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Your vet will perform a physical examination, which includes being alert for other problems that can cause pain and mimic back ache. The vet will support the dog's back end and turn the back of the paw so that it rests on the ground. This is to check the dog is aware the paw is in the wrong position and correct it. Not to do so could indicate nerve damage. The vet will also check for other nerve reflexes, such as the ability to feel pain in the toes, as an indication of whether there is nerve damage or not. The vet will gently feel along the spine, being especially alert for local areas of tenderness and muscle "fasciculation," which is where the muscles twitch because they are sensitized to pain. If back pain is confirmed, the vet may suggest imaging to check what is causing the pain. Sources of pain include disc disease, spinal arthritis, spondylitis (infection in the vertebra), inflammatory nerve disease, muscle sprains and strains. A diagnostic test commonly used at veterinary clinics is to take x-rays of the spine. Each section of the back is x-rayed in turn (depending on where the suspected damage is), such as the neck, chest, and lower back. Two views are usually taken of each area so as to provide a cross reference: One view taken from the side (the lateral) and one from above or below (the dorso-ventral or ventro-dorsal). Radiography can provide helpful information about the bones of the spine and the spaces between them, but it cannot provide a picture of the spinal cord itself. For this more advanced imaging methods are needed. A limitation of x-rays is they can be misleading. For example, a narrowed space between two vertebra is abnormal and suggest that the disc is diseased. However, the disc may have ruptured harmlessly to one side and avoided pressurizing the spinal cord. Thus, x-rays can give a clues, which can be interpreted in the light of clinical signs as giving a diagnosis. More sophisticated imaging techniques, where available, have taken over from x-rays. These sophisticated techniques can visualize the spinal cord itself. Thus if a disc has prolapsed into the spine, the clinician will be able to see the "waistline" in the spine where it is compressed. This is vital information if specialist decompression surgery is being considered, as it allows the surgeon to know exactly which discs are involved, so they operate in the correct place. Unfortunately, MRI and CT scans are costly. In addition, the dog also needs to be anesthetized so that it keeps still in the scanner. This will have an additional cost, as well as a further health risk for the dog.
Take your dog for a veterinary exam. Consent to your vet giving the dog an x-ray. Ask your veterinarian about getting an MRI or CT scan instead of an x-ray.