Title: Degenerative lumbosacral stenosis

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| name            =  Degenerative lumbosacral stenosis
| synonyms        = Cauda equina syndrome
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'''Degenerative lumbosacral stenosis''' ('''DLSS'''), also known as '''cauda equina syndrome''', is a pathologic degeneration in the [[lumbosacral]] disk in dogs; affecting the articulation, nerve progression, tissue and joint connections of the disk.&lt;ref name=&quot;:0&quot;&gt;{{Cite journal|last1=Danielsson|first1=Fredrik|last2=Sjöström|first2=Lennart|date=1999|title=Surgical Treatment of Degenerative Lumbosacral Stenosis in Dogs|url=https://onlinelibrary.wiley.com/doi/abs/10.1053/jvet.1999.0091|journal=Veterinary Surgery|language=en|volume=28|issue=2|pages=91–98|doi=10.1053/jvet.1999.0091|pmid=10100762 |issn=1532-950X|doi-access=free}}&lt;/ref&gt;&lt;ref name=&quot;:2&quot;&gt;{{Cite journal|last1=Jeffery|first1=Nick D.|last2=Barker|first2=Andrew|last3=Harcourt-Brown|first3=Tom|date=2014-07-01|title=What progress has been made in the understanding and treatment of degenerative lumbosacral stenosis in dogs during the past 30 years?|url=http://www.sciencedirect.com/science/article/pii/S1090023314001798|journal=The Veterinary Journal|volume=201|issue=1|pages=9–14|doi=10.1016/j.tvjl.2014.04.018|pmid=24878265 |issn=1090-0233|url-access=subscription}}&lt;/ref&gt; This [[Degeneration (medical)|degeneration]] causes compressions in soft tissues and nerve root locations in the ultimate caudal area of the [[Spinal cord|medulla]], causing [[Neuropathic pain|neuropathic]] pain in the lumbar [[vertebra]]e.&lt;ref name=&quot;:3&quot;&gt;{{Cite journal|last1=Giudice|first1=Elisabetta|last2=Crinò|first2=Chiara|last3=Barillaro|first3=Giuseppe|last4=Crupi|first4=Rosalia|last5=Macrì|first5=Francesco|last6=Viganò|first6=Fabio|last7=Di Pietro|first7=Simona|date=2019-09-01|title=Clinical findings in degenerative lumbosacral stenosis in ten dogs—A pilot study on the analgesic activity of tramadol and gabapentin|url=http://www.sciencedirect.com/science/article/pii/S1558787819300176|journal=Journal of Veterinary Behavior|volume=33|pages=7–15|doi=10.1016/j.jveb.2019.05.004|s2cid=181851509 |issn=1558-7878|url-access=subscription}}&lt;/ref&gt;&lt;ref name=&quot;:4&quot;&gt;{{Cite journal|last1=Meij|first1=Björn P.|last2=Bergknut|first2=Niklas|date=2010-09-01|title=Degenerative Lumbosacral Stenosis in Dogs|url=https://www.vetsmall.theclinics.com/article/S0195-5616(10)00064-1/abstract|journal=Veterinary Clinics: Small Animal Practice|language=English|volume=40|issue=5|pages=983–1009|doi=10.1016/j.cvsm.2010.05.006|issn=0195-5616|pmid=20732601|url-access=subscription}}&lt;/ref&gt;

== Signs and symptoms ==
DLSS has been found to affect dogs between the ages of 7 and 8, males ranging twice as higher than females in the research area. Medium to large-sized working breeds with high rates of activity are mostly affected by this disease, the [[German Shepherd]] breed being the most common on DLSS diagnosis.&lt;ref name=&quot;:0&quot; /&gt;

Common symptoms in dogs are physical difficulties in normal daily activities, such as:

* Mild to severe pain when walking (dragged hind limbs).&lt;ref name=&quot;:0&quot; /&gt;
* Discomfort when ascending or descending stairs.&lt;ref name=&quot;:0&quot; /&gt;
* Lumbar disturbances when resting or lying down.&lt;ref name=&quot;:0&quot; /&gt;
* Unwillingness to perform exercise.&lt;ref name=&quot;:0&quot; /&gt;
* Urinal and defecation discomfort.&lt;ref name=&quot;:3&quot; /&gt;

Behavioural problems will also be presented in dogs affected by DLSS, due to the pain they suffer on their lower back. It has been researched that there is a positive correlation regarding a dog's behaviour with the amount of lumbar vertebrae that are affected by this disease, respectively showing that behavioural disturbances are more likely to appear with dogs that have 3+ affected vertebrae. Symptoms such as [[anxiety]], sudden loss of [[appetite]], or mild [[Aggression|aggressiveness]] when performing physical activities can become clear signs of this disease.&lt;ref name=&quot;:5&quot;&gt;{{Cite journal|last1=Dodd|first1=Tiana|last2=Jones|first2=Jeryl|last3=Holásková|first3=Ida|last4=Mukherjee|first4=Meenakshi|date=2019-08-02|title=Behavioral problems may be associated with multi-level lumbosacral stenosis in military working dogs|journal=Journal of Veterinary Behavior|volume=35 |pages=8–13 |doi=10.1016/j.jveb.2019.07.010|pmid=32477020 |pmc=7259540 |issn=1558-7878|doi-access=free}}&lt;/ref&gt;

== Research ==
DLSS is associated with behavioural problems depending on how much the disease affects the dog; in other words, the more tissue and bone that is affected by DLSS, the more reluctant the dog will be to perform any kind of physical activity. Its most general overview and research ground for understanding this [[Pathology|pathological]] disease takes place in the [[military]], since dogs who take part in the special forces ([[German Shepherd|German]] and [[Dutch Shepherd]], [[Labrador Retriever]] and [[Malinois dog|Belgian Malinois]] being the most proper breeds) are widely studied as they progress through their incredibly active life. Those affected by DLSS, generally diagnosed in their retirement period, show a wide range of decreased activity when performing certain demanding tasks that require physical stress, thus, becoming crucial exemplars for lumbar diseases.&lt;ref name=&quot;:2&quot; /&gt;&lt;ref name=&quot;:5&quot; /&gt;

==Diagnosis==
DLSS is commonly identified through magnetic resonance imaging ([[Magnetic resonance imaging|MRI]]) or computed tomography ([[Computed tomography angiography|CT]]) due to their precision in recognising abnormalities in soft tissue and small bone structures.&lt;ref name=&quot;:2&quot; /&gt;&lt;ref name=&quot;:4&quot; /&gt;

== Treatment ==
Medical treatment is necessary to correct this lumbar disease, generally varying from [[anti-inflammatory]] drugs (lacking [[steroid]]s, such as: [[tramadol]] and [[gabapentin]])&lt;ref name=&quot;:3&quot; /&gt; to surgical correction; surgery being the most effective of course. [[Laminectomy|Dorsal Laminectomy]] is the most common procedure for DLSS treatment,&lt;ref name=&quot;:0&quot; /&gt;&lt;ref&gt;{{Cite journal|last1=Haan|first1=JACEK J. de|last2=Shelton|first2=Shirley B.|last3=Ackerman|first3=Norman|date=1993|title=Magnetic Resonance Imaging in the Diagnosis of Degenerative Lumbosacral Stenosis in Four Dogs|url=https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1532-950X.1993.tb00359.x|journal=Veterinary Surgery|language=en|volume=22|issue=1|pages=1–4|doi=10.1111/j.1532-950X.1993.tb00359.x|pmid=8488668 |issn=1532-950X|url-access=subscription}}&lt;/ref&gt; which implies the decompression or des-inflammation of soft tissues and [[nerve root]]s.↵Surgical fusion of the lumbosacral vertebrates has also been found to improve the affected vertebrae, since it reduces motion by eliminating certain nerve compressions located in the [[Spinal cavity|vertebral canal]].&lt;ref name=&quot;:2&quot; /&gt; Specific [[facetectomy]] (fat surgery) can also be performed in order to maintain stability in the affected joint tissue.&lt;ref name=&quot;:0&quot; /&gt;&lt;ref name=&quot;:4&quot; /&gt;

Alternative conservative or non-surgical treatment is also a convenient option with dogs that have not fully developed Degenerative Lumbosacral Stenosis; ranging from regular walks to underwater exercises that aid the affected lumbar vertebrae decompress and tone the corresponding muscle. Statistically, [[Physical therapy|physiotherapy]] has a success rate of 79% in all affected patients. If there is no surgical intervention, oral [[tramadol]] and alternative [[gabapentin]] have shown to decrease the neuropathological pain dogs suffer when affected by the disease.&lt;ref name=&quot;:3&quot; /&gt;

==References==
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[[Category:Dog diseases]]