Thursday, May 26, 2016

IVDD. Dr Kelcourses' Advice.



Matthew Kelcourse, DVM commented ...

Hello Sara.

I have managed hundreds of spinal patients in my years - from conservative home therapy to surgery; so I am copy pasting my client education handout I provide to my clients when the earliest signs of IVDD are evident. (I don't know well it may copy/paste but I could not see a way to attach the handout to this post.

Dr K
Intervertebral Disc Disease (IVDD)

What is IVDD?

IVDD is a degenerative condition that affects the cartilage discs that act as shock absorbers between each of the boney vertebrae of the spine. Degenerative means that over time, the daily stresses of normal activities take their toll on the cartilage discs, causing them to become more resistant and less resilient to the mechanical forces endured while running, playing and jumping. The condition is commonly referred to as a bulging disc, a slipped disc, a herniated disc, or a ruptured disc.

Who is Affected by this Condition?

Chondrodystrophic breeds such as the Dachshund, Shi Tzu, Lhasa Apso, Miniature Poodle and other small breeds (including mixed and designer breeds) that are known for having short legs in comparison to the length of their spine make up the majority of patients affected by this condition.





Why Does This Condition Affect Some Breeds More Than Others?

The shorter legs of chondrodystrophic breeds do not have the ability to absorb as much of the high impact energy of running and jumping as the larger, longer legs of some other breeds and this excessive impact energy is passed along to the spine and intervertebral discs. This excessive energy absorption the spine needs to deal with adds up; and the more they jump, the faster it adds up and the sooner the symptoms of IVDD begins to affect the patient.

The act of a dog jumping down from a height results in two very different but damaging actions:
The high impact energy we discussed a moment ago is focused solely on the front legs when landing (instead of sharing the load with all four legs) and this energy is passed along to the spine and intervertebral discs.
Upon landing on the front legs, a dog will arch its back while bringing the back legs down to the floor and this arching of the back will focus a lot of the impact energy in the middle of the arched back and neck.
Simply said; the more often a dog jumps off the furniture or out of a car, the faster the spinal discs will degenerate and the sooner symptoms will begin to become obvious.

What are the Symptoms of IVDD?

The symptoms may vary for each patient, but the symptom first noticed by most guardians is pain and this pain may actually seem to manifest in many different ways:
Poor appetite and/or decreased water consumption: back pain may cause nausea but may also be preventing a pet from comfortably bending over or leaning down to the food or water dish
Not defecating on a normal schedule: the back may be too painful to position properly for defecation; so a patient may hold it in or sometime just release it while laying in their bed
Difficulty finding a comfortable position for sitting or laying down
Arching their back or neck as if their stomach is painful
Noticeable decrease in activity levels (including playing, jumping, greeting at the door, etc…)
Crying out in pain when picked up
Excessive salivation (drooling)
Vomiting
Panting
Whining
More involved symptoms in order of increasing urgency of medical attention are:
Drunken Sailor Syndrome: the pet is walking around on wobbly limbs as if they got into the liquor cabinet. This is actually an indication that a bulging disc is pressing on the spinal cord and causing an interruption of communication between the brain and the limbs; causing a kind of balance disorder known as proprioception deficits.
Dragging the limbs occurs when the interruption of communication between the brain and the limbs is severe enough to cause partial or complete paralysis of one or more limbs.
Drooping Tail Syndrome: is when a bulging disc has traumatized the spinal cord to the point where all, or nearly all, communication between the brain and limbs has been interrupted and the pet is now dragging their limbs while also being unable to use a limp tail.






What are the Treatment Options for IVDD?

There are three stages of treatment options for intervertebral disc disease and the recommended treatment is determined by the the severity of the symptoms.

I. Conservative Outpatient Therapy: is ideal for those patients who present with early and minimal symptoms such as back pain and only mild proprioception deficits. Treatment begins with the use of NSAIDs (non-steroidal anti-inflammatory drugs); pain-relief medications; and sometimes a muscle relaxant while resting quietly at home.

II. Conservative Inpatient Therapy: is a 42 to 48 hour inpatient therapy necessary for patients who have moderate to severe Drunken Sailor Syndrome and treatment involves receiving an intravenous anti-inflammatory steroid medication administered through an IV catheter (called a constant rate infusion; or CRI); pain medications; muscle relaxants; and other medications that may be required.


III. Surgical Decompression Procedure: is reserved for patients with severe Drunken Sailor Syndrome and those having difficulty moving their limbs. Spinal surgery will always come with intrinsic risks and is therefor performed only when a surgeon believes the patient will not be able to walk and play normally again without surgical intervention. This treatment may require a few days in the hospital and entails the Inpatient Therapy described above (II.); performance of a myelogram (or other special imaging technique) to locate the exact position of the bulging/ruptured disc; and surgical decompression of the spinal cord at the identified location by performing a laminectomy to remove some of the bone covering the spinal cord to release pressure from the spinal cord.

What to do if You Suspect Your Pet has IVDD

The best thing to do is to contact your veterinarian as soon as possible to set up a physical examination. If the symptoms are more serious – such as Drunken Sailor Syndrome or worse – contact your veterinarian or your nearest veterinary emergency hospital immediately. This is important because the sooner treatment is initiated, the better the prognosis for a patient suffering with IVDD.

How do You Minimize the Risk of Your Pet Developing IVDD?

1. Keep your pet in a healthy body condition; feeding a proper diet and getting plenty of low-impact exercise – obesity is one of the major contributing factors increasing the risk of IVDD.
2. Prevent, or at least minimize, jumping off furniture, out of cars, etc…. You can help by placing pet steps at the edge of furniture: even if your pet doesn’t use the steps, it’s important they are there just in case they decide to use them some day.
3. Use a daily joint supplement like Glycoflex Chews that help maximize joint health; including the joints in the spine.



The original Pawbly question can be found here.

Dr. Kelcourses bio from Pawbly; Graduated from Tufts University School of Veterinary Medicine in 1992. Special interests in orthopedic and spinal medicine and surgery.

If you have a pet question about IVDD, or any other pet related question please come visit us at Pawbly.com. It is free to use and open to anyone who loves animals.

Related IVDD blogs can be found here;


3 comments:

  1. Thanks for the share, love reading your blog.

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  2. Thanks for the post - we are in year 2 of our Beagle with IVDD - another flare up the other day and back on the heavy medications now...a little bit tougher with a toddler in the house but managing

    ReplyDelete