IVDD non-surgical treatment

If your dog has IVDD, the main treatment options are surgical and non-surgical. You might be starting non-surgical treatment if:

• • your dog has mild signs of IVDD and is able to walk
  • your dog has more severe signs, but an operation isn’t feasible (e.g. due to cost or availability, or perhaps the dog can’t have an anaesthetic for some reason)
  • you’re considering an operation, but want to try without it first
  • your dog is recovering from spinal surgery. Following an operation, most dogs take a couple of weeks (or sometimes longer) to learn to walk again^1,2,3,4, and recovery continues over the following months. Therefore your dog may have had spinal surgery but still need non-surgical treatment to improve ongoing recovery. 

Above: Walter (with the help of his owner, Rachel Williams) is doing standing practice at home. Most dogs learn to stand before they can walk.

What is non-surgical treatment?

For IVDD, non-surgical treatment is sometimes also called conservative treatment or management. The goals of non-surgical treatment are to help get the dog as comfortable and pain-free as possible, to get the dog standing and walking again, and to help restore bladder and bowel control. Non-surgical treatment also helps to prevent or treat other problems that the IVDD may cause, e.g. skin sores, behavioural issues and breathing problems. 

Above: A pen or large crate helps the recovering dog avoid risky activities. Photo: Frankie owned by Helen Gouldstone

For all dogs showing clinical signs of IVDD, non-surgical treatment involves:

• • • Pain relief (medication supplied by your dog’s vet). 
    • Activity-modification:
      • Avoid risky activities such as running and jumping. 
      • Continue and support safe activities. Standing and a little slow walking are safe, but you may need to help your dog, e.g. by supporting them with your hands or with a hindquarter sling. 
      • Safe basic exercises (e.g. standing practice) once they’re ready for this. 
      • Avoid fatigue. These dogs tire rapidly. Keep any exercise sessions and toilet-breaks very short.
      • Don’t let your dog loose to drag themselves about. Dragging and other ‘compensatory movements’ soon become difficult habits to break, and can make it more difficult for your dog to learn to walk on four paws again.
    • Nursing care either in the hospital or by the owner at home (keeping the dog clean and dry, regular turning if they’re very collapsed, sling-support for toilet breaks if they can’t walk, expressing their bladder if they can’t walk, ‘TLC’). 
    • Appropriate mental stimulation so that your dog doesn’t get too bored during recovery (the daily routine is important, and toys,  quiet games, and trips out in a dog pushchair/stroller may help).
    • Dietary care. A good quality diet is important. This may need to be calorie-counted to help avoid weight gain during recovery. 

Some IVDD dogs also need the following:

• • • • Managing any loss of bladder control
      • Managing any loss of bowel control
      • Managing any breathing problems  (mainly for dogs hospitalised with severe neck IVDD)

Above: Recovering dogs need short amounts of outdoor time (always on the lead). Photo: Burt owned by Vicky Watt-Hedges

• Up-to-date non-surgical treatment

In the past, dogs suffering from IVDD were either given surgery, or they were sent away with anti-inflammatory drugs and basic advice on nursing care. The hope was that time would heal the problem. Times have changed, and non-surgical treatment can now be offered as a positive recovery plan for dogs.

Leaving these dogs in a small cage 24/7 is no longer considered best practice. Yes, a recovery crate or pen increases safety, and the dog should be on a lead or carried whenever outside this safe space. We now know that practising coordinated activities is key to recovery⁵ and, if safety guidelines are followed, this can be started from day one.

“Practising coordinated activities is key to recovery”

Steroids used to be given routinely to dogs presenting with IVDD. More recently, studies have shown that steroids tend to be unhelpful in this situation and are generally best avoided during the early stages of a disc extrusion^6,7,8,9,10.

Vets now have various medical options for helping IVDD dogs to feel better. These include NSAIDs (non-steroidal anti-inflammatory drugs), gabapentin and, in the hospital,  opiates, ketamine and lidocaine. Other types of pain medication are also available. For painful animals, we now tend to get best results with ‘multi-modal analgesia’, i.e. two or more types of painkiller medication are given at the same time¹¹. 

Above: Trips out in a dog pushchair provide important mental stimulation for recovering patients. Photo: Darcy Dolittle owned by Tim and Lisa West

Getting started with non-surgical treatment for IVDD

First arrange to see your dog’s vet who can assess your dog and start treatment. If surgical treatment is expected to improve your dog’s outcome and/or if you are keen to get the diagnosis confirmed, the vet may refer your dog to a neurologist. 

For those of you who are sticking with non-surgical treatment, the vet will either send your dog home with advice and prescribed painkillers, or may in some cases initially admit your dog to the clinic for fluids, stronger pain-relief and nursing care. If your dog goes home with you, then do arrange to see the vet again for regular rechecks. A next-day recheck is a good idea for severely-affected dogs. A few unlucky dogs deteriorate over the first few days and, if this starts to happen with your dog,  your vet might be prompted to offer surgical referral. Another important reason to keep in close touch with your vet is to ensure that your dog can pee and to address this issue if needed. Some dogs need to have their bladder expressed (squeezed out). If needed, your vet can show you how to do this.

When your dog comes home with you, set them up in a recovery crate or pen to help keep them safe. 

Activity-modification is a key part of your dog’s recovery. This is best supervised by a canine physiotherapist who has good experience of neurological patients. Ask your vet for a physiotherapy referral at this early stage. 

Above: Exercises should be chosen to suit each individual dog and, for best effect, must be done correctly. Early referral to a physiotherapist is worthwhile. 

Borrowing equipment for recovery (dachshunds in the UK only)

Dedicated to Dachshunds with IVDD  is an amazing charity that loans out recovery equipment for dachshunds in the UK (Registered Charity number 1199050). Depending on availability, this includes good-quality recovery pens, slings and pushchairs. To request a loan or to support their great work, get in touch with them here. 

Further information to help your dog during IVDD recovery

This website contains plenty of information about caring for a dog with back or neck issues. Try going to IVDD and clicking on links on that page to start exploring this free resource.

For a complete and practical guide to home care, we recommend The IVDD Handbook. This is a comprehensive home care guide for dogs with IVDD (disc extrusion or ‘slipped disc’). It’s also suitable for those with certain other back or neck problems including FCE and traumatic disc. Use this book in conjunction with talking to your own vet. It contains:

• clear practical guidelines for each stage of recovery
• illustrated how-to guides for everything from sling-walking to home exercises
• notes on when to contact your vet
• an illustrated guide to understanding your dog’s surgical report
• advice on keeping your recovering dog happy and content
• a section on maintaining your own wellbeing while caring for your own dog
• example daily routines suitable for dogs at each stage of recovery
• hundreds of colour photos showing what to look for and how to help your dog
• an index, glossary and colour-coded chapter to help you find information fast. 

How to get your copy

Click here to buy or look inside The IVDD Handbook.

The above link should redirect you to your country’s Amazon site.

Order the book to be delivered to you from the US or UK if you live in Australia, New Zealand or Singapore. For further details, click here. 

Links to the book on this page are provided as part of the Amazon Associates program. Buying the book after clicking on one of these links will earn the author a small commission, thus contributing to the ongoing running of this website. 

Booking an appointment

For bespoke supervision of your own dog’s recovery, you are welcome to contact me to arrange a video consultation appointment. To book an appointment, use the contact form here or email me at [email protected]. I’ll get back to you as soon as I can. Please note that these contact details are for appointments only. I offer home visit appointments, when appropriate, for dogs and cats living near me in North Herts, UK. Video consultations are available for both local and distant patients. 

References

1. 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 Association, 241(12), 1617-1626
2. Davis, G. J., & Brown, D. C. (2002). Prognostic indicators for time to ambulation after surgical decompression in nonambulatory dogs with acute thoracolumbar disk extrusions: 112 cases. Veterinary surgery, 31(6), 513-518.
3. Ferreira, A. J. A., Correia, J. H. D., & Jaggy, A. (2002). Thoracolumbar disc disease in 71 paraplegic dogs: influence of rate of onset and duration of clinical signs on treatment results. Journal of small animal practice, 43(4), 158-163.
4. Ito, D., Matsunaga, S., Jeffery, N. D., Sasaki, N., Nishimura, R., Mochizuki, M., … & Ogawa, H. (2005). Prognostic value of magnetic resonance imaging in dogs with paraplegia caused by thoracolumbar intervertebral disk extrusion: 77 cases (2000–2003). Journal of the American Veterinary Medical Association, 227(9), 1454-1460.
5. Fouad, K., & Tetzlaff, W. (2012). Rehabilitative training and plasticity following spinal cord injury. Experimental neurology, 235(1), 91-99
6. 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 surgery, 36(5), 482-491
7. Olby, N. J., Muguet‐Chanoit, A. C., Lim, J. H., Davidian, M., Mariani, C. L., Freeman, A. C., … & Longshore, R. (2016). A Placebo‐Controlled, Prospective, Randomized Clinical Trial of Polyethylene Glycol and Methylprednisolone Sodium Succinate in Dogs with Intervertebral Disk Herniation. Journal of Veterinary Internal Medicine, 30(1), 206-214.
8. Hurlbert, R. J. (2000). Methylprednisolone for acute spinal cord injury: an inappropriate standard of care. Journal of Neurosurgery: spine, 93(1), 1-7.
9. Mathews, K., Kronen, P. W., Lascelles, D., Nolan, A., Robertson, S., Steagall, P. V., … & Yamashita, K. (2014). Guidelines for recognition, assessment and treatment of pain. Journal of Small Animal Practice, 55(6).
10. COATES, J. R., SORJONEN, D. C., SIMPSON, S. T., COX, N. R., WRIGHT, J. C., HUDSON, J. A., … & BROWN, S. A. (1995). Clinicopathologic effects of a 21‐aminosteroid compound (U74389G) and high‐dose methylprednisolone on spinal cord function after simulated spinal cord trauma. Veterinary Surgery, 24(2), 128-139.
11. Mathews, K., Kronen, P. W., Lascelles, D., Nolan, A., Robertson, S., Steagall, P. V., … & Yamashita, K. (2014). Guidelines for recognition, assessment and treatment of pain. Journal of Small Animal Practice, 55(6).