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Fracture of the Sacrum in Dogs

By: Dr. David Diamond

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Isolated fractures of the sacrum are infrequently encountered in veterinary medicine. More commonly, this type of fracture occurs in conjunction with other fractures of the pelvis and is usually a result of trauma.

The pain and neurological deficits are caused by compression or disruption of the nerves that pass through the sacrum from the spinal cord to the hind legs, urinary and anal sphincters and tail. The resulting neurological deficits may be temporary or permanent, depending on the degree of nerve injury.

The potential long-term effects of these fractures range from none to life-long neurological dysfunction.

What to Watch For

  • Hind limb lameness
  • Urinary or fecal incontinence
  • Tail dysfunction

    Diagnosis

    A thorough physical examination is very important. Since sacral fractures are usually a result of significant trauma, other injuries may be present. No laboratory tests are required to make the diagnosis, but additional tests may include:

  • Chest radiographs (x-ray) to rule-out injury to the lungs caused by the trauma

  • Complete orthopedic examination for other fractures or joint injuries

  • Radiographs of the spine and pelvis

    Treatment

    Emergency care may be required for concurrent problems caused by the trauma. Treatment of the sacral fracture may be delayed until life threatening issues are under control. After stabilization, additional treatments may include:

  • Treatment of concurrent fractures and soft-tissue injuries. Repair of pelvic fractures is frequently performed initially without surgically addressing the sacral fracture.

  • Unless there is severe, unmanageable pain associated with the fractured sacrum, most sacral fractures are treated conservatively (without surgery).

  • In cases of intractable pain, surgery may be attempted to stabilize the fracture and/or relieve compression on the nerve roots. This is often difficult due to the small size and fragile nature of the sacrum.

  • Injectable analgesics (pain medications) may be given to the animal while being treated in the hospital and may be continued orally once discharged from the hospital.

    Home Care and Prevention

    If the fracture is your dog's only problem and it is managed conservatively, your dog usually will be confined for a period of 6 to 8 weeks while the bone heals and, hopefully, neurological function returns.

    If surgical repair of the fracture is used, your dog may also be restricted from activity for several weeks and the skin incision will be monitored while he is healing.

    Neurological deficits may take many days to several months to return (if they return at all). During this period, your pet may continue having difficulty walking on one or both hind legs and may continue to have urinary or fecal incontinence and need continual nursing care to prevent skin problems.

    A recheck appointment with your veterinarian may occur in several weeks to evaluate how the bone is healing (with new radiographs (x-rays)), to monitor your dog's neurological progress and to make sure it is safe to increase your dog's activity level.

    Many traumatic events are true accidents and thus unavoidable. Avoid the chance for motor vehicle trauma by not allowing your dog to roam.

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