🐶 New Insights: 7-Year Surgical Follow-Up in Pugs with Spinal Myelopathy

Case Report: Long-term surgical outcomes in pug dogs with articular facet dysplasia-associated thoracolumbar myelopathies

Anna Tauro, Colin J. Driver, Jeremy Rose, Ricardo Fernandes, Clare Rusbridge

Background

Pug dogs are predisposed to thoracolumbar myelopathy, often linked to vertebral articular process (VAP) dysplasia, suggesting a biomechanical and possibly immunological cause. Clinical signs include paraparesis, proprioceptive ataxia, and incontinence. Prior research showed short- and mid-term benefits of vertebral stabilization, but long-term outcomes beyond two years remained unknown. This study aimed to assess neurological recovery, recurrence, survival, and quality of life in Pugs more than 7 years after surgery.

Methods

This retrospective descriptive case series followed 7 Pug dogs that underwent vertebral stabilization surgery (with or without decompression) in 2017. They were previously part of a 2019 study and included here with caregiver consent. Dogs were grouped by diagnosis: intervertebral disc protrusion (IVDP), spinal arachnoid diverticulum (SAD), or pia-arachnoid fibrosis (PAF). Follow-up data were collected via caregiver questionnaires, clinical records, and imaging when available. Outcomes assessed included neurological recovery (graded 0–4), time to recurrence, lifespan, urinary/fecal incontinence, and caregiver-perceived benefit.

Results

-Neurological outcomes: 71% (5/7) showed temporary improvement or stabilization, especially in IVDP and SAD groups.

-Recurrence: 80% of improved dogs relapsed, with median time to recurrence 8.9 months. PAF group had the poorest prognosis, showing minimal benefit.

-Survival: Median survival after surgery was 3.2 years (range 0–7 years). One SAD dog (case 13) remained alive and neurologically stable at 9.2 years of age.

-Complications: Urinary/fecal incontinence affected 71% (5/7) of dogs, and recurrent urinary tract infections were common, sometimes with antibiotic resistance.

-Caregiver perspective: Surgery was considered beneficial in 57% (4/7) of cases. Favorable outcomes correlated with younger age, shorter lesion extension, and milder spinal cord hyperintensity on MRI.

Limitations

The study was limited by its small sample size, retrospective design, reliance on caregiver reports, and lack of standardized outcome measures. Imaging follow-up was incomplete, and no statistical analyses were possible. The heterogeneity of concurrent conditions (e.g., syringomyelia, airway disease, seizures) may have influenced outcomes.

Conclusions

Vertebral stabilization with decompression may provide temporary benefit in Pug dogs with thoracolumbar myelopathy, but recurrence is common, particularly in pia-arachnoid fibrosis. Prognosis appears more favorable in younger dogs with milder MRI lesions. Urinary incontinence requires close management to reduce complications. The findings highlight the need for standardized long-term outcome measures, prospective studies, and further exploration of adjunctive therapies (e.g., corticosteroids, antifibrotic agents, CSF diversion techniques).

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