Prognostic Factors Associated with Recovery of Ambulation and Urinary Continence in Dogs with Acute Lumbosacral Spinal Cord Injury.

Abstract

BACKGROUND: Limited information is available about prognostic factors for recovery after spinal cord injury (SCI) to the L4-S3 segments. Previous research suggests that L4-S3 SCI does not have a worse prognosis than T3-L3 SCI. HYPOTHESIS/OBJECTIVES: To elucidate prognostic factors for regaining urinary continence and ambulation in dogs with L4-S3 SCI and compare prognosis to T3-L3 SCI. ANIMALS/METHODS: A retrospective study on 61 nonambulatory dogs with L4-S3 SCI, matched to dogs with T3-L3 SCI, compared 3&#xa0;weeks after onset. Prognostic factors explored using logistic regression and used for matching: nonchondrodystrophic dogs >15&#xa0;kg versus dogs that were chondrodystrophic or <15&#xa0;kg; compressive versus noncompressive lesions; presence versus absence of conscious pain perception (CPP); and lower vs upper motor neuron (LMN/UMN) incontinence. RESULTS: Fewer L4-S3 dogs regained continence compared to T3-L3 dogs (64 vs 85%, P&#xa0;=&#xa0;.0033), but no difference existed for regaining ambulation (66 vs 75%, P&#xa0;=&#xa0;.1306). In L4-S3 SCI dogs, fewer dogs regained continence with loss of CPP (P&#xa0;<&#xa0;.001), LMN incontinence (P&#xa0;=&#xa0;.004), and noncompressive lesions (P&#xa0;=&#xa0;.006). Negative prognostic factors for regaining ambulation included absent CPP (P&#xa0;<&#xa0;.001) and large nonchondrodystrophic breed (P&#xa0;=&#xa0;.022). CONCLUSIONS AND CLINICAL IMPORTANCE: Dogs with L4-S3 SCI have a poorer short-term prognosis than do dogs with T3-L3 SCI. Dogs with L4-S3 SCI had a poor prognosis with loss of CPP, or noncompressive lesions combined with LMN incontinence. Small-breed or chondrodystrophic dogs with retained CPP, compressive lesions, and UMN incontinence had an excellent prognosis. These findings may help guide decision-making in L4-S3 SCI.