IVDD dogs who can walk

IVDD dogs who can walk

IVDD dogs who can walk

Dogs with IVDD can be mildly or severely affected. Chances of getting better are highest for those dogs who are able to walk at the time of diagnosis so, if your dog can walk, then this is promising.

Being able to walk puts your dog into the yellow (mildly-affected) part of the clinical grading scaleThis is quite a diverse group. Some dogs have a painful back but can walk fairly normally. Others find it difficult to walk but are able to do so without any support from a sling. They might stagger like a drunken sailor,  place paws on the floor upside-down now and again, or move with paws crossed over.

Treatment options for dogs who can walk

Non-surgical treatment: For dogs who are able to walk, good-quality non-surgical treatment is usually the most sensible option to start with. This is true even if the dog is quite wobbly when walking. These dogs have a very good chance of doing well without an operation Davies & Sharp 1983, Levine et al 2007, Mann et al 2007.  If the dog’s condition deteriorates, if he fails to improve over several weeks, or perhaps if the problem keeps recurring, then referral for surgery may however become the best option.

Non-surgical treatment mostly involves home care, though treatment may be started on an in-patient basis (see below). The aim of non-surgical treatment is to keep the dog as comfortable, strong and coordinated as possible while preventing any rushing about (running and jumping may be risky). Your dog will need a recovery area (typically a crate or pen) and a routine involving gradual increase of controlled exercise as supervised by your vet or physiotherapist. For further information about home care for these dogs, click here

Recurrence of IVDD clinical signs is quite common after initially recovery, so you may find yourself back at the clinic months or even years later. 

Spinal operation plus aftercare: Surgery is available for dogs who can walk and usually has a very good eventual outcome. Do however bear in mind that many of these dogs have a reasonable chance of recovering without an operation. And not every spinal operation is a success: some mildly-affected dogs ( grades 1 and 2) have been reported to be unable to walk for a couple of weeks after spinal surgery (i.e. they get worse for a while) and, unfortunately, a tiny percentage of dogs deteriorate badly after surgery Aikawa et al 2012.

If your dog can walk and you’re considering an operation, then discuss these issues with your surgeon who will help you make an informed decision. Spinal surgery should reduce the risk of the IVDD signs coming back, though the problem does still recur in many dogs.

Is treatment an emergency?

If your dog has IVDD but is able to walk, then he is unlikely to need an operation on an emergency basis. However, he should be seen as soon as possible by your vet for assessment and prescription of painkillers. Ask for the next available appointment.

Do ask to speak to a vet straight away if your dog seems to be getting worse and worse. A few cases deteriorate and may need more urgent help. 

Important: If your dog seems to be getting worse and worse, then ask speak to your vet immediately. There’s a possibility that urgent referral may become necessary. 

 

Above: Sybil the dachshund was able to walk but was shaking with pain. IVDD-affected dogs are painful and should see the vet asap for painkillers and assessment. Video courtesy of M. Lucas.

Is it worth having my dog admitted to the first-opinion clinic?

Some of these dogs may do better if started off with in-patient care, whereas others do well with home care from the start. In-patient care involves painkillers (intravenous if needed), regular monitoring and, in some cases, intravenous fluids and oxygen to benefit the spinal cord. With your dog safe in a hospital kennel, you have a chance to set up a recovery area (usually a large cage or pen) ready for when your dog comes home. Your dog will need to be kept comfortable and given plenty of TLC from the start, so only have him admitted for in-patient care if the clinic has good round-the-clock staff and resources.

Watch out for deteriorating dogs: A few dogs start with mild signs which then get worse as the spinal disc continues to herniate. The problem may get worse gradually or suddenly. Therefore it’s important to keep an eye on your dog and to be prepared for a change of treatment plan, especially in the early stages. Deterioration is generally nobody’s fault. It’s just that the disc has herniated over hours to days rather than all at once. As far as possible, prevent your dog from running and jumping during early recovery (see below for more guidance on this). We occasionally hear of dogs who start off mildly-affected, but then suddenly lose the ability to walk just after jumping off a sofa or chasing across a room. 

Above: Here is a video of a dachshund with grade 2 IVDD. Unfortunately, this little dog got much worse and became paralysed six hours after the video was taken. He eventually made a good recovery following spinal surgery and dedicated home care.

Home care for IVDD dogs who can walk

Set up a “safe space” for your dog

Set up a safe, comfortable recovery space for your dog. This could be a crate if you can get hold of one big enough for your dog. Or it could be an open-topped pen if your dog definitely won’t jump out. Many dachshunds do well in an indoor pen. For guidance on choosing a crate or pen, click here

“The goal of the crate or pen is to improve safety, but not to immobilise the dog.”

The aim of the recovery space is to prevent your dog from doing anything risky. Whenever your dog is outside their crate or pen, they should be on a lead or in your arms to prevent any risky dashing about. There’s a small risk that exuberant activity might make your dog suddenly worse. Over-activity also prevents any inflammation from settling down. Here’s a list of things to avoid:

  • Running
  • Jumping (e.g. on/off the sofa or bed, or in/out of the car)
  • Going up or down stairs or over steps (NB you may need to lift your dog over a shallow doorstep or raised threshold, especially if your dog is a short-legged breed)
  • Ball games
  • Being let outdoors unsupervised. Safety tip: keep your dog on the lead for toilet breaks, even in the garden.
  • Rough play/chasing with other dogs or children
  • Rushing over slick surfaces (e.g. tiled or laminate flooring) Safety tip: Place non-slip runners or carry your dog over any slick flooring.

Trotting is generally also not a good idea until later in recovery. A little gentle moving around is fine and, if your dog is able to stand and walk, then these are also safe activities. Your dog will tire easily, so the amount of walking he’s allowed to do will be restricted. Exercise-prescription varies from patient to patient, so your vet and/or physiotherapist will assess your dog and advise you.

It’s essential not to immobilise your dog completely. A little moving around will help him maintain his strength and ability to walk. Here’s a list of safe activities for your recovering dog:

  • Standing
  • Sitting
  • Getting up from rest, and moving around gently
  • Resting in any comfortable position 
  • A little gentle walking over non-slip flooring (e.g. carpet), short grass, concrete and other easy surfaces. He should walk for no longer than 5 minutes at a time to start with. Some dogs should walk for less than this (e.g. only 1-2 minutes at a time). Ask your vet to advise you. Keep your dog on a lead whenever outdoors. If he’s likely to run, then he may also need to be carried or on a lead indoors, except when confined in his recovery crate or pen.
  • Relaxing with you on the sofa, but only if he is very safely restrained. Safety tip: Have him wear a harness, and keep your fingers tucked around the harness straps to be sure that he won’t leap off the sofa unexpectedly. 
  • Chewing on toys (so long as he doesn’t shake them violently or throw and catch them)

For larger breeds, or for very calm dogs who definitely won’t try to jump onto the sofa, you might set up a room in your house to be a “recovery room” for your dog instead of using a crate or pen. If so, the room must have non-slip flooring, and all members of the family will need to take care whenever opening and closing the door so that the dog doesn’t slip out. If your vet has already advised “crate rest” or “room rest” for a certain number of weeks, then do your very best to follow their recommendation. Try the following links for more information:

Crate rest summary
Choosing a recovery crate
Where to put the recovery crate
Room rest summary
Choosing a recovery room

Keeping your dog comfortable during IVDD recovery

For good recovery, your dog needs to be as comfortable as possible in their recovery space. For a start, the crate or pen must be large enough for your dog to lie fully stretched out, and to sit, stand and turn around easily, and it should offer enough space for your dog to eat and drink as well as to lie down.

Above: Tiggy in her recovery pen. Toys and soft bedding are important, and take care to block off any draughts coming through the pen or crate. Some dachshunds like to hide in a fabric pouch.  If your dog has just had spinal surgery, check with your dog’s surgeon as to whether this is safe for your own dog. Photo courtesy of Michelle Randall.  

It is a good idea to introduce your dog’s recovery area gradually if at all possible. It is also important to set the recovery space up as a pleasant area before your dog even sees it.

Remember to include soft bedding, food, water and something good to chew on. You may find the following links useful:

Introducing your dog to the recovery crate or pen
Keeping your recovering dog calm and content
Crate rest: Bedding
Toys for recovering dogs

Outside the recovery crate or room

Whenever your dog is outside the recovery crate, pen or room, he should be on a lead or carried to prevent any dashing off.

You will of course need to take your dog outside for regular “toilet breaks” (to pee and poo). It’s important to follow your vet’s guidelines regarding how often to take your dog outdoors and on how long these outdoor sessions can be. In the absence of any advice, a good starting point is typically 3-5 toilet breaks per day, with each outdoor session being no longer than 5 minutes. Some IVDD dogs need to be given more frequent outdoor chances to pee, e.g. up to 7 toilet break sessions per day (each up to 5 mins long, and carry your dog part of the way if required).

You’ll need to take special care to keep your recovering dog safe whenever they are outside their crate, pen or recovery room. A harness, fixed-length lead, and non-slip floor matting are all very useful. The following links offer more information on keeping your dog safe through the recovery period:

Keeping your dog safe outside the recovery crate
Keeping your dog safe outside the recovery room
Harness for recovering dogs
Choosing a lead for recovery
Walking with your recovering dog

Above: It is essential to keep your recovering dog on the lead whenever outdoors.

The recovery routine

A regular routine is important during recovery. Recovering dogs cope better once they learn when to expect meal times, toilet breaks, and any quality time spent with the owner. It is also helpful to set aside quiet times during which your dog should expect no interaction from you (especially during the night, of course). For details on the daily routine during recovery, try the following links:

Crate rest daily routine
Room rest daily routine

Physiotherapy to help recovery

If your dog is not walking normally, then a tailored exercise programme is indicated from the start. This will help him recover by practising basic coordinated activities (e.g. getting up, standing, sitting and stepping). It’s essential that any exercises are performed safely and correctly. Ask your vet to refer your dog to a canine physiotherapist who is experienced in neurological cases. 

Problems during recovery

Miserable dogs Some dogs need extra time to accept their new routine during recovery. If your dog won’t settle down in the crate, pen or recovery room, then try this link for advice. Also bear in mind that certain types of medication may cause individual dogs to act out of character. If you suspect that this may be happening, then discuss it with your vet. You might also find the following links useful:

Keeping your dog calm and content
Staying positive during your dog’s recovery.

Dogs who don’t improve Treatment aims to get your dog more comfortable and eventually walking well. With successful non-surgical treatment, your dog should feel  more comfortable within the first week or so while still on painkillers. There are various types of painkiller available, each suiting some dogs better than others. If your dog is still very sore, then your vet may find it useful to change the medication and/or to add another painkiller to the regime.

Improvements in walking ability may happen gradually, typically over 1-2 months, and further improvement may continue beyond this. It may be possible to phase out the painkillers and increase exercise bit by bit after the first month or so. Your vet will recheck your dog and advise you. 

If your dog is getting worse at any stage (walking less comfortably than before, or appears more painful), then go and see your vet at the next available appointment. A change to the treatment plan could be necessary. 

If your dog is not getting worse but not really improving over time, then it’s worth discussing this with your vet. Unfortunately, not every dog manages to walk well again, though most do show some improvement. Failure to improve may mean that the non-surgical treatment programme needs adjusting, or may mean that an operation becomes the preferred option.

Other problems: If your dog goes off his food, starts vomiting, develops diarrhoea, or has difficulty peeing, then ask your vet for advice. 

References

Aikawa, T., Fujita, H., Kanazono, S., Shibata, M., & Yoshigae, Y. (2012). Long-term neurologic outcome of hemilaminectomy and disk fenestration for treatment of dogs with thoracolumbar intervertebral disk herniation: 831 cases (2000–2007). Journal of the American Veterinary Medical Association241(12), 1617-1626. Out of 279 grade 1-2 dogs, 96.8% had a good long term outcome, but there was a non-ambulatory period after surgery in many dogs, with only 86.7% dogs walking within 14 days, and 3% of “successful” cases not walking until 2 months post-op.

Levine, J. M., Levine, G. J., Johnson, S. I., Kerwin, S. C., Hettlich, B. F., & Fosgate, G. T. (2007). Evaluation of the success of medical management for presumptive thoracolumbar intervertebral disk herniation in dogs.Veterinary surgery36(5), 482-491. A retrospective questionnaire-based study looking at non-surgical management. Out of 122 grade 1 dogs, 84 recovered (69%). Out of 63 grade 2 dogs, 35 recovered (56%). Out of 23 grade 3 dogs, 13 recovered (57%). Out of 12 grade 4 dogs, 6 recovered (50%). Out of 3 grade 5 dogs, none recovered.

Mann, F. A., Wagner‐Mann, C. C., Dunphy, E. D., Ruben, D. S., Rochat, M. C., & Bartels, K. E. (2007). Recurrence rate of presumed thoracolumbar intervertebral disc disease in ambulatory dogs with spinal hyperpathia treated with anti‐inflammatory drugs: 78 cases (1997–2000).Journal of Veterinary Emergency and Critical Care17(1), 53-60.  A retrospective questionnaire-based study looking at non-surgical management. Out of 77 grade 1-2 dogs treated non-surgically, 100% recovered, but around 50% then experienced a recurrence of clinical signs. Most but not all recurrences happened within the first year (median 9 months after first episode). Recurrence rate was significantly higher in dogs treated with corticosteroids than in dogs treated with NSAIDs.

Davies, J. V., & Sharp, N. J. H. (1983). A comparison of conservative treatment and fenestration for thoracolumbar intervertebral disc disease in the dog. Journal of Small Animal Practice24(12), 721-729. Out of 8 grade 1 dogs managed non-surgically, 100% recovered. Out of 38 grade 2 dogs managed non-surgically, 84% recovered. Out of 10 grade 3 dogs managed non-surgically, 100% recovered. Out of 6 grade 4 dogs managed non-surgically, 3 recovered (50%). Out of 14 grade 5 dogs managed non-surgically, 1 recovered (7%). Mean average recovery times were 3 weeks (grade 1 dogs), 6 weeks (grade 2 dogs), 9 weeks (grade 3 dogs), 12 weeks (grade 4 dogs) and 4 weeks (grade 5 dog). Signs of IVDD recurred at a later date in some cases, though the severity of recurrence is not stated. Rate of recurrence was 28% (grade 1 dogs), 27% (grade 2 dogs), 66% (grade 3 dogs), 33% (grade 4 dogs).

Further references available on request.

Further information and getting in touch

For further information about caring for your dog during recovery, try clicking on the various links on this webpage. 

Further questions or comments about recovery are best posted on the Recovery Space Facebook page by clicking here. You are welcome to include photos or a video clip of your dog along with your question.

Even if you prefer to avoid Facebook, then you can still share your question by posting it in any comments box on this website (e.g. the one at the foot of this page).

To book a physiotherapy session with The Rehab Vet (Herts, UK) or for other one-to-one support, please contact me here.

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