A 14-MONTH-OLD intact male Doberman pinscher-mix was presented to Texas A&M University's Texas Veterinary Medical Center (TVMC) for evaluation of chronic spinal pain and lameness. The dog had been adopted as a stray eight months previously. The owner stated that the dog had exhibited intermittent, mild spinal pain that had progressively increased in intensity and frequency since adoption.
Pain was elicited on palpation of the lumbosacral region. Findings from the remainder of the physical examination and a neurologic examination were unremarkable. No abnormalities were found on radiographic examination of the thoracic, lumbar, and sacral vertebrae, and we tentatively diagnosed lumbosacral stenosis. The owner declined additional diagnostic testing and elected conservative treatment, consisting of one month of strict cage rest and a tapering dose of oral prednisone: 2 mg/kg orally twice a day for three consecutive days, then once a day for three consecutive days, then every other day for three more doses. The dog's clinical signs improved within days of our initiating this treatment regimen, but recurred about three weeks into the course of treatment.
The dog was presented to the TVMC four months after the initial visit for reevaluation. Since the previous visit, the owner reported that the dog had exhibited intense pain when its spine was manipulated. The spinal pain was now continuous, and the dog was moderately lame in the hindlimbs. Additionally, the animal's activity level had diminished, it had become inappetent, and the owner reported that the dog had lost weight.
Physical examination and diagnostic tests
On physical examination, the dog was mildly febrile (102.7 F [39.3 C]), thin (body condition score of 1.5 on a scale of 1 to 5), and exhibited weightbearing lameness in both hindlimbs. Intense pain was elicited on palpation of the caudal thoracic, lumbar, and sacral vertebral column. Conscious proprioception and spinal reflexes were normal in all four limbs. The scrotum and testicles were normal on palpation. On transrectal palpation, the prostate was unremarkable. Abdominal palpation and thoracic auscultation revealed no abnormalities. Peripheral lymph nodes were palpably normal. The ocular anterior chamber and fundic examination findings were normal.
Radiographic examination of the thoracic and lumbar spine showed osteolytic disease of the vertebral end plates with spondylosis associated with the intervertebral disk space at T5-T6 and L2-L3 (Figure 1). Lesser changes were present in the adjacent vertebral end plates at T13-L1, and equivocally at L3-L4 and L4-L5. Evidence of chronic irregularity of the articular facets was present at L3-L4 and L5-L6. Because of these radiographic findings, we diagnosed chronic diskospondylitis of the thoracic and lumbar spine with atypical degenerative joint disease of the lumbar spine.
1. A close-up view from a lateral thoracic and lumbar spinal radiograph showing the second and third lumbar vertebræ of an 18-month-old intact male Doberman pinscher-mix evaluated for chronic back pain and lameness. Osteolysis of the vertebral end plates (black arrows) with spondylosis associated with the intervertebral disk space (arrowheads) is present. There is evidence of chronic irregularity of the third lumbar articular facet (white arrow).