Common Questions About Intervertebral Disk Disease (IVDD)

1. Why does Intervertebral Disk Disease (IVDD) happen?

There are two general types of IVDD, Types I and II. Type I IVDD typically affects younger to middle aged chondrodysplastic dogs (smaller dogs with short legs) such as the Dachshund, and usually results in an acute onset of clinical signs. Type I IVDD degeneration begins early in life in predisposed breeds. Over time, the center of the disk (called the nucleus pulposus) loses water content and undergoes calcification. As a result, the disk is prone to herniation and extrusion of disk material into the spinal canal causing compression of the spinal cord.

Normal Canine Spine

Normal Canine Spine, Reprinted with permission by the copyright owner, Hill’s Pet Nutrition, Inc.

Canine Spine with IVDD

Canine Spine with IVDD. Reprinted with permission by the copyright owner, Hill’s Pet Nutrition, Inc.

2. What are the signs to watch for?

Disk herniation results in varying degrees of pain and neurologic deficits depending on the site of disk herniation, degree of spinal cord compression, and amount of concussive injury or bruising to the spinal cord. Common signs may include reluctance to move or jump, holding the nose pointed to the ground (common in neck injuries), holding the head arched backwards (common in back injuries), screaming or crying when touched or picked up, trembling, an ataxic (wobbly or uncoordinated) gait, and dragging one or more legs (often both back legs).

3. Why aren’t x-rays sufficient to diagnose IVDD?

Radiographs (or X-rays) are an excellent diagnostic tool, and can be used to rule out other processes such as broken bones, cancer of the bone or infection of the bone. Radiographs can also suggest intervertebral disk disease, but do not provide enough information to allow for surgical planning. A myelogram can demonstrate cord compression, but is not specific for IVDD. This test is more invasive and involves injection of a contrast agent into the spinal canal. Computed tomography (CT) can also be used with or without a myelogram to identify the site of disk herniation. A CT does provide more detailed images of the bone and spinal cord than radiographs. However, Magnetic Resonance Imaging (MRI) provides the best imaging of the spinal cord and intervertebral disks. MRI allows detailed evaluation of the spinal cord and offers superior images for diagnosis and surgical planning

4. I had a friend who’s dog recovered with steroids. Can’t we give my dog steroids?

Medical and surgical options are available for treatment of IVDD. Dogs that are more severely affected (pain that does not respond to medications and rest, and dogs that are showing neurologic signs such as wobbliness or dragging the back legs) are candidates for surgical management. Dogs that are less severely affected (first-time with pain only, or dogs that can still walk but are wobbly) may be treated with medical management. Medical management consists of strict cage confinement and medications to relieve pain. Anti-inflammatory drugs (ex. Rimadyl) or steroids (ex. Prednisone) can be used to reduce inflammation and pain associated with disk herniation, but should not be used in combination. Additionally, other pain medications may be used to keep pets comfortable. Typically, it takes dogs longer to recover if they are managed conservatively, their degree of recovery is less than with surgery, and the risk of recurrence is higher than with surgery.

“Mega-dose” steroids such as large amounts of dexamethasone or Solu-medrol (methylprednisolone sodium succinate) have fallen out of favor with most veterinary neurologists. There are several studies that support this. In one study, dogs treated with surgery alone had as high of a chance of recovery as those treated with surgery and steroids. In several other studies, dogs that received steroids had a higher likelihood of side effects such as stomach upset and urinary tract infections. Recently, a multi-institutional, placebo-controlled, double-blinded study comparing solu-medrol, polyethylene glycol and placebo was completed. While the results have not yet been published, the researchers have reported that there is no beneficial effect of solu-medrol OR polyethylene glycol over surgery alone.

5. What are the chances of fixing my dog?

Prognosis depends on the degree and duration of neurological signs and type of treatment. Many dogs treated conservatively can improve; however, time to recover is longer, completeness of recovery is less, and recurrence of clinical signs is higher. Many dogs with mild neurological signs (can walk, but are mildly incoordinated) can have a functional recovery with medical therapy. Dogs who are unable to walk, but can still move their legs, have a worse prognosis (50-60% chance) fore returning to normal function with medical management. The prognosis for paralyzed dogs treated conservatively is guarded with only 50% of dogs returning to an ambulatory status with fecal and urinary continence.

Dogs that are managed with surgery have a good prognosis for walking again even if they have severe neurologic deficits. Additionally, these dogs recover faster and have less chance of recurrence. Even paralyzed dogs have about a 95% chance of walking again with surgical treatment if they can still perceive pain in their affected limbs.

Prognosis declines if dogs lose the ability to perceive pain and is dependent on time. Dogs without pain perception have about a 50-60% chance of walking again with surgery if it is performed within the first 24 hours. However, the chance of walking is low (5%) if treated conservatively.

6. What are the chances of this happening again?

Recurrence of disk herniation occurs but is less common in dogs treated surgically. About 10-20% of dogs will herniate another disk at another point in their lifetime and may require surgery. Recurrence rates tend to be higher (40-50%) in dogs that are managed medically.

Dr. Michael Wong and the staff at Southeast Veterinary Neurology (SEVN) are specialists in diagnosing and treating IVDD.  If you have any questions about your pet and your veterinarian has recommended evaluation by a neurologist, please contact SEVN at (305) 274-2777.

4 Comment(s)

  • by Melissa Posted July 3, 2018 2:16 pm

    My french bulldog had a hemilaminectomy about three weeks ago. Prior to the surgery she had mobility in her legs and could stand for short periods. She also had deep pain sensation. After three weeks and 6 laser therapy treatments, she still has no deep pain sensation and cannot walk. Currently we are trying physical therapy. Is it likely that she will regain any normal function, or deep pain sensation?

  • by Southeast Veterinary Neurology Posted July 5, 2018 10:11 pm

    Hi Melissa. While it’s tough for us to know without seeing your Frenchie in person, it would be considered atypical/unexpected to go into surgery with the ability to move the legs and come out without any feeling. Please call the office at (305) 274-2777 or (561) 736-7736 so we can take a closer look and be of more use.

  • by Deb Freeman Posted July 8, 2018 5:49 am

    Hello We live in Australia, my doxie had surgery for IVDD in May 2016 after she lost the use of her back legs but still had deep pain sensation. She was crated for 8 weeks recovery recovered well and although a tiny glimpse of weakness on her left rear leg she was well and back to her normal self. In May this year, she had a bought of pain on picking her up and her back end became wobbly and her tail was droopy. We crated her again for 4 weeks with Previcox and Tramadol and she recovered well. We started walking her for short walks and she seemed fine but last week she went down hill again and is now in pain (yelping when we pick her up) and is reluctant to stand. She has strength on her right if we stand her up but her left leg she is holding up and is weak on that side. Vet is unable to do anything other than re-supply meds for which she has been on for 6 days now but she is still in pain and no better. We are crating her. What are the chances of recovery if a second operation is done?

  • by Southeast Veterinary Neurology Posted July 8, 2018 12:34 pm

    Hi Deb,
    Sorry to hear that your puppy is going through this not once, but twice. Unfortunately, dachshunds are more likely than other breeds to have IVDD. Like your dog, most dogs have a 90-95% chance of having an excellent recovery as long as they still have deep pain perception.

    Unfortunately, also like your dog, pets that have one slipped disk are at risk for having a second disk extrusion at some point in their life. We do a preventative procedure at SEVN that reduces the likelihood of a second disk herniation, but it is still possible.

    Also like your dog, many dogs can improve with crate rest and pain medications. This works in about 50-60% of dogs that can still feel and move their legs. That means 40-50% of dogs won’t respond to rest and medications and would benefit from surgery.

    It is impossible for me to give an accurate answer without seeing your pet. However assuming your dog has a new slipped disk, and since she can still walk but is having pain that isn’t resolving with rest, another MRI is warranted. If a slipped disk is found, the likelihood of recovery should again be in the realm on 95%.

Leave a Reply

Your email address will not be published. Required fields are marked *

Looking For More Information? Call Us Today!
Miami: (305) 274-2777 | Boynton Beach: (561) 736-7736

Digital Strategy by SEOversiteDigital Strategy by SEOversite
Web Design & Hosting By Infinity Digital