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Thankfully, most dogs do very well with surgery and recover normal function quickly, but severely affected dogs may be left with varying degrees of permanent damage. Strict rest is incredibly important after surgery, as too much activity can lead to pain, trauma, and reinjury. This time, Tango’s owner was prepared.

Disc Disease

Disc disease is most prevalent among small and toy breed dogs such as Dachshunds, Lhasa Apsos, Poodles, Beagles and Pekingese dogs. However, there is also a significant occurrence of disc disease in large and giant breed dogs such as Dobermans, Dalmations, Labradors, Mastiffs, St. Bernards, German Shepherds, Rottweilers, and Great Danes as well as cats! In the more prevalent smaller breeds, primarily due to genetic factors, the disc is prone to premature aging thus making them more likely to rupture even with minimal movements. In these genetically predisposed breeds the highest incidence of disc rupture occurs between three and six years of age. Intervertebral discs can rupture either in the middle-back (thoraco-lumbar region) or the neck (cervical spine). Different clinical signs in the effected patient will depend on the site of rupture and the amount of trauma associated with the disc rupture.

To evaluate the proportion of non‐ambulatory dogs with cervical intervertebral disc herniation (IVDH) in a private clinic and to compare signalment and outcome between those that underwent single or multiple ventral slot decompression (VSD). Ruptured Disc in the neck or Ventral Slot. Many dogs especially the miniature dachshund suffer a ruptured, slipped or herniated intervetebral disc. This can lead to paresis or weakness of the hind limbs and can be severe enough to cause a complete paralysis. According to VCA Animal Hospitals, stage 4 dogs have a recovery rate between 85 and 95 percent if operated on within three days of becoming symptomatic, while successful recovery drops to 60 to 70 percent past that three-day window. Dogs with stage 5 disc disease have a 50 percent recovery rate if surgery is performed within 24 hours. Investigations in 161 dogs with an intervertebral disc disease. After that, we performed a cranial (n = 31), caudal (n = 125) or both (n = 5) types of myelography at the same time, and surgery - ventral slot decompression (SLOT) (n = 18) or hemilaminectomy (n = 143). During the post.

The Disc: Anatomy and Pathology

A normal disc resembles a jelly-filled doughnut. The outer layer (the dough) is called the annulus and consists of a tough fibrous tissue that connects each of the spinal vertebrae together into a column. (Fig. 1) Due to the flexibility of the annular fibers, the vertebral column is able to flex and bend. The center of the intervertebral disc (the jelly) is called the nucleus and contains a viscous liquid.

Within degenerating discs (discs susceptible to rupture), the nucleus changes in consistency, becoming denser and more like toothpaste rather than jelly. Simultaneously, cracks will develop in the annulus: when these cracks become sufficiently large or sufficiently weaken the structure, the central nuclear material can herniate (squirt out), resulting in compression and damage to the spinal cord.

Even a small amount of ruptured nuclear material may cause your pet to experience mild to moderate back or neck pain with or without limb weakness (paresis) and unsteadiness (ataxia). Larger quantities of disc material expelled (extruded) at once and with extreme velocity, however, can cause acute loss of control of the legs (paralysis), sudden loss of bowel and bladder function and, in severe cases, difficulty breathing, abnormal heart rhythms and death.

The chance of your pet recovering from a ruptured disc depends on overall medical health, the number of previous episodes of pain or paralysis, and the length of time between the onset of the current problem and the intervention of veterinary care. The best indicator of return to good function is your pet’s neurologic status at the time of surgery.

Myelography

If your pet fails to respond sufficiently to non-surgical, medical management, surgery may be indicated. If so, radiographs (x-rays) and a myelogram are important diagnostic tools to identify the exact location of disc rupture.

A myelogram must be performed with the patient under general anesthesia. A spinal tap is performed and radio-opaque dye is injected around the spinal cord to make its shape visible on radiographs. Following the injection a series of radiographs may indicate which disc has ruptured and delineate the amount of compression of the spinal cord. (Fig. 2) The surgeon can then determine which type of surgical technique to use and where the surgical approach should take place.

Rarely, following a myelogram, a patient may have transient seizures (usually resolving with overnight monitoring and treatment). A more common side-effect of myelography is an increase in limb weakness that may last for as long as one to two weeks. More severe side effects are rare but possible. The benefits of myelography far outweigh these risks and this diagnostic modality still remains one of the most routine tests available to identify a ruptured disc. In some situations, myelograms are slowly being replaced by CT’s and MRI’s. (Figs 3 & 4) However, these alternatives are more expensive, they are not always available on an emergency basis, nights or weekends, and even with these advanced imaging techniques, radio-opaque dye injection may still be indicated.

Disc Surgery: Back

Often, pets with back pain only or minor spinal cord injury can benefit from a fenestration surgery. (Fig. 5) In this procedure, the surgeon cuts a window in the annulus of several discs in the back and removes the inner, abnormal nuclear material that is applying pressure to the spinal cord. This technique removes the nucleus from the currently rupturing disc as well as that of other discs that appear likely to rupture in the future. Unfortunately, this technique is rarely effective in patients with demonstrable disc extrusion.

Instead, paralyzed patients, or patients with demonstrable disc extrusion, are candidates for laminectomy surgery. (Fig. 6) This technique involves removing part of the bony vertebrae surrounding the region of damaged spinal cord. The material extruded from a ruptured disc is removed from around the spinal cord, thus relieving pressure and preventing further trauma. As the swelling in the cord gradually subsides following surgery, some nerve function returns to the legs. It is important to realize that recovery does not happen overnight, and that not all nerve function may recover.

Some pets suffer temporary setbacks in their neurologic status following surgery. These delays relate to the effects of the myelogram, manipulation of the spinal cord during surgery and the progressive swelling and damage from the initial disc rupture. While these setbacks are not usually permanent, they do prolong the patient’s postoperative rehabilitation and require additional efforts by owner, pet and veterinarian alike.

Disc Surgery: Neck

Once a cervical (neck) disc has ruptured, your pet will rarely improve without treatment or surgery. Often, there may be a reduction in the pain by administering anti-inflammatory medications and muscle-relaxants, but steroids are not recommended because of harmful side effects when used long-term. Surgical repair of ruptured cervical discs is generally quite successful.

After the specific ruptured disc is located by myelography or MRI, a ventral cervical slot procedure allows access to the spinal cord and removal of the extruded material. The ventral slot technique relieves pressure from the spinal cord and also fenestrates additional cervical discs to remove abnormal nuclear material and prevent at-risk discs from rupturing in the future. (Fig. 7) The annulus is left intact to stabilize the neck and to allow the vertebrae of the neck to move normally after surgery.

Similar to disc surgery in the back, inflammation and neck pain start to subside once the pressure on the spinal cord is relieved. Some nerve function should start to return and gradual recovery begins.

Postoperative Recovery and Care

After back surgery one should expect approximately four weeks of intensive home nursing care before clinicians may fully determine the outcome of the procedure. During this recovery phase your pet may not have bladder or bowel control and may have no or only partial movement of the limbs. Because of these conditions, the patient will require a great deal of assistance and attention. Our staff will provide you with complete instructions to assist you during this recovery period.

Many paralyzed pets start to move their legs in approximately two to four weeks time. Within four to eight weeks many will regain continence and start to walk. Some pets return to very good hind limb function, while others may have permanent impairments and wobble or have difficulty jumping for the remainder of their lives.

The primary goal of neck surgery is to relieve the pain caused by the ruptured disc and most pets also regain very good motor function. It is important to keep the patient quiet and confined for four weeks following surgery to help with healing and recovery. Again, temporary neurologic deficits may persist and, although generally they are not permanent, they may prolong postoperative rehabilitation.

In most cases the swelling and pain associated with a ruptured neck disc subside in two to four weeks. If nerve damage also exists, improvement may take four to eight weeks or longer. Decreasing doses of steroids may be administered during this transition to decrease inflammation and associated pain. Even with the most ideal surgical technique and recovery management, it is possible that your pet may not recover full function of the limbs or return to pre-injury functional status.

Remember, regardless of the location along the spine of a disc rupture, the very best indicator of your pet’s chances of recovering full functional status (walking and continence) is the neurologic status at the time of surgery. Fortunately, even pets that remain permanently paralyzed and incontinent, while challenging to care for, can live happy and healthy lives.

Conclusion

Ventral Slot Surgery Dog Recovery Treatment

An accurate diagnosis and prognosis for surgical success can be made only after a thorough medical, physical and neurologic examination of your pet. We will discuss our findings and expectations with you to help make the best decisions for your family and for your friend. Please call Veterinary Surgical Centers with any questions or concerns about intervertebral disc disease in your pet.

Surgery isn't always required for IVDD, but for dogs suffering from Intervertebral Disc Disease which affects their ability to walk, surgery is can be the best treatment option. Today our Mooresville vets explain more about surgery and other treatment options for dogs with IVDD.

The Intervertebral Disc

The intervertebral disc is a fibrous ring of tissue containing a jelly like inner substance. These discs give the spine flexibility and help to cushion the load to the spine whenever your dog is actively moving around, running or jumping.

Intervertebral Disk Disease (IVDD)

IVDD is an age related, gradual degenerative process that affects the spinal cord of the dog over a period of time, often undetected. This condition is otherwise described as a ruptured, slipped, bulging or herniated disk and may occur anywhere in your dog's back or neck.

Dogs of any breed can suffer from IVDD however, it is most often seen in beagles, dachshunds, pekingese, shih tzus, and basset hounds.

Causes IVDD in Dogs

As IVDD progresses, the shock absorbing discs between your dog's vertebrae gradually begin to harden until they are unable to cushion the vertebrae properly. After awhile the hardened discs may go on to bulge and compress the spinal cord.

Often, a simple jump or poor landing can lead one or more of the hardened discs to burst and press into the nerves of the dog's spinal cord causing pain, possible nerve damage or even paralysis.

Can a dog recover from IVDD without surgery?

If your dog has been diagnosed with IVDD but is still able to walk non-surgical treatments may be able to help your dog recover from IVDD. Dogs who have lost their ability to walk require emergency treatment which will likely include surgery.

Non-surgical treatments for IVDD aim to help relieve pain, get your dog walking again, and help restore lost bladder and bowel control (which can be caused by nerve damage associated with IVDD). Non-Surgical treatments for IVDD in dogs include:

• Strict Crate-Rest - Your dog will need to be strictly confined to a small room or crate for least 4 weeks in order to give the dog's body sufficient time to try and mend the damage.
• Anti-Inflammatory Medications - Anti-inflammatory medications can to help reduce pain and swelling. These meds are used in conjunction with restricted activity and crate-rest.
• Dietary Care - Your vet will carefully calculate the precise number of calories required by your pet in order to manage weight and help to prevent added pressure on your dog's injured spine.
• Physical Rehabilitation (Physical Therapy) - Rehab can work wonders for pets suffering from mild - moderate cases of IVDD, as well as those recovering from surgery. Your vet can recommend a qualified rehabilitation practitioner to help your dog recover from IVDD.

Surgery for IVDD

Surgery may help to restore your dog's ability to walk, reduce pain and prevent further disc problems. IVDD surgery is considered the best (and sometimes the only) treatment for dogs suffering from severe IVDD.

The goal of IVDD surgery to remove the diseased intervertebral disk material in order to relieve the pressure on your dog's the spinal cord, restore normal blood flow, and prevent disc problems in the future.

There are a number of different IVDD surgeries including hemilaminectomy, laminectomy, fenestration and ventral slot. Which surgery will be used to treat your dog will largely depend upon the location of the diseased disc. For some dog's a vertebral stabilization (fusion) procedure may be recommended. This is usually the case in large breed dogs.

How much IVDD surgery costs will depend upon a number of factors but is generally in the region of $1,500 to $4,000.

Success Rates for IVDD Surgery

Surgery is typically very successful. Outcomes are most successful in dogs that have not lost their ability to walk.

If IVDD surgery is not successful in returning your dog's ability to move normally, a dog wheelchair can help your pup to enjoy a happy and active life even while living with IVDD.

Recovery from IVDD surgery requires 6 - 8 weeks of restricted activity combined with medications to help manage with pain and swelling. In many cases physical rehabilitation is recommended to help dogs recovering from IVDD rebuild strength and stability.

Should I consider euthanasia for my dog with severe IVDD?

If you dog has been diagnosed with severe IVDD you are likely facing some very difficult questions regarding treatment for your beloved pet. Your vet will be sure to explain the appropriate treatment options, and the likely outcome for each. Sadly, caring for a dog that is recovering from IVDD can be both time-consuming and costly regardless of whether you opt for surgical or non-surgical treatment.

Every pet is different and your dog's prognosis will depend on a number of factors including your dog's age, the severity of your dog's condition, where on the spine the injury is located, and the length of time between symptoms appearing and treatment. Your vet will take the time to carefully and compassionately explain your dog's likelihood of recovery so that you are able to make an informed treatment decision.

Ventral Slot Surgery Dog Recovery

If you are considering euthanasia for your dog following an IVDD diagnosis, speak to your vet openly and honestly. Veterinarians understand how much you love your pet and have been trained to help you make the best decision for you and your pet.

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