Intervertebral Disc Disease – IVDD

a degenerative spinal condition in dogs. 

Intervertebral Disc Disease (IVDD) is a degenerative disease seen most commonly in dog breeds with shorter legs and longer backs (chondrodystrophoid). The most commonly affected breeds are the Dachshund, Shih-Tzu, Beagle and Cocker Spaniels, however no dog is completely immune to disc disease. In rare instances trauma such as being hit by a car, shot or falling from a height can cause a traumatic rupture of a disc. 

In the chondrodystrophoid breeds a genetic error in disc metabolism causes the interior portion of the disc (nucleus pulposus) to absorb calcium and other minerals which effectively limit the discs ability to act as a shock absorber between the vertebra. 

A major difference between disc herniation in people and dogs is that in people the disc tends to move to the side, putting pressure on nerve roots, causing pain but not paralysis, where as in dogs the disc tend to herniate upward into the spinal canal putting pressure on the spinal cord and causing weakness or paralysis. 

Intervertebral disc disease (IVDD) is a progressive disease both in the degeneration of the disc and the progression (severity) of the clinical signs. A I-V scale is used to stratify dogs with disc disease. Dogs with grade I disease exhibit only discomfort in the neck or back, Grade II-IV patients display a loss of neurologic function from fine motor control to complete loss of motor function. Grade V patients have lost the ability to transmit pain sensation from the appendages to the brain, a functional severing (transaction) of the cord. 

Dogs suffering from stage I or II disease often respond to medical treatment consisting of anti-inflammatory medications, drugs for pain relief and strict (crate) rest. While dogs more severely affected can be treated medically most will regain function more quickly and regain a greater degree of function if surgical treatment is pursued. If medical treatment is elected, it is critical that the patient be monitored for any signs of progression as a Grade I or II dog can rapidly (within hours) progress to a grade V dog. The prognosis for dogs with Grade I-IV disease is very good with greater than 90% of patients regaining ambulatory abilities in 1-6 months time. The prognosis for dogs classified as grade V is guarded with less than 30% regaining ambulatory abilities. 

Symptoms:

- Breeds most commonly affected are long-backed, short legged dogs, such as the Dachshund, Shih-Tzu, Cocker Spaniel and Beagle breeds. 

- Signs of IVDD in the lower back (thoracolumbar region) include: 

- Reluctance to jump, walk or climb stairs 

- Wobbly hind legs or hind legs cross while walking 

- As condition worsens: 

- Inability to walk or stand 

- Inability to urinate 

- Symptoms in the neck region include: 

- Neck pain and will protect neck from movement 

- Stiff gait or unwilling to lift or bend neck 

- Sudden movements may produce a yelp 

- Front or rear limb weakness 

Procedure:

Depending on the location of disc injury or abnormality, the surgery performed will be a Hemilaminectomy, Ventral Slot Decompression, or Dorsal Laminectomy. 

The surgical procedure is designed to relieve pressure on the spinal column that causes pain and paralysis. The operation will generally begin immediately following a diagnostic myelogram. All of the surgical procedures consist of removing the bony portion of two adjacent vertebra to allow access to the spinal canal. This enables the surgeon to remove the herniated disc material that is compressing the spinal cord. 

Clif the Beagle, one day after Hemilaminectomy Disc Surgery

Following corrective surgery, the amount of time it takes to regain function is highly variable. For some return of neurologic function is almost immediate, the majority of patients see a gradual return to function over 1-3 months, while in severely affected patients, improvement will continue for up to 6 months. 

Approximately 90% of patients return to full function after disc surgery and ultimately live pain-free, healthy lives. 

After Care:

Hospitalization: 

- Your pet will need to stay overnight one night and a pick up can be scheduled during our regular business hours the day after surgery. 

- When you get your pet home, place your pet in a cool/warm (season dependent), quiet and dark room. If you leave your pet alone, he/she will sleep and be comfortable. You can increase your pet’s anxiety by doting. Your pet will have adequate medication for pain so you do not need to worry about discomfort. 

Medications: 

- The transdermal pain patch used for pain relief can cause constipation. Feed (1/2) can of tuna in oil daily for 4 days to prevent constipation. When you get your pet home, offer him a small amount of water. If he drinks it and does not vomit, offer twice the original amount. 2 hours later if no vomiting has occurred, offer ¼ of the amount of food in a normal meal. If your pet eats and no vomiting occurs in a 2-hour time period, then you may resume normal alimentation. 

- Refer to your discharge letter for specific dosage of all medications 

Food & Water: 

- When you get your pet home, offer him/her a small amount of water. If your pet drinks it and does not vomit, then offer twice the original amount. 

- Two hours later if no vomiting has occurred, offer ¼ of the amount of food in a normal meal. 

- If your pet eats and no vomiting occurs in a 2-hour time period, then you may resume normal feeding(s). 

- Please call Dr. Dew’s or your veterinarian’s office if your pet does not drink within the first 6 hours of being home or if vomiting occurs. 

Exercise Restriction: 

- Crate confinement for 2 weeks is suggested. 

- Avoid stair activity 

- Limit outdoor activity to urination and defecation 4 times daily 

- After 2 weeks gradually increase leash activity 

- Eliminate jumping on/off furniture 

Rechecks: 

- Your pet should be rechecked by Dr. Dew 10-14 days following surgery. Please call (866) 838-4282 to schedule this appointment. 

Physical Therapy: 

- Passive Range of Motion (PROM) exercises should be done 4 times daily, 10-15 repetitions are adequate 

- Tail walking will exercise front limbs and promote rear limb function 

- Bladder management will be required until normal function returns, express bladder 4 times daily 

- Swimming in tub or pool is excellent physical therapy and will decrease the severity of pressure sores or urine/fecal scalding.