Spinal Injury
Spinal injuries in dogs and cats encompass a wide spectrum of damages that can affect the bony skeleton of the spine, the surrounding soft tissues, as well as the spinal cord and the nerves branching from it. The spine of our pets consists of a series of vertebrae connected by intervertebral discs, ligaments, and joints. It forms a protective canal for the delicate spinal cord, which, as part of the central nervous system, represents the connection between the brain and the body’s periphery.
The spine of dogs and cats has anatomical features that distinguish it from the human spine. While dogs have between 50 and 53 vertebrae depending on the breed, cats typically have 52-53 vertebrae. The spine is divided into five sections: cervical spine (7 vertebrae), thoracic spine (13 vertebrae in dogs, 13 in cats), lumbar spine (7 vertebrae in dogs, 7 in cats), sacrum (3 fused vertebrae), and caudal spine (20-23 vertebrae). Particularly in cats, the extraordinary flexibility of the spine should be emphasized, which is enabled by special joint structures and gives them their characteristic agility.
Causes
A spinal injury is usually the result of severe trauma or a fall.
However, short, intense impacts such as a sudden jerk on the leash or movements during play and jumping can also lead to injuries in the spinal area.
In these cases, the small joints in the spinal area and the intervertebral discs are more affected than the bones.
Additions
Spinal injuries in dogs and cats occur through various mechanisms, with traumatic events being the most common cause. Traffic accidents are one of the main causes of severe spinal injuries, especially in free-roaming cats and unsupervised dogs. Falls from great heights, particularly in cats, can lead to compression fractures of the vertebrae. The so-called “high-rise syndrome” describes injury patterns in cats after falls from several floors.
In addition to external trauma, less obvious events can also lead to spinal damage. A sudden jerk on the leash can cause injuries in the cervical spine area in dogs. Excessive strain during jumping or playing can lead to intervertebral disc herniations, primarily in chondrodystrophic breeds such as Dachshunds or French Bulldogs. These breeds have a genetically predetermined earlier degeneration of the intervertebral disc tissue, making them more susceptible to such injuries.
Pathological fractures due to underlying conditions such as osteoporosis, tumors, or infections can also lead to spinal injuries without adequate external trauma. In older animals, degenerative changes play an increasing role, compromising the stability of the spine and making it more susceptible to injuries.
Symptoms
• Your animal shows severe pain.
• It assumes an unusual body posture.
• The animal cannot walk or has limited ability to walk.
• The animal is (partially) paralyzed.
• With damage to the intervertebral discs of the cervical spine, the animal does not want to lift its head or bend it in a certain lateral direction.
• The paralysis can also affect the bladder and rectum.
The clinical signs of a spinal injury vary greatly depending on the location and severity of the injury. It is particularly important to distinguish between injuries that only affect the bony skeleton and those that additionally damage the spinal cord. The latter lead to neurological deficits, which can range from mild coordination disorders to complete paralysis.
In injuries of the cervical spine, affected animals often show a stiff head and neck posture, avoid head movements, and express pain when manipulated. Damage in the thoracic spine area can lead to ataxia of the hind limbs, weakness, or complete paraparesis. Lumbar spine injuries manifest similarly, with additional frequent disturbances in bladder and bowel function.
A particularly alarming sign is the so-called ship deck phenomenon, where the animal can no longer move its trunk and appears as if nailed down. Deep pain sensation in the limbs is an important prognostic factor – its absence indicates severe spinal cord damage. In case of complete transection of the spinal cord, spinal shock syndrome can occur, where initially all reflexes below the lesion fail before hyperreflexia develops.
Cats often show more subtle symptoms than dogs and can better compensate for their neurological deficits. They often only become noticeable through changed behavior, withdrawal, or aggression when touching certain body areas.
First Aid
• Keep your animal calm.
• Do not check the mobility in the spinal area yourself and do not try to resolve any “blockages”.
• Present your animal to a veterinarian in a timely manner.
• In case of severe pain and signs of paralysis, seek veterinary care immediately.
Diagnosis
The diagnosis of spinal injuries requires a systematic approach that begins with a thorough clinical and neurological examination. The veterinarian locates the lesion based on neurological deficits and pain. Precise localization is crucial for further diagnostics and treatment planning.
Imaging techniques play a central role in diagnostics. X-rays in at least two planes serve as basic diagnostics and can show fractures, dislocations, and gross misalignments of the spine. However, they are limited in assessing soft tissue structures such as the spinal cord itself. Computed tomography (CT) offers a more detailed representation of bony structures and is particularly valuable for complex fractures or surgical planning.
Magnetic resonance imaging (MRI) is the method of choice for assessing the spinal cord and surrounding soft tissue structures. It allows the visualization of edema, bleeding, and compressions of the spinal cord. In specialized centers, myelography can also be performed, where contrast medium is injected into the subarachnoid space to visualize compressions of the spinal cord.
Laboratory tests mainly serve to rule out systemic diseases and for preoperative evaluation. In certain cases, analysis of the cerebrospinal fluid can provide additional information, particularly to rule out inflammatory or infectious causes.
Further veterinary measures
Spinal injuries usually affect not only the bones but also ligaments, intervertebral discs, nerves, and the spinal cord.
If nerves and the spinal cord are affected, the prognosis is significantly less favorable.
For spinal injuries, X-rays are generally taken in two planes. Other imaging techniques, particularly computed tomography, are also used. It is the most important examination method for assessing the injury and determining the resulting therapeutic measures.
Minor injuries can often be treated by keeping the animals calm and still.
For severe spinal injuries (instability, herniated disc pressing on the spinal cord or nerves branching off from the spinal cord), appropriate surgical therapy is necessary.
Additions
The treatment of spinal injuries depends on the type and severity of the injury as well as the neurological status of the patient. Generally, a distinction is made between conservative and surgical therapy.
Conservative therapy is used for stable injuries with no or only minor neurological impairment. It includes strict cage rest for 4-6 weeks to minimize further movement of the spine and promote healing. Pain medication and anti-inflammatory drugs are used as accompanying treatments, typically non-steroidal anti-inflammatory drugs such as Carprofen or Meloxicam. For severe pain, opioids like Buprenorphine or Methadone may be used short-term. Muscle relaxants such as Methocarbamol can be helpful for muscle spasms.
Surgical therapy is indicated for unstable fractures, progressive neurological deficits, or compression of the spinal cord. Depending on the type of injury, various surgical techniques are used: For herniated discs, a hemilaminectomy or ventral slot technique is performed to remove the protruding material. Fractures are stabilized using various implants such as plates, screws, or pins. For dislocations, reduction and subsequent stabilization are performed.
In addition to medical therapy, physical rehabilitation plays a crucial role in the healing success. This includes passive range of motion exercises, controlled active movement, massages, and later targeted muscle building exercises. For paralysis, hydrotherapy can be particularly valuable as the water supports the body while providing resistance for muscle building.
Prognosis and aftercare
The prognosis for spinal injuries depends significantly on several factors: the location and extent of the injury, the degree of neurological impairment, the time between injury and treatment initiation, and the presence of deep pain sensation. Patients with preserved deep pain sensation generally have a much better prognosis than those without it. With complete loss of deep pain sensation for more than 48 hours, the prognosis for functional recovery is unfavorable.
Aftercare includes close neurological monitoring to detect improvements or deteriorations early. For paralyzed patients, consistent bladder management is essential to prevent urinary tract infections. The bladder must be manually emptied regularly if the animal cannot urinate independently. To prevent pressure sores, soft, well-padded resting surfaces and regular turning of the patient are necessary.
The rehabilitation should be intensified gradually, starting with passive movement exercises and later active exercises under physiotherapeutic guidance. Aids such as walking aids or special rolling carts can support mobility and improve quality of life. For chronic neurological deficits, adaptation of the home environment is necessary, for example by avoiding slippery floors or installing ramps instead of stairs.
Owner education and training is a central component of aftercare, as home care for paralyzed animals is demanding and requires patience. Regular follow-up examinations are important to monitor the healing process and adjust therapy if necessary.
Summary
Spinal injuries in dogs and cats are complex emergencies that require quick and expert action. The injuries can range from minor bruises to severe fractures with spinal cord involvement and cause correspondingly different clinical pictures. The diagnosis is based on a thorough clinical and neurological examination as well as imaging techniques such as X-ray, CT, and MRI.
The therapy depends on the type and severity of the injury and includes conservative measures such as immobilization and medication or surgical interventions to decompress the spinal cord and stabilize the spine. The subsequent rehabilitation plays a crucial role in the success of the treatment and can be supported by various physiotherapeutic measures.
The prognosis depends on various factors, particularly the degree of neurological impairment and the presence of deep pain sensation. Early diagnosis and therapy improve the chances of complete or partial recovery. In case of severe injuries with permanent neurological deficits, long-term adaptation of housing conditions and intensive care are necessary to enable a good quality of life for the animal.
Outlook on current research
Research in the field of spinal injuries in small animals has made significant progress in recent years. Particularly promising are developments in regenerative medicine aimed at repairing or replacing damaged nerve tissue. Stem cell therapies are in focus as they have the potential to promote regeneration of nerve cells and modulate inflammatory processes. Initial clinical studies in dogs with severe spinal cord injuries have shown that transplantation of mesenchymal stem cells can lead to improved motor function.
New biomaterials are being developed to serve as scaffold structures for growing nerve fibers. These materials are designed to mimic the natural extracellular matrix while releasing bioactive molecules that stimulate nerve growth. Combined with growth factors, they could represent a promising therapeutic option in the future.
In the field of surgical techniques, minimally invasive procedures are increasingly being established, causing less tissue damage and thus shortening rehabilitation time. 3D printing technologies enable the production of patient-specific implants that are precisely adapted to the anatomy of the individual animal.
The development of improved imaging techniques, especially functional MRI techniques, allows for more precise assessment of spinal cord function and could enable more accurate prognostic statements in the future. Research into biomarkers in blood or cerebrospinal fluid that indicate the severity of spinal cord damage is also an active field of research with potentially high clinical relevance.
Frequently asked questions (FAQs)
- Which dog breeds are particularly prone to spinal injuries?
Chondrodystrophic breeds such as Dachshunds, French Bulldogs, Pekingese, and Beagles have an increased risk of intervertebral disc herniation due to their genetic predisposition for early disc degeneration. - Can my pet fully recover from paralysis due to spinal injury?
The chances of recovery depend heavily on the severity of the injury. Animals with preserved deep pain sensation have good chances of recovery, especially with timely treatment. If deep pain sensation is lost for more than 48 hours, the prognosis is significantly worse. - How long does rehabilitation take after spinal surgery?
The rehabilitation time varies depending on the injury and surgery, but typically lasts 6-12 weeks. The first 4-6 weeks require strict rest, followed by a phase of increasing controlled activity. - What signs indicate an emergency in spinal injuries?
Sudden paralysis, severe pain, inability to stand or walk, loss of bladder control, or breathing problems are emergency situations that require immediate veterinary attention. - How do I properly transport an animal suspected of having a spinal injury?
The animal should be stabilized on a firm, flat surface (e.g., a board or sturdy cardboard) to minimize movement of the spine. The head should be kept in a neutral position, neither overextended nor flexed. - Are alternative therapies such as acupuncture effective for spinal injuries?
Acupuncture can be helpful as a complementary therapy for pain management and rehabilitation, but it does not replace conventional medical treatment. Scientific studies show positive effects on pain reduction and functional improvement. - How can I prevent spinal injuries in my pet?
Weight control, appropriate exercise, using harnesses instead of collars for predisposed breeds, avoiding jumps from great heights, and ensuring safe transport conditions in the car can reduce the risk. - What aids are available for animals with permanent paralysis?
There are specially adapted wheelchairs, carrying aids, non-slip socks, orthopedic beds, and incontinence aids that can improve the quality of life for paralyzed animals.
Literature
- Spinal trauma. Merck Manual Professional Edition. https://www.merckmanuals.com/professional/injuries_poisoning/spinal_trauma/spinal_trauma.html?qt=spinal trauma&alt=sh. Retrieved on December 27, 2018.
- Thomas, WB: Overview of Diseases of the Spinal Column and Cord, 2013, https://www.msdvetmanual.com/nervous-system/diseases-of-the-spinal-column-and-cord/overview-of-diseases-of-the-spinal-column-and-cord
- Löwe, G. and Löwe, O. (2021). Emergencies in Dogs and Cats – A Veterinary Guide. Kynos-Verlag. 208 p.
- Jeffery ND, Levine JM, Olby NJ, Stein VM. Intervertebral disk degeneration in dogs: consequences, diagnosis, treatment, and future directions. Journal of Veterinary Internal Medicine. 2013;27(6):1318-1333.
- Olby N, Levine J, Harris T, et al. Long-term functional outcome of dogs with severe injuries of the thoracolumbar spinal cord: 87 cases (1996-2001). Journal of the American Veterinary Medical Association. 2021;222(6):762-769.
- Granger N, Carwardine D. Acute spinal cord injury: tetraplegia and paraplegia in small animals. Veterinary Clinics of North America: Small Animal Practice. 2020;50(6):1157-1168.
- Lewis MJ, Cohen EB, Olby NJ. Magnetic resonance imaging features of dogs with incomplete recovery after acute, severe spinal cord injury. Spinal Cord. 2018;56(2):133-141.
