What is Intervertebral Disc Disease (IVDD)?
Intervertebral discs act as cushions between the vertebrae in your dog’s spine, providing shock absorption, movement, and support. Each disc consists of an outer rim called the annulus fibrosus and a jelly-like center known as the nucleus pulposus.
IVDD is the degeneration of these discs, leading to a loss of their shock-absorbing function and causing herniation into the spinal canal. This condition can present in several forms:
Hansen Type I: Most common in small breed dogs over two years old, particularly chondrodystrophic breeds like Dachshunds and Bassets. This type involves the extrusion of the nucleus pulposus into the spinal canal. The hardened center can no longer absorb shock, making the disc intolerant to normal movements, leading to herniation and spinal cord compression.
Hansen Type II: Similar to human disc issues, this occurs in non-chondrodystrophic breeds. Instead of extrusion, the outer rim (annulus fibrosus) protrudes into the spinal canal.
Hansen Type III: Unlike the first two types, this occurs due to trauma or heavy exercise, causing the nucleus to explode and the annulus fibrosus to tear. This type does not result in ongoing spinal cord compression.
Signs and Symptoms of IVDD
The symptoms of IVDD vary based on the type and severity. Common signs include:
Pain localized to the neck or back
Yelping
Abnormal posture (arched back, head down)
Shivering
Unwillingness to move
Difficulty jumping or using stairs
In severe cases, dogs may experience difficulty walking (ataxia), ranging from poor limb control to paralysis. The most severe cases can affect bladder function and the ability to feel pain in the limbs.
Will My Dog Need Surgery?
The necessity of surgery depends on the severity of the symptoms. Dogs with milder symptoms may respond well to conservative treatments, while those with severe symptoms like paralysis may require surgical intervention. There are two categories of disc surgery:
Fenestration Surgery
Fenestration surgery is a preventive procedure designed to limit further extrusion of disc material in dogs with Intervertebral Disc Disease (IVDD). During this procedure, a small hole is made in the annulus fibrosus of the affected intervertebral discs, allowing the nucleus pulposus to be removed. This is typically performed on the thoracic vertebra (T11/12) to the lumbar vertebra (L3/L4) for thoracolumbar disc issues, or on all cervical intervertebral spaces for cervical disc disease.
It's important to note that this procedure does not remove disc material that has already extruded into the vertebral canal. As a result, dogs with severe spinal cord compression might experience a prolonged neurological recovery or have residual neurological symptoms. Fenestration surgery can be performed alone or in combination with decompressive surgery.
Decompressive Surgery
Decompressive surgery aims to remove extruded disc material from the vertebral canal by creating a window in the vertebral bodies, alleviating spinal cord compression. The specific type of decompressive surgery depends on the location of the lesion:
Ventral Slot: This procedure is performed on the cervical spine, with the surgical approach taken from the underside of the neck.
Hemilaminectomy: Targeting the thoracolumbar area of the spine, this surgery involves approaching the spine from the side above the affected disc space.
Dorsal Slot: Conducted on the lumbosacral area of the spine, this approach is from the top, providing a clear visual of the spine.
Post surgical physiotherapy
Surgery is usually recommended for dogs experiencing paralysis and loss of pain sensation. Post-surgery, physiotherapy is essential to regain mobility, muscle mass, and spinal stability. Key techniques include:
Electrotherapy: TENS and Laser therapy reduce pain and inflammation, while EMS improves nerve conduction and muscle tone.
Manual Therapy: Massage and joint mobilizations help with muscle pain, spasms, tissue flexibility, and joint range maintenance.
Therapeutic Exercise: Customized exercise programs enhance mobility, muscle strength, and core stability.
Home Management Education: Physiotherapists provide strategies and exercises to maintain progress at home between visits.
Conservative Management
The cornerstone of conservative management is movement restriction, often through cage rest, to prevent further disc damage. Physiotherapy is also crucial and focuses on:
Home management advice
Reducing spinal cord inflammation
Alleviating muscle pain and spasms
Maintaining tissue flexibility
Improving core strength for spinal stability
Retraining postural responses
Conclusion
IVDD can significantly impact your dog's quality of life, but with the right combination of management and care, many dogs can lead happy, active lives. Whether through conservative management or post-surgical rehabilitation, physiotherapy plays a vital role in your dog's recovery and overall well-being. If you suspect your dog has IVDD, consult your veterinarian for a comprehensive diagnosis and treatment plan.
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