Discovering that your dog requires spinal surgery can be a worrying time. It is not uncommon for such surgery to require your pet to travel to a referral centre. But why might this be and why might spinal surgery be necessary in the first place?
Table of contents
Why might my dog need spinal surgery?
The spinal column (or backbone) is made up of a series of small bones called vertebrae. These are separated by cartilaginous intervertebral discs which allow the spine a small degree of flexibility and act as shock absorbers. Within the vertebrae lies the protective vertebral canal through which travels the spinal cord. This delicate structure consists of a collection of nerves that transmit messages between the brain and the rest of the body.
There are very many different conditions that can affect the spinal cord in dogs. Certain breeds are unfortunately more prone to spinal disease. Some of the more common conditions that may require surgery are discussed in a little more detail below.
Herniated intervertebral disc (slipped disc)
A herniated or slipped disc is the most common reason for dogs to require spinal surgery. This condition can occur in any dog but is more commonly seen in Dachshunds as well as other breeds such as the Shih Tzu, Pekingese, Pug and French Bulldog. In these breeds the disc herniation often occurs secondary to a degenerative process which causes the discs to become hard and lose their shock absorbing properties.
A slipped disc may occur very suddenly and without warning. It results in abnormal pressure on the spinal cord. Clinical signs caused by a slipped disc vary depending on which disc (or discs) are involved and on the degree of herniation. You might notice your dog showing signs of pain such as having a hunched back. They may scuff their feet when walking or they may be unable to stand. They may have difficulty toileting. Sometimes there may be a complete loss of movement in the hind legs. If your dog is showing any of these signs, then it is important to phone your vets for advice.
In many cases disc herniation will require surgical management. Assessment for surgery should be performed as soon as possible. There is evidence that significant delay between presentation and surgery increases the risk of deterioration in signs in some dogs and could affect the outcome (Martin et al, 2020). The urgent nature of this condition in many dogs is a key reason that referral may be recommended by your vet.
Cervical Spondylopathy (Wobblers)
This is a condition seen predominantly in Dobermanns and Great Danes. It arises due to abnormalities in the neck vertebrae which can lead to instability and associated slipped discs. Dogs with wobblers tend to show signs of neck pain and an abnormal (or wobbly) gait in their back legs.
Atlantoaxial subluxation
Atlantoaxial subluxation is most common in toy breed dogs such as the Yorkshire Terrier and Chihuahua. It results from instability between the first two vertebrae in the neck known as the atlas and axis. Pain results from abnormal pressure on the spinal cord. Movement to the limbs can also be affected.
Due to the small size of these patients, surgical stabilisation is often a very complicated procedure. This is best undertaken by a vet with experience treating this condition, usually in a referral setting.
Degenerative lumbosacral stenosis
This is a progressive condition seen in large breed dogs especially German Shepherds. It affects the lower back and causes dogs to have difficulty with the movement in their back legs as well as pain and sometimes incontinence.
Other conditions of the spinal cord such as traumatic fractures or tumours may also be treated surgically.
Will my vet carry out any tests?
In order to make a diagnosis and to determine the best course of action for any dog with suspected spinal cord disease a number of investigations are often required. Advanced imaging with a CT or MRI scan often forms a significant part of such investigations. These can give very important information as to the likely extent of any damage to the spinal cord and helps guide any potential surgery. This advanced equipment is not widely available in general practices and therefore referral to a specialist centre may be required.
What surgery might be recommended?
The type of surgery will vary depending on the cause of the spinal issue. Spinal surgery usually aims to remove abnormal pressure on the spinal cord. This may involve the removal of a small portion of vertebral bone, allowing the surgeon access to the spinal cord. This is delicate surgery and requires precision and often the use of advanced surgical equipment. In some referral centres this now includes the use of operating microscopes which significantly improves the surgeon’s visibility of delicate structures.
In conditions where there is instability between vertebrae, surgery may involve the placement of implants to correct this. Such implants can now be custom-made to fit the patient, in some cases. 3D printing of implants and instruments is becoming more common in referral settings and has the potential to offer significant advantages for some more complicated spinal surgeries.
What aftercare will be needed?
The degree of aftercare needed depends on the type of surgery performed and the extent of the damage to the spinal cord. It is not unusual for patients to remain hospitalised for at least a few days after surgery. Some dogs will require intensive nursing to ensure that they do not get pressure sores and to help with urination if they cannot pass urine on their own. Close monitoring is required to ensure that any pain is adequately controlled. This high level of care is best offered by staff with experience in caring for pets following spinal surgery. Your vet may advise that a referral setting is best placed to provide the level of care needed in these circumstances.
Longer term, many dogs will require an ongoing physiotherapy programme to help their recovery and some referral centres may have dedicated physiotherapists who will oversee this.
Overview
There are many reasons that your vet may recommend referral if your dog presents with signs of spinal disease. Spinal surgery is complicated surgery and is best performed by a veterinary surgeon with experience in this area. Outcomes for some spinal surgeries, such as disc herniation, may be improved if any delay prior to surgery is kept to a minimum.
Diagnosis of conditions involving the spine often require access to advanced equipment which may only be available in a referral setting. Patients may also require a significant level of aftercare to improve their outcome, and this may not always be possible to achieve in general practice. Whilst spinal surgery may seem a scary prospect, for many conditions a favourable outcome can be achieved.
You might also be interested in:
References
Martin S, Liebel F.X, Fadda A, Lazzerini K, Harcourt-Brown T (2020) Same-day surgery may reduce the risk of losing pain perception in dogs with thoracolumbar disc extrusion Journal of Small Animal Practice Jul 61(7): 442-448
Discussion