What is Intervertebral Disc Disease (IVDD)?

dog spinal column showing ruptured disc from IVDD

Intervertebral Disc Disease, also known as IVDD, is a degenerative disease in dogs that affects the discs of the spine.  A disc is like a cushiony shock absorber between each vertebrae.  It allows the movement of the spine without the vertebrae rubbing together.  Each disc has a softer gel-like interior surrounded by a tougher rubbery layer.  IVDD causes the discs to degenerate over time.  This simply means that the outer layer hardens and becomes brittle.  Unfortunately, there isn’t really a way to know this is happening without an MRI.  At some point, when the disc has become too brittle, it will rupture. The gel like substance inside will be forced out into the spinal column, causing nerve/spinal cord compression and profound inflammation.  This is usually caused by normal dog activity like a jump or turning too fast.  When the inside of the disc starts to bulge into the spinal column, this is when you will start having problems.  This is also likely when your dog will first be diagnosed with the disease.  

symptoms of the 5 stages of IVDD

Symptoms can range from mild pain to paralysis.

 

The amount of disc fluid protrusion will affect the severity of your dog’s symptoms, as well as the rate of protrusion.  Symptoms can range from mild pain to full on paralysis of the limbs.  Nearby nerves may be affected, or the spinal cord may be compressed and/or damaged, accompanied by severe inflammation in the spinal column, causing the paralysis.  An acute and forceful rupture will cause more damage to the spinal cord, which also means a lower chance for recovery.  Most commonly the hind legs will be affected, but the front limbs can also be affected if the injury is in the neck.  

 

Some breeds are more likely be affected.

 

There is no known cure for IVDD, but some preventative measures can be taken in advance.  Certain breeds are genetically predisposed to this disease, most commonly chondrodystrophic or “dwarfed” breeds.  These are the ones with short legs and long backs like dachshunds, corgis, beagles, and shih tzus.  Lhasa apsos, pekingese, cocker spaniels, and poodles may also be affected.  Obesity raises the risk for these dogs.  Some larger breeds are also at risk of IVDD, including german shepherds, labrador retrievers, and doberman pinschers.  The onset of symptoms is usually more gradual with larger breeds.  Other dogs who are not genetically predisposed may still get IVDD. 

If your dog is genetically at risk, you may want to take some preventative measures like not letting them use stairs, no jumping on and off furniture, and building ramps in your home.  A study on mice has shown that CBD oil may slow the degeneration of the discs.  It is also a very potent anti-inflammatory.  Probably the most important thing you want to do if your dog is a predisposed breed is to know what symptoms to look out for so that you can catch it in it’s early stages.  The faster you act when symptoms first show up, the better chance your dog will have of not becoming paralyzed and making a full recovery. 

 

The five stages of IVDD

 

Symptoms:

We can break IVDD down into 5 stages.  Your dog will present with one or more of the following symptoms.  The severity of their symptoms will determine what stage they are in.  Onset of certain symptoms may be sudden, gradual, or intermittent.

Stage 1:  Mild Pain

  • Mild pain in the back or neck area
  • Stiffness in the neck or back
  • Reluctance to move the neck or head
  • Lowered head stance
  • Reluctance to jump up or down from furniture

Stage 2:  Moderate to Severe Pain

  • Moderate to severe pain in the neck or back
  • Yelping when moved or touched
  • Yelping when trying to get up or down
  • Possible aggression when moved or touched
  • Panting, trembling indicating pain
  • Arched (hunched back)

Stage 3:  Ataxia or Lack of Coordination

  • Includes symptoms of stage 2
  • Lack of coordination in one or more limbs (ataxia)
  • Difficulty walking
  • Paws knuckling over or dragging when walking

Stage 4:  Paralysis

  • Includes symptoms of stage 2
  • Paralysis, or no voluntary movement, of affected limbs
  • May lose control of bladder function

Stage 5:  Paralysis With Loss of Deep Pain Perception

  • Includes symptoms of stage 4
  • Loss of bladder control
  • No feeling or deep pain perception in affected limbs
  • Abnormal reflexes in affected limbs.

 

What to Do When Your Dog Presents Symptoms?

 

No matter what stage of IVDD your dog may have, it is absolutely critical that you take the proper steps as soon as possible.  Stage 1 can very quickly become stage 5 if left unaddressed.  As soon as you see any of these symptoms you should immediately confine your dog to a crate to restrict their movement and call your vet.  Even if your dog is just stiff, if they are left to run about one wrong move or jump can lead to full on paralysis when a disc has ruptured.  If you have confined your dog and their condition continues to deteriorate, you need to go to an emergency animal hospital if you can not get in to see your regular vet right away. 

If your dog is paralyzed you need to get to a vet immediately and get a referral to a neurologist.  You can also go straight to an emergency animal hospital where there will likely already be a neurologist onsite.  If you can afford to do surgery, it’s important to act fast.  Dogs who receive surgery within the first 24-48 hours will have a much better chance of recovery.  If you can’t afford surgery, it’s still important to act fast to get your dog the proper medications.  Inflammation of the spinal column will cause a lot more damage.  It is vital to get them started on medication to reduce inflammation as much as possible.  I would also immediately start giving your dog CBD oil as it is a very effective anti-inflammatory and will help manage pain and stress.

 

Progressive Myelomalacia

 

Progressive Myelomalacia is something that you may not hear about often, but it’s something that you should be aware of.  It is a rare condition that is estimated to affect about 5% of dogs in the most advanced stages of IVDD.  Not a lot is known about PMM, but it is thought to be attributed to more acute disc ruptures.  It is characterized by necrosis or hemorrhaging of the spinal cord after an acute spinal injury.  Paralysis will start at the point of injury, but will eventually progress throughout the spinal cord.  Surgery can not be performed at this point, and surgery also does not seem to prevent it. 

Clinical signs include loss of anal and abdominal tone, loss of reflexes further up the body, eventually leading to paralysis of all limbs, and then death due to paralysis of the respiratory muscles.  There is no way to definitively prove progressive myelomalacia until a necropsy is performed, but it can be diagnosed through a combination of clinical signs and magnetic resonance imaging (MRI).  The time of onset of PMM usually ranges from immediately to 5 days after the initial disc rupture, though most dogs will present signs within 2 days.  Euthanasia is performed before the respiratory muscles are affected, usually within 3 days, but lasting up to 2 weeks.  The condition is said to be irreversible. 

 

My dog survived myelomalacia.

 

However, I will tell you this.  Four days after her initial diagnosis of stage 4 IVDD, my dog, Cali, was diagnosed with Progressive Myelomalacia.  She had all the clinical signs and her MRI showed evidence of  cranial deterioration of her spinal cord.  She had lost all feeling from the site of injury to her feet and tail.  She lost bladder function, reflexes, anal and abdominal tone.  We were told that she would not make it more than 2 days.  We brought her home and immediately started giving her CBD oil.  We constantly checked to see if her paralysis was progressing.  We wanted to make sure that when it was time, she could go peacefully. 

two weeks came and went, and it never progressed further up her spine.  Instead her pain went away and she was back to her happy playful self.  I have searched many hours trying to explain this miracle.  My neurologist had told me that she had never seen a dog recover from myelomalacia.  So how did this happen?

I was able to find a study done on 51 dogs all presenting symptoms of myelomalacia.  Five dogs were excluded because they had presented symptoms, but their symptoms had stopped.  Some other dogs had been euthanized immediately upon presentation of symptoms.  They concluded that it is possible that for some of them, the progression of the disease could have eventually stopped, and they could have survived. 

I thank god every day that I did not listen to the neurologist and euthanize my Cali right away.  I decided to wait for the symptoms to progress, so that I knew for sure there was no other way.  This is an extremely rare case, but my dog survived myelomalacia.