are surgical candidates. The surgery is specialist surgery and not every veterinarian can perform it. Bladder function is also affected with these animals and management of this is an important part of recovery.

The milder cases may respond to strict cage/bed rest for six weeks and pain meds. If symptoms progress then surgery is advised. In some cases damage is so severe that the deep pain sensation is lost. These dogs cannot feel pain when their toenails are clamped with a forceps. This means that the spinal cord was severely damaged and makes the prognosis more guarded for recovery.

Cases with no deep pain can still be managed using a two-wheeled cart. This gives the dog mobility.

Obviously, as with a paraplegic person, there is a lot of nursing care; so this decision must not be taken lightly.

Generally your vet can be reasonably confident of the diagnosis with a general examination, but a MRI or myelogram is preferred to confirm the diagnosis and locate the exact area where surgery needs to be performed.

Other dogs commonly affected with disc prolapses are beagles, fox terriers and German shepherd dogs (less common).

Another important cause of neck pain in small breed dogs is meningitis. This is not the meningitis people get, which is bacterial and very contagious. Meningitis in small breed dogs is a non-infectious condition where the body’s immune system becomes overactive.

There is probably a trigger, but none has yet been identified. These animals present with a variety of signs, as the inflammation can affect the spinal cord and the brain. Common ones are neck pain, a head tilted to one side or weakness in one side. These dogs are not clinically ill and do not have a fever.

The diagnosis is made with a spinal tap to obtain cerebrospinal (CSF) fluid for analysis. In humans a lumbar puncture is performed. That space is too small in dogs and we collect the sample at the base of the skull where there is dilation with fluid around the cord.

These animals are treated with corticosteroids and other immunosuppressive medications. Some can come off the medication, others need it lifelong. A similar condition affects young large-breed dogs, but these dogs only have severe neck pain with a fever. They resist neck movement and look up with their eyes only, trying not to move their necks. Treatment is similar.

Especially with a disc prolapse, early management and treatment may be vital to preserve nerve function. If you have these breeds, know what to look for and where to go.

 

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