How to Treat Discospondylitis in Dogs

Discospondylitis is a serious spinal infection in dogs that affects the intervertebral discs and adjacent vertebrae, leading to pain, neurological deficits, and, in severe cases, paralysis. Early diagnosis and effective treatment are crucial for the recovery and quality of life of affected dogs. In this article, we will explore the causes, symptoms, diagnostic methods, and comprehensive treatment options for discospondylitis in dogs.

What is Discospondylitis in Dogs?

Discospondylitis is an inflammatory condition caused by a bacterial or fungal infection that targets the intervertebral discs and the adjacent vertebral endplates. It is a distinct condition from spondylitis, which affects only the vertebrae, and from intervertebral disc disease (IVDD), which is a degenerative disc problem. Discospondylitis can lead to spinal instability, nerve compression, and significant discomfort for your dog.

Causes of Discospondylitis

1. Bacterial Infection:
The most common cause of discospondylitis is a bacterial infection, often originating from a primary site such as the urinary tract, skin, or oral cavity. Common bacterial culprits include 'Staphylococcus', 'Streptococcus', 'Escherichia coli', and 'Brucella canis'.

2. Fungal Infection:
Fungal discospondylitis, though less common, can be caused by organisms such as 'Aspergillus' and 'Coccidioides'. These infections often occur in immunocompromised dogs or in regions where fungal spores are prevalent.

3. Hematogenous Spread:
The infection usually reaches the spine through the bloodstream, spreading from distant infections or through invasive procedures, injuries, or surgeries.

4. Foreign Bodies and Trauma:
Penetrating wounds, grass awns, or other foreign bodies can introduce bacteria into the spinal area, leading to discospondylitis.

Risk Factors

• Breed Predisposition:
  Large breed dogs such as German Shepherds, Great Danes, and Boxers are more susceptible.
• Age:
  Middle-aged and older dogs are more commonly affected, but young dogs can also develop the condition.
• Immune Status:
  Dogs with compromised immune systems due to conditions like diabetes, cancer, or prolonged steroid use are at a higher risk.
• Concurrent Infections:
  Dogs with ongoing infections elsewhere in the body are more vulnerable.

Symptoms of Discospondylitis

Recognizing the signs of discospondylitis early is essential for prompt treatment. Common symptoms include:

1. Spinal Pain:
The most consistent sign, characterized by reluctance to move, vocalization when touched, or a stiff posture.

2. Lameness or Weakness:
Affected dogs may show signs of limping or weakness, especially in the hind limbs.

3. Fever:
Dogs often present with a fever due to the underlying infection.

4. Loss of Appetite and Weight Loss:
Discomfort and systemic illness can cause decreased appetite and weight loss.

5. Neurological Deficits:
Severe cases can lead to nerve damage, resulting in ataxia (lack of coordination), incontinence, or even paralysis.

6. Behavioral Changes:
Dogs may become more withdrawn, irritable, or anxious due to chronic pain.

Diagnosing Discospondylitis in Dogs

Accurate diagnosis is crucial for effective treatment. Veterinarians use a combination of clinical examination, imaging, and laboratory tests to confirm discospondylitis.

• Physical and Neurological Exam: A thorough examination helps assess the extent of pain, spinal mobility, and any neurological deficits.
• Radiographs (X-rays): X-rays can reveal disc space narrowing, lysis (destruction) of the vertebral endplates, and other structural changes. However, early stages may not be visible.
• MRI or CT Scan: Advanced imaging techniques like MRI or CT scans provide detailed views of the spine, revealing soft tissue involvement, abscesses, and spinal cord compression.
• Blood Tests: Blood work may show elevated white blood cell counts or markers of inflammation. Blood cultures can help identify the causative organism.
• Urinalysis and Urine Culture: Since discospondylitis often spreads from urinary infections, these tests are vital for identifying the infection's source.
• CSF Analysis: In some cases, cerebrospinal fluid (CSF) analysis may be performed to detect infections spreading to or from the nervous system.
• Biopsy or Fine-Needle Aspiration: In certain situations, direct sampling of the affected discs or vertebrae may be necessary to identify the pathogen accurately.

How to Treat Discospondylitis in Dogs

Effective treatment of discospondylitis involves a combination of antimicrobial therapy, pain management, supportive care, and sometimes surgical intervention.

1. Antimicrobial Therapy

a. Antibiotics:
The primary treatment for bacterial discospondylitis involves long-term antibiotic therapy, often lasting several months. The choice of antibiotics depends on the identified organism and its sensitivity. Commonly used antibiotics include:

• Cephalexin
• Clindamycin
• Trimethoprim-sulfa
• Fluoroquinolones (e.g., enrofloxacin)

Empirical antibiotic therapy is usually started while waiting for culture results, which may take several days. Once the causative organism and its antibiotic sensitivity are identified, the treatment can be adjusted accordingly.

b. Antifungal Medications:
For fungal discospondylitis, antifungal medications like *itraconazole* or *fluconazole* are used. Fungal infections generally require longer treatment durations and are often more challenging to manage.

2. Pain Management

Pain relief is critical in discospondylitis treatment. Common pain management strategies include:

• Non-Steroidal Anti-Inflammatory Drugs (NSAIDs):
  These medications reduce inflammation and alleviate pain. Examples include carprofen, meloxicam, and deracoxib.
• Opioids:
  For severe pain, opioids such as tramadol or gabapentin may be prescribed.
• Corticosteroids:
  These are typically avoided due to their immunosuppressive effects, which can worsen infections, but in select cases with severe inflammation, they may be used cautiously.

3. Supportive Care

• Restricted Activity:
  Strict rest is essential to prevent further spinal damage. Crate rest or confinement may be recommended for several weeks.
• Physical Therapy:
  Once the pain is under control, gentle physical therapy and rehabilitation can help maintain muscle tone and improve mobility.
• Nutritional Support:
  Ensuring your dog is eating a balanced diet rich in essential nutrients can aid in the healing process.

4. Surgical Intervention

Surgery may be necessary in severe cases where conservative treatment fails, or there is significant spinal instability, abscess formation, or neurological impairment.

Surgical options include:

• Debridement:
  Removal of infected or necrotic tissue to reduce the bacterial load.
• Stabilization:
  Spinal stabilization techniques, such as implants or bone grafts, may be needed to restore spinal alignment and stability.
• Drainage of Abscesses:
  In cases where abscesses are compressing the spinal cord, surgical drainage may be required.

Prognosis and Long-Term Management

The prognosis for dogs with discospondylitis varies based on the severity of the infection, the causative organism, and the timeliness of treatment. Early intervention and adherence to the prescribed treatment plan significantly improve outcomes.

Positive Prognosis:
Dogs treated promptly with appropriate antibiotics often recover fully, although treatment may take several months.

Guarded Prognosis:
Cases with severe neurological deficits, fungal infections, or delayed treatment may have a less favorable outlook, requiring ongoing management.

Relapse Prevention:
Regular follow-up visits, including repeat imaging and blood tests, are essential to monitor the infection’s resolution and adjust treatment as needed.

Preventing Discospondylitis in Dogs

Prevention focuses on minimizing the risk of infections that can spread to the spine:

Maintain Good Hygiene and Regular Vet Check-ups:
Regular dental cleanings, skin care, and prompt treatment of urinary tract infections can reduce the risk of systemic infections.

Avoid Spinal Trauma:
Minimize activities that could lead to spinal injury, especially in predisposed breeds.

Screen for Brucellosis:
Testing breeding dogs for 'Brucella canis' can prevent transmission of this specific bacterial cause of discospondylitis.

Conclusion

Discospondylitis is a challenging condition that requires prompt diagnosis and aggressive treatment to prevent lasting damage to your dog's spine and overall health. With the right combination of antimicrobial therapy, pain management, supportive care, and, when necessary, surgical intervention, many dogs can recover and return to a good quality of life. Early recognition of symptoms and adherence to your veterinarian’s treatment plan are key to successful management. If you suspect your dog may have discospondylitis, consult your veterinarian immediately for evaluation and appropriate care. Early action can make a significant difference in your dog’s recovery and long-term well-being.