Intervertebral Disk Disease (Canine)

Intervertebral disk disease, is the most common neurological syndrome in dogs. It occurs when a portion of the intervertebral disk herniates and compresses the spinal cord. However, not all disk herniations result in spinal cord injury. The condition is most common in the dachshund, Pekingese, and beagle. Clinical signs include lameness to paralysis and pain. Some dogs can be managed with rest and anti-inflammatory medications while others require surgery. Long-term care is required.

Scientific name: Intervertebral Disk Disease (IVD)

Diagnosis

Signalment
Intervertebral disk disease occurs most commonly in the dachshund, Pekingese, beagle, but can occur in any breed of dog. The average age varies from 4-10 years old. Male dogs may be more commonly affected than females.

Incidence/prevalence
Intervertebral disk disease accounts for approximately 2% of all diseases diagnosed in dogs. Of dogs with disease, the dachshund accounts for 25% of cases, followed by the Pekingese (8%), Welsh corgi (7%), beagle (5.4%), Lhasa apso (5%), and miniature poodle (3%).

Geographic distribution
There is no known geographic distribution for intervertebral disk disease.

Clinical signs (primary, most to least frequent, scientific term, synonyms)
Back or neck pain, ataxia (stumbling, staggering), difficulty walking, paralysis, loss of pain sensation to the affected limbs.

Clinical signs (secondary, most to least frequent, scientific term, synonyms)
Difficulty urinating, urinary tract infections, difficulty defecating.

Cause (scientific, common term)
Disk degeneration (aging of the disk), genetic predisposition.

Organ system affected (most to least affected)
Neurological, urinary.

Diagnostic tests
Radiographs, Myelography (spinal column contrast imaging), magnetic resonance imaging (MRI), spinal tap.

Differential Diagnosis
Neoplasia (cancer), trauma, vascular Event (blood clot).

Overview

Intervertebral disk disease is the most common cause of spinal cord injury in dogs. It is most common in chondrodystrophic (abnormal cartilage) breeds including the dachshund, Pekingese and beagle. Clinical signs are variable depending on the duration and location of the injury, volume of the herniation, dynamic considerations, (e.g., acute massive extrusions versus chronic progressive protrusions), and secondary injury events. Most common clinical signs consist of back or neck pain, difficulty walking, paralysis or loss of pain perception to the affected limbs. The disease is diagnosed via contrast imaging of the spinal cord and physical examination. This can be accomplished either through myelography, (series of radiographs taken after contrast material is injected to highlight the spinal cord) or via magnetic resonance imaging (MRI). Treatment options are either medical, surgical or both.

Treatment

Home Care
If clinical signs suggestive of intervertebral disk disease are noted, evaluation by a veterinarian is immediately required. Key elements of home nursing care include restricted physical activity, regular bathing combined with soft, dry bedding to prevent urine scald and pressure sores, monitoring of urination and defecation and physical therapy as directed by a veterinarian.

Professional Care
Medical treatment is reserved for animals with only mild clinical signs such as pain or mild difficulty walking. Medical treatment alone or following surgery may include corticosteroids, non-steroidal anti-inflammatories, muscle relaxants and other medications to reduce spinal cord swelling and pain. For severe cases, including moderate to severe difficulty walking, paralysis, loss of pain sensation to the limbs, require surgical decompression. Surgery is performed to remove the portion of the disk that has herniated and to relieve the pressure on the spinal cord. This is combined postoperatively with home nursing care.

Action
Evaluation by a veterinarian should be done as soon as possible. A decision can then be made if medical or surgical management is appropriate.

Outcome
Prognosis depends on the severity and duration of clinical signs. Dogs that retain pain perception respond favorably to decompressive surgery. Recovery rates of 80-96% have been reported in dogs that received decompression within 48 hours of onset. Once pain perception is lost, recovery rates drop to 50% and rapid surgical intervention becomes critical. Recurrence occurs approximately 20% of the time and is usually within 3 years of the initial incident. Some dogs with permanent rear limb paralysis can do well managed at home with special carts to permit movement. Dogs with intervertebral disk disease require lifelong care.

Recommended Treatment
See your veterinarian immediately for proper diagnosis and care if intervertebral disk disease is suspected.

References/Additional Readings

Toombs, JP, Waters DJ. Intervertebral disc disease. In: Slatter. Textbook of Small Animal Surgery, 3rd edition. Philadelphia: W.B. Saunders, 2002; 1193-1209.

Coates, JR. Intervertebral Disk Disease. Veterinary Clinics of North America. 2000; 30: 77-82.

Mayhew, PD, et al. Risk Factors for recurrence of clinical signs associated with thoracolumbar intervertebral disk herniation in dogs: 229 cases (1994-2000). JAVMA. 2004; 225; 1231-1236

Author

Karen L. Cherrone, DVM

DACVS

Editor

Steven Hansen, DVM, MS, MBA

DABVT, DABT