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What is Lumbosacral Stenosis (Cauda Equina Syndrome)?

Much like ours, the dog’s spine has disks between the bones that act as shock absorbers between adjacent vertebrae. The spinal cord (a bundle of nerve fibers) passes through a large canal (vertebral column) which protects it from injury. The spinal cord, which is shorter than the vertebral column, ends at the lower back.  The nerves to the bladder, rectum, tail and limbs extend off the end of the spinal cord, out through the vertebral column. The area where the nerves extend off the end of the spinal cord resemble a horse’s tail.  This is why this particular area is called the cauda equina. The “cauda equina” is Latin for horse’s tail.

Lumbosacral stenosis usually occurs in large breeds.  Clinical signs usually occur between 3 – 7 years of age. Lumbosacral stenosis (cauda equina syndrome) is also referred to as lumbosacral instability, lumbosacral spondylolisthesis and lumbosacral nerve root compression.

Lumbosacral stenosis in dogs is a condition that causes the nerves of the lower back (cauda equina) to be compressed as they leave the spinal canal. The pressure on the nerves causes nerve injury. This condition is extremely painful.

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Symptoms of Lumbosacral Stenosis (Cauda Equina Syndrome) in Dogs

Symptoms will vary depending on the severity of nerve damage. Symptoms may include:

  • Difficulty getting up and down from furniture or the car
  • Difficulty posturing to defecate or urinate
  • Unable to climb stairs
  • Lameness of one or both hind legs
  • Whines/yelps when trying to get up
  • Muscle loss to one or both hind legs
  • Leakage of urine
  • Cries out when lower back is petted
  • Shuffling gai
  • Scuffed toes
  • Chews or bites at pelvic area, tail or hind legs because of tingling sensation to the area

Causes of Lumbosacral Stenosis (Cauda Equina Syndrome) in Dogs

  • Congenital - The dog was born with the condition
  • Arthritis - Causes thickening of the joints of the spinal cord.
  • Herniation of the lumbar intervertebral disks
  • Thickening of the ligaments within the spinal canal
  • Abnormal growths - Tumor growing on the lower spinal cord
  • Partial dislocation - Spinal bones malalignment

Diagnosis of Lumbosacral Stenosis (Cauda Equina Syndrome) in Dogs

The veterinarian may want to go over the patient’s medical history.  He will want to know what symptoms you have observed and when did they begin. If the dog is lying down he may want to see him get up and walk around.

The veterinarian will then perform a physical examination of the dog.  He will take the patient’s weight, pulse and blood pressure.  The veterinarian may palpate the muscle tone of both limbs.  Hind leg manipulation can help determine which positions are painful.  The veterinarian will test your dog’s reflexes.  Consideration will be made as to the extent of pain this may cause. The veterinarian may recommend taking a complete blood count on the patient.  

X-rays of the spine and pelvic area will be recommended.  If he suspects lumbosacral stenosis he may want the patient to have a myelogram.  This is a specialized x-ray that uses an injection of contrast dye to find abnormalities to the spinal cord, spinal canal, nerve roots and surrounding tissue. Your dog  will need to have general anesthesia for this procedure.

Treatment of Lumbosacral Stenosis (Cauda Equina Syndrome) in Dogs

Treatment of lumbosacral stenosis (cauda equina) in dogs may be treated nonsurgically or surgically depending on the severity of the condition.  In mild cases of lumbosacral stenosis, the patient will be treated with restricted limits of movement/exercise.  Your dog may be prescribed pain medication and an anti-inflammatory such as prednisone. Once he is feeling better, hydrotherapy may be recommended. Some dogs may also respond to epidural steroids injections.

Dogs with more severe cases of lumbosacral stenosis or patients who are diagnosed with a tumor will be referred to a veterinary orthopedic surgeon.  The surgeon will discuss with you which is the best surgical procedure for your dog.  In some cases, the bones are fused together in a “normal” position. Another surgical procedure that can be performed, also known as decompression surgery, is a laminectomy.

Recovery of Lumbosacral Stenosis (Cauda Equina Syndrome) in Dogs

Dogs that undergo surgery will have to be confined for 2-4 weeks after surgery.  The surgeon will provide you with post-operative instructions.  The patient will be prescribed pain medications and anti-inflammatory medications.  He may also be placed on antibiotics as a preventative to an infection. An elizabethan collar (cone) should be worn by the dog so that he does not lick or bite at the incision. Dogs that undergo surgery usually have a good prognosis.  Dogs that still having difficulty urinating may need help; manually expressing the bladder of urine will be required.  The patient will need follow up visits to monitor his progress and to remove sutures.

Canines that are treated medically will need to be monitored for the progression of the condition and for any side effects from the medications. They will need to remain on anti-inflammatory and intermittent pain medications.  Hydrotherapy and acupuncture may also help the patient with the pain caused by lumbosacral stenosis.

Lumbosacral Stenosis (Cauda Equina Syndrome) Questions and Advice from Veterinary Professionals

Roxy
pit bull terrier
13 Years
Serious condition
0 found helpful
Serious condition

Has Symptoms

As noted above

My 13 year old pitbull over the last approximately 6 months has lost a good chunk of her hearing she can hear only when you are screaming at her from the top of your lungs, she also has been peeing in the house constantly, sometimes not long after coming in from outside, she will pee in our bed while she is sleeping, the floor standing right next to you. It has gotten to the point where I am spot shampooing at least 3 spots a day, on a minimum. I am at my wits end with what else to do. I have limited food and water, let her out frequently, put her out on the chain, nothing has helped to cut back on the accidents. She has struggled for the last year getting up on couches, chairs, cars. When standing her back leg extends awkwardly like she can't feel it. Just at a loss. When I let her outside she will run and frolic around like she is a puppy. I know she is getting older, she has many moments of confusion, where she walks around confused, but will come up and kiss you.

Dr. Michele King, DVM
Dr. Michele King, DVM
1604 Recommendations
Many things can start to happen as dogs age that are not their fault. Diabetes, kidney disease, and thyroid disease can all cause increased urination and drinking, even in the best behaved dogs. It would be a good idea to have an examination with a veterinarian, and some lab work, to assess her general health and get her some help so that she is comfortable and hopefully easier for you to live with. I hope that she is okay.

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RD
pitbull
14 Years
Serious condition
0 found helpful
Serious condition

Has Symptoms

unusual gait in back legs

Medication Used

has had an epidurtal

my dog was just diagnosed with lumbosacral stenosis. she is 14 years old and i have an upcoming appt with a veterinary neurologist. will they be hesitant to surgically treat her because of her age? Am i wrong in wanting her to have this surgery as i feel it is her only option and i will do what is necessary for her. would appreciate some advice. thanks

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
3314 Recommendations
Each case is treated on a case by case basis, the Neurologist will talk through your options regarding management or surgical options after they make their examination. I cannot give you any indication of what would be advised by the Neurologist as I haven’t examined RD; however I would be hesitant to recommend surgery given his age. Regards Dr Callum Turner DVM

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Clavel
Dachshund
4-5
Serious condition
0 found helpful
Serious condition

Has Symptoms

Constant wimpering
Cant hold up neck
weakness in the neck
weakness in front legs
Loss of movement in hind legs
Incontinence

Medication Used

prednisone

My 4 year old Dachshund was diagnosed with cauds equina a week ago but just a few days later she became became completely limp and does not do anything on her own. She seems to have lost complete movement in her hind legs but also she does not have strength in her front legs so she can't stand up, if she tries to sit on her front legs she will fall over and she has trouble holding up her neck so I've had to help her with water and food. is this normal for a dog with cauda equina? Plus she cries all the time perhaps from the pain and is totally incontinent.

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
3314 Recommendations
This isn’t a typical presentation of cauda equina syndrome, especially at this rate of progression; I can understand hind limb weakness and incontinence but not the issues with the forelimbs or neck. I would consult with your Veterinarian to reevaluate the x-rays and possibly taken another set for comparison; online like this, I cannot offer any useful advice in this case. Regards Dr Callum Turner DVM

My Australian Cattle Dog was just possibly diagnosed with this...I say possibly because my vet had only radiographs to go off of and his exam and the symptoms I provided. He suggested an MRI next if I wanted a definite prognosis for this which they can't provide. I know these can be quite costly and not sure what I should do next? She has the stiffness from laying down and getting up, the not wanting to bend to defecate, and hardly ever wags her tail anymore. This is a tough working breed so she never shows sign of pain as far as whining or any of that. We had her on Prednisone hut her liver count was off so we had to take her off, she is now on Tramadol. I'm just wondering which route to take...an MRI but probably can't afford a surgery if it came to that....or just keep doing the pain meds and maybe look into acupuncture or something?

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Bailey
Golden Retriever
12 Years
Serious condition
0 found helpful
Serious condition

Has Symptoms

weakness, inability to stand

I believe my dog has CES. He is a nearly 13 yr old Golden Retriever/Chow mix. For some time now he had been having trouble walking an is now to the point he can no longer pull himself up to a standing position without assistance. When he ambulates, he can only take one or two steps on his own before his back legs given out. Often he stands on/walks on his "knuckles" which I am sure is not normal. He used to carry his tail curled over his back like a chow, but has not done so for several months. Hi is incontinent of bowel and bladder. His vet would not prescribe medication for pain other than gabapentin. Occasionally, when he does try to stand, I notice his front legs quivering. But it mainly seems to be that his issues are with his back legs. I was told by his vet that he does not have hip dysplasia, as I had thought. She stated he had spondylosis. I am not 100% sure what that means, does it sound like CES from the symptoms? Would prednisone help since he is not on any pain medication?

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
3314 Recommendations
Spondylosis deformans is a condition where there is a bony bridge formed between vertebrae which may cause pain, immobility and other symptoms which is easily visible on x-ray; many times it is diagnosed when checking for other issues (like a foreign object or tumour in the abdomen). If the cause is cauda equina syndrome it would be identifiable on x-rays; also cauda equina syndrome may occur secondary to other conditions. Since I haven’t examined Bailey, I cannot prescribe or recommend any prescription medications, but an x-ray(s) should be taken if not done so already and if you need a second opinion you should consult PetRays which have board certified Specialists available for consultation. Regards Dr Callum Turner DVM www.petrays.com

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Otter
as stated above
as stated above
Mild condition
0 found helpful
Mild condition

Has Symptoms

lameness

I have been told by my veterinarian that the surgery fo lumbosacral stenosis doesn't work however, everything I am reading says that is the best way to go for a long term solution. She is 12.5 yrs old. Has been very active. Medium size border collieX. She is slow to arise and has trouble getting into my car and has trouble going up stairs now.

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
3314 Recommendations

In many cases, surgery usually leads to a positive prognosis; however in some severe cases or when treatment is delayed there can be long term problems, each case is different. Some cases of lumbosacral stenosis require surgery by a Specialist; it may be worth getting a second opinion to make sure, you may want to try acupuncture as well as there are positive reports of results in these types of cases. Regards Dr Callum Turner DVM

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Wookie
Chihuahua
6 Years
Moderate condition
0 found helpful
Moderate condition

My chihuahua mix was staying with family and became overweight as they were giving him too many treats (he’s on a diet and losing weight at the moment). When we went to collect him I noticed the nails on his back paws were a dark colour and he was obsessively licking and chewing them, he also limped a lot. We took him to the vet and he had his x-ray done and it showed that he has lumbosacral stenosis. The vet prescribed Meloxicam and to give him a 20lbs dose once a day, I give this to him at noon and it helps with the limping and pain but in the evening the pain and limping comes back again. I don’t want him to continue taking the medication for the rest of his life since it won’t stop the pain completely. I wanted to ask if you recommend the surgery at this stage? As I read it is better to have the surgery done before symptoms worsen.

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
3314 Recommendations
You should discuss Wookie’s options with your Veterinarian to determine if he is a good candidate for surgery or not; also a review of pain management may be useful to move over to something more effective and longer lasting. Your Veterinarian will be able to discuss Wookie’s case with you and will advise you of the risks and the recovery of the surgery if you proceed. Regards Dr Callum Turner DVM www.cliniciansbrief.com/sites/default/files/attachments/ASK_Treatment%20of%20Lumbosacral%20Disease.pdf

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