title: 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.
  
  
  OBJECTIVE
  To elucidate prognostic factors for regaining urinary continence and ambulation in dogs with L4-S3 SCI and compare prognosis to T3-L3 SCI.
  
  
  METHODS
  A retrospective study on 61 nonambulatory dogs with L4-S3 SCI, matched to dogs with T3-L3 SCI, compared 3 weeks after onset. Prognostic factors explored using logistic regression and used for matching: nonchondrodystrophic dogs >15 kg versus dogs that were chondrodystrophic or <15 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 = .0033), but no difference existed for regaining ambulation (66 vs 75%, P = .1306). In L4-S3 SCI dogs, fewer dogs regained continence with loss of CPP (P < .001), LMN incontinence (P = .004), and noncompressive lesions (P = .006). Negative prognostic factors for regaining ambulation included absent CPP (P < .001) and large nonchondrodystrophic breed (P = .022).
  
  
  CONCLUSIONS
  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.
authors.affiliation: School of Veterinary Sciences, University of Bristol, Langford, North Somerset, UK.
authors.forename: T A
authors.identifier: http://orcid.org/0000-0002-1850-2215
authors.initials: TA
authors.lastname: Shaw
authors.affiliation: Centre for Small Animal Studies, Animal Health Trust, Kentford, Newmarket, Suffolk, UK.
authors.forename: L
authors.initials: L
authors.lastname: De Risio
authors.affiliation: School of Veterinary Sciences, University of Bristol, Langford, North Somerset, UK.
authors.forename: E J
authors.initials: EJ
authors.lastname: Laws
authors.affiliation: Fitzpatrick Referrals, Halfway Lane, Eashing, Surrey, UK.
authors.forename: J H
authors.initials: JH
authors.lastname: Rose
authors.affiliation: School of Veterinary Sciences, University of Bristol, Langford, North Somerset, UK.
authors.forename: T R
authors.initials: TR
authors.lastname: Harcourt-Brown
authors.affiliation: Cave Veterinary Specialists, George's Farm, West Buckland, Nr. Wellington, Somerset, UK.
authors.forename: N
authors.initials: N
authors.lastname: Granger
mesh_terms: D000818:Animals; D004283:Dog Diseases / Q000175:diagnosis*; D004285:Dogs / Q000293:injuries*; D008161:Lumbosacral Region / Q000293:injuries; D011379:Prognosis; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D013119:Spinal Cord Injuries / Q000175:diagnosis / Q000662:veterinary*; D014549:Urinary Incontinence / Q000175:diagnosis / Q000209:etiology / Q000662:veterinary*; D016138:Walking
keywords: Disk extrusion; Disk herniation; Fibrocartilaginous embolism; Intervertebral disk disease