As I approached my first patient of the day, I felt really sorry for him and his human caregiver. A cute miniature Dachshund stood braced on the exam table with eyes as big as saucers. When I touched his back he screeched in pain! His muscles were so tense and the more he panicked, the worse the pain became. The little guy was suffering from intervertebral disc disease, also known as IVDD.
The best thing you can do for a dog with acute back pain caused by IVDD is to strictly limit his activity (rest). Dogs with mild back pain benefit from having a warm heating pad set on low and wrapped in a towel placed over the sore area for 5-10 minutes at a time. Dogs with pain so severe they can’t get comfortable should see a veterinarian as soon as possible for pain medication.
What Causes Intervertebral Disc Disease (IVDD) in Dogs?
The cause of IVDD in dogs is degeneration and breakdown of the tissue that forms the cushioning disc between vertebrae in the spine. Disc material herniates out of the normal position and puts pressure on nerves, causing pain and sometimes paralysis.
Intervertebral discs, or discs for short, are composed of a couple of different kinds of tissue. A simplified explanation compares discs to a jelly donut. A healthy disc has a fibrous outer portion and a gel-like inner portion. In unhealthy discs, the gel portion starts to dry out. (Bach et al., 2007). The disc has little blood supply and it doesn’t undergo much repair once it starts to degenerate.
Dried Out Discs Break Down
With the dehydration of the center of the disc, the outer part becomes weaker and more prone to injury. Normal activity like jumping off a chair or walking across the room can cause the outer part of the disc to tear then the gel center squeezes out. That’s when the big problems start.
The leaking disc material puts pressure on the spinal cord and the nerves that come off of it to innervate the rest of the body. Depending on how much nerve compression occurs, a dog may experience mild to severe pain or complete paralysis of one or more limbs.
IVDD lesions occur in the neck or the thoracolumbar spine (from the last few ribs to the low back area). Lesions in the neck area may affect the front legs or both the front and rear legs. Lesions in the thoracolumbar spine affect the rear legs and the back half of the body.
Type 1 IVDD in Dogs
Although the causes of IVDD in dogs are not fully understood, we do know that some breeds inherit a tendency to have weak discs (Hansen Type I disc disease). Breeds with short, crooked legs and/or short faces (chondrodystrophic breeds) are the ones who get Hansen Type I IVDD.
The breed most associated with Hansen Type I disc disease is the Dachshund, but Basset Hounds, Corgis and Shih-Tzus. These dogs experience a breakdown of disc material because they’re bred to have abnormal cartilage. The genes that give them short legs and faces also weaken the discs in their spines.
Type 2 IVDD in Dogs
Non-chondrodystrophic dogs experience a different version of disc disease, called Hansen Type II disc disease. “Wear and tear” causes disc breakdown in Hansen Type II disease.
Dogs with Hansen Type II disease experience IVDD at an older age and at different locations in the spine. Some of the breeds affected by Type II IVDD include Beagles, German Shepherds, and Dobermans.
No matter the type of IVDD, symptoms in dogs are the same.
IVDD in Dogs: Symptoms
When it comes to IVDD in dogs, symptoms can range from a vague decrease in activity to complete paralysis and even death in extreme (and uncommon) cases. In my experience, most people notice that the dog cries out at random times, can’t get comfortable when lying down and can’t jump without pain. I’ve even had people tell me their dog just seems “really scared!”
- Sudden onset of discomfort is common
- Crying out in pain at random times
- Crying when touched or picked up
- Tail held down
- Head held down
- Reluctant to jump or climb stairs
- Not moving around as much as usual
- Pain/limping on a front leg (neck IVDD)
- Weakness in limbs–wobbly gait, dragging toes
- Inability to move one or more limbs (advanced cases)
- Not eating
- Avoiding urinating or defecating due to pain
- Grouchy attitude
In more serious cases, you might see uncoordinated movements such as wobbly gait, dragging the toes or stumbling. Occasionally, a dog will present with complete paralysis of the rear legs. Less commonly the front legs or all four legs are paralyzed.
Then there are cases that start with pain and progress to wobbly gait and paralysis over a period of hours or days. The most severe form of the disease–ascending myelomalacia–involves bleeding in the spinal column that can lead to respiratory paralysis and death. Thankfully, this last form is rare and is not represented in the table below.
Veterinary Grading Scale for IVDD Stages
Veterinarians have a classification system for different sets of symptoms. It starts at the mildest disease, Grade 1, and ends with the most severe disease at Grade 5.
- Grade 1: Pain only, walking normally, no neurological abnormalities.
- Grade 2: Pain plus ataxia, conscious proprioceptive deficits, paresis (wobbly, weak gait; able to move limbs but not very well), no incontinence, deep pain reflex present (able to feel hard toe pinch on affected limbs).
- Grade 3: Pain plus paraplegia (paralysis of limbs, most often rear limbs, but could be all four in cervical IVDD), no urine incontinence, deep pain reflex present.
- Grade 4: Pain plus paraplegia, urinary retention and overflow (dribbling urine), deep pain reflex present.
- Grade 5: Pain plus paraplegia, urinary retention and overflow, loss of deep pain perception (doesn’t feel a hard toe pinch)
The vast majority of the cases I’ve seen over the last couple of decades present as Grade 1. If you’ve ever had a backache, you can sympathize with the pain your pet is feeling. It’s hard to find a comfortable position or to complete your normal activities. Dogs with IVDD become anxious probably because they’re confused or frightened by the pain.
Diagnosing IVDD in Dogs
Making a 100% accurate diagnosis of IVDD requires advanced imaging techniques such as MRI or myelogram. However, we can often get a pretty good idea of the diagnosis based on history, symptoms, and plain radiographs (x-rays). Plain radiographs are usually the first step in making a diagnosis at your regular vet’s clinic.
Dogs in severe pain often need pain medication before they can be positioned comfortably for x-rays. Based on the findings during the physical exam, the vet clinic staff will take radiographs of the neck or lower back.
What they’re looking for on the x-ray images are irregularities in the spaces between the vertebrae that indicates the disc material has been “squeezed” out of the normal position. Sometimes there are calcifications at the edges of the vertebrae that indicate chronic instability. All these signs make your vet suspicious of IVDD, but they don’t prove the diagnosis beyond a shadow of a doubt.
With plain radiographs, your vet is looking for other causes of back pain as much as she’s looking for signs of IVDD. Bones that look moth-eaten or swollen sometimes show up on spinal radiographs with more serious diseases.
Without advanced imaging, there’s always a chance that a less common disease process such as tumor, infection or embolism is causing the symptoms. An embolism happens when a fragment of cartilage blocks the blood supply to the spinal cord. All of these diseases can cause very similar symptoms to IVDD.
The decision on whether to pursue advanced imaging depends on the severity of the symptoms. Dogs with pain only often don’t undergo advanced imaging. Advanced imaging is usually recommended for dogs with wobbly gait or paralysis. Most, if not ALL, dogs preparing for surgery will have advanced imaging.
IVDD Treatment Without Surgery
Dogs experiencing mild pain symptoms can recover with activity restriction and complete rest for a week or two. Rest and home remedies are appropriate for a dog who is experiencing moderate discomfort from overexertion. A couple days of rest gives the body a chance to deal with the minor disc abnormalities and get back to normal.
Caring for a Dog with Mild to Moderate IVDD
- Massage: Gently massage of the muscles on either side of the spine. Use the heel of your hands or flats of your fingertips to massage in circles up and down the back. Stop if your pet protests, but you can do this several times if she likes it. Massage helps decrease muscle spasms.
- Heat or Cooling: Use a heating pad set on low, wrapped in a towel for no more than 5 minutes at a time to prevent burns. If heat doesn’t go over well, try a cold compress by using a bag of frozen peas wrapped in a towel. Apply this to the painful area for 10 minutes at a time, several times a day.
- Strict Rest: Avoid exercise walks for about a week. Try your best to prevent running, jumping and going up and down stairs. Don’t play tug games and don’t let other dogs engage the one with a sore back in vigorous play.
- Use a Harness Instead of a Collar: Especially if your dog has pain in his neck, but all dogs with IVDD benefit from the use of a harness instead of a neck collar for walking outdoors.
Medications for IVDD
Veterinarians can prescribe pain medication for dogs who are crying out in pain, not eating or have a major disruption of daily activities. Non-steroidal anti-inflammatory drugs (NSAIDs), muscle relaxers, general pain medications, and steroids act quickly to increase your dog’s comfort.
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These drugs have varying degrees of side-effects and are not appropriate for use in all dogs. Long-term use of NSAIDs and steroids is not desirable due to side-effects.
Slipped Disc Recovery Time
Dogs with Grade 1 IVDD usually feel a lot better after 7 days of rest with pain meds/anti-inflammatories.
Dogs with higher grades of IVDD take longer to recover. Most of the dogs I’ve seen with pain and only mild neurological symptoms take a period of several weeks to months to recover. And the sad truth is that some dogs never recover, but you won’t know that until you give them at least a few months to see what happens.
The most severely affected dogs have a poorer prognosis, but it’s far from hopeless! One study found that 58% of paralyzed dogs (IVDD Grade 5) who had undergone surgery recovered within 3 months after the surgery (Jeffery, Barker, Hu, Alcott, Kraus, Scanlin, … & Levine 2016).
Recurrence of symptoms is common but does not occur in every case.
Natural and Holistic Treatment for IVDD Dogs
Alternative therapies for IVDD pain include acupuncture (Hayashi et al., 2014), cold laser (Draper et al., 2012), homeopathy, chiropractic manipulation, physical therapy, massage and herbal therapy.
Alternative therapies may be used alone or along with conventional meds. Some may even be used along with surgery. It’s important to get help from a veterinarian experienced with alternative therapies to have the best outcome. You can find one near you by looking at the following websites:
Chi Institute of Traditional Chinese Veterinary Medicine (acupuncture, etc.)
Curacore Integrative Medicine and Education Center (acupuncture, etc.)
Pitcairn Institute of Veterinary Homeopathy (veterinary homeopathy)
In any case, rest is still recommended as an important part of recovery. Depending on how severe your dog’s situation is, you could spend $200 to $1000 and up on alternative therapies.
Transporting large dogs who are in pain may be difficult when repeated treatments are needed. But alternative therapies are a lot less invasive, less risky, and less expensive than surgery.
IVDD Spinal Surgery and Cost
Surgery is reserved for dogs who have a wobbly gait, paralysis, or intractable pain. IVDD surgery and recovery care are fairly expensive (in the range of $3500- $7000 and up) and time-consuming. The rate of recovery for dogs undergoing surgery depends on the severity of their disease.
According to William Thomas, a veterinary neurologist at the University of Tennessee:
“In general, for acute TL [thoracolumbar as opposed to neck] discs, prognosis depends mostly on the severity of the neurologic deficits:
- Back pain only: 85% resolve with cage rest; 95%+ resolve with surgery
- Paraparesis (still walking): 65% resolve with cage rest; 95%+ resolve with surgery
- Paraplegia with intact deep pain: 40% resolve with cage rest: 95% resolve with surgery
- Paraplegia with loss of deep pain: 5% resolve with cage rest: 50% resolve with surgery.”
IVDD surgery involves removing tissue around the ruptured disc to decrease pressure on the spinal cord and adjacent nerves. It’s not an easy or simple surgery. Complete recovery can take up to 6 months, although most dogs show improvement sooner.
Post-surgical IVDD dogs require nursing care during the recovery period to keep them clean and comfortable. Some dogs have difficulty urinating and defecating, especially if they can’t stand.
The sad truth about surgical intervention for IVDD is that your dog can still experience problems at other disc spaces in the future. Surgeons can do preventive procedures on adjacent discs, but it’s not practical to do this at all the disc spaces at risk for herniating. Dogs who have abnormal tissue in one disc are at higher risk for experiencing similar problems in other discs.
Supplements for IVDD
There are no proven methods or therapies to prevent IVDD. People have told me they try to prevent their dogs from jumping so they don’t “slip” a disc. This is of little value since chondrodystrophic dogs could “slip a disc” just walking across the room. Their discs are abnormal enough that even low-level activity can cause the tissue to break down.
Glucosamine and Chondroitin
Nutritional supplements containing different forms of glucosamine and chondroitin are recommended, but not proven for prevention of disc degeneration. The idea is to keep the disc from breaking down by increasing the supply of structural materials.
While glucosamine/chondroitin does seem to increase healing in discs, there is no clinical research showing that this works to prevent IVDD. I’d put glucosamine/chondroitin supplementation in the category of “probably won’t hurt and may help.” The product I usually recommend is Vetri Disc.
How to Help Prevent IVDD in Dogs
Keeping your dog lean can help in a couple of ways. First, there is less weight putting stress on the spine and second, obesity increases general body inflammation. Increased inflammation may be associated with weaker tissues or decreased ability to recover from injuries.
Regular, controlled exercise appropriate to the dog’s age, conformation and fitness level is recommended. Exercise builds stronger muscles to help support the spine, may contribute to lower inflammation in the body and helps prevent obesity.
Regular Chiropractic Care
Regular chiropractic adjustments are recommended by some practitioners for prevention as well as treatment of IVDD. In dogs with chronic, life-disrupting pain, surgery may also be considered to remove the offending disc material.
- Intervertebral disc disease (IVDD) is a common cause of pain and other symptoms in dogs.
- The cause of IVDD in dogs is degeneration and breakdown of the tissue that forms the cushioning disc between vertebrae. The disc material “squeezes” out of the normal position and puts pressure on nerves to cause pain.
- Symptoms of IVDD range from vague pain to paralysis and death.
- Treatment depends on the severity of disease and may include rest, anti-inflammatory and pain medication, acupuncture and other alternative therapy, or surgery.
- There are no treatments known to reliably prevent IVDD in dogs. Glucosamine/chondroitin supplements may help but are not a sure thing. Recommendations include: maintaining a normal weight, high-quality nutrition, regular supplementation with natural anti-inflammatories and exercise.
Bach, F. C., Willems, N., Penning, L. C., Ito, K., Meij, B. P., & Tryfonidou, M. A. (2014). Potential regenerative treatment strategies for intervertebral disc degeneration in dogs. BMC veterinary research, 10(1).
Draper, W. E., Schubert, T. A., Clemmons, R. M., & Miles, S. A. (2012). Low‐level laser therapy reduces time to ambulation in dogs after hemilaminectomy: a preliminary study. Journal of Small Animal Practice, 53(8), 465–469.
Jeffery, N. D., Barker, A. K., Hu, H. Z., Alcott, C. J., Kraus, K. H., Scanlin, E. M., … & Levine, J. M. (2016). Factors associated with recovery from paraplegia in dogs with loss of pain perception in the pelvic limbs following intervertebral disk herniation. Journal of the American Veterinary Medical Association, 248(4), 386-394.
Hayashi, A. M., Matera, J. M., & de Campos Fonseca Pinto, A. C. B. (2007). Evaluation of electroacupuncture treatment for thoracolumbar intervertebral disk disease in dogs. Journal of the American Veterinary Medical Association, 231(6), 913–918.
Melrose, J., Roberts, S., Smith, S., Menage, J., & Ghosh, P. (2002). Increased nerve and blood vessel ingrowth associated with proteoglycan depletion in an ovine annular lesion model of experimental disc degeneration. Spine, 27(12), 1278–1285.
Last update on 2021-04-13 / Affiliate links / Images from Amazon Product Advertising API