by Suzanne Stack, DVM
(Excerpt from Spring 2003 issue of GCNM News)
As our greyhounds age, quite a few of them, especially the males, become
weak, wobbly, and/or painful in the rear end. Many of these are affected
by lumbosacral stenosis(LS), a narrowing of the last part of the spinal
canal, which causes compression of the nerve roots.
Signs are rear end
pain, lameness, weakness, "shuffling", knuckling over, foot
dragging, and muscle wasting. Both urinary and fecal incontinence are
possible and carry a worse prognosis. Greyhounds may even lose their appetite
from the pain and "waste away".
The difficulty in
diagnosing LS is twofold. Many veterinarians simply do not recognize the
signs. LS looks neurologic, and technically, it is. But a rare and obscure
neurological disease, it is not. Beware a diagnosis of "hip dysplasia"
in a greyhound - greyhound hips are by and large excellent. The second
problem is that unless your greyhound is "lucky" enough to have
visible arthritis on lumbosacral x-rays, the only techniques to confirm
LS are pretty high tech - CT, MRI, discography, etc.
Not only can LS be
difficult to "nail down", the other problem is that oral medications
such as Rimadyl, Etogesic, glucosamine, aspirin, etc. do little for LS
and it presents a sad problem. The "cure" is referral spinal
surgery to free up the trapped nerve roots, not something many owners
will consider in a geriatric greyhound. Many, if not most greyhounds,
simply get worse and worse until euthanasia becomes necessary.
The good news is
that there is a simple palpation technique to detect LS and a way to inject
Depo-Medrol intralesionally to help it, similar to what is done in humans.
It was taught to me by Dr. Mike Herron, a professor of small animal orthopedic
surgery at Texas A&M for 32 years, owner of racing greyhounds, and
all around "greyhound guru".
You may want to clip
this out for your vet to see should one of your greyhounds begin showing
signs of LS: First, look at this diagram to see where the L-S joint lies
in relation to the iliac crests so that you hit the right spot both with
your thumbs for palpating and with the needle for injecting.
Put all your fingers
on the underside of the greyhounds pelvis (inguinal area). Put each
thumb just medial to each iliac crest about halfway down its ridge. Your
thumbs should be between the iliac crest and the vertebrae. Be sure to
look at the diagram so you can see where the L-S joint lies in relation
to the iliac crests. Try to "crack" (move) the L-S joint. If
it hurts (or he falls to the ground!), chances are he has LS.
Draw up 40 mg of
Depo-Medrol and using a 1" needle, inject half of this into each
side. Go about halfway down the ridge of the iliac crest, go in (medially)
1", and inject just off the midline (this is where you put your thumbs
to try to "crack" the L-S joint).
If the greyhound
does not show improvement within 48 hours, the problem is something else.
Repeat as needed, as Depo-Medrols effect wears off - usually 1,2,or
3 times a year.
A footnote worth
mentioning for LS is Ultram, a human "combination" drug with
both a narcotic-like and an antianxiety component. Used sometimes for
bone cancer in dogs - another very painful condition - I have tried it
with good results on two LS dogs when Depo-Medrol injections were not
enough. A greyhound dose is 1/2 a 50 mg Ultram as needed for pain, given
up to twice daily.