Intervertebral Disc Disease

Overview

Intervertebral disc disease (IVDD) involves the protrusion of disc material into the spinal cord. The disc material presses on delicate nerves and causes neurological defects and pain. It can occur anywhere along the neck and back. The vast majority of cases involve the mid-back area (85%), whereas the rest involve the neck. It is most common in dachshunds, beagles, Corgis, shih tzus, poodles, Pekingese, and cocker spaniels. It is reported that 1 in 4 dachshunds will develop IVDD. This is synonymous to humans having a "slipped disc".

Causes

The disc material degenerates over time and becomes unstable. It is quite common for the disc to protrude after a patient has recently been active or jumped off the bed or couch. Overweight pet carry their weight in their back and are predisposed to develop IVDD.

Symptoms

All patient are extremely painful, especially with neck, or cervical, IVDD. Patients with cervical IVDD will be reluctant to move their head and may have a very stiff gait. Knuckling of all four limbs or paresis from the neck down can be seen.   Pets with mid-back IVDD show pain when touched or petted on the back. They will walk with a hunched posture or may walk ataxic or "drunk". In severe cases, they may be completely paralyzed in the rear legs.

Treatment

Treatment is going to vary depending on clinical signs. If the patient is only exhibiting pain and has very mild neurological defects, then medical management may be attempted. This involves STRICT REST with steroids and in some cases, muscle relaxers. The strict rest is extremely imperative as steroid therapy will lessen the patient’s pain and they will attempt to resume normal activity before the area has healed. The patient must be boarded at a veterinary hospital or placed in a crate when the owner can not monitor. The patient is not allowed on walks and should be put on a leash to urinate and defecate outside. They can not climb stairs or jump up and down on a couch or bed. This needs to be done for a minimum of 4 weeks to allow the disc material to heal.If the patient has more serious neurological defects (paralysis, no pain sensation in toes) or worsens even on appropriate medical treatment, surgery to remove the degenerated disc material is necessary. In most cases, this is done on an emergency basis-the longer the spinal cord is compressed by the disc, the poorer the prognosis for recovery of sensation. If the surgery is performed within 48 hours of the trauma, the prognosis is good. These patients will also need to be monitored for urination and bowel movements and may need to be catheterized or receive enemas during recovery.Acupuncture has been reported to help patients with chronic pain or when surgery is not possible. Laser ablation of the disc material has also been reported to prevent IVDD and may be recommended for patients with recurrent cases. Once the disc material is surgically removed or ablated, it is impossible to get IVDD in that area again, but disc material in adjacent vertebra can protrude. Avoiding weight gain and strenuous activity in predisposed breeds may be helpful in preventing IVDD.