Why Your Dog with IVDD Needs a Vetrehabber on Their Team

Intervertebral disc disease (IVDD) is a condition that affects your dog’s spine. The intervertebral disc herniates into the spinal canal, either slowly as a result of degeneration of the disc material over time, or suddenly as a result of a traumatic event.

Understanding IVDD

The intervertebral disc (IVD), as its name suggests, sits between the vertebrae throughout the spinal column. Healthy IVDs provide shock absorption, aid in spinal stability and create space between the vertebrae to allow movement and to protect the bones from rubbing against one another.  Overall, they protect both the spine and the spinal column from damage.

Each disc is made up of two parts: the outer annulus fibrosis and the inner nucleus pulposus. The intervertebral disc can be compared to a jelly doughnut; the outside of the doughnut is the annulus fibrosus, the structure that determines the shape of the disc, and the jelly is the nucleus pulposus, the inner gelatinous substance with a high-water concentration that allows the disc to absorb shock. 

The cartilaginous annulus connects the disc to the bony vertebral body on either side, creating a continuation from one vertebrae to the next.

When the disc degenerates, the annulus becomes harder and more brittle until it ruptures, while the nucleus loses its gelatinous quality and calcifies.

How the Disc Herniates

Broadly speaking, the disc can herniate into the spinal canal in one of two ways:

A disc protrusion occurs when the annulus remains intact, but the shape deforms and bulges into the spinal canal compressing the spinal cord.

A disc extrusion occurs when the annulus ruptures and the nucleus pulposus escapes into the spinal canal.

There are five distinct kinds of IVDD. How your dog is treated and recovers from their spinal injury will be determined by the kind of IVDD they have.

Five Kinds of IVDD

Acute Non-Compressive Nucleus Pulposus Extrusion (ANNPE)

An acute rupture of the annulus fibrosus leads to the escape of the liquid nucleus pulposus that causes contusion but no compression. This can only be managed non-surgically.

Hydrated Nucleus Pulposus Extrusion (HNPE)

In this condition, the annulus fibrosus ruptures with herniation of the nucleus pulposus. This is a high-pressure rupture leading to contusion rather than compression, and is more common in the neck vertebrae. It can be managed surgically or non-surgically.

ANNPE and HNPE

Both of these conditions can occur together. These conditions tend to be non-painful, although the symptoms can sometimes begin with the patient yelping in pain during vigorous activity.

Treatment is primarily conservative, relying on rehabilitation and physiotherapy.

How Does a Disc Herniation Affect your Dog?

When an intervertebral disc herniates into the spinal cord, it will compress the spinal cord from the bottom up. The nerve pathways on the outside and bottom of the spinal cord are responsible for transmitting messages related to proprioception – your dog’s awareness of where their body is in space. The next level of compression affects the nerves that are responsible for coordinated movement. Following that, compression will affect their ability to feel sensations on their skin or under their feet, which can put them at further risk of injury. The deepest neural pathways in the spinal cord are responsible for deep pain sensation; if these pathways are compressed or compromised, your dog can no longer feel sensations that are painful.

A loss of neural function will always happen from the outside to the inside, and it will come back from the inside to the outside. For that reason, as your dog starts to recover, they will first regain deep pain sensation, then superficial sensation, followed by coordination and finally proprioception.

Treating IVDD

IVDD may be treated either surgically or conservatively.

Surgical management

Surgery is performed to decompress the spinal cord and to remove any disc material that may be putting pressure on it. Before going to surgery, your dog will need a diagnostic MRI to identify the affected spinal level. There may be a need to remove disc material from more than one spinal level.

Conservative management

Non-surgical management provides the time and space for the body to re-absorb the prolapsed disc material naturally. It includes protective crate rest, pain management, exercise therapy, and rehabilitation.

Conservative management can be pursued for disc prolapses where dogs still have deep pain sensation, with a good prognosis. In higher grades of IVDD where deep pain is absent, a positive prognosis decreases for both surgical and conservative management.

Vetrehabbers Make the Most of Neuroplasticity

Although nerves don’t heal as well as muscles or some of the other tissues in our bodies, they do have some capacity to heal, especially if we provide them with the support to do so.

Neuroplasticity concerns the way in which the nervous system adapts, grows and heals after an injury. In the first six weeks after a spinal cord injury, neuroplasticity will be at its highest – or, put another way, the spinal cord has the best possible capacity for healing in the first six weeks after injury.

A veterinary rehabilitation therapist is able to stimulate and facilitate neuroplasticity during the critical first six weeks in a way that is both safe for the individual patient and progressive in nature. Modalities such as laser therapy or pulsed electromagnetic field therapy will probably be used.

By providing novel sensations to the affected paws and other areas of the body,  the Vetrehabber will stimulate neural activity,  gently challenging the muscles of the hindlimbs to activate, and restoring motor control.

For neuroplasticity to occur, it is essential that the nervous system is stimulated and challenged.

This is one of the reasons it is important that daily exercises are performed with your dog, especially in the first six weeks after injury. Your rehabilitation team will help you and your dog to learn how to do this safely and effectively, and how to continue to challenge the nervous system week after week to ensure the greatest possible opportunity for healing.

Your Vetrehabber Can Help!

If you are feeling uncertain about the best way forward for your dog with IVDD, your local veterinary rehabilitation therapist can help.

Here are some of the ways your veterinary rehabilitation therapist can assist you today:

1. He or she can provide you with information and education on IVDD and how it affects your dog.
2. They can help you understand the differences between surgical and conservative management, and the implications of each treatment option.
3. They will guide you on making environmental adaptations to the home, and the optimal ways to use them, such as setting up a crate or a room for rest and recovery.
4. They will advise you on the tools and equipment that can make handling and recovering easier for you and your dog.
5. Most importantly, they will develop and implement a tailor-made rehabilitation programme for your dog, including exercises, daily neurological stimulation, and more. This will hugely boost a positive prognosis for your dog after IVDD.

Client Educational Resources for Vetrehabbers

If you are a veterinary rehabilitation professional who is passionate about providing your clients with high-quality education and support, we are here to help!

We’ve created a series of digital products that you can fully rebrand and edit to make your own. One of our best-sellers is Your Guide To Recovery: Intervertebral Disc Disease.

Learn more about these products and how you can use them in your practice here.