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Clinical signs and outcome of dogs treated medically for degenerative lumbosacral stenosis: 98 cases (2004–2012)

Steven De DeckerDepartment of Veterinary Clinical Science and Services, Royal Veterinary College, University of London, North Mymms, Hertfordshire, AL97TA, England.

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Lauren A. WawrzenskiDepartment of Veterinary Clinical Science and Services, Royal Veterinary College, University of London, North Mymms, Hertfordshire, AL97TA, England.

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Holger A. VolkDepartment of Veterinary Clinical Science and Services, Royal Veterinary College, University of London, North Mymms, Hertfordshire, AL97TA, England.

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Abstract

Objective—To compare clinical signs of dogs treated medically or surgically for degenerative lumbosacral stenosis (DLSS) and assess outcome after medical treatment.

Design—Retrospective case series.

Animals—Client-owned dogs treated medically (n = 49) or surgically (49) for DLSS.

Procedures—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.

Results—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.

Conclusions and Clinical Relevance—Clinical signs differed in dogs treated medically or surgically for DLSS. Medical treatment for dogs with DLSS was associated with a fair prognosis.

Abstract

Objective—To compare clinical signs of dogs treated medically or surgically for degenerative lumbosacral stenosis (DLSS) and assess outcome after medical treatment.

Design—Retrospective case series.

Animals—Client-owned dogs treated medically (n = 49) or surgically (49) for DLSS.

Procedures—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.

Results—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.

Conclusions and Clinical Relevance—Clinical signs differed in dogs treated medically or surgically for DLSS. Medical treatment for dogs with DLSS was associated with a fair prognosis.

Contributor Notes

Presented in abstract form at the 26th Symposium of the European Society of Veterinary Neurology, Paris, September 2013.

Address correspondence to Dr. De Decker (Sdedecker@rvc.ac.uk).