At Mainstone Vets we all have a passion for helping our clients’ pets, especially in their senior years. We see lots of older large breed dogs who have had great lives running around the New Forest. Unfortunately, in our older large breed dogs we do see Lumbo-sacral disease. Lumbosacral disease is the degeneration of the lower spine (towards the pelvis), which can include the compression of the nerves.
This joint is actually the highest-motion joint in your dog’s spine. AS it undergoes a unique set of stresses (very similar to the human lower back), degeneration can occur at this site. This area is the transition from the very mobile lower spine to the fused sacrum, and hence is a stress riser.
This can lead to arthritis in the articulations in the area, degenerative disc disease (including protrusion of the disc) and this instability in the area. This can lead to compression or impingement of nerves in the area causing the signs that you may be seeing at home, or that we can pick up here. Clinical signs include:
- Pain in the caudal lumbar region
- Pelvic limb weakness (reluctance to jump, climb and rise)
- Pelvic Kyphosis (lowered back end)
- Reaction to digital pressure around the lower back
- Low Lumbar lordosis painful (evoked by hind-limb extension)
- Proprioceptive deficits
- Urinary or faecal incontinence
- Stamping (nerve root signature)
Whilst there are a number of medical and in some cases surgical options steroid epidurals are also an option.
We are aware that Lumbo-sacral disease is increasingly common in our older patients, whose owners are often concerned about putting their old pet through what is a significantly invasive surgery.
In these cases, assuming clinical and radiographical evidence supports the diagnosis of lumbo-sacral disease (can’t be definitive without MRI) then a steroid epidural can be considered. The rational is that all aspects of lumbo-sacral disease are exacerbated by inflammation in the area. This local deposition of steroid, which has very strong anti-inflammatory effects, can lead to a significant improvement or relief from some of the symptoms.
Placing the epidural is very challenging as there is a lot of soft tissue between the surgeon and the small area surrounded by bone. In lumbo-sacral disease, even more bone can proliferate around this small window in some cases leaving us unable to access the area. The first epidural should be performed to check for improvement in signs.
The epidural takes 1-4 days and see improvement, and we see improvement in 79% of cases. This commonly works for about 2 weeks after which amelioration can deteriorate. If improvement is sufficient repeat epidurals at 14 (12-16) and 6 weeks after day 1 (40 – 50 days). This has been shown to give the longest duration of amelioration, with the average time to relapse from day if having all 3 being 5.3 months. Your vet will have a consultation with you between each epidural to help assess efficacy and determine which protocol to follow in each case.
We hope by offering this service to improve not only the quality but potentially the longevity of you pets life, enabling them to continue to be active in their later years. If you have any queries please contact us and we will do our best to assist you.