Abstract

To compare clinical signs of dogs treated medically or surgically for degenerative lumbosacral stenosis (DLSS) and assess outcome after medical treatment. Retrospective case series. Client-owned dogs treated medically (n = 49) or surgically (49) for DLSS. Medical records from 2004 to 2012 were reviewed. Dogs were included if they had clinical signs, clinical examination findings, and MRI abnormalities consistent with DLSS. Several variables were compared between surgically and medically treated dogs: age, sex, duration of clinical signs, presence or absence of neurologic deficits, urinary and fecal incontinence, concurrent medical conditions, and medical treatment before referral. Medical treatment after obtaining a final diagnosis of DLSS consisted of restricted exercise in combination with anti-inflammatory and analgesic drugs. Surgical treatment consisted of dorsal lumbosacral laminectomy. Outcome for medically treated dogs was obtained via a standardized questionnaire. Neurologic deficits were observed significantly more often in surgically treated dogs. Surgically treated dogs had unsuccessful medical treatment before referral significantly more often than did medically treated dogs. Thirty-one of 49 (63.3%) medically treated dogs were available for follow-up evaluation. Of these 31 dogs, 17 (55%) were managed successfully, 10 (32.3%) were managed unsuccessfully and underwent surgical treatment, 3 (9.7%) were euthanized because of progression of clinical signs, and 1 (3.2%) was alive but had an increase in severity of clinical signs after medical management. Clinical signs differed in dogs treated medically or surgically for DLSS. Medical treatment for dogs with DLSS was associated with a fair prognosis.

Highlights

  • Relevance—Clinical signs differed in dogs treated medically or surgically for DLSS

  • Medical treatment for dogs with DLSS was associated with a fair prognosis. (J Am Vet Med Assoc 2014;245:408–413)

  • Degenerative lumbosacral stenosis is a multifactorial disorder in which a combination of bony and soft tissue abnormalities causes progressive stenosis of the lumbosacral region of the vertebral canal with subsequent compression of the cauda equina.[1,2]

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Summary

Methods

Case selection—Medical records from the University of London Royal Veterinary College Small Animal Referral Hospital between 2004 and 2012 were searched to identify dogs with DLSS. Dogs with complete medical records, clinical signs and neurologic examination findings compatible with DLSS, and a diagnosis of DLSS confirmed by MRI were included in the study. Dogs that received surgical or medical treatments (or both) were included. Medical records review—Information retrieved from the medical records included signalment, duration and type of clinical signs before initial evaluation, physical examination findings, presence or absence of neurologic deficits, urinary or fecal incontinence, concurrent medical conditions, and results of medical treatment before referral. For dogs that received medical treatment before referral, a static or deteriorated clinical status before initial evaluation at the Royal Veterinary College was considered as unsuccessful medical treatment before referral

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