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Back Pain in Dogs

When a dog has back pain, it can be extremely debilitating. Back pain in dogs and related issues can often be a sign of a more severe disorder that may become permanent without veterinary intervention. Many back issues also tie in with nerve and neck disorders.

Common Symptoms:

  • Arched back
  • Changes in posture
  • Difficulty urinating or incontinence
  • Increased pacing behavior
  • Reluctance or inability to rise or walk
  • Reluctance to move head
  • Vocalizations of pain when moving
  • Weakness
  • Wobbly or unusual gait
  • Yelping or whining when touched

Causes of Back Pain

A partial dislocation of the two vertebrae is known as an AA subluxation. It happens when the link between the first (atlas) and second (axis) vertebrae becomes unstable, resulting in spinal cord compression. A set of ligaments, as well as the structure of the bones themselves, hold the bones together. A process of the axis called the dens stretches forward and fits against the atlas, helping to maintain the connection between these two bones. Trauma, inherited factors, or a combination of these two variables can induce atlantoaxial luxation. Trauma can include jumping off the couch or being jumped on by another dog. Forceful flexion of the neck in the case of trauma can injure the atlantoaxial joint. The ligaments that support the joint may be ripped, or the dens on the axis may be shattered. If the correct pressures are applied, these injuries can occur in any breed of dog at any age and are usually most common in younger, small breed dogs such as Yorkies and Chihuahuas.

The symptoms can vary depending on the severity of the case and can have either sudden onset or slow progress over time. Symptoms of AA subluxation include neck pain, weakness, and an uncoordinated gait. Dogs may be unable to walk, breathe correctly or it may even result in death. In very severe cases, there may be complete paralysis and with this, there is often paralysis of the diaphragm where the dog is unable to breathe and usually dies before medical attention. To diagnose AA subluxation, a vet will look at the breed and age as well as their medical history, the clinical signs they are showing, and x-rays and possibly a CT scan.

Treatment:

  • Conservative treatment for mild cases with strict crate rest, a neck brace, and possibly Steroids and pain medications.
  • Surgical treatment to relieve pressure on the spinal cord.

Cervical Spondylomyelopathy is often referred to as “wobblers syndrome” and is a condition in which there is chronic instability of the vertebrae at the base of the neck and poor transmission of nerve signals between the body and the brain. It’s a condition of the spine that takes place in the neck. Affected dogs may have a variety of morphological issues with their neck bones. The intervertebral discs, which deteriorate and protrude against the spinal cord, are most commonly affected by these bone deformities. Instability of the spine in the neck area, as well as reactive alterations in the facet joints, are common complications. These modifications may cause the spinal cord to be compressed even more. Furthermore, differing neck positions may have an impact on spinal cord compression. As a result, recurrent damage to the spinal cord may occur when afflicted dogs move their necks and affected dogs may experience muscular spasms in the neck. Giant breeds such as Danes are more predisposed. The clinical signs vary based on the severity of the disease but the most common is a ‘wobbly’, uncoordinated gait with a tendency to stumble and scuff their feet, along with neck pain and could possibly progress to complete paralysis of all four limbs. If a vet suspects a dog of having Caudal Cervical Spondylomyelopathy, they will conduct an MRI.

Treatment:

Cauda Equina Syndrome is a very painful disease for dogs that is caused by the bottom of the spine calcifying with age, causing the base of the spine to become narrow and compress the nerves which result in severe pain. This can make it very painful for dogs to walk or even just walk their tail. As the disease progresses, the nerves continue to become more compressed to the point in which the dog won’t be able to use its hind legs or go to the bathroom properly. Initially, a dog may start having incontinence but a back problem isn’t always considered the initial culprit as the back pain comes later. Signs to look out for if you suspect your dog to have Cauda Equina Syndrome are difficulty standing, poor coordination and posture, dragging their hind paws, shuffling as they walk, weak rear limbs, trouble urinating, or defecating which may cause incontinence and unable to use stairs. There are actually many causes of this syndrome aside from just age. Those include:

  • Infected disc
  • Inflammatory disease such as neuritis
  • Tumors
  • Joint instability
  • Large breeds and dogs with long spinal cords are most susceptible
  • Metastatic neoplasia such as prostatic carcinoma
  • Acute intervertebral disk extrusion
  • Primary neoplasia
  • Subluxation or luxation
  • Fractures or Injury
  • Congenital lesions of the vertebrae
  • Herniated disc

To try and diagnose Cauda Equina Syndrome, a vet will do a neurological exam to observe the dog’s gait for lameness or stiffness. They will also do a physical examination that involves palpation over the spine to try and determine where it is more painful for the dog. They will also try and manipulate the hips and tail to get a pain response that is common in dogs with this syndrome. On top of that, the vet may continue to test the dog’s reflexes, foot placement, and anal tone. Other ways they diagnose is through the use of x-rays and MRIs and/or CTs.

Treatment: 

Diffuse Idiopathic Skeletal Hyperostosis (DISH) is a form of arthritis and while it can be found in any breed, it’s most prevalent and common in purebred Boxers. DISH occurs in the soft tissues, including the ventral longitudinal ligament and other bone attachments such as ligaments, tendons, and capsules, which become calcified and ossified in which both the axial and appendicular skeletons are affected. DISH in dogs is distinguished by widespread new bone development that takes place as fluid ossification along with the ventral and lateral aspects of the vertebral column due to their trabecular pattern. Clinical signs of a dog suffering from DISH include spinal pain, stiffness, and neurological symptoms in the advanced stages but not all dogs present painful symptoms. A vet may do spinal radiography and possibly advanced imaging if neurological signs are present in the dog. Unfortunately, this disease does not have a cure.

Treatment:

  • No known cure.
  • Surgical decompression of neural tissues may provide temporary remission.
  • Relief with anti-inflammatory drugs and other pain medication.

Discospondylitis is a bacterial or fungal infection of the intervertebral disks and the adjacent vertebral bones which can occur in one location of the spinal column or in multiple locations. There are multiple causes for this disease which are either blood-borne spread, direct contamination, or migration of a foreign body towards the spinal cord. A dog may be more predisposed if they have chronic infection or immunosuppression through either medication or another underlying condition but it’s more common in large breed dogs with Great Danes, German Shepherds, Boxers, Rottweilers, Doberman Pinschers, and English Bulldogs being the highest risk.

 

Signs a dog may have Discospondylitis often start slowly and continuously progress over time with the first clinical sign usually being back pain. Dogs who suffer may be acting stiff and not wanting to jump on or off furniture and acting like they are in pain while doing certain movements or being touched in certain spots. With the progression of the condition, more signs become apparent such as muscle weakness and in severe cases, paralysis. Most dogs who are affected also show signs of decreased appetite, lethargy and weight loss. Discospondylitis is usually diagnosed via spinal x-rays as the changes in the bony vertebrae can be seen. But, these changes usually can’t be seen for about 2-6 weeks after clinical signs start to be seen. Advanced imaging such as CT scans may also be required. If Discospondylitis is suspected, the vet may perform tests to confirm the infection such as blood cultures, urine cultures, and testing for an infection called brucellosis. A cerebrospinal fluid (CSF) tap may also be requested as well as a neurologist, wanting to obtain a culture directly from the infected disk. 

Treatment:

Meningitis is the inflammation of the membranes that cover the brain and spinal cord. While it is rare in dogs, several breeds such as Beagles, German Shorthaired Pointers and Bernese Mountain dogs are most commonly diagnosed. Infectious and immune-mediated factors can cause meningitis. These include bacterial, viral, fungal, and protozoal infections that can reach the central nervous system via the sinuses, vertebrae, inner ear, or via bloodstream. When a case is non-infectious, the cause is due to the body attacking its own tissues. Dogs will  commonly experience steroid-responsive meningitis (an immune-mediated condition), which is seen in early adulthood. Clinical signs include pain (can be severe), fever, and a rigid neck. Dogs may also refuse to eat and become lethargic. In some cases, meningitis can occur with encephalitis (inflammation of the brain) that presents neurological signs. These include seizures, circling, pacing, paralysis, blindness, and loss of consciousness. Diagnosing includes a physical exam, lab tests, and a cerebrospinal fluid (CSF) tap to accurately diagnose meningitis. Treating meningitis depends on the underlying cause. 

Treatment:

  • Bacterial and protozoal infections: antibiotics.
  • steroid-responsive meningitis: prednisone.
  • Intravenous fluids.
  • Medications that decrease brain swelling. 
  • Pain relievers.

A tiny fragment of cartilage enters the circulatory system of the spinal cord and restricts blood flow to the spine, causing a fibrocartilaginous embolization (FCE). Incoordination and weakness/paralysis symptoms appear quickly and may worsen over the next six to twelve hours. The indications are stable to improving after the first 12 hours. It’s usually associated with middle-aged large and giant dogs and is often caused by mild trauma or vigorous exercise. It often affects the middle part of the spinal cord, affecting only the hind limbs, but it can occur in the neck affecting all four limbs. Signs of FCE in dogs include acute pain for a short period of time, and nervous system deficits in one side of the body (but can occasionally affect both sides). To diagnose FCE, a vet will look at the clinical signs, consider the dog’s medical history, as well as a neurologic exam, and spinal cord imaging.

Treatment:

  • No treatment available.

Hemivertebra is a disease in which the vertebrae are deformed in either that it they are fused or wedge-shaped which causes a twisting of the spine. This congenital condition can happen to either just one or multiple vertebrae and is considered a congenital disease. While it initially sounds like it would be extremely painful to have a spine in that condition, it doesn’t always cause an issue for the affected dog. It is usually dependent on if the spinal cord is being compressed or if there is a weak section of the spinal column. If the abnormality is right at the tail then it doesn’t usually cause a problem but will cause significant problems if located in other parts of the spine. Breeds that have Hemivertebra of the tail are those breeds with a “curly q tail” or “screw tail” such as Pugs, French Bulldogs, and other brachycephalic breeds. Dogs may not always experience symptoms but if severe, they may experience weakness of the hind limbs, the inability to walk, pain, or incontinence. Signs often present in puppyhood and progressively get worse until they plateau around 9 months of age once the spine has stopped growing. If suspected, a veterinarian will use radiographs as it’s fairly simple to see in an x-ray but they may also use myelograms, CT scans, or MRIs to detect spinal cord compression.

Treatments: 

Insect bites in pets are a common problem and while can sometimes be harmless, certain insects can cause serious health complications and pain. It’s important to note the three categories of insects that sting: Vespidae (yellow jackets, and wasps, hornets), Formicidae (i.e. fire ants), and Apidae (i.e. honeybees, African killer bees). While it can take 20 stings from one of these to be lethal in mammals, it can happen quickly if a pet disturbs a hive or colony. Clinical signs that your dog has been bit or stung by an insect include swelling and redness at the site of the bite, hives, swollen face or muzzle, localized pain at the site of the bite (can vary from mild to severe), puncture wound, and itchiness. Dogs experiencing anaphylaxis may have diarrhea, vomiting, weakness, seizures, respiratory distress, cardiovascular arrest, and collapsing. Initial diagnosis is based on the clinical signs being presented. Blood samples might also be taken to help determine an allergic reaction.

Treatment:

  • Treatment is based on type of bite, how many, and severity of clinical signs.
  • Removal of stinger or other insect parts (if applicable).
  • Antihistamines and anti-inflammatory agents such as corticosteroids.
  • Treatment for anaphylactic shock includes supportive measures such as intravenous fluids, corticosteroids, oxygen therapy, and epinephrine.

Intervertebral Disc Disease happens to be the most common spinal disorder in dogs and is considered a degenerative disorder. Intervertebral discs are the cushions in the space between the spinal vertebrae and are subject to a variety of degenerative conditions and forces which prevent bulging or splintering over time. While this is a disease that often occurs in older dogs, certain breeds are more at risk for developing IVDD at a younger age including chondrodystrophic dogs (those who have disproportionately short and curved limbs such as dachshunds and basset hounds) and crosses of those breeds. IVDD also most commonly occurs in the thoracolumbar (mid-spine) and cervical (neck). Dogs with spinal IVDD generally suffer from neurologic dysfunction, such as fatigue, lameness, etc., and pain while those with cervical IVDD suffer from extreme pain on its own.

IVDD falls under two categories:

  • Type 1: Hansen type-I disc disease is most prevalent in small breed dogs over the age of two, although it can also affect larger breeds. The onset is fairly acute with a variety of clinical signs which contribute to the prognosis as well as how long the signs last. Clinical signs include a range from severe pain in the neck and back to paralysis. The inner contents of the intervertebral disc are more conveniently identified as an "extrusion" or "herniation" in Hansen type-I intervertebral disc disease. That arrangement of the intervertebral disk is similar to that of a jam doughnut where the "jam" (nucleus pulposus) becomes hard and isn't compressive anymore.
  • Type 2: Hansen type-ll is more comparable to disc disease in humans while also occurring in non-chondrodystrophic dogs. Instead of an excursion like in type-l where the “jam” explodes outwards, the annulus, which is the outer part of the disc, bulges and protrudes. Signs onset fairly acutely but can also develop progressively over time. Clinical signs include not wanting to exercise/go for walks, reluctance to jump or walk upstairs, or have a hunched back or look stiff. Treatment varies on the severity.

Treatment: 

  • Drugs such as steroids or non-steroidal anti-inflammatories along with one or more types of pain management.

Lumbosacral stenosis (also referred to as sacral stenosis) is a disease that directly affects the structures of the spinal cord in the lumbar and sacral regions of the spine. Lumbosacral stenosis is caused by the narrowing of the spinal canal which then imposes compression on the spinal nerve roots (the nerves that directly exit the spine). This compression can be caused by intervertebral disc herniation, congenital malformation, arthritis, or a spinal tumor. More commonly, this condition is caused by arthritis or an intervertebral disc herniation. Signs of lumbosacral stenosis include pain in the hind end, unable to rise or wag their tail, difficulty rising after sitting or lying down, gnawing on paws or tail, or urinary/fecal incontinence. These signs indicate inflammation of nerves and muscles to the aggravated spinal cord and the affected area. As the disease progresses, the disc located between the last lumbar vertebrae and sacrum may erupt, causing uncoordinated movement or paralysis of the rear legs. X-rays can indicate arthritic changes but diagnosing the condition consists of a myelogram (injection of contrast to highlight any pressure put on the spinal cord) or MRI and CT scans.

Treatment:

Myotonia Congenita is a rare disease that affects the muscles by causing muscle fibers to contract continuously which causes dogs to experience abnormal muscle stiffness and difficulty getting up. The disease is painful and is a result of chloride channel malformations in dogs. Clinical signs to look out for include muscle stiffness, an enlarged tongue which makes it difficult to swallow, craniofacial structure anomalies, furrowing on several muscles when they are struck, muscle stiffness, and a gait that resembles a bunny hop. Symptoms usually present themselves when dogs are a few weeks old. Diagnosis is done through genetic testing, clinical signs, EMG, and muscle biopsies.

Treatment:

  • No treatment available.
  • Physical therapy may help alleviate pain and uncomfortableness. 
  • Procainamide may help alleviate symptoms.

Prostatomegaly, which is an enlarged prostate, is a disorder reserved for male dogs and is more common in dogs that are not neutered and more so over the age of 8. The prostate gland sits between the bladder and rectum and produces prostatic fluid which is regulated by the dog’s testosterone. A dog who has an enlarged prostate will spend more time than usual urinating and only produce a thin stream of urine, which occasionally may have blood in it. Other signs a dog may have an enlarged prostate include pain while walking, pain while urinating or defecating, ribbon-like stools, constipation, and just general signs of pain. It’s often benign but can easily increase in severity and become life-threatening without veterinary intervention. To determine whether your dog has an enlarged prostate, a vet will palpate the prostate through the abdominal wall or via rectal exam in an attempt to physically feel if it’s enlarged. An x-ray or ultrasound may also be necessary. There are also many other tests to determine the cause of the prostate enlargement as there are numerous diseases that can cause it. There are three main causes of an enlarged prostate:

  • Benign prostatic hyperplasia (BPH): very common and happens as a part of the aging process. It may also cause benign cysts and put pressure on the tissue and organs around the prostate which results in signs of discomfort.
  • Prostatitis: a bacterial infection that can be either acute or chronic which can lead to abscesses in the prostate.
  • Prostate Cancer: makes up less than 10% of enlarged prostate cases but there are also other types of cancer that can affect the prostate.

Treatment is dependent on the underlying disorder or disease causing the enlarged prostate.

Treatment:

  • Benign prostatic hyperplasia (BPH): neutering and draining cysts.
  • Prostatitis: antibiotics but if chronic may include injections, enemas, and surgery.
  • Prostate Cancer: no cure but radiation therapy may help relieve pain.

Osteoarthritis, also known as Degenerative Joint Disease (DJD), affects both dogs and humans alike and is the most common form of arthritis affecting nearly a quarter of a million dogs worldwide at any given time. It is a progressive, chronic joint condition marked by the weakening of joint cartilage, thickening of the joint capsule, and the forming of new bone around the joint (osteophytosis), both of which contribute to pain and limb dysfunction. The majority of OA in dogs is caused by developmental orthopedic diseases including cranial cruciate ligament disease, hip dysplasia, elbow dysplasia, OCD, and patella (knee cap) dislocation. In a small percentage of dogs, OA develops for no apparent reason and is linked to genetics and age. Bodyweight, obesity, exercise, and diet are all factors that contribute to osteoarthritis. Symptoms of osteoarthritis itis in dogs are fairly noticeable and include stiffness, limping, difficulty standing, not wanting to run or jump, weakness, muscle atrophy irritability, weight gain, vocalizing when touched, and incontinence. Unfortunately, the damage caused by OA is irreversible but treatment plans help reduce pain and improve quality of life. 

Treatments: 

  • Weight loss for overweight dogs can help take pressure off affected joints.
  • Regular moderate exercise helps keep joints healthy.
  • Physical medicine including acupuncture, chiropractic, laser therapy, regenerative medicine, medicinal massage, and physical rehabilitation.

Osteosarcoma is a bone tumor that is malignant and resembles human pediatric osteosarcoma. Limbs are the most often affected but it can still affect other bones like the jaw, hips, pelvis, ribcage, and skull. It's even possible for it to arise in non-bony tissue like mammary glands and muscles. It’s more often found in large and giant breed dogs such as Great Danes, Rottweilers, and Irish wolfhounds. This disease can be quite painful in the joints and lameness is often presented in affected dogs. Affected dogs may also present signs of lethargy, loss of appetite, and reluctance to walk or play. Pain medication may be given to help with joints and lameness but may only work for about one to two weeks. Swelling of the bone at the tumor site can be observed at this point and is sometimes sore, swollen, and hot to the touch. Amputation is often the recommended treatment to prevent the cancer from spreading but seeing an oncologist is recommended since it can still spread.

Treatments:

  • Amputation of the affected limb to maintain control of the spread of the cancer.
  • Chemotherapy.
  • Radiation therapy.
  • Pain Medication for temporary relief.

Rocky Mountain Spotted Fever is a tick-borne illness that’s caused by an intracellular parasite known as rickettsia rickettsii. American dog tick, wood tick, or brown dog tick infected with the disease are the culprits that transmit it to the dog. An unfed tick can take up to 10 hours to affect a dog or a fed tick can take only 10 minutes which is why it’s always so important to remove ticks properly as soon as you see them. Dogs that have been bitten by an infected tick may show the following signs: pain in the abdomen or joints, lethargy, diarrhea, cough and fever, nosebleed, enlarged lymph nodes, reduced appetite, nose or eye discharge. Vomiting, lameness in the limbs, and swelling in the legs or face. Clinical signs can range from mild to severe or life-threatening. A vet will consider the clinical signs and then run diagnostic tests, including basic blood tests, urinalysis, and x-rays. In a blood test, they will look for low numbers of red blood cells (anemia) and platelets, or abnormal complete blood count (CBC) results, or white blood cell counts. 

Treatment: 

Spina Bifida is a rare congenital abnormality in which the vertebrae of the spinal column is incomplete due to something going wrong with the fusion of the vertebral arches when embryonic development is occurring. This causes an absence of vertebral arches or the presence of a cleft in the middle of vertebral arch. Breeds can be predisposed to this condition with the most notable being English Bulldogs and other “screw tail breeds”. The disease can be minor and more significant depending on the severity. Clinical signs for more severe cases include limb weakness, paralysis, incontinence, lack of coordination and the Skin may be dimpled at the location where the defect is present. Affected dogs start showing signs in puppyhood. This spinal disorder can be seen via an x-ray when a dog is laying on their back. In more severe cases with significant neurological defects and pain, there is a very poor prognosis for affected dogs.

Treatments:

  • No treatment needed for dogs that do not show symptoms.
  • Possible reconstructive surgery for cases with mild symptoms.
  • Vet may recommend euthaniasia for severe cases.

Spinal tumors are often uncommon in dogs but when they occur, can be debilitating depending on the location of the tumor. They are often slow-growing and 90% of spinal tumors occur in large dogs. They can progress over a span of weeks or months. Spinal tumors may either affect the bones of the vertebral column or come about from the neural tissue in the spine. If a dog is suspected to have a spinal tumor, veterinary intervention is critical to avoid irreversible progression. It can be difficult to suspect if your dog has a spinal tumor as some dogs don’t even display any symptoms in the early stages. Symptoms of a spinal tumor in dogs in general pain, changes in their activity level and how they act during activity, lethargy, reluctance to eat or drink, difficulty standing or laying down, weak limbs, neurological changes such as depression, trouble urinating/defecating or even sudden paralysis. If a vet thinks that your dog may have a spinal tumor, diagnosis often includes x-rays of the chest, a biopsy of the tumor, urinalysis, ultrasound, bloodwork, and/or CT Scan and/or MRI. 

Treatments:

Spondylosis deformans is a noninflammatory disease that impacts the spine's vertebral bones and is distinguished by the appearance of bony spurs or osteophytes along the margins of the bones. A single bone spur can form on the spine; however, it is more typical for several bone spurs to form in various areas along the spine. In dogs, Spondylosis Deformans is most common in the lower back vertebrae. Age, injury, or a genetic disposition to bone spurs are the most common causes of these growths. Some dogs may not show any clinical signs but the bone spur may still be able to be physically felt by the owner. Affected dogs may also have a stiff spine and restricted movement. If those spurs fracture, it could cause pain in the dog as well as cause them to become lame along with neuromuscular signs associated with damage to the spinal cord or spinal nerves. Usually, the signs that are present are dependent on the location of the bone spurs along the spine.  An x-ray of the spine can be used to diagnose Spondylosis Deformans but it could also be stumbled upon accidentally if x-rays are being taken for another reason.

Treatment: 

  • No treatment necessary for dogs not showing pain. 
  • NSAIDs or other analgesics.
  • Physical therapy.
  • Weight loss..
  • Controlled exercise programs.