Intervertebral Disc Disease
Intervertebral disc disease can occur a few different ways in dogs and is quite different to disc disease in humans.
The spinal cord is responsible for messages traveling between the brain and body. It is protected by the bones vertebrae, which protect it from physical damage. To allow movement of the spine between each vertebrae there are joint to allow flexion, extension, rotation, and side bending to different degrees. It is important that this movement is well controlled so between each of these there is a disc that acts as a cushion to absorb forces and smooth out movement. The disc has an outer fibrous ring around an inner gelatinous center. The ring is significantly thicker at the bottom than the top (where the spinal cord runs). The central area has a high water content and acts as the cushion between the vertebrae.
As dogs age the gelatinous centre decreases in water content and becomes stiffer and less elastic. In small breed dogs this change can begin to occur at a very young age, with some transformation noted in dogs as young as two months of age. These dogs are 'chondrodysplastic' and include Dachshunds, Beagles and Maltese.
Over time the abnormal transfer of forces through the cushion causes damage to the outer ring at its weakest point, at the top of the disc, eventually causing a rupture. Further pressure forces the central tissue to erupt up into the area occupied by the spinal cord.
In non chondrodyslpastic dogs the change to the central disc material does not begin until seven years of age and it is accompanied by degeneration of the fiberous capsule. Instead of an explosion of disc material, the pressures across the disc cause it to bulge up.
The pressure on the spinal cord can cause a varying symptoms of varying and severity, which influences the treatment options that will best help your pet.
We classify IVDD based on the location of the disc prolapse - cervical, thoracic or lumbar.
We also classify IVDD based on the severity of symptoms.
Stage 1 Pain
Stage 2 Your dog can walk however wobbles and looks weak
Stage 3 Your dog can not stand up without assistance. You can still see them moving their legs
Stage 4 Your dog is unable to move their legs. They can still perceive painful sensation from their legs
Stage 5 Your dog is unable to move their legs or feel any pain
Pain relief is my first priority when assessing a dog with IVDD. Adequate pain management is vital from the time IVDD is first suspected and throughout rehabilitation. This allows accurate assessment of your dog and creation of an appropriate plan for treatment. Using a multi-modal approach with a variety of medications, manual therapies and modalities, including TENs, will minimise side-effects while maximising your dogs comfort.
Throughout rehabilitation we aim to set your dog up for a successful return to normal life. Breaking apart how your dog moves into tiny pieces so we can teach muscular control means we don't miss steps in the path and we progress quickly. Teaching a dog to walk before we teach it to move from a down to a sit and through to a stand misses important steps in the rehab process. Each point sets up your dog to progress through to the next step. It creates independence and ensures that we are maintaining a safe environment.
This is an evidenced based approach, using studies and experience to guide you and your dog throughout the entire process.
- Maintain normal range of motion
- Activation of spinal muscles to support and protect the spine
- Body awareness will manage your dogs injury risk while recuperating
We can help you bring your dog home, work through how to manage them those first few, very stressful days. Running through management techniques including bladder palpation, moving your dog safely at toilet time, and managing boredom, are all areas that will impact the outcome.
Identification of the severity/stage of your dogs signs will determine the recommendations made.
Ideally, appropriate diagnosis through advanced imaging is done early, which will require a referral to a specialist clinic. MRI is the gold standard, CT with contrast myleogram is an alternate choice. X-rays may identify abnormally calcified discs, however are not accurate enough to diagnose IVDD accurately.
Dogs in Stage 1 may be managed with crate rest and exercise restriction.
Stage 2 may also be managed conservatively, particularly with dogs who improve early in therapy may also be managed conservatively.
Stage 3 and above will usually require immediate surgery to maximise your dog's return to full function. There are times when this is not possible and conservative management is trailed.
The aim of surgery is to remove the disc material that has pushed up into the area of the spinal column. This immediate decompression and cleaning out of tissue can relieve the pressure on the spinal column. It will also manage your dogs pain.
Management, if you can not proceed to surgery, or post operatively, is to reduce any pressure through your dogs signal column to reduce the risk of further disc material being pushed up into the spinal column. It is recommended that your dog does not have any uncontrolled activity for six weeks to allow the outer fibrous ring to heal, keeping the disc material in place.
Active rehabilitation during this 6 week time is focused on safety. Teaching your dog how to lay down, sit and stand in ways that will protect their spine is important as they will perform these activities regardless of their confinement. Setting them mind challenges and encouraging them to track scents will manage boredom and prevent silliness.
Why dogs develop disc disease, can we prevent it?
Disc disease has strong breed predispositions.
Dachshunds are over represented in the breeds that commonly experience disc disease. A breed survey was conducted in the UK in 2015 that identified lifestyle factors that appeared to increase the risk of IVDD. The complete results can be found here, key points include correlations of increased risk in neutered dogs, inactivity and individuals with longer backs.
We have other hypothesised ways of reducing disc disease. Paraspinal muscles are responsible for maintaining back support and alignment, so strengthening manages abnormal forces being placed across the disc. Being fit and active will achieve this and Primal Paws has supported activities such as Earthdog for small terriers and regularly runs conditioning clinics to introduce owners to safe ways to exercise their dogs.