196 Chapter 7

Spondylosis deformans

Spondylosis is defined as the formation of bony ‘spurs’ on the vertebrae, often leading to fusion of an intervertebral joint, resulting in ankylosis (202, 203). It is often seen as an incidental finding when thoracic or abdominal radiography is undertaken. It is a chronic condition of older animals and is typified by osteogenesis and osteophyte formation at the dorsal margins of the vertebrae. Spondylosis is usually of no clinical importance, although, in some circumstances, pain (thought to be similar to that of arthritis) is noted. Clinical signs including difficulty to rise, reluctance to climb or jump, and exercise intolerance.

Treatment

There is no specific treatment, but physiotherapy and massage may help in clinically affected cases. However, the effects of massage therapy are dependent on the position and the extent of the spondylytic lesion. This can be a frustrating condition for the physiotherapist to treat, as the response can vary from excellent to exceedingly disappointing. However, like all lameness issues, therapists most certainly have a role in assisting the secondary muscular conditions.

Degenerative myelopathy

Degenerative myelopathy, otherwise known as chronic degenerative radiculomyelopathy (CDRM) is a degenerative disorder of the white matter of the spinal cord, involving the demyelination (stripping of the myelin sheath) of nerve fibres, designed to accelerate nerve impulses. The cause of CDRM remains unclear; however, theories include an immune-mediated cause, breeding, or nutritional deficiencies. The initial clinical signs include a seemingly innocuous weakness of the pelvic limbs, progressing

to the classical sign of scuffed shortened nails and knuckling of the pelvic limbs as proprioceptive deficits progress (see 42). Often an increased muscular tone, particularly in the quadriceps group, is evident, and reflexes are generally exaggerated, suggesting a lack of nerve impulse inhibition. This narrows the region of suspicion to the upper motor neuron system, and particularly spinal cord segments T3−L3. Diagnostic imaging is largely unremarkable; therefore, diagnosis relies on the clinical signs and the exclusion of other diseases, such as spinal trauma and intervertebral disc disease.

Treatment

Treatment regimes used to date have proved ineffective. Steroids or immunemodulating drugs aimed at nullifying any immune-mediated condition have proved ineffectual. Other treatments concentrate on the nutritional aetiology of the disease. Neither appears to halt the progression of the condition. Nevertheless, myotherapy and massage can assist enormously with the compensatory muscular results of this extremely distressing condition; this is especially relevant in the lumbar region and the shoulders. Because this condition leads to large pelvic limb proprioceptive deficits, the shoulder muscles become hypertonic and engorged from pulling the dog forwards; by easing the shoulders, this can be diminished, and mobility assisted. The lumbar region is under huge stress to remain stable; therefore, easing pain in the area can also help mobility, and, more importantly, quality of life.

Peripheral neurological disease

Neurological deficits causing lameness in the dog are usually due to spinal cord disease; these have already been discussed. However, lameness may also be due to