Treatment of lumbosacral disease involves either conservative medical treatment or surgical intervention depending on the duration and severity of the clinical signs. Your veterinarian will recommend the most appropriate treatment based on your pet’s individual condition.

Conservative management

Dogs with mild disease often respond well to medical management and may return to normal pain-free mobility with some eventually able to discontinue medications. However, recurrence of clinical signs can occur.

Conservative management includes:
• Strict rest and exercise restriction – confinement to a crate, fenced off area in backyard or small room (avoiding stairs and jumping on/off furniture). Dogs should be taken outside on a lead for toileting only.
• Weight management if overweight, to reduce stress on the lumbosacral spine.
• Physiotherapy to support strength and mobility during recovery.
• Anti-inflammatory drugs (e.g. meloxicam) to reduce pain and inflammation
• Additional pain-relief (e.g. gabapentin)

Epidural steroid injections

If conservative management is unsuccessful, epidural steroid injections may be considered prior to surgical intervention to provide longer-term pain relief. Previous studies reported an improvement in approximately 80% of dogs. Some protocols recommend a series of three injections, administered at day 1, 2 weeks and 6 weeks. Repeated injections may be considered every 6 months thereafter.

However, not all dogs respond adequately to medical management or epidural injections. In some cases, pain may persist or gradually worsen as the condition progresses. If this occurs, or if neurological signs such as weakness or difficulty walking develop, surgical treatment may be recommended to relieve pressure on the affected nerves.

Surgical intervention

The goal of surgery is to relieve pressure on the nerves at the LS region, which can improve comfort, mobility, and overall quality of life. In many cases, surgery provides good long-term results such as reduced pain and improved neurological function.

The exact procedure depends on the findings from advanced imaging. Surgery typically involves one or more of the following:

• Dorsal laminectomy – a procedure that removes a small portion of bone from the top of the affected vertebrae (L7-S1) to relieve pressure on the nerves
• Foraminotomy – widening the opening where the spinal nerves exit the spine
• LS stabilisation – in some dogs, implants may be used to stabilise the joint and reduce abnormal movement between the vertebrae

Overall, many dogs respond well to surgical treatment. The outcome is, however, dependent on how severe the signs were and how long they have been present before surgery.