IVDD In Dogs: Non-Surgical Alternatives

Dogs are good at hiding pain … and back pain can be especially difficult to identify because it can cause a variety of symptoms. IVDD in dogs is a type of back problem that can happen as your dog ages. So it’s important to recognize the signs. Early diagnosis will make it more likely you can use alternative treatments for your dog and avoid having to make a difficult decision about conventional surgery.

What is IVDD?

IVDD stands for intervertebral disc disease. In the Merck Veterinary Manual, William Thomas DVM MS DACVIM explains IVDD as “a degenerative disease of the spinal column that results in compression of the spinal cord and/or spinal nerves.” (1). This degeneration leads to herniated (or “slipped”) discs in either the neck or the middle of the back.

In the neck herniated discs cause pain, stiffness and muscle spasms … and they can lead to partial or total leg paralysis. Herniated discs in the middle of the back can cause back pain and spinal curvature. Your dog may suffer neurologic signs like loss of motor control in the hind legs, paralysis and incontinence. 

Breeds At Risk Of IVDD

IVDD is up to 5 times more common in smaller breeds (especially those with longer backs and short legs) like Dachshunds, Beagles, Welsh Corgis, Shih Tzus, Lhasa Apsos, and Pekingese (2). Their spinal discs can start degenerating when they’re only a few months old, leading to herniated discs as young as 1-2 years old. In larger breeds, degeneration usually starts after they’re about 5 years old.

Besides being a short-legged, long-backed breed, another important risk factor for IVDD is obesity. Excess weight puts more pressure on your dog’s spine.

The Two Types Of IVDD

In IVDD the disc between two vertebrae deteriorates and presses on the spinal cord. There are two types of intervertebral disc disease. Dr Kari Foss DVM DACVIM is a veterinary neurologist at the University of Illinois Veterinary Teaching Hospital. She explains that the disc is like a jelly donut. It has a fibrous outer layer, filled with gel that acts as a shock absorber.

In Type I, the gel extrudes (gets squeezed out) through the outer layer and presses on the spinal cord. Over time it hardens and doesn’t have the same cushioning effect. Dogs with long backs and short legs have more risk for Type I IVDD.  In Type II, the outer layer starts to break down, causing the disc to bulge out and compress the spinal cord. Type II is more common in larger breeds of dogs.

Dr Foss adds, “…both types of IVDD result in the compression of the spinal cord and can occur in any dog.”

Signs Of Back Pain In Dogs

Some signs of back pain in dogs can be obvious, but some (like limping, diarrhea or lack of appetite) can also be signs of other problems. Other back pain symptoms include …

• Reduced activity
• Weakness in the limbs
• Dragging one or more legs
• Hunched back
• Incontinence
• Difficulty moving head and neck
• Trembling
• Collapsing
• Anxiety

Your dog may have additional symptoms that help to determine if the IVDD is in his neck or his back … such as a tense belly, limp tail, or inability to stand.

How Vets Diagnose IVDD

Your vet will diagnose IVD with a physical exam that should include x-rays as well as other imaging such as myelography, computed tomography (CT), or magnetic resonance imaging (MRI). If your dog has any paralysis of the legs, your vet should also do a pinch test (usually on the toe or tail) to assess whether your dog feels pain. This is very important when it comes to surgery decisions (read why below). 

IVDD Treatments

Dogs with minimal to moderate signs who can still feel pain may be candidates for conservative treatment. These dogs may recover with a few weeks of rest. Conventional vets will prescribe medications like anti-inflammatories, steroids or pain medication but  your dog will have to be on crate rest for up to 6 weeks. Too much activity may cause the gel to extrude further and compress the spinal cord more.

IVDD Surgery

Despite the above conservative approach, symptoms will recur in 30% to 40% of dogs with IVDD. If that happens, your vet will likely suggest surgery. Also, if your dog has severe neurological symptoms, vets will recommend surgery to relieve pressure on the spinal cord.

But surgery is not an easy decision, because it has some risks. First, it must be performed promptly  –before your dog loses pain perception. In 2005, researchers at the University of Pennsylvania examined 46 cases of dogs who had surgery for thoracolumbar intervertebral disc disease. The study showed (3) …  

• Of the 46 dogs who had surgery, 19 dogs (41.3%) “recovered.” Recovery was defined as able to walk, but weak and wobbly in the rear legs (called ambulatory paraparesis), with urinary and fecal continence.
• All the dogs who’d “recovered” had loss of deep pain perception (DPP) for less than 24 hours before surgery. None of the dogs who’d lost DPP for longer than 24 hours before surgery recovered. (Assessing DPP isn’t easy. It’s tested by pinching at the base of the toenail to see if the dog cries out or turns his head in pain, so it can be subjective.)
• 21.7 percent of dogs who had surgery had complications. Several dogs were euthanized either during surgery due to other findings, or a few months later.

Natural Management Of IVDD

Fortunately, there are some therapies that can help manage your dog’s IVDD. Several alternative therapies have been quite widely researched for IVDD (4, 5)

Physical Therapy

A veterinary rehabilitation facility can provide exercises and other therapies to help maintain your dog’s mobility. (If you’ve opted for surgery, they can also help with post-surgical rehab).

Treatments may include:

• Hydrotherapy – swimming or underwater treadmill allows your dog to exercise and improve strength and mobility while supported by water to reduce impact. Don’t do hydrotherapy too soon after surgery because one study found it could increase the likelihood of infection and other complications if done too soon (6).
• Laser therapy – Researchers at Mississippi State. University found that surgical wounds healed faster and more cosmetically with laser treatment (7)
• PEMF (Pulsed Electromagnetic Field) therapy – A study at North Carolina State University found that PEMF reduced pain and helped other factors like proprioception in dogs after IVDD surgery (8)
• Balance, strengthening and stretching exercises
• Massage

Your rehab therapist should also teach you some massage movements as well as exercises to do with your dog at home.

Acupuncture

Acupuncture can help with inflammation and pain. Studies have shown promising results (9). Electro-acupuncture is a newer technique that can also help with IVDD, improving walking and neurologic deficits (10). Your vet rehab facility may offer these therapies. Otherwise find a veterinarian trained in acupuncture and Traditional Chinese Veterinary Medicine (TCVM). You can find one at ahvma.org.

Chiropractic

If you have a good animal chiropractor nearby (ask your vet if you’re not sure), regular chiropractic adjustments can help balance your dog’s body, ease discomfort and maintain mobility.

Food And Supplements

As always, feed a fresh, whole food raw diet if you can. This is the most nutritious diet to support your dog’s joint health and mobility. Whatever you feed, try to avoid kibble. The high levels of starch in kibble can cause or aggravate inflammation and degenerative disease.

Supplements that support joint health can be helpful in managing degenerative spine disease. Turmeric (or its active constituent curcumin) and omega-3 supplements, especially derived from green lipped mussels, can also reduce the pain and inflammation associated with IVDD (11, 12).

Caution: avoid turmeric or curcumin if you have a “hot” dog who’s always panting or looking for a cool place to lie. Turmeric is a warming spice and may not help him.

CBD Oil

CBD oil can help manage pain and inflammation. Many cannabinoids, including CBD oil, have anti-inflammatory effects. Research (13) shows that CBD oil can:

• Reduce chronic inflammation
• Lower pain
• Slow premature aging from oxidative stress

Mobility Assistance

A sturdy harness with a handle can make it easier to help your dog get around, go up and downstairs, get in the car (or onto your bed or sofa!). If your dog develops partial paralysis, consider a wheelchair so he can still enjoy walks and other activities.

Can You Prevent IVDD In Dogs?

As your dog ages, his spine and discs naturally degenerate. Be especially observant of any beginning mobility problems if you have a breed who’s prone to IVDD.

• Keep your dog active with exercise that’s within his physical capabilities. Keep him fit but don’t do so much that he injures or weakens himself. Physical therapies like those described above can be helpful in preventing IVDD. 
• If you have a short-legged, long backed breed who’s more susceptible to IVDD, you may need to limit activities like jumping from high places.
• Manage his weight. Obesity can make him more susceptible to any kind of joint disease, and extra weight will put extra pressure on his spine.
• Walk your dog using a harness to avoid putting pressure on his neck by walking on a collar.

IVDD is a difficult problem to deal with and surgery has limited success. But catching the disease early can help you use many alternative therapies to keep your dog moving. 

References

1. William B Thomas DVM, MS, DACVIM (Neurology), University of Tennessee. Disorders of the Spinal Column and Cord In Dogs. Merck Veterinary Manual October 2020.
2. William A. Priester. Canine intervertebral disc disease — Occurrence by age, breed, and sex among 8,117 cases. Theriogenology, Volume 6, Issues 2–3, 1976,
3. Laitinen, O.M., Puerto, D.A. Surgical Decompression in Dogs with Thoracolumbar Intervertebral Disc Disease and Loss of Deep Pain Perception: A Retrospective Study of 46 Cases. Acta Vet Scand46, 79 (2005).
4. Lauren R. Frank, Patrick F.P. Roynard. Veterinary Neurologic Rehabilitation: The Rationale for a Comprehensive Approach, Topics in Companion Animal Medicine, Volume 33, Issue 2, 2018.
5. Laurie Edge-Hughes, BScPT, MAnimSt(Animal Physio), CAFCI, CCRT. Conservative Management of Chondrodystrophic Dogs with Thoracolumbar Intervertebral Disc Disease (IVDD). CHAP Newsletter, December 2007
6. A Mojarradi et al. Safety of early postoperative hydrotherapy in dogs undergoing thoracolumbar hemilaminectomy, Journal of Small Animal Practice. Vol 62, issue 12, December 2021.
7. Jennifer L., Gazzola Krista M et al. Laser Therapy for Incision Healing in 9 Dogs. Frontiers in Veterinary Science.29 January 2019.
8. Zidan N, Fenn J et al. The Effect of Electromagnetic Fields on Post-Operative Pain and Locomotor Recovery in Dogs with Acute, Severe Thoracolumbar Intervertebral Disc Extrusion: A Randomized Placebo-Controlled, Prospective Clinical Trial. J Neurotrauma. 2018 Aug 1;35(15):1726-1736.
9. BW Koh, BVM, MS. Improving Neurological Outcome with Acupuncture and Rehabilitation. World Small Animal Veterinary Association Congress Proceedings, 2018
10. Joaquim JG, Luna SP, Brondani JT, Torelli SR, Rahal SC, de Paula Freitas F. Comparison of decompressive surgery, electroacupuncture, and decompressive surgery followed by electroacupuncture for the treatment of dogs with intervertebral disk disease with long-standing severe neurologic deficits. J Am Vet Med Assoc. 2010 Jun 1;236(11):1225-9.
11. Knott L et al. Regulation of osteoarthritis by omega-3 (n-3) polyunsaturated fatty acids in a naturally occurring model of disease. Osteoarthritis and Cartilage. 1 Sep 2011;19(9):1150-7.
12. Kohli K et al. Curcumin: A natural antiinflammatory agent. Indian Journal of Pharmacology. 2005;37(3):141-7.
13. Formukong EA, Evans AT, Evans FJ. Analgesic and antiinflammatory activity of constituents of Cannabis sativa L. Inflammation. 1988 Aug;12(4):361-71.