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Unstable spine surgery being performed by a vet

Neuroprosthesis

Neuroprosthesis

We offer state-of-the-art treatment for urinary incontinence in dogs with spinal cord damage by use of a neuroprosthesis. This treatment applies to dogs following severe spinal cord injury, from a few weeks to several months (sometimes years) after the paralysis. This is well-known and very effective therapy in humans, which is now readily available for dogs with > 20 cases having been successfully treated.

Dogs are commonly affected by intervertebral disc disease (‘slipped disc’) in the back region. Small dogs such as Dachshunds, Shih Tzu, French Bulldogs, Cocker Spaniels, amongst many other breeds, are predisposed. This is often very sudden in onset and causes paralysis. Many dogs recover following diagnosis with MRI or CT followed by spinal surgery, but a proportion of dogs (~approximately 15% of them) can remain paralyzed in the chronic phase of the disease. While the paralysis can be managed, a slipped disc in the back region in dogs will also lead to incontinence. This is a major issue for these pets. It can cause repeated bladder and kidney infections and skin sores due to the fur being soiled. Up until recently, the only way to empty the bladder was by gently pressing on the abdomen by hand or using catheterization. But these methods cause pain, discomfort as can cause further urine infections.

Dr. Nicolas Granger developed with Prof. Nick Jeffery (Texas A&M University) a system for dogs – based on existing equipment for paralyzed humans – that allows extremely efficient voiding of the urinary bladder without having to use the above methods. It is composed of a small implant placed in surgery around the nerves controlling the bladder. The implant is activated by a remote that the dog’s owner uses daily when bladder emptying is required. With more than 20 companion dogs now treated, we have strong evidence showing that the system is safe and efficient and can be used for several years without failing (some of our cases have lived with the system for 8 years). The system should also reduce infections of the bladder which is almost always the rule in chronically paralyzed dogs. Finally, many dogs also have reflex incontinence, losing small quantities of urine through the day, and this can stop once the system is implanted.

Dogs eligible for this treatment are those with a ‘thoraco-lumbar’ spinal cord lesion (middle of the back between vertebrae T3 to L3) who have not (or only partially) recovered urinary continence (or fecal continence) after their injury. The system can work for fecal incontinence as well. The cause of the spinal cord injury could be a slipped disc but dogs with other type of injuries such as trauma to the spine caused by road traffic or spinal embolism causing incontinence are eligible too. We can consider the implantation from 3 weeks after injury but it can be done at any point in time after the injury. The treatment will not impact on future chances of recovery, should there be new treatments for paralysis in the future.

We would like to raise awareness of this cutting edge therapy for pets because it is fully available to affected dogs. You can find a scientific report by following the link below to an online open access peer reviewed veterinary journal: Journal of Veterinary Internal Medicine. The system is called ‘SARS’, standing for ‘Sacral Anterior Root Stimulation’.

Useful links:

Restoration of urinary function in spinal cord injury

Use of an implanted sacral nerve stimulator to restore urine voiding in chronically paraplegic dogs.

Use of an Implanted Sacral Nerve Stimulator to Restore Urine Voiding in Chronically Paraplegic Dogs.