Neurologic lumbosacral disease in a 6 year old dog
Fogg, Rachel L.
Lumbosacral disease is an acquired degenerative disorder of middle aged to older, large breed dogs, especially the German Shepherd. Covering a spectrum of disorders, it is the result of compression of the nerve roots of the cauda equine at the lumbosacral junction (roots of pelvic, sciatic, pudendal, and caudal nerves). Patients typically present with an owner complaint of difficulty rising and lameness. As such, it may initially be treated as osteoarthritis or hip dysplasia, and may progress for many months before it is correctly diagnosed. In this case, a six year old, male castrated Entlebucher Sennenhund was referred to the Cornell Orthopedic Service for evaluation of chronic left hind limb lameness of three years duration. Physical exam revealed hind limb muscle atrophy, abduction of the left hind limb, and decreased withdrawal of the left hind limb. Radiographs of the spine and hind limbs were found to be normal with the exception of a transitional lumbosacral segment. Due to the muscle atrophy and decreased withdrawal, a lesion was localized to the L4-S3 spinal segment. An MRI was then performed, which revealed left sided nerve root compression at the L7-S1 junction, and the patient was subsequently diagnosed with cauda equine syndrome caused by lumbosacral diseased. Medical management was initially attempted, but signs progressed over the next month, and the patient was admitted to the Neurology Service for surgery. A dorsal laminectomy and left sided foraminotomy were performed, and a cortical bone screw was placed to stabilize the lumbosacral junction. Despite surgical site infection and seroma formation, the patient recovered well, and his lameness continued to resolve. This case presentation will address the clinical signs, differential diagnosis, diagnostics, medical therapy, and surgical therapy of lumbosacral disease in this patient, and discuss the significance of neurological lumbosacral disease in small animal veterinary practice.
Senior seminar paperSeminar SF610.1 2013
Dogs -- Diseases -- Case studies