updated Feb 2009

1. What is IVDD?
   IVDD stands for Inter-Vertebral Disc Disease. Between the bones that make up the spinal column, called vertebrae, there are gel-like cushions called discs. Discs are made of a material that should have the consistency of a gel toothpaste. When a dog has IVDD, disc material hardens prematurely. When pressure is applied to the disc, like the pressure the spine receives from a jump, the hardened disc material can break through the weak disc wall, oozing or even shooting out with the force of a bullet. When the material escapes, it can enter into the space where the spinal cord is.
   Side view—www.michvet.com/library/article_images/ivds1.swf
   Cross section—www.michvet.com/library/article_images/ivds3.swf

   The spinal cord, is the main communication system between body parts (legs, bladder, etc) and the brain. So if the disc material presses on the spinal cord, the affected limbs or organs cannot send or receive information to and from the brain. That is why the dogs become paralyzed and commonly also lose bladder and bowel control. No information goes through from the site of the herniation towards the brain and vice versa.

   If only a little disc material oozed out, the spinal cord may not be too damaged and the dog can fully recover. If the disc rupture is severe and hit the cord with enough force causing the spinal cord a lot of damage, the dog might need a lot of time to recover, perhaps surgery and therapy. Chances of recovery are slimmer with a severe disc rupture, but there are accounts of some dogs that have been paralyzed for up to 3 years, that have suddenly gotten up and started to walk again. Nerves are the slowest part of the body to heal and each dog has their own timeline as to when or if healing can happen.

2. What signs should I look for?
   Pain is present at the start in almost every herniation. Signs of pain are shivering, trembling, a hunched back and yelping, loss of appetite and hiding under the bed. A drunken walk or paralysis are common signs of a more serious herniation.
3. How is IVDD diagnosed?
   Discs are soft tissue which cannot be seen in X-rays, which show only bone, but x-rays can be used to rule out other diseases that mimic IVDD or to “suspicion” disc herniation. A myelogram, MRI or CT scan are the ideal methods to confirm IVDD, since in them you can see either the soft tissue of the disc or where the spinal cord is pressed by the disc material. Your vet can also do a neurological exam, in which he will see how the dog reacts to pain (called deep pain recognition) and how well his reflexes are working. A good neuro test can also tell, with a fairly good degree of accuracy, the approximate site of the herniation.
4. What treatments are available?
   Currently there are 2 basic methods of treatments: Surgical and Conservative.

   With surgery, a board certified surgeon or a specialized neurological or orthopedic surgeon will first perform an MRI, CT Scan or myelogram to locate the herniation, and then will proceed to operate, removing the disc material that is pressing on the spinal cord, allowing the spinal cord to regain normal blood circulation and to have room again to begin healing so it can once again send and receive information.

   The surgeon may or may not fenestrate. Fenestration is when the surgeon makes a small cut into the discs next to the one that herniated to remove a bit of the disc material. The theory is that this reduces the chances of those discs herniating on their own later, and damaging the spinal cord.

   The conservative method is basically medicines (steroids or anti-inflammatories, muscle relaxers, pain killers and sometimes antibiotics) and 8 weeks of crate rest without surgery being done.

   After both treatments, and when the vet OKs it, the dogs usually have to undergo physical therapy to regain muscle tone and improve coordination and nerve reconnection.

5. Is putting to sleep (euthanasia) an option?
   There is no reason to. After the swelling of the herniated disc goes down, the dog’s pain goes away, so IVDD dogs rarely live in pain or suffer; as a matter of fact, even paralyzed dogs don’t suffer a bit since they cannot feel pain from the site of the herniation downwards.

   In rare instances Myelomalacia can happen, after a herniation. It causes the dog’s entire spinal cord to die moving forward towards the chest, eventually to suffocate. It is irreversible and fatal. This would be the only time your dog will certainly not heal and will suffer and euthanasia is necessary and kind.

   There can certainly be complications. Always keep in mind that dogs can heal from IVDD before you make a decision that you cannot take back. Most dogs do recover from IVDD and live happy healthy lives. They just need time and a chance!

6. Which is the best treatment?
   It depends on the herniation itself. If the dog is still walking and the symptoms are mild, your vet might want to try conservative treatment first.

   If the dog is suddenly paralyzed, in too much pain, or conservative treatment is just not enough, surgery is generally thought to be the best way to go. Surgery is usually more successful the sooner it is done, (Ideally within the first 12-24 hours following loss of deep pain sensation) since the disc material will have less time to damage the spinal cord.

7. How do you pick a good surgeon/facility?
   First, ask your vet to recommend one to you. Use this list of questions to help you identify IVDD friendly medical services.

   Universities and teaching hospitals usually have surgeons that can perform these surgeries and are experienced with IVDD.

   Another option to locate an ortho- or neuro-surgeon near you:
   www.acvs.org/AnimalOwners/DiplomateDirectory
   or
   http://www.acvim.org/websites/acvim/index.php?p=3#

8. How do I know when will my dog walk?
   It is important that you know that each dog is different and that statistics and prognosis are not rules. So always give your dog time and patience.

   First, the dog needs crate rest for 6 weeks after surgery (8 weeks with conservative treatment) for the damage done by the rupturing disc to heal completely. Starting any strenuous activity before completing crate rest could cause the dog to re-injure himself.

   After the resting period is over, the dog can benefit greatly from low impact physical therapy and may even need a couple of months of more demanding therapy. It is important that you remember that the dog just had a BIG neurological trauma and needs time, just like you would.

   After that time, if the dog still doesn’t recover fully, or needs aid walking, you can start considering a cart. Carts are made of all sizes and fit all budgets, they are a wonderful solution and have kept hundreds of dogs happy for many, many years.

9. What is the most important thing I can do?
   You must educate yourself about IVDD and put your dog on strict crate rest during the recovery for 6-8 weeks, 24/7. IVDD is a disease, and your dog will have it for life. There are ways to prevent another episode, though none is 100% effective. But the more we know and the more we do, the higher the chances our pups have of avoiding another herniation and living a happy and healthy life.
10. What are the different drugs for? Steroids: They are anti-inflammatories and immune system suppressors. They are good especially if given in the vein the first 8 hours or by shot in the muscle, and followed by pills at home. The most commonly used are: prednisone and dexamethasone. Accompany with a stomach protector such as Pepcid (famotidine).

    NSAIDs (non steroidal anti-inflammatory drugs): they are anti-inflammatories, and also have pain killing properties too. They must never be mixed with steroids or the NSAID aspirin. The most commonly used are: Rimadyl, Deramaxx, Previcox or Metacam. Accompany with a stomach protector such as Pepcid (famotidine).

    Muscle relaxers: During a herniation a dog can have nasty muscle spasms. Muscle relaxers help prevent them and they also help keep the dog calm while in crate rest. The most commonly used are: Methocarbamol and Valium.

    Pain killers or analgesics: They help through the healing period by making your dog more comfortable. The most commonly used are: Tramadol or a Fentanyl patch.

    Do remember that all drugs have side effects and some (steroids and NSAIDs) need to be given with a stomach protector. Steroids and NSAIDs should never be mixed or switched without washing out the other from the body for 7 days. Ask your vet or pharmacist for an informative brochure on each drug or search the web for adverse side effects. More information on IVDD drugs

11. Is there financial help? Yes. If your dog needs surgery and you cannot afford it, there are options. First, talk to the surgeon, they might have payment plans. If not, go to: www.carecredit.com they provide credit for the surgery with little or no interest. www.imom.org is also another institution that could provide financial help. Other financial aid links.
12. Alternative additions to surgical or conservative treatments:
13. Acupuncture is a good therapy to relieve pain and help nerves heal.
14. Chiropractic VOM therapy should never be used on a dog with a current disc episode.
15. Supplements can be used with IVDD:
16. Nutrition during healing is also important.
17. Locate a holistic Vet: www.holisticvetlist.com

Disclaimer:
This information is presented for educational purposes and as a resource for the Dachshund community. The coordinators are not veterinarians or health care professionals. Nothing herein should be interpreted as medical advice and all should contact their pet care professionals for advice. The coordinators are not responsible for the substance and content contained herein and do not advocate any particular product, item or position contained herein.