Intervertebral disc disease (IVDD) in dogs is well recognized with an estimated 2.3 percent of dogs affected. In cats, the incidence is generally considered to be low with an estimated 0.02-0.12 percent of cats. These low estimates are likely a reflection of how good cats are at hiding the disability and pain caused by IVDD. With the increasing awareness of chronic pain in cats, there is a growing recognition of the prevalence of conditions like degenerative joint disease and spinal disorders in cats leading many authorities to believe that IVDD is much more common in cats than earlier estimates. This is supported by autopsy evaluations that show disc rupture and herniation are common and generally found in middle-age to older cats. The discs in the spine of the chest (thorax) and lower back (lumbar) are most often affected. Disc degeneration generally leads to degeneration of the small joints of the spine and formation of bone spurs that can, when severe, bridge between vertebrae.

In one study, the most severely affected area for IVDD was the lumbosacral (LS) disc. The LS disc lies between the last lumbar vertebra and the sacrum. This is the area at the front of the pelvis. Disease of the LS area is complex and can involve disc protrusion, degeneration of the articular areas of the vertebra, and thickening of the associated soft tissues. Some of the associated soft tissues are inside the spinal canal, and the thickening results in narrowing of the spinal canal. Problems with the disc and instability of this area of the spine can result in pain from degeneration and nerve impingement.

By some estimates, cats with LS disease are generally 8 years of age and older. Affected cats compensate for weakness and pain in the rear limbs by reducing their activity, discontinuing jumping, and by pulling themselves up onto furniture using their front limbs. This effort to compensate often leads to overuse of muscles associated with the front limbs, which can cause some amount of discomfort. Depending on the level of discomfort and dysfunction with the LS area, these cats may have difficulty even getting into the litter box to defecate and urinate, especially if the box has high sides. In addition, they often have difficulty posturing to eliminate. As a result, many affected cats will eliminate outside of the litter box.

Cats with these signs should have a full evaluation, because there are other problems that can affect this part of the spine and result in a pattern of dysfunction similar to LS disease. These problems include infectious disease, inflammatory problems, injuries, vascular problems and cancer. Evaluation should include a complete history of the problem, physical examination, neurological examination, blood and urine testing, and X-rays. These tests are a valuable part of the evaluation, but definitive diagnosis typically involves MRI studies.

Treatment recommendations for cats with LS disease generally involve pain management medications, control of inflammation, weight reduction as needed, and possibly surgery to remove herniated disc material and stabilize the affected vertebra. While the number of medications available for pain management is growing for the cat, options for long-term management are still limited. Integrative supportive care involves the use of osteopathic or chiropractic manipulations, acupuncture, laser therapy, rehabilitation therapies, homeopathic remedies and nutritional supplements. Supplements that may be beneficial include glucosamine, fish oil (n-3 fatty acids), vitamins C, E and A, and minerals like manganese. Since this is a degenerative problem, ongoing supportive therapy and pain management are needed with the goal of maintaining quality of life.

If you have questions or concerns about back pain and dysfunction in your cat, contact your veterinarian.

Ron Carsten, DVM, PhD, CVA, CCRT, was one of the first veterinarians in Colorado to use the integrative approach, has lectured widely to veterinarians, and has been a pioneer in the therapeutic use of food concentrates to manage clinical problems. In addition to his Doctor of Veterinary Medicine, he holds a PhD in Cell and Molecular Biology and is a Certified Veterinary Acupuncturist and Certified Canine Rehabilitation Therapist. He practices integrative veterinary medicine in Glenwood Springs.