Canine intervertebral disc disease (called I.V.D.) is a common
orthopedic problem seen by veterinarians.
The discs are thick plate- or disc-like cushions which lie between
the bony vertebrae in the spine. They are composed of a fibrous
outer layer called the annulus fibrosus and a pulpy, gelatinous
center called the nucleus pulposus. They help to cushion the spine
as your dog walks, trots, runs, twists, and jumps.
As time goes by, the discs start to degenerate. The blood supply
to the disc decreases, so the tissues are not so vital and resilient.
The soft, gelatinous central material is replaced with harder
cartilaginous material.
2.)
What causes I.V.D.?
In certain breeds, called the chondrodystrophic breeds, the discs
degenerate much faster than in non-chondrodystrophic breeds. (Chondrodystrophic
means “abnormal cartilage”.) In fact, degeneration
can
start as early as 6-12 months in some chondrodystrophic dogs!
(Examples of chondrodystrophic breeds are the Dachshund, Pekinese,
Lhasa Apso, Shih Tzu, Basset, Beagle, and Poodle.)
Other factors which cause or worsen the degeneration are the wear-and-tear
associated with an active life, obesity, and a poor diet.
Disc disease is of two types: Type I and Type II. Type I consists
of a sudden, large tear in the degenerated, weak outer layer of
the disc which causes the degenerated, hard center to explode
up into the spinal canal.
Members of the chondrodystrophic breeds get Type I I.V.D.. Since
degeneration of the discs occurs earlier in these dogs, Type I
I.V.D. usually shows up first between 4 to 6 years of age.
In the Type II disc disease, the tear in the outer layer is smaller
and tends to occur gradually over a period of time. The central
material tends to bulge up into the spinal canal but then will
fall back into place between the vertebrae. This second Type tends
to occur in breeds with normal cartilage. Since the degeneration
in these dogs occurs more gradually, Type II I.V.D. usually shows
up first between 8 to 10 years of age.
3.)
If my dog has I.V.D., what signs would I look for?
When the core material comes out of its normal place in the center
of the disc and goes into the spinal canal, it presses against
the nerve roots as they come off the spinal cord. Pain results
from this pressure on the spinal nerve roots and from damage to
nerves in the outer disc layer when it tears.
When the inner disc material presses or explodes into the spinal
canal, it causes mild to severe damage to the spinal cord, for
there is little or no room within the canal for the cord to move
away from the invading foreign matter. As mentioned above, in
Type I I.V.D., where the disc material breaks out with great force,
trauma to the cord can be extensive. Things are further complicated
when the cord swells in reaction to the blow. Traumatic hemorrhage
within the cord damages it further.
Putting this all together, what would you see if your dog had
I.V.D.? If your dog is one of the chondrodystrophic breeds, the
symptoms will tend to be more acute (sudden). Pain is the most
common symptom, manifested in several ways, from shivering to
reluctance to move to muscle rigidity to lameness to screaming.
In more advanced cases your dog could suddenly be partly or completely
paralyzed, and may be unable to urinate or defecate.
If your dog is of the non-chondrodystrophic breeds, the symptoms
tend to be less acute. That is, they come on more gradually, and
they can come and go (as the disc material bulges in and out).
Both pain and signs of nerve/cord damage (knuckling over, dragging
of feet, partial or complete paralysis, incontinence) are seen.
The symptoms also tend to be less severe, although this is not
always the case.
4.)
Where in my dog’s spine is I.V.D. most likely to cause problems?
Discs tend to rupture most commonly in areas of the spine where
there is the most movement. This occurs in areas of transition
in the spine, ie, the cervical/thoracic (neck/chest) and the thoracolumbar
(chest/lower back) areas. The vertebrae in the thoracic area are
rather rigid in terms of movement, whereas in the cervical and
lumbar areas they are looser. There is therefore more of a chance
of a shearing movement in these areas that connect the looser
and more rigid sections of the spine, and this type of movement
can cause a disc to rupture. A very simple movement, such as going
down a small step, turning suddenly, or even straining to defecate,
can cause a tear in a weakened disc.
5.)
What is the treatment for I.V.D.?
Conventional treatment consists of enforced rest, anti-inflammatory
drugs (usually corticosteroids or drugs related to cortisone),
pain medication, muscle relaxants, and sometimes tranquilizers
(to keep the patient quiet). If this fails, or if there is paralysis,
surgery is often done. Surgical intervention relieves pressure
on the cord and nerve roots by either scraping away disc material
from underneath (done in the neck area) or removing part of the
vertebra forming the bony spinal canal (done in the back area).
If surgery is to be successful, it needs to be done quickly,
preferably within the first 24 to 36 hours after the disc ruptures.
Surgical intervention prevents further damage to the cord as pressure
is relieved, but it cannot heal the damage already done to the
cord and nerves.
6.)
What part do acupuncture and chiropractic play in the treatment
of I.V.D.?
One or both can be very helpful in this condition. They can be
done separately or together, and they can be combined with drug
treatmentand/or surgery or done instead of the more conventional
treatments.
Acupuncture, like drug treatment or surgery, has the most success
if done soon after the disc ruptures. Chiropractic adjustments
are not done in the immediate area of the injury while things
are still “hot” (acutely inflamed), but they can be
done above and below the “hot” area immediately after
the injury to treat the compensatory muscle spasm and vertebral
misalignments in other areas of the spine.
With acupuncture and chiropractic, as with drugs and surgery,
the chances for recovery also depend on how severe the injury
to the cord and nerves is to begin with. As you would expect,
animals with mild damage have a good chance of complete recovery.
Animals with severe damage may only have slight or partial recovery.
7.) How do acupuncture and chiropractic help a dog with
I.V.D.?
Let’s first discuss acupuncture. After over 20 years of
investigation in the West, we know that acupuncture stimulates
nerves, relieves muscle spasm, and increases blood circulation,
as well as causing the release of endorphins (for pain) and cortisol
(for reducing inflammation).
From a Traditional Chinese Medicine (TCM) point of view, the stimulation
of various points on the routes (called meridians) along which
the body’s energy flows helps to restore the flow of energy
which was interrupted by trauma or other factors. The return of
a more natural energy flow allows healing to take place so that
more normal function can return and pain can be relieved.
Fine needles are most commonly used to stimulate the acupuncture
points, but pressure, laser or other high-intensity light, electrical
stimulation, and a healing herb treatment called moxibustion can
also be used. Most dogs don’t mind acupuncture; in fact,
as time goes by and they realize the treatments make them feel
good, they even look forward to them!
The wonderful thing about acupuncture is that it utilizes the
body’s own healing forces. It doesn’t have the serious
side effects sometimes seen with drugs and surgery. It will enhance
your dog’s chances of recovery, especially if started right
after the injury. If some time has passed since the injury, the
likelihood of success for acupuncture decreases, but this does
not mean it cannot help at all. Your veterinary acupuncturist
can help you evaluate the chances for success with acupuncture
for your dog.
How does chiropractic care help? A dog with I.V.D. usually has
what are called subluxations in the vertebrae of the spine. These
are misalignments between vertebrae, or, in simpler terms, the
vertebrae don’t exactly line up with one another. These
subluxations or misalignments come about through injury, poor
posture, and various other insults to the spine. They put abnormal
pressure on the discs, further increasing the likelihood of a
rupture. Once the disc rupture takes place, the subluxations get
worse, exaggerated through spasm of the spinal musculature and
the odd positions the body takes as it tries to compensate for
the injury. These misaligned vertebrae also further pinch the
spinal cord and nerve roots which are damaged when the disc ruptures,
resulting in more pain and impairment. Chiropractic adjustments
help to re-align the vertebrae, relieving pressure on the cord,
nerves and discs. It is even more effective when combined with
muscle work which reduces the muscle spasms which cause or contribute
to the subluxations. As mentioned above, adjustments are not done
over the area of injury when it first occurs. However, adjustments
and muscle work are very helpful in other areas of the spine immediately
following the injury. These treatments can be wonderfully effective
in relieving pain and helping to restore function. When the injured
area has stabilized somewhat, chiropractic work in that area further
promotes the return to better functioning.
When acupuncture is combined with chiropractic, the results are
synergistic; that is, they each enhance the other treatment.
8.)
How frequently are these treatments done?
Initially, treatments are done one or more times a week. As improvement
occurs, the time between treatments is increased. If a dog is
brought for treatment soon after the injury occurs, fewer treatments
are usually needed.
Canine
Intervertebral Disc Disease