Guest Opinion: Intervertebral disc disease a threat to dogs
Integrative Pet Vet
Intervertebral disc disease (IVDD) is the most common neurological problem in dogs. It can result in problems ranging from pain and mild nerve dysfunction to complete paralysis. In addition, the onset can range from very rapid or more gradual, occurring over a longer period of time.
The pain can result in a reluctance to move, loss of appetite, or vocalizing when touched or moved. Nerve damage can result in weakness, loss of urine and bowel control, and if severe enough, an inability to walk. Clearly IVDD can be a very serious problem.
Intervertebral discs are positioned between the vertebrae (bones of the spine) of the back and neck. They stabilize and act as a cushion between the vertebrae. Each disc has an outer fibrous layer and a gel-like center. As dogs age, discs undergo a process of degeneration where the central gel loses its fluid and is less able to recover or withstand normal mechanical stresses. The outer, fibrous portion also weakens and becomes stiffer.
As the degenerative changes advance in dogs with IVDD, the central gel part can bulge into or rupture through the outer layer. This more severe manifestation of degeneration and can lead to disc material pressing against the spinal cord or the adjacent nerve roots, causing pain and nerve damage. Bulging or rupture can sometimes occur slowly, often leading to milder problems. Other times the disc bulge or rupture can occur rapidly, causing more severe signs.
It is generally difficult to identify a single event such as jumping or aggressive play that results in a bulging or ruptured disc. This is because the problem is thought to be caused by a combination of normal activity and normal mechanical stresses on a weakened, degenerated disc. It is also interesting to note that the majority of dogs will experience a progressive deterioration over a few hours or days rather than sudden paralysis. Some dogs experience recurrent episodes of pain or nerve deficits over months or even years.
Some dog breeds are predisposed to IVDD. The chondrodystrophic dog breeds — those with the short legs with angular deformities like the dachshund, bulldog, basset hounds, corgis, and shih tzus are genetically programed to undergo disc degeneration starting at an early age. Generally, these breeds are affected in middle age (4-8 years) but it is not uncommon for 2- to 3-year-old dogs to have disc problems.
Episodes in the chondrodystrophic breeds tend to be an acute, explosive rupture of the disc leading to neck or back pain, depending on which disc is involved. Severity of the injury to the spinal cord and location of the affected disc dictates the type of nerve dysfunction seen. In dog breeds that are not chondrodystrophic, such as German shepherds, Labrador retrievers and Dobermans, the IVDD involves a gradual herniation of the disc material in older dogs (8-10 years of age). The most common area of the spine that is affected is near the last rib. Other areas that are less commonly affected include the middle of the neck and the spine near the pelvis.
A grading system for severity has been developed to help in making diagnostic and treatment decisions. Grades run from painful with no neurological deficits to complete paralysis and loss of bowel and urine control. Diagnosis is based on the history, physical examination and neurological examination, along with some combination of imaging techniques like X-rays, myelograms, CT scans or MRI. The thoroughness of evaluation for diagnosis depends on a number of factors including the severity and treatment decisions like surgery.
Treatment depends on severity and can range from conservative treatment that includes confinement, anti-inflammatory drugs and pain medications as needed, manual therapies, acupuncture and therapeutic laser to emergency surgery to remove the problem disc material. Some studies are showing that electroacupuncture alone or in combination with surgery has been more effective than surgery alone in severely affected dogs. Electroacupuncture in conjunction with corticosteroids appears to improve the speed of recovery. Therapeutic laser can improve nerve regeneration and tissue healing along with benefiting pain management. Herbs and nutritional supplements that support healing and the adrenal glands can be an important part of the recovery process. Rehabilitation therapies can also facilitate recovery.
IVDD in the dog can be a challenging and catastrophic problem to address. Early supportive care is important. If you have questions about IVDD, contact your veterinarian for additional discussion.
Ron Carsten, DVM, PhD, CVA, CCRT of Glenwood Springs was one of the first veterinarians in Colorado to use the integrative approach and has been a pioneer in the therapeutic use of food concentrates to manage clinical problems. In addition to his doctor of veterinary medicine, he holds a Ph.D. in cell and molecular biology and is a certified veterinary acupuncturist and certified canine rehabilitation therapist.
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