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Bulldogs and Bifid Backs: Surgery Offers Hope for Dogs With Spina Bifida and Tethered Cord
Frontiers in Veterinary Science 2025
Obi Veterinary Education
January 13, 2026
Patrick Roynard, Curtis Wells Dewey
Background:
Neural tube defects (NTDs), including meningoceles (MCs) and myelomeningoceles (MMCs), are congenital malformations involving protrusions of meninges and/or spinal cord tissue. In dogs, these defects most often localize to the lumbosacral (LS) region and are prevalent in screw-tail breeds such as Bulldogs. Lumbosacral MCs/MMCs may be associated with tethered cord syndrome (TCS), leading to progressive neurologic deficits. Historically considered untreatable, increasing clinical recognition and surgical experience have prompted reevaluation of management strategies. This review synthesizes published cases and the authors’ clinical experience to evaluate surgical outcomes and clarify terminology and pathophysiology.
Methods:
The authors reviewed 14 literature cases and 9 of their own surgically treated cases of LS MCs/MMCs in dogs, all with at least one-month follow-up. The study evaluated clinical signs, imaging features (radiographs, CT, MRI), intraoperative findings, and surgical outcomes. Dogs underwent preoperative neurologic evaluations, imaging-based diagnosis, and a standardized microsurgical untethering procedure. Data on improvement in pelvic limb neurologic function and continence were collected.
Results:
Most affected dogs were young Bulldogs presenting with urinary/fecal incontinence, pelvic limb paresis or ataxia, and characteristic cutaneous signs over the LS region. Imaging confirmed MC/MMC, spina bifida, and features of TCS such as dorsal spinal cord deviation and syringomyelia. Of the 17 surgically treated dogs with preoperative neurologic deficits and follow-up ≥1 month, 82% (14/17) showed improvement in pelvic limb function. Recovery of urinary/fecal continence was achieved in 48% (10/21) of cases at one month and 38% (8/21) at ≥6 months. One dog with a lipomyelomeningocele died postoperatively due to suspected fat embolism. Most dogs showed improved quality of life post-surgery.
Limitations:
This review includes a small, non-randomized cohort with variable follow-up periods. Histologic confirmation of all intraoperative findings was not performed. Owner-reported continence outcomes may be subjective. Many published cases lacked standardized diagnostic or neurologic documentation, and outcomes were not uniformly defined.
Conclusions:
Surgical correction of LS MCs/MMCs in dogs, particularly in Bulldogs, is associated with meaningful improvement in neurologic function and, in some cases, continence. Although outcomes vary, and not all dogs achieve full recovery, surgical untethering offers a viable therapeutic option for selected cases with progressive signs. Early recognition, thorough imaging assessment, and timely surgical intervention may improve prognosis in this congenital condition.
6 month-old female French Bulldog illustrating the concepts of multiple sites of neural tube defects (NTDs) and external/cutaneous signs (visible on dorsal midline) being suggestive of NTDs. (A) Lateral, (B) frontal, (C) dorsal views of the head and (D) dorsal view of the neck, with corresponding magnetic resonance images (MRI) vertically aligned. (E) Midline and (F) para-midline sagittal T2W images of the brain, indicating the level of the transverse T2W images of the (G) frontal lobes and (H) thalamus, with dorsal T2W images at the level of the (I) corpus callosum and (J) thalamus. Note the bifid nasal planum (complete cleft in B), change of hair implantation with a ridge of hair in the frontal area and on dorsal cervical midline (red arrowheads in A–D) and swirls of hair over the calvaria (reminiscent of the “hair collar” sign in humans) (red arrows in A–D), associated with palpable osseous defect (cranium bifidum occultum, red hollow arrow in E,F). Features of NTD affecting the brain are visible, including hydrocephalus (F,H–J), abnormal gyrification of the frontal lobes (G) and failure of interhemispheric midline fusion with agenesis/dysgenesis of midline structures: interthalamic adhesion (red four points star in H,J) and corpus callosum (black hollow arrow in H,I, note the abnormal folding of the cingulate gyrus). In the cervical area, under the less pronounced swirl of hair (seen in D), (K) sagittal and transverse T2W MR images at (L) caudal aspect of T1 and (M) mid-T2 show further features of NTD/spina bifida: only partially fused spinous process at T1 (white arrowheads in L), dorsal deviation of the dural sac within the vertebral canal (white hollow arrow in K,L) and dorsal deviation of the spinal cord within the dural sac (with obliteration of the dorsal subarachnoid space), tucked under the lamina of T2 (plain white arrow in K,M).
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