Section: Veterinary Care In-depth
Veterinary care should include diagnostic tests and subsequent treatment recommendations.
Diagnosis In-depth
Diagnostic tests are necessary to recognize lumbo-sacral disease and exclude other diseases that may cause similar symptoms. Tests may include the following:
Complete medical history and physical examination. During the examination your veterinarian will watch how your dog stands, sits, lies down and gets up. The gait will also be monitored before assessing the lower spine and the back legs.
Typically, dogs with lumbo-sacral disease have significant back pain. Evidence of this can be elicited on direct palpation, which is checking body parts and organs by touching and feeling, by picking up and flexing the tail, or a combination of pushing on the lower spine and extending one or both hips. Pain elicited during hip extension must be distinguished from hip pain that occurs in dogs with hip dysplasia.
A neurological examination. This may include tests that assess your dog's awareness of the foot position, the reflexes of the hind legs and an assessment of bladder function and anal tone.
A blood sample may be obtained to ensure that your dog is healthy enough to undergo surgery. In cases where infection or other metabolic disease is suspected, blood work will also be performed.
Radiographs (X-rays) of the lumbo-sacral region may show bony changes associated with instability, evidence of infection, fracture or dislocation of the spine, or bone damage consistent with cancer. They do not demonstrate actual spinal cord or nerve root compression.
Electromyography (EMG). This is a study performed under general anesthesia in which needle probes are placed through the skin in order to measure the electrical activity of muscles and nerve conduction. Abnormal activity is recorded with lumbo-sacral disease, and this can be a good first diagnostic tool before more invasive tests such as myelography or epidurography are performed.
Myelography and epidurography. X-ray studies highlight the cord and nerve roots, respectively, as they pass through the lower portion of the spine. These studies can define the type of compression present and, therefore, give useful information as to whether surgery is appropriate and/or likely to be beneficial.
CT scans and MRI, if available, can help to determine the cause of the lumbo-sacral disease.
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