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Intervertebral Disc Disease (IVDD) in Dogs: Grading, Imaging, and Treatment Decisions

IVDD is degeneration or herniation of intervertebral discs causing spinal cord compression. Common in chondrodystrophic breeds (short legs, long backs) but occurs in all dogs.

Pathophysiology: Two Distinct Types

Hansen Type I (Chondroid Metaplasia)

  • Early nuclear degeneration → calcification → acute extrusion through annulus.
  • Breeds: Dachshund, French Bulldog, Beagle, Corgi, Pekingese, Shih Tzu.
  • Age 3–6 years. Sudden onset.

Hansen Type II (Fibroid Metaplasia)

  • Slow annular degeneration → chronic protrusion (bulge) without extrusion.
  • Breeds: German Shepherd, Doberman, Labrador, large breeds.
  • Age 5–12 years. Insidious onset.

Clinical Signs: Graded 1–5

GradeSigns
1Spinal pain only (arching, reluctance to jump, vocalization)
2Ambulatory paresis (ataxia, weakness, knuckling)
3Non-ambulatory paresis (cannot walk, voluntary motor present)
4Paraplegia (no voluntary motor) ± deep pain sensation (DPS)
5Paraplegia + absent DPS (poor prognosis)

Diagnosis

  • Neurologic exam (localize: T3-L3, L4-S2, cervical).
  • Imaging: MRI is gold standard (cord compression, edema, hemorrhage). CT + myelogram if MRI unavailable. X-rays only for screening (calcified discs, instability).

Treatment

Medical (Grades 1–2, some 3)

  • Strict crate rest 4–6 weeks (crucial).
  • NSAID (carprofen, meloxicam) ± gabapentin ± muscle relaxant (methocarbamol).
  • Bladder management (expression, catheter).
  • Success rate ~80% for Grade 1–2; lower for 3.

Surgical (Grades 3–5, failed medical)

  • Hemilaminectomy (thoracolumbar), ventral slot (cervical), dorsal laminectomy (LS).
  • Fenestration (prophylactic) controversial.
  • Timing: Grade 4 + DPS → surgery ASAP (best <24–48 hrs). Grade 5 + no DPS → guarded even with surgery.
  • Success: Grade 4 + DPS ~90% ambulatory; Grade 5 no DPS ~50%.

Post-Op / Long-Term

  • Rehab: laser, acupuncture, hydrotherapy, PROM exercises.
  • Recurrence risk: 15–20% at other discs.
  • Weight control, harness (not collar), ramps, non-slip flooring.

Early recognition and grade-appropriate intervention maximize recovery. "Time is spine."

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