spinal fractures / broken back in dogs and cats
Fractures (breaks) of the spine occur when dogs and cats are involved in road traffic accidents or suffer other major trauma such as a fall or running into a patio door. Spinal fractures are often associated with varying degrees of injury to the spinal cord (the bundle of nerves inside the vertebrae) and, therefore, nerve damage. Although many animals may be paralyzed as a result of the fracture, they will often recover, provided that they retain the ability to feel pain and that they are managed appropriately. Some cases can be treated medically, but it is often necessary to consider surgery to stabilize a fractured spine.
Symptoms of Spine fractures and a broken back in dogs and cats
- Pain on the spine
- Other evidence of trauma (shredded nails in the occurrence of vehicular collision or bite wounds from attack)
- Spinal hyperesthesia
- Signs of pain
- Reduced appetite
- Inability or reluctance to walk
Reasons why dogs and cats fracture their spine or break their back
The spinal cord is protected by the vertebrae; impact that crushes or changes this structure can lead to spinal cord injury. Although the occurrence of this injury is acute, secondary damage often occurs in the 24 – 48 hour time frame following the trauma, and in some cases damage can continue months to years after. Spinal fractures are more common in young dogs who lack in road sense and intact males which may be more likely to wander due to mating urge.
What is involved in a dog or cat spinal fracture?
In a spinal fracture, the bones (vertebrae) of the spine break (fracture) or come apart from each other (dislocate or luxate). Fracture of the spine usually occurs as a result of a significant injury, such as being hit by a car, although occasionally the bones in the spine may fracture with minimal, if any, trauma because they are already weakened by a condition such as a tumour (referred to as a ‘pathological fracture’).
When the vertebrae of the spine fracture or dislocate (luxate) the associated vertebral displacement often injures the nerves of the spinal cord. The concussion and compression of the spinal nerves affects nerve function, and the signs that develop may vary from only mild weakness through to paralysis (inability to voluntarily move the limbs). Severely affected patients may become incontinent and lose the ability to feel pain in their limbs and tail.
How are spinal fractures diagnosed in dogs and cats?
Physical examination of the patient by the specialist may enable detection of instability of the spine or abnormal alignment of the spine. Importantly, examination also enables assessment of the severity of any associated spinal cord injury – in particular, whether or not the patient can still feel pain.
X-rays (radiographs) are often obtained to look for evidence of fracture (or luxation) of the vertebrae and are generally sufficient to make a diagnosis in the majority of cases. Occasionally a more advanced imaging technique is preferred, to provide additional detail of the spine. CT scanning is particularly good at looking at the bony detail of fractures which may not be apparent on normal X-rays. MRI scanning is not so good at detecting damage to bones of the spine, but it is excellent for assessing any damage to the spinal cord.
How are spinal fractures managed in dogs and cats?
The initial treatment for your dog will be stabilization. If respiratory distress or cardiovascular distress are present intravenous fluids, oxygen and appropriate medications may be necessary.
To provide pain relief your pet will likely be given opiate analgesia. His bladder function will be carefully monitored following spinal injury, during in-patient care your pet’s bedding will be assessed for signs of urinary incontinence and his bladder palpated to determine if your dog is effectively emptying his bladder. If your dog is unable to control urination, manual expression will be required to prevent further complications.
Spinal fractures (and luxations) are often emergencies because of the associated spinal cord injury and risk of further damage. As a result, they need to be treated with the minimum of delay. Affected dogs and cats are often in significant pain, and care should be taken to avoid the handler being bitten or scratched. Patients should be moved with great caution in case the spine (vertebral column) is unstable, as further movement may aggravate the injury and any nerve damage. Strapping the patient to a rigid board may be helpful in some cases.
Some fractures of the spine may be treated conservatively without the need for surgery. This is particularly appropriate in patients with relatively stable vertebrae and minimal spinal cord injury. Conversely, dogs and cats with unstable fractured spines, those with significant spinal cord injuries and those in severe pain are often best treated surgically. Surgery aims to re-align and stabilise the affected vertebrae. The procedure most often involves placing screws or pins in the bones on either side of the fracture (or luxation) and securing them with either a plate or cement.
- Non-surgical Treatment – Your veterinarian may recommend non-surgical treatment for your pet which may require cage confinement and exercise restriction for 6-8 weeks. Your veterinarian may choose to utilize external support bandages to provide spinal stability, it is vital in these cases that this is kept clean and dry.
- Surgical Treatment – Your pet may require surgical treatment to stabilize his spine, this is considered the most effective technique with the most common types of internal fixation being metal screws, wires, and pins.
- Nursing Care – In either surgical or non-surgical treatment nursing care is essential to support your pet’s recovery.
The following steps should be taken:
- Soft, water-proof bedding should be provided and regularly changed to prevent urine scalding and prevent bed sores
- Your dog should be regularly turned to prevent bed sores and atelectasis – your veterinarian should regularly auscultate your pet’s lungs
- Highly palatable foods should be given to encourage nutrition
After surgery Recovery / rehab for a spine fracture in Dogs or cats
To aid your companion’s recovery the following steps may be taken:
- Provide a safe non-slip area for your pet to resume walking and provide assistance as needed, slings to provide support may be necessary
- Therapy such as physiotherapy, acupuncture and hydrotherapy may be beneficial for your pet’s recovery
- Wound care as needed if surgery has taken place
Your pet should regularly revisit the veterinarian for follow up evaluations, in some cases repeat radiographs may be necessary. Following healing, your veterinarian will discuss exercising your pet, it is vital that this is done gradually with careful attention paid to how your pet is tolerating this.
A canine who has suffered from a spinal fracture often has a guarded prognosis. During initial examination the presence or absence of sensation may indicate prognosis, unfortunately for those pets that do not experience deep pain sensation the chance of recovery is poor. For dogs who demonstrate sensation, urinary and bowel continence and ability to mobilize, improvement 4 – 6 weeks following the trauma may be seen.
What is the outlook (prognosis) in patients with spinal fractures?
The outlook in dogs and cats with a spinal fracture is primarily dependent on the severity of the spinal cord injury and how the patient is treated. Provided the ability to feel pain in the limbs and tail is maintained and the patient is managed appropriately, the outlook is generally good. Recovery may take a number of weeks (or even months in severely affected cases) and supportive care, including physiotherapy/hydrotherapy exercises, may be necessary. In contrast, patients with spinal fractures that can no longer feel pain are very unlikely to recover, no matter how they are treated, since the spinal cord injury is generally severe and irreversible.