InterVertebral Disc Disease (IVDD) is one of the most common neurological conditions in dogs. The condition manifests as a syndrome of pain and neurological deficits caused by displacement of part of the disc. IVDD is most prevalent in the thoracolumbar spine, followed by the cervical region. Many aspects of managing this disease remain controversial namely; medical versus surgical treatment, the use of corticosteroids, the choice of surgery and surgical approach to decompression, as well as accurate prognosis relative to deep pain perception. In all cases of IVDD, regardless of the chosen treatment, physical rehabilitation plays an integral role in the overall care and recovery of the patient.
At AHAH we often hear, “Why did my vet not tell me about this?” or, “Both options I was given by my vet are not possible. Now I find you and you are willing to try. I don’t want to go back there.” Surgery is not an option for all clients, and euthnasia cannot be contemplated when the dog is mentally alert. AHAH has treatment protocols to manage all patients whether Grade 1 or Grade 5. These options include:
- Photobiomodulation aka therapeutic laser
- Acupuncture and electroacupuncture
- Massage and myofascial release
- Homeopathic and/or herbal remedies to support recovery and repair
- Physical rehabilitation
- And any combination of the above depending on the patient
Team members at AHAH provide emotional support and practical guidance to clients that struggle to adequately confine their companions. Most of the texts reiterate that the single most important factor contributing to a successful outcome (following disc herniation) is cage rest.
Dogs conservatively managed usually begin exercise later than the surgical patients, to allow for some healing and stabilization to occur at the injury site. For those patients without neurological deficits the focus is on activating and strengthening the core musculature. In people with herniated lumbar discs, appropriate exercise is a proven way in which to manage the condition. Research to support this premise in dogs is not yet available but common sense prevails.
Neurological rehabilitation is of the utmost importance in those dogs exhibiting these symptoms. Treadmill training (to stimulate central pattern generators responsible for walking) is a researched method of rehabilitation and should be applied early in the recovery. The reason this is successful is because of the phenomenon of neuroplasticity which allows the regeneration of neural tissue to be influenced by appropriate loading and exercise. Nerves are more readily affected within 6 weeks of injury. Thereafter, the rehabilitation is more difficult. The underwater treadmill fulfills this role whilst providing support to the body where dogs are unable to stand. The water enhances sensory perception and proprioceptive feedback.
In dogs with no deep pain perception, rehabilitation is still possible but takes patience and time. AHAH has successfully rehabilitated these dogs by teaching them to spinal walk. Another alternative is a mobility cart.
AHAH discusses all options, their advantages and disadvantages as well as the management thereof. We would be delighted to partner with you in this regard. Please contact us for further information.