If your IVDD-affected dog cannot walk but they can still feel their toes, they’ll be in the middle (blue) section of the clinical grading scale table. Please scroll down for treatment options for these dogs, home care advice and some other useful information. 

The ‘middle group’ of dogs (grades 3-4)

Some of these dogs are not quite able to walk but can stand a little if held in a supported position. They might also move their hind legs in an attempt at walking. Others are worse-affected and cannot bear any weight or move their hind legs at all. None of these dogs have lost the ability to feel pain in their toes.

 

Above: Clinical grading scheme chart for dogs with IVDD  (this is for back problems, not for neck problems). For a closer look at the chart, please click here. This will open up a larger, printable version in a new window. 

Treatment options for grade 3 and 4 dogs 

Treatment options are:

  • Spinal surgery plus aftercare

or

  • Non-surgical treatment (also called conservative management)

Spinal surgery

If your dog cannot walk, an operation might improve their chance of recovery. Spinal surgery should only be performed by someone with specialist training. If your dog is to go for surgery, ask your vet to refer them to a neurologist. 

The neurologist assesses the dog and then, under a general anaesthetic, uses advanced imaging (MRI or in a few cases CT or myelography) to confirm which disc spaces are affected and on which side of the spine. Surgical techniques vary depending on these findings.

These days, most spinal surgery procedures involve the removal of disc material that is pressing on the spinal cord. An example of this is the ‘hemilaminectomy’ procedure. To surgically decompress the spine, the surgeon removes a section of vertebral bone overlying the spinal cord and then very carefully removes herniated disc material so that it no longer presses on the spinal cord. In some cases, a ‘fenestration’ procedure is also performed on the affected disc and/or adjacent discs.  Fenestration may reduce the risk of the problem recurring. It involves removing the centre of the disc (the nucleus pulposus) via a little window cut out of its side.

After successful spinal surgery, it usually takes these dogs about 1 to 3 weeks to start walking. A few dogs take much longer than this. Dogs usually stay in the hospital for a few days. They are discharged once they are fairly comfortable and can be managed at home. You’ll need to set up a safe indoor recovery space (crate, pen or possibly a recovery room) ready for when your dog comes home. Be prepared – your dog might not yet be able to walk and they might not have perfect bladder and bowel control on returning home. 

Above:   Home care following surgery typically includes on-lead toilet breaks with sling walking if needed to help support the dog’s hindquarters. Darcy Dolittle needed support from a sling for a few days on coming home to prevent falls. A scarf makes a useful temporary sling. 

 

Non-surgical treatment. Non-surgical treatment can be a reasonable option for these dogs. Most grade 3 and 4 dogs will recover, even without a spinal operation. Recent studies have demonstrated good results without surgery. For example, in a study on dachshunds recovering without surgerySedlacek et al 2022, all the grade 3 dogs, and 7/9 grade 4 dogs made a good recovery. Further studies looking at non-surgical recovery are ongoing. 

Non-surgical treatment involves good pain-relief, a comfortable recovery area,  exercise therapy, nursing care and, if needed, help with bladder management. Any exercise therapy is best tailored to the dog and  supervised. 

Initially, it may be worthwhile having your dog admitted to a veterinary hospital for intravenous fluids and oxygen (both of which may benefit the damaged spinal cord) and for top-quality pain-relief and nursing care. This may also give you a chance to set up a safe indoor recovery space (crate, pen or recovery room) ready for when your dog comes home. If your clinic does not offer in-patient care, or if you cannot afford this, then your vet may send your dog home straight away with pain-medication and you can make a start with home care.

You’ll need to learn some special skills for helping your dog if they cannot walk. These include sling-walking, supporting your dog in a standing position, and expressing their bladder if they cannot pee unaided. See your vet regularly for advice and monitoring. A next-day check-up is a good idea to start with.

Physiotherapy is particularly important for IVDD-affected dogs who cannot walk. These dogs recover mainly through neural plasticity (the ability of the central nervous system to adapt to meet functional demands) Fouad & Tetzlaff 2012. Improvement will therefore not happen while the dog is lying in a cage or dragging themselves about, but will be triggered by practice of coordinated movements and postures. Exercises aim to achieve this improvement, but must be performed correctly and safely. Physiotherapy referral is a good idea during the first week. Tip: Ask your physiotherapist to start teaching you how to do the exercises with your dog, so that you can continue the good work between physio sessions. To get in touch to book your dog’s IVDD assessment and supervised home physiotherapy and rehabilitation program, click here

Is treatment an emergency?

If your dog has just gone down with IVDD and is unable to walk, they should be seen as soon as possible by your vet for assessment and treatment including painkillers. Ask for the next available appointment. Ask to speak to a vet straight away if your dog seems to be getting worse and worse. A few cases deteriorate (see below) and may need urgent help.

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

Unless your dog is getting worse and worse,  there is no need to rush into surgical referral for IVDD. Most studies show that delaying the operation does not affect the dog’s outcome Davis & Brown, Kazakos et al 2005, Ito et al 2005, Jeffery et al 2016. You should generally have a chance to consider all options and to check your financial position before going for surgery. It can be sensible in some cases to start with non-surgical treatment and then progress to an operation if your dog is not improving. If surgery is delayed, then excellent pain-medication is important, and your dog should either be admitted to the clinic or have frequent repeat visits for monitoring. 

Watch out for deteriorating dogs

A few dogs start with mild signs which then get worse. 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. Unless these dogs get really bad, then this won’t change the eventual outcome. However, there’s a big difference in outlook for grade 4 dogs (can’t walk, paralysed hind legs) and grade 5 dogs (can’t walk, paralysed hind legs and no deep pain sensation in toes). If your dog is in the ‘middle group’ (grade 3-4) and you are considering an operation but hoping to avoid one,  have your vet keep a close eye on them for the first few days.

If your dog is rapidly-deteriorating,  quick referral for surgery might be wise, ideally before they lose toe pain-sensation. 

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 get much worse just after jumping off a sofa or chasing across a room. 

Home care for IVDD dogs who cannot walk

Whether or not your dog has had an operation, good recovery requires a combination of medicine (including painkillers), nursing care, specific home care and exercise therapy.

You’ll need to set up a large crate or pen to help keep your dog safe (see below). It’s also sensible to get hold of a fixed-length lead and a chest harness. These precautions will help your dog to avoid risky activities. It’s important that your dog doesn’t drag themselves about the house, otherwise dragging will soon become a habit and make it difficult for them to learn to walk properly again.

These dogs are however not expected to improve if just left to languish in a cage. Whether or not your dog has had an operation, specific exercises are important in getting them stronger and in teaching them how to walk again. You’ll also need to help your dog with some basic activities if they can’t walk. They’ll need help with standing, plus sling-support whenever they’re taken out to the toilet. Nursing care for these dogs includes keeping them comfortable, cosy and clean (bedding may need frequent changes) and in some cases, bladder expression if your vet advises you to do this. 

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 keep the dog safe, but not to immobilise them.’

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:

  • Allowing your dog to drag or scoot across the floor or garden. Dogs have a better chance of learning to walk if they are prevented from dragging or scooting. This is because, once a dog learns to get somewhere by dragging himself, it becomes a very difficult habit to break. 
  • Being let outdoors unsupervised (keep your dog on the lead for toilet breaks, even in the garden)
  • Going up or down stairs or over steps (lift your dog over any doorstep or raised threshold, especially if they have short legs).
  • Resting unrestrained on a sofa, couch or bed (these dogs have poor coordination and are at risk of falls)
  • Ball games
  • Trying to run 
  • Trying to jump
  • 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 best left until later in recovery. A little gentle moving around is fine and, if your dog can stand and walk, these are also safe activities. Your dog will tire easily, so the amount of walking they’re allowed to do is restricted. Exercise-prescription varies from patient to patient, so your vet and/or physiotherapist will assess your dog and advise you.

Above: A comfortable pen that is suitable either for home recovery after surgery or for non-surgical treatment

Don’t immobilise your dog completely. A little moving around will help them maintain their strength. Here’s a list of safe activities for your recovering dog:

  • Resting in any comfortable position 
  • Getting up from rest, and moving around gently. It’s safe for your dog to try and push themselves up to a standing position on a non-slip surface once they feel able to do so. It’s also safe for them to try to walk in their pen once they feel ready for this. 
  • Standing with support from your hands (don’t let them fall)
  • Sitting with support from your hands (your physiotherapist can show you how best to help them to move between supported sitting and standing positions)
  • With your help, a little gentle walking over non-slip flooring (e.g. carpet), short grass, concrete and other easy surfaces. You’ll need to support their rear end with a hindquarter sling. Lift the sling just as much as is needed to prevent his paws from getting scraped, especially when moving over hard surfaces. They should be up on their feet for no more than 5 minutes at a time to start with. Many dogs should walk for less than this (e.g. only one minute at a time before being picked up for a rest). Ask your vet to advise you. Keep your dog on a harness and lead during any attempts at walking. The lead slows them down, giving their rear end a chance to catch up and learn to walk. 
  • Relaxing with you on the sofa, but only with very careful restraint at all times. Safety tip: Have them wear a harness, and keep your fingers tucked around the harness straps to be sure that they won’t leap off the sofa unexpectedly. 
  • Chewing on toys  (so long as they won’t shake them violently or throw and catch them)
  • It’s okay for your dog to drag or scoot himself the short distance across his crate or pen. They’ll soon have to stop and turn around, so dragging within the pen is unlikely to be habit-forming.

For larger breeds, 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. 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 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

You’ll need to take special care to keep your recovering dog safe whenever they are outside the recovery crate or pen A harness, fixed-length lead, and non-slip floor matting are all essential. You’ll also need a hindquarter sling if your dog cannot walk. Click here for advice on sling-walking your dog.

You will of course need to take your dog outside on the lead for regular toilet breaks (to pee and poo). 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 4 to 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).

Watch your dog for signs of tiredness while you’re outside together. Early in recovery, their legs may get tired long before the five minutes is up. If your dog is getting increasingly weak and wobbly, pick them up or put them in a dog pushchair to give them a break.

All walking should be slow. Even if your dog wants to use their front paws to rush ahead, use the lead to encourage them to move slowly. This will give their weak hind legs a chance to learn to step. 

 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. Photo: Attie owned by Maia D’Costa-Kalsi and family

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’s 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, a tailored exercise programme is indicated from the start. Practising basic coordinated activities will help them to recover. For example,  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 canine neurological cases. Tip: Ask your physiotherapist to start teaching you how to do the exercises with your dog, so that you can continue the good work between physio sessions. 

Is my dog getting better?

If your dog has been unable to walk, don’t expect a sudden overnight recovery. Improvement is expected to be gradual. We would hope to see at least a little improvement each week, though full recovery can take months. Signs of improvement can be quite subtle: 

  • Reappearance of voluntary leg movement if this wasn’t there before. This tends to start with a little movement from the top of the leg.
  • Becoming able to hold a ‘stand’ position when supported.
  • Becoming able to stand for longer, and eventually with less support.
  • Becoming able to step a bit more normally with sling-support.
  • Managing to get up into a standing position unaided.
  • Managing to push off with a couple of steps from a standing position.

A good physiotherapist will watch out for these little signs of improvement and adjust the exercise programme accordingly. 

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, try this link for advice. Also bear in mind that certain types of medication may cause individual dogs to act out of character. Discuss this 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. Unfortunately, not every dog manages to walk again. Improvements in walking ability tend to happen gradually.  There should at least be small signs of improvement each week (see above). If your dog is not improving as expected, ask your vet for advice. Good professional hydrotherapy and supervised physiotherapy can be useful add-ons. 

If your dog is getting worse at any stage (walking less comfortably than before, or appears more painful), 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, discuss this with your vet. Failure to improve may mean that the non-surgical treatment programme needs adjusting, or may eventually mean that an operation becomes the preferred option.

Other problems: If your dog goes off their food, starts vomiting, develops diarrhoea, starts drinking much more than before, or has difficulty peeing, ask your vet for advice. 

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 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 Marianne@ajdorn.plus.com. 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

 

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. There was a 95% good outcome in 180 grade 3 81.9% of dogs walked within 2 wks. 2.3% of dogs took >61 days to walk again. Mean time to walking was 7.7 days (Aikawa et al 2012). Outcome was 98% successful in 161 grade 4 dogs. Approx 70% walked within 14 days, and about 8% dogs took >61days to walk again. Mean time to walking was around 11 days. 52% of 211 grade 5 dogs recovered ambulation. 36% of successful cases could walk within 14 days. 26% walked within 15-30 days, 18% walked at between 31-60 days. 11% walked at between 2-6 months. 3% walked at between 6-12 months. The remaining few dogs were lost to follow-up.

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).

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 surgery31(6), 513-518. Out of 112 grade 3 and 4 dogs, 96% were able to walk within 3 months of surgery. Mean time to ambulation was 12.9 days (range 1-55 days) and surgical decompression was performed within 6 days of onset of non-ambulatory status. There was an inverse relationship between “time between onset of clinical signs and surgery” and “time to ambulation following surgery”.

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 practice43(4), 158-163. Out of 71 grade 3 and 4 dogs, 86% regained the ability to walk following surgical decompression. Mean time to ambulation was 10.8 days (range 1-60 days). NB: 17% of the 71 dogs regained the ability to walk but were left with ongoing paraparesis and/or pain. The authors looked at whether or not “time from start of clinical signs to surgery” affected outcome. On average (mean value), dogs that regained the ability to walk had spinal surgery at 6.7 days after onset of clinical signs. Within the study group, only 7 dogs had surgery within 2 days of onset of clinical signs, 31 dogs had surgery at 2-6 days after onset of clinical signs, 33 dogs had surgery at >6 days after onset of clinical signs (maximum delay to surgery is not stated). Dogs operated within 6 days recovered walking ability on average 4.5 days sooner than dogs operated after 6 days. However, time from start of clinical signs to surgery did not affect the dogs’ eventual outcome (i.e. whether or not they regained walking ability).

Fouad, K., & Tetzlaff, W. (2012). Rehabilitative training and plasticity following spinal cord injury. Experimental neurology235(1), 91-99

Hayashi, A. M., Matera, J. M., & de Campos Fonseca, A. C. B. (2007). Evaluation of electroacupuncture treatment for thoracolumbar intervertebral disk disease in dogs.Journal of the American Veterinary Medical Association231(6), 913-918. 16 out of 19 (84%) grade 3 and 4 dogs regained the ability to walk without surgery. Out of 14 grade 5 dogs managed non-surgically, 4 regained the ability to walk. According to the authors, “most” dogs in this study were only assessed over a period of three weeks. Therefore it may be possible that recovery continued beyond this point in some “unsuccessful” dogs, and also that recurrence may have occurred in “successful” dogs. Some of the dogs in this study had received electroacupuncture.

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 Association227(9), 1454-1460 Out of 48 grade 3 and 4 dogs, 92% regained the ability to walk. For grade 3 and 4 dogs, surgery was performed at up to 30 days after onset of clinical signs and, within this group, time to surgery did not affect outcome. Mean time to ambulation with only slight ataxia was 45 days (range 7 to 180 days). Out of 28 grade 5 dogs, 18 (64%) regained the ability to walk. Mean time to ambulation for grade 5 dogs was 30 days (range 14 to 270 days). For grade 5 dogs, surgery was performed at up to 11 days after onset of clinical signs. Time from onset of clinical signs to surgery did not affect outcome.

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 Association248(4), 386-394. Out of 78 grade 5 dogs managed with surgery, 58% had a successful outcome (walking within 3 months)). Dogs were not followed up beyond 3 months post-op. For recovered dogs, median time to ambulation was 27 days. Mean time and range not stated. Dogs in this study were first assessed at the referral centre at up to 48.1hours after loss of ambulation. Clinical signs started up to 4.9 days before treatment. Time between onset of clinical signs and surgery did not affect outcome.

Joaquim, J. G., Luna, S. P., Brondani, J. T., Torelli, S. R., Rahal, S. C., & de Paula Freitas, F. (2010). 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. Journal of the American Veterinary Medical Association236(11), 1225-1229. The study looked at 19 severely-affected dogs treated with conservative management including electroacupuncture (these were 9 grade 4 dogs and 10 grade 5 dogs). 15/19 (79%) improved to grade 1-2 within 6 months. 

Kazakos, G., Polizopoulou, Z. S., Patsikas, M. N., Tsimopoulos, G., Roubies, N., & Dessiris, A. (2005). Duration and severity of clinical signs as prognostic indicators in 30 dogs with thoracolumbar disk disease after surgical decompression. Transboundary and Emerging Diseases52(3), 147-152. 6/6 grade 3 dogs all did well after surgery. 8/11 (73%) grade 4 dogs had a “fair to good” outcome, ie. they could walk. Out of 8 grade 5 dogs, 4 regained the ability to walk after surgery (Kazakos et al 2005). Walking took 15 days -2 months.

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.

Sedlacek, J., Rychel, J., Giuffrida, M., & Wright, B. (2022). Nonsurgical Rehabilitation in Dachshunds With T3-L3 Myelopathy: Prognosis and Rates of Recurrence. Frontiers in Veterinary Science, 955. Retrospective study looking at 40 dachshunds (or dachshund crossbreeds) with presumed disc extrusion. All had non-surgical recovery including some rehabilitation. 27 of 27 grade 1-3 dogs recovered. 7/9 grade 4 dogs recovered. 0/4 grade 5 dogs recovered. BUT 6 of the dogs that entered the study with deep pain had previously been recorded as having no deep pain. Out of these dogs with questionable deep pain, 3/6 recovered.

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