What You Should Know About Canine Intervertebral Disk Disease.
by Jim Cook, DVM, PhD, DACVIM
Crusoe, the celebrity Dachshund, has IVDD. Photograph by Heather Schulman.
The condition known as intervertebral disk disease is frequently abbreviated as IVDD or IVDH (“herniation” instead of “disease”). Other less common acronyms are sometimes used but mean the same thing. Affected disks are often referred to as slipped, herniated, ruptured, or pro- lapsed. They all mean basically the same thing and refer to disk contents forcing their way through normal retaining structures and allowing disk contents to enter the spinal canal where they cause pressure on the spinal cord and nerve roots.
have seen dogs as young as 10 months requiring surgery for Type I disk disease because of paralysis. Both Type I and Type II disks can be seen in mature cats but the overall incidence in cats is estimated to be much less than 5% of that seen in dogs. Dachshunds and French Bulldogs are very common victims of Type I disk disease but any small breed dog is at risk. Clinical signs are related to the location of
the disk problem and its severity. Disk issues in the cervical (neck) region usually cause signifi- cant pain but, while it is possible, do not often cause paralysis. Disk issues in the lower back also cause pain in most cases and paralysis of the hind legs is a very frequent feature. Disk disease is often categorized as follows: Stage 1: Patient is still walking, primary problem is pain. Stage 2: Patient is painful and is having difficulty walking (clumsy, uncoordinated). Stage 3: Patient cannot walk but still has good feeling ability in the legs (positive superficial pain sensation). Stage 4: Patient cannot walk; superficial pain sensation is absent but patient responds to very aggressive stimulation of sensitive structures like bone (negative superficial pain sensation, positive deep pain sensation). Stage 5: Patient cannot walk; ALL feeling to the paralyzed legs is ABSENT (negative deep pain sensation). Determination of Stage 5 disease should be
In general, completely normal disks rarely
Jim Cook, DVM, PHD, DACVIM is a Board-Certified Neurologist with SCAN. Working with your family veterinarian, SCAN provides advanced state-of-the-art care. Ask your veterinarian about SCAN.
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rupture. Typically the disk must be degenerated either from aging or from genetic factors. In some dogs it may be a combination of both. Older large breed dogs tend to have chronic disk disease with aging changes of fibrosis and dehy- dration (Type II). This situation is usually more chronic but in the right circumstances a Type II disk can rupture acutely. Younger small breed dogs usually have more
acute disk problems related to genetic factors. In this circumstance contents of the disk undergo transformation from normal gelatin consistency liquid to chunks of cartilage or even calcification (Type I). When this type of disk content is extruded into the spinal canal, the pressure on the spinal cord and nerve roots can be considerable, resulting in severe pain and partial or even com- plete paralysis. Because of the genetic nature, we
done by an experienced veterinarian. Dogs with Stage 5 disease can have reflex withdrawal of a stimulated limb which is often interpreted incorrectly as the patient having sensation when in fact it does not. Patients in Stage 1 and 2 are often initially
treated with rest and medication and may make a full recovery with time although a lifestyle change is recommended (exercise restriction, no high-impact activities) to prevent repeat occurrences, which may happen in up to one in three patients treated conservatively. Patients with Stage 1 and 2 disease should be
considered as surgical candidates if their clinical signs do not resolve rapidly or if they have repeated episodes. We encourage veterinarians to initiate contact with SCAN or their local neurosurgery service during Stage 1 or 2 for cooperatively planning treatment and possible future surgical intervention.
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