Clinical efficacy of epidural injection of betamethasone in dogs with lumbosacral stenosis

Cover Page

Cite item

Abstract

Results of conservative treatment of degenerative lumbosacral stenosis in dogs are presented. For the first time, clinical efficacy of epidural injection of anti-inflammatory drug Diprospan (betamethasone) in dogs with lumbosacral stenosis was shown. 32 animals were treated at VetProfAlliance Veterinary Surgery Center from 2023 to June 2024. Comparable data in case histories and feedback for evaluating treatment outcomes were established with the owners of 22 dogs. 22 case histories were analyzed. To exclude possible concomitant orthopedic pathologies, X-ray examination of knee and hock joints in mediolateral projection and hip joints in ventrodorsal projection was performed. Patients with discospondylitis at lumbosacral level were excluded from the study group. All dogs with lumbosacral stenosis belonged to large and giant dog breeds. The age of clinical symptoms is from 6 to 11 years old, and breed variability to this disease was also noted. Males predominate by gender - 59% (13/22). At the same time, 69% (9/13) of males were castrated and 78% (7/9) of females were sterilized. 32% (7/22) of dogs in this group were obese, and 50% (11/22) were overweight. Studies have found that Diprospan injections with 20…30 days interval can completely neutralize neurological symptoms in 50% of dogs with 1…4 degrees of neurological disorders caused by lumbosacral stenosis. In 22 out of 32 dogs, the result of treatment was assessed as positive with improvement in condition or achievement of complete remission.

Full Text

Fig. 1. Radiograph of the dog’s vertebral column in lateromedial projection on the right side: narrowing of the intervertebral space between the bodies of vertebrae L7-S1, ventral spondylosis of L6-L7-S1, sclerosis of the end plates of caudal pole of L6—7 and cranial pole of S1, ventral displacement of S1—3
Source: created by S.A. Yagnikov, L.S. Barsegyan

Fig. 2. MRI of lumbosacral spine of dog: sagittal (a) and segmental (б) section. Protrusion of intervertebral disc L7-S1 with migration of fibrous ring into spinal canal. Foraminal stenosis with compression of spinal nerves at L7-S1 level
Source: created by S.A. Yagnikov, L.S. Barsegyan

 

Changes in neurological deficit in dogs on the 30th–40th day after a single or double epidural injection of Diprospan

№ 

Breed

Age, years

Body weight, kg

Gender

Location of intervertebral disc protrusion

Degree of neurological disorders before treatment

Degree of neurological disorders after treatment

Remission at the time of last contact with the owner, months

1

German Shepherd

8

45

Female

L7-S1

3

no

7

2

Cane Corso

10

48

Female

L7-S1

4

2

6

3

Bernese Sinnenhund

6

52

Female

L7-S1

3

2

4

4

Mixed breed

7

36

Male

L7-S1

4

no

8

5

Mixed breed

10

38

Male

L7-S1

3

no

12

6

Laika

11

28

Female

L7-S1

3

1

7

7

Pit Bull Terrier

11

25

Male

L7-S1

2

no

3

8

German Shepherd

8

39

Female

L7-S1

2

no

4

9

Pit Bull Terrier

9

25

Male

L7-S1

2

2

8

10

Cane Corso

6

54

Female

L7-S1

3

no

14

11

Mixed breed

8

34

Male

L7-S1

2

no

3

12

Drahthaar

7

34

Male

L7-S1

3

2—1

5

13

Kurzhar

6

37

Male

L7-S1

2

1

2.5

14

Weimaraner

8

40

Female

L7-S1

4

2

3

15

English Setter

10

33

Male

L7-S1

3

1—2

15

16

Hungarian Vyzgla

10

30

Female

L7-S1

2

no

2

17

Rottweiler

8

52

Female

L7-S1

4

2

4

18

American Akita

7

43

Male

L7-S1

3

2

5

19

Samoyed

7

30

Male

L7-S1

3

1

10

20

Labrador

7

39

Male

L7-S1

2

no

3

21

Labrador

6

40

Male

L7-S1

1

no

7

22

Central Asian Shepherd

8

52

Male

L7-S1

2

no

4

×

About the authors

Sergey A. Yagnikov

VetProfAlliance Veterinary Surgery Centers; RUDN University

Author for correspondence.
Email: yagnikovorc@yandex.ru
ORCID iD: 0000-0003-2567-272X
SPIN-code: 3104-7566

Doctor of Veterinary Sciences, Professor, Head of VetProfAlliance Veterinary Surgery Centers; Professor, Department of Veterinary Medicine, RUDN University

6 Markova st., Chekhov, 142306, Russian Federation; 6 Miklukho-Maklaya st., Moscow, 117198, Russian Federation

Lusine S. Barseghyan

VetProfAlliance Veterinary Surgery Centers

Email: vetprophy@mail.ru
ORCID iD: 0009-0007-0329-9748

Candidate of Veterinary Sciences, Veterinarian-surgeon

6 Markova st., Chekhov, 142306, Russian Federation

References

  1. Suwankong N, Meij BP, Voorhout G, De Boer AH, Hazewinkel HAW. Review and retrospective analysis of degenerative lumbosacral stenosis in 156 dogs treated by dorsal laminectomy. Veterinary and Comparative Orthopaedics and Traumatology. 2008;21(3):285-293. doi: 10.1055/s-0037-1617374
  2. Worth AJ, Hartman A, Bridges JP, Jones BR, Mayhew JIG. Computed tomographic evaluation of dynamic alteration of the canine lumbosacral intervertebral neurovascular foramina. Veterinary surgery. 2017;46(2):255-264. doi: 10.1111/vsu.12599
  3. Worth AJ, Thompson DJ, Hartman AC. Degenerative lumbosacral stenosis in working dogs: current concepts and review. New Zealand Veterinary Journal. 2009;57(6):319-330. doi: 10.1080/00480169.2009.64719
  4. Worth A, Meij B, Jeffery N. Canine degenerative lumbosacral stenosis: prevalence, impact and management strategies. Veterinary Medicine: research and reports. 2019;10:169-183. doi: 10.2147/VMRR.S180448
  5. Scharf G, Steffen F, Grüenenfelder FI, Morgan JP, Flückiger M. The lumbosacral junction in working German Shepherd dogs - neurological and radiological evaluation. Journal of Veterinary Medicine Series A. 2004;51(1):27-32. doi: 10.1111/j.1439-0442.2004.00587.x
  6. Suwankong N, Voorhout G, Hazewinkel HA, Meij BP. Agreement between computed tomography, magnetic resonance imaging, and surgical findings in dogs with degenerative lumbosacral stenosis. Journal of the American Veterinary Medical Association. 2006;229(12):1924-1929. doi: 10.2460/javma.229.12.1924
  7. Henninger W, Werner G. CT examination of the canine lumbosacral spine in extension and flexion. Part 1: Bone window. Eur J Companion Anim Pract. 2003;13(2):215-226.
  8. Henninger W, Werner G. CT examination of the canine lumbosacral spine in extension and flexion. Part 2: Soft-tissue window. Eur J Companion Anim Pract. 2003;13(2):227-233.
  9. Jones JC, Cartee RE, Bartels JE. Computed tomographic anatomy of the canine lumbosacral spine. Veterinary Radiology & Ultrasound. 1995;36(2):91-99. doi: 10.1111/j.1740-8261.1995.tb00223.x
  10. Mayhew PD, Kapatkin AS, Wortman JA, Vite CH. Association of cauda equina compression on magnetic resonance images and clinical signs in dogs with degenerative lumbosacral stenosis. Journal of the American Animal Hospital Association. 2002;38(6):555-562. doi: 10.5326/0380555
  11. McCormick Z, Kennedy DJ, Garvan C, Rivers E, Temme K, Margolis S. Comparison of pain score reduction using triamcinolone vs. betamethasone in transforaminal epidural steroid injections for lumbosacral radicular pain. American Journal of Physical Medicine & Rehabilitation. 2015;94(12):1058-1064. doi: 10.1097/PHM.0000000000000296
  12. Ness MG. Degenerative lumbosacral stenosis in the dog: a review of 30 cases. Journal of Small Animal Practice. 1994;35(4):185-190. doi: 10.1111/j.1748-5827.1994.tb01683.x
  13. Roelofs P, Deyo RA, Koes BW, Scholten RJ, Van Tulder MW. Nonsteroidal anti-inflammatory drugs for low back pain: an updated Cochrane review. Spine. 2008;33(16):1766-1774. doi: 10.1097/BRS.0b013e31817e69d3
  14. Sayegh FE, Kenanidis EI, Papavasiliou KA, Potoupnis ME, Kirkos JM, Kapetanos GA. Efficacy of steroid and nonsteroid caudal epidural injections for low back pain and sciatica: a prospective, randomized, double-­blind clinical trial. Spine. 2009;34(14):1441-1447. doi: 10.1097/BRS.0b013e3181a4804a
  15. Scott HW, McKee WM. Laminectomy for 34 dogs with thoracolumbal disc disease and loss of deep pain perception. Journal of Small Animal Practice. 1999;40(9):417-422. doi: 10.1111/j.1748-5827.1999.tb03114.x
  16. Staal JB, de Bie R, de Vet H, Hildebrandt J, Nelemans P. Injection therapy for subacute and chronic low-back pain. Cochrane Database of Systematic Reviews. 2008;(3): CD001824. doi: 10.1002/14651858.CD001824.pub3
  17. Stolke D, Sollmann WP, Seifert V. Intra-and postoperative complications in lumbar disc surgery. Spine. 1989;14(1):56-59.
  18. La Rosa C, Morabito S, Carloni A, Davini T, Remelli C, Specchi S, et al. Prevalence, MRI findings, and clinical features of lumbosacral intervertebral disc protrusion in French Bulldogs diagnosed with acute thoracic or lumbar intervertebral disc extrusion. Frontiers in Veterinary Science. 2023;10:1302418. doi: 10.3389/fvets.2023.1302418
  19. Aprea F, Vettorato E. Epidural steroid and local anaesthetic injection for treating pain caused by coccygeal intervertebral disc protrusion in a dog. Veterinary Anaesthesia and Analgesia. 2019;46(5):707-708.
  20. Becker C, Heidersdorf S, Drewlo S, de Rodriguez SZ, Krämer J, Willburger RE. Efficacy of epidural perineural injections with autologous conditioned serum for lumbar radicular compression: an investigator-­initiated, prospective, double-­blind, reference-­controlled study. Spine. 2007;32(17):1803-1808. doi: 10.1097/BRS.0b013e3181076514
  21. Bussières MP, Grasso S, Jull P. Preliminary evaluation of an indwelling epidural catheter for repeat methylprednisolone administration in canine lumbosacral stenosis. The Canadian Veterinary Journal. 2024;65(5):462-472.
  22. De Decker S, Wawrzenski LA, Volk HA. Clinical signs and outcome of dogs treated medically for degenerative lumbosacral stenosis: 98 cases (2004-2012). J Am Vet Med Assoc. 2014;245(4):408-413. doi: 10.2460/javma.245.4.408
  23. Dernek B, Aydoğmuş S, Ulusoy I, et al. Caudal epidural steroid injection for chronic low back pain: a prospective analysis of 107 patients. Journal of Back and Musculoskeletal Rehabilitation. 2022;35(1):135-139. doi: 10.3233/BMR-200262
  24. Vilkovysky IF, Vatnikov YA, Yagnikov SA, Shpinkov DV, Rusnak IA. Surgical correction of degenerative lumbosacral stenosis in dogs. Bulliten KrasSAU. 2022;(12):161-167. (In Russ.). doi: 10.36718/1819-4036-2022-12-161-167
  25. Vilkovysky IF. Dynamics of cerebrospinal fluid in correction of degenerative lumbosacral stenozis during the postoperative period in dogs. RUDN Journal of Agronomy and Animal Industries. 2022;17(3):382-391. (In Russ.). doi: 10.22363/2312-797X-2022-17-3-382-391
  26. Chambers J. Degenerative lumbosacral stenosis in dogs. Vet Med Rep. 1989;1(2):166-180. doi: 10.1016/j.cvsm.2010.05.006
  27. Janssens L, Beosier Y, Daems R. Lumbosacral degenerative stenosis in the dog. Veterinary and Comparative Orthopaedics and Traumatology. 2009;22(6):486-491. doi: 10.3415/VCOT-08-07-0055
  28. Lee GY, Lee JW, Lee E, Yeom JS, Kim KJ, Shin HI, et al. Evaluation of the efficacy and safety of epidural steroid injection using a nonparticulate steroid, dexamethasone or betamethasone: a double-­blind, randomized, crossover, clinical trial. The Korean Journal of Pain. 2022;35(3):336-344. doi: 10.3344/kjp.2022.35.3.336
  29. De Risio L, Sharp NJ, Olby NJ, Muñana KR, Thomas WB. Predictors of outcome after dorsal decompressive laminectomy for degenerative lumbosacral stenosis in dogs: 69 cases (1987-1997). Journal of the American Veterinary Medical Association. 2001;219(5):624-628. doi: 10.2460/javma.2001.219.624
  30. Liotta AP, Girod M, Peeters D, Sandersen C, Couvreur T, Bolen G. Clinical effects of computed tomography - guided lumbosacral facet joint, transforaminal epidural, and translaminar epidural injections of methylprednisolone acetate in healthy dogs. American Journal of Veterinary Research. 2016;77(10):1132-1139. doi: 10.2460/ajvr.77.10.1132

Supplementary files

Supplementary Files
Action
1. Fig. 1. Radiograph of the dog’s vertebral column in lateromedial projection on the right side: narrowing of the intervertebral space between the bodies of vertebrae L7-S1, ventral spondylosis of L6-L7-S1, sclerosis of the end plates of caudal pole of L6—7 and cranial pole of S1, ventral displacement of S1—3

Download (123KB)
2. Fig. 2. MRI of lumbosacral spine of dog: sagittal (a) and segmental (б) section. Protrusion of intervertebral disc L7-S1 with migration of fibrous ring into spinal canal. Foraminal stenosis with compression of spinal nerves at L7-S1 level

Download (103KB)

Copyright (c) 2024 Yagnikov S.A., Barseghyan L.S.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies