Neurology Resident BluePearl Pet Hospital (North Dallas) Lewisville, TX, United States
Abstract: Background – Presence of nociception is an important prognostic factor in dogs diagnosed with thoracolumbar intervertebral disc herniation (IVDH) undergoing surgical decompression (hemilaminectomy). Absence of nociception in both pelvic limbs is associated with a worse prognosis. There is little published data on paraplegic dogs with asymmetrical incomplete loss of nociception i.e. nociception present in at least 1 pelvic limb or tail but absent elsewhere.
Hypothesis/Objectives – To investigate paraplegic dogs with asymmetrical loss of nociception (classified as Modified Frankel Score; MFS 4b) secondary to thoracolumbar IVDH, and their prognosis of regaining ambulation and continence following hemilaminectomy, in comparison to dogs with absent nociception in both pelvic limbs and tail (MFS 5)
Animals – 76 client-owned dogs with thoracolumbar IVDH with MFS of 4b and 5 treated with hemilaminectomies met the inclusion criteria
Methods – Retrospective cohort study
Results – At the time of recheck (≥30 days post-operatively), 80% (16/20) of dogs with presurgical MFS 4b regained ambulation, compared to 27% (15/56) of dogs with presurgical MFS 5. The probability of regaining ambulation was 3x higher in MFS 4b dogs (RR(95%CI) = 3.0(1.9-5.0), p< 0.001), and median MFS scores were significantly better at recheck (p < 0.001). The probability of having incontinence at recheck was 70% less in MFS 4b dogs (RR(95%CI) = 0.30(0.10-0.63), p< 0.001).
Conclusions and Clinical Importance – Paraplegic dogs with asymmetrical loss of nociception secondary to thoracolumbar IVDH are likely to have a successful outcome with hemilaminectomy. This information can better guide clients on the decision to pursue surgery.
