Igloo is an active, energetic dog, going for long walks and loving rough play with Una’s other dog, another large Husky. The two dogs enjoy tussling together, rolling around, chasing each other, jumping and twisting as part of the game. The first sign that told Una something was amiss happened two days previously, when Igloo started to hide instead of engaging in the normal games. Instead of facing up to his housemate, Igloo slinked off into the bushes, and hid. This was such unusual behaviour that Una realised a visit to the vet was necessary: something was badly wrong.
The first thing a vet does when checking an animal is to read over the past history of the animal. And when I did that, my memory was jogged about a similar incident that happened in May 2017, a full year ago. At that time, Igloo had begun to find it difficult to jump into the car, had started yelping when standing up from a lying position, and had yelped when Una had patted her lower back. When I examined her at that stage, she had a distinctly painful area in her lower back, on the left side only. There were a number of possible causes, including a physical injury (like a bruise or a sprain) or an early slipped disc. I gave her a general treatment, using anti-inflammatory pain relief, as well as giving strict instructions to stop doing any exercise for two or three weeks. She made a full recovery, and within a couple of months , she was back to exercising normally, jumping into the car, and playing enthusiastically with her housemate.So when she came in this week, my first thought was that it was likely that she was suffering from a recurrence of the same problem. I lifted her carefully onto my consulting table, taking care not to twist her spine in any way, then I gently felt around her lower back, probing for areas of tenderness.
This is one of those situations where vets would love if animals could talk: I knew she was in pain, and it would have made things much easier if she could have simply told me where it hurt. As it was, I had to push and poke until I found the sore area.
Predictably, it turned out that she was sore in almost exactly the same place as last year: when I pushed my fingertips against the area around her lower spine, she yelped. I had to do this a couple of times to work out the precise area that was painful. I also flexed her lower back, to try to get more information about exactly which part of her back was bothering her. Again, she duly yelped when my manipulations tweaked the sore area.
This time, the area of pain is significantly different to the previous episode. Last year, there was just one sore area, on the left side of her lower back, and her spine did not seem uncomfortable at all when it was manipulated. When I examined her this week, she has sore areas on both sides of her lower back, not just the left. And when I flexed her spine, it was obvious that the focus of her discomfort was the so-called lumbo-sacral junction, which is is the area where the spine connects to the sacrum, in the centre of the pelvis.
This area is particularly prone to injury; it’s a mechanical point of stress, where all of the weight of the upper body is transmitted through the pelvis to the back legs. When a dog jumps and twists, the lumbosacral junction is the hinge that takes all the pressure. This makes it prone to injuries, as well as other issues like slipped discs, and the effects of arthritis at the joints between the adjacent bones of the spine.
It’s impossible to pinpoint the precise cause of pain in a case like Igloo from a simple examination: to find out more information, it would be necessary to refer her to a specialist centre for a CT or MRI scan. This is sometimes necessary, if a dog is in immense pain, or if the problem keeps coming back too frequently. But in most cases, like Igloo, vets give the usual treatment of anti-inflammatory pain relief and strict rest. As with many humans with painful lower backs, this treatment often fixes the problem, so there is no need for further complex and expensive diagnostics.
Igloo’s condition is known as “Lumbo Sacral Syndrome”. The pain is usually caused by something (such as an early slipped disc) putting pressure on the nerves that leave the spinal cord to go to the back legs at this point. Although most dogs respond well to the standard simple treatment, it does tend to recur in around two-thirds of cases, so owners like Una need to be aware of this risk. Repeated short courses of anti-inflammatory medication may be needed.
There is a small risk that at some stage in the future, the issue may become more severe, causing pain that does not respond to medication, and perhaps causing other complications, such as weakness or paralysis of the back legs. If that ever does happen, then surgery could be needed for a permanent cure, and a CT / MRI scan would be needed beforehand, to be absolutely clear about the precise cause of the problem.
The great news for Igloo is that she has no idea what is going on. Her back was sore, she went to the vet, she got better, and now she can play again. The world of Igloo is far simpler and less stressful than our own world.