Intervetebral disc disease (IVDD)
Intervertebral disk disease (IVDD) in dogs is a common cause of back pain, rear limb paralysis, and an inability to walk or feel the back legs. Certain breeds including the Dachshund, Bulldogs, Shih tzu, Pekingese and Beagle are commonly affected.
IVDD signs and symptoms
In some breeds, the inner nucleus pulposus loses it’s ‘jelly-like’ properties and becomes dry and brittle. The dorsal (top) of the annulus fibrosus is thinner than the rest of the annulus fibrosus. In dogs that herniate (or ‘slip’) a disk, the nucleus pulposus extrudes dorsally from the annulus fibrosus and may forcibly strike the spinal cord and/or compress the spinal cord.
This leads to signs of intervertebral disk disease. Signs of thoracolumbar intervertebral disk disease include back pain, pelvic limb ataxia (walking wobbly), inability to stand, inability to move the rear legs, or even inability to feel the back legs. A grading scale is used in dogs:
This leads to signs of intervertebral disk disease. Signs of thoracolumbar intervertebral disk disease include back pain, pelvic limb ataxia (walking wobbly), inability to stand, inability to move the rear legs, or even inability to feel the back legs. A grading scale is used in dogs:
- Grade 1) Pain Only – These dogs are able to walk normally, but exhibit signs of pain including reluctance to move, reluctance to jump, shivering, crying, muscle spasms, and/or a tense abdomen.
- Grade 2) Ambulatory Paraparesis – These dogs are able to walk, but are weak and wobbly in the rear legs. They may cross their back legs when walking, splay out, knuckle over or stumble in their back legs.
- Grade 3) Non-Ambulatory Paraparesis – These dogs are still able to move their legs and wag their tails, but are not strong enough to support their own weight and walk.
- Grade 4) Paraplegia – These dogs have no voluntary movement in the rear legs.
- Grade 5) Paraplegia with Absent Nociception (no ‘deep pain’) – In addition to being unable to move the back legs, they are unable to feel their back legs.
Treatment depends on the severity of the signs, but can be divided into two options:
- Non-Surgical – For dogs with a first episode of back pain or mild pelvic limb ataxia, a conservative approach of crate rest (also known as cage rest) and medications may be elected.
- Surgical – Dogs with more severe signs (grade 2-5) or recurrent or persistent back pain that does not respond to rest and medications are best managed with surgery to decompress the spinal cord.
Treatment of IVDD
Living with IVDD
- Grade 1-4 – The chances of success are about 95% in the hands of an experienced neurosurgeon. For dogs that are managed non-surgically (crate rest), the chances of regaining the ability to walk are about 50-60%. However, dogs that are that are managed without surgery have a much higher risk for recurrence, may take longer to improve, and are at risk for worsening when compared to those that are treated with surgery.
- Grade 5 – Are a surgical emergency. The chances of recovery are significantly lower than those that can still feel their back legs. If surgery is to be successful, it should be performed as soon as reasonably possible and certainly within 48 hours of losing the ability to feel the back legs. Dogs that are paraplegic with absent nociception are at risk for myelomalacia, an extremely serious condition that is typically progressive and fatal.
Further reading
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This review summarizes the advances indiagnosis and treatment of IVDD that have been made since the 1950s when the first detailed description of the degenerative changes was published. It also discusses new approaches to treatment of the associated spinal cord injury and methods by which to classify injury severity.
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Highlight recent findings regarding prognostic indicators used for spinal cord injury in dogs, promote an awareness of the current recommendations of standard of care for traumatic spinal cord injury in veterinary medicine, and highlight the findings of clinical trials of therapies for spinal cord injury in dogs.
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