Pete the Vet: Could your dog be suffering from back pain?

Pete the Vet says we all need and deserve healthy, pain-free backs, humans or animals alike.

Pete the Vet: If a pet has more serious back pain, or if minor back pain does not resolve with rest and pain relief, a more detailed investigation is needed.

People are often surprised to hear about pets having similar problems to humans, but as a vet, it’s no surprise at all. After all, animal and human bodies are fundamentally the same: our bones, muscles, nerves, organs and other anatomical structures are remarkably similar. So, of course, just as humans can suffer from back pain, so can animals.

The types and causes of back pain are, understandably, different. Humans walk vertically, on two legs, while animals move around horizontally on four legs. Animals don’t lift heavy objects with their forelegs like humans do, while humans don’t run through fields at breakneck speed like dogs, or climb quickly up trees, or leap from object to object, like cats.

The diagnosis of back pain is far more difficult in animals compared to humans. It’s easy for doctors: their patients say “I have a sore back”. Vets are often presented with animals that seem vaguely unwell, and we need to question owners closely, searching for clues from the animal’s behaviour that might indicate discomfort in the back.

The starting point is often very general: an animal with back pain may seem quieter than usual, showing less interest in engaging, and being generally less active.

Other, more specific signs include dogs refusing to go up steps, or cats being unwilling to jump down from a chair as normal. A dog with neck pain often stops barking. Sometimes an animal might limp, or move around awkwardly. They may tremble or shiver. A muscle spasm may be seen by an owner, with the skin twitching. Less commonly, a pinched nerve in the back may cause reduced nerve supply to the hind quarters, causing a foot to be dragged.

When a pet presents to a vet with these signs, a thorough physical examination is the best way to find out more information. Gentle palpation along the spine, feeling the muscles and bones with probing fingers, is a good way to identify tense, tender or painful areas. Vets watch animals carefully for signs of a pain reaction as they do this: sometimes this can be as subtle as a dog licking their lips, turning their head, or blinking repeatedly. More commonly, when a tender area is pressed, a dog might yelp or a cat miaow, and they’ll often try to move away. For vets, it’s a delicate balance between gathering important information while trying to cause the least possible discomfort to our patients.

Sometimes vets will extend and flex the spine, by lifting the hind legs and manipulating the animal’s body. Obviously, we won’t do that if we have already determined that the back is painful, but this can be a useful way of thoroughly ruling out back pain. 

A healthy animal doesn’t mind having their back moved from side to side and up and down like this.

A so-called neurological examination is also carried out: this involved checking a pet’s reflexes and nerve function (eg skin sensation). This is especially important when a slipped disc is suspected, to analyse and record any nerve damage caused by pressure of the disc on the spinal cord.

If we do find a focus of pain in the back, there’s a long list of possible reasons. As in humans, minor causes – like pulled muscles or bruises – are more common than serious issues. If a pet just has mild back pain, a simple course of pain-relieving medication combined with strict rest may be sufficient to solve the problem. Resting a pet is more difficult than resting a human: if you tell a dog to stop chasing the ball they love to run after, they’ll ignore you. Humans need to take proactive steps to force a dog to rest: lead exercise only, no unrestrained running or jumping.

This enforced rest is especially important when a dog is being given pain relief. Pain is nature’s way of telling an animal to avoid putting pressure on a damaged part of the body. If the pain is taken away with drugs (which is important, for the animal’s comfort), there is a risk that they may be too active before their injured area has fully healed. This can delay full healing, or it can even make a bad situation far worse (a minor slipped disc causing pain can prolapse explosively if a dog is too active, resulting in complete paralysis). That’s why it’s essential for owners to control their pets’ activities as they recover from injuries.

If a pet has more serious back pain, or if minor back pain does not resolve with rest and pain relief, a more detailed investigation is needed. This usually starts with a so-called “minimal database”: blood and urine tests to ensure that there is no other underlying illness. Liver and kidney diseases can also cause back pain, and they need to be ruled out. Next, radiographs (x-rays) are often recommended: these are a useful screening tool to identify slipped discs, bacterial bone infections and cancers, all of which can cause painful backs.

For most pets, this is as far as investigations go: a diagnosis is made and treatment can be given. Rarely, even more advanced work ups, including CT or MRI scans may be needed. The exquisite detail of all bodily structures revealed by these state-of-the-art scans allows the fullest analysis of the problem to be carried out. While this is not needed in most cases, it may be recommended in complex situations such as severe slipped discs that require spinal surgery, or cancers that need to be clearly delineated.

We all need and deserve healthy, pain-free backs, humans or animals alike.