What is the spinal column?
The spinal column is made up of a series of vertebrae (bones) interposed by fibrous intervertebral discs. The spinal cord lies with a tunnel inside the vertebral bodies which provide protection for the spinal cord.

What is a disc?
An intervertebral disc is a soft structure that sits between each vertebrae. Each disc allows flexibility between the adjacent vertebrae and also acts as a shock absorber. The disc can be likened to a jam-doughnut, in that it has a soft gel-like centre and a fibrous capsule.

Why does disc disease occur?
Certain breeds such as Dachshunds, Shih Tzu, Lhasa Apso may be more predisposed to IVDD. These breeds are known as chondrodystrophoid breeds. This means that they have been genetically pre-programmed to have shortened limb bones relative to their body. They are also more likely to suffer from early dehydration of the gel in the centre of the disc. Dehydration of the gel can reduce the shock-absorbing ability of an individual disc. Subsequent changes to the fibrous capsule can cause weakening, and the hardened, dehydrated gel can move upwards towards the delicate spinal cord.

How does IVDD effect my dog?
In cases the some cases the dehydrated contents of the disc can breach the weakened capsule and is propelled into the spinal cord. This can sometimes occur at speed ,and even a relatively small amount of material can impart high energy impact on the cord causing bruising and trauma. It is the bruising and damage that lead to spinal cord injury that can ultimately cause paralysis. Some dogs can walk but have uncoordinated movement (appear drunk), others can stand but not walk, and others cannot stand at all. If cord bruising and trauma is severe then loss of ability to urinate and paralysis can be seen.

Depending on the severity of IVVD some patients may just show discomfort to complete paralysis.

What investigation is required?
Examination will allow us to grade the severity of the problem and enable us to localise the area in which the problem has occurred. IVVD disease can bee seen in the neck, in the middle of the back and at the last junction in the back. Clinical examination is not normally sufficient to allow an exact diagnosis and further tests are required.

1. Plain survey radiographs (x-rays) This will help in many cases to rule out certain causes of spinal problems but will not often give a diagnosis. For this reason we will often perform:

2. Myelography: The spinal cord is made of soft-tissue and will not be shown on plain radiographs. Myelography involves the injection of a contrast agent (dye) that outlines the spinal cord. This can show if the cord has been compressed by disc material.

3. CSF Examination: The fluid from around the spinal cord (cerebrospinal fluid or CSF) may be collected for analysis.

4. Additional investigation with MRI or CT imaging may also be considered.

What treatment is required?
If compression of the cord is identified then surgery will usually be recommended to decompress the spinal cord. This involves making a small window in the affected portion of the spine and removing the abnormal disc material. The site of origin of this material, the inter-vertebral disc, can also be inspected and treated accordingly to minimise the risk of any problems in the future.

Disc patients treated non-surgically may have a recurrence of back problems at the same site.

Post operative management?
Following surgery both rest and controlled activity are of importance. Rest is required to allow the inflammation and bruising of the cord to resolve. Active physiotherapy is started to encourage mobility and strength in the limbs. Gentle walking is encouraged for short periods to aid limb function recover. Running, jumping and climbing on furniture is not allowed for at least 6 weeks.

In patients treated non- surgically there is a risk of further material moving into the spinal canal after the initial injury. Non surgical cases with compression are therefore confined strictly for 6 or more weeks after the incident, whilst surgically managed cases do not face this risk and can be active as soon as they are ready (within limits of course).

The vast majority of dogs with surgically managed inter-vertebral disc disease will make a recovery. Some dogs will not regain their full pre-injury status, however they will hopefully improve to the point of being able to lead an independent and active lifestyle with perhaps a subtle change in the way they use their legs.

We are hear to help and give advice throughout the recovery period. We will be to offer advice and assistance with specific problems and demonstrate physiotherapy exercises to perform in the home. Physiotherapy can also be offered on an out-patient basis.