CWCCA Health Seminar – IVDD

We attended the presentation on intervertebral disc disease presented by Dr Randy Longshore DVM of Gulf Coast Veterinary Specialists.

Anybody who reads this and wants to add more in the comments (whether they attended or not) please feel free to do so. I may edit the first page to include the comments.

He talked about the types of IVDD and did a good job of explaining them in layman’s terms:
Hansen’s Type I – explosive rupture which emplodes fluid into the spinal column – often at 4-6 years of age
Hansen’s Type II – a rupture which slowly leaks fluid
Hansen’s Type III – rupture due to traumatic injury

Type III was a recent addition in terminology. The difference between Type I and III is that Type I is from a degeneration and III is from an injury.

Dr Longshore went on to say that dwarf dogs such as dachshunds and corgis almost always have an explosive rupture (Type I). He feels it is hereditary, though we didn’t go into the exact method in which achondroplasia affects bone development. He did mention the fact that changes in the discs often start at an early age.

He feels that the following are not pertinent to disc rupture:
1) The weight and condition of the dog
2) The activity level of the dog
3) supplements sold on the internet purporting to aid in back health are of no value

However, good conditioning of the dog at the time of surgery can lead to an easier and earlier recovery.

If your dog is exhibiting symptoms please do not resort to chiropractic solutions. Imagine what applying force to a disc which is about to rupture can do.

He showed us several examples of views of calcified and ruptured discs take with 1) x-rays, 2) myelograms, 3) CT scans, and 4) MRI. Things learned:
1) the x-ray doesn’t show you much. It’s fairly easy to see calcified discs, but you won’t see the actual rupture.
2) myelogragraphy – if your vet is using that, you are getting 1990’s technology. It does show more than an x-ray as you can see the point where the dye stops. There is also a danger of seizure following a myelogram.
3) CT scans and MRIs are both effective at showing the actual site of the rupture. (Of course for some of us in the boonies finding a nearby veterinary MRI facility in an emergency is not possible).

We watched an interesting video showing an actual surgery, showing the white disc material (looks like cottage cheese) suctioned out.

Dr Longshore touched on the difference in symptoms and onset of IVDD and DM and brushed on the genetics involved.

Symptoms of disc rupture in range of severity:
1) pain
2) loss of proprioception – the sense of where the body is in relation to space
3) loss of mobility
4) loss of superficial pain sensation
5) loss of deep pain sensation (i.e. bone)

To test loss of proprioception, you can turn a dog’s rear foot over. The dog will normally right it automatically. If a dog comes in already not walking there is no need for that test. Similarly if a dog comes in to the practice still mobile, there is no need to test for loss of pain perception.

We were given statistics about recurrence rates with and without surgery for different levels of damage.

We watched a video of dogs with disc problems in the neck area, and how they held their heads.

We watched a video of a recovering dog with partial mobility on the ground and on a underwater treadmill.

After the seminar, I went up to the doctor and told him about Ethan’s case. From the symptoms and the time frame he guessed that the problem was (as posted on Mandy’s FB thread) ascending myelomalacia. He didn’t give us any statistics for how often it happens, but I would guess that “rarely” is thankfully correct. As I understood the explanation, the dying nerve cells in the spinal cord release a toxic substance. That toxic substance kills the next cell in line, which releases a substance killing the next cell in line, and so forth. At some point it reaches the nerves that control the muscles of the diaphragm which are necessary for the dog to breathe. At that point it is invariably fatal. A fever often accompanies the process as the body looses its ability to control temperature.

I’m not sure that makes it easier to deal with, but it is at least an explanation.

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24 Responses to CWCCA Health Seminar – IVDD

  1. Bobbie Mayer says:

    Myelomalacia is thankfully rare; I’ve read about it but this is the first case I’ve actually heard of. A more common life-threatening complication is UTI so it is really important to make sure the bladder is being emptied- often it is assumed that because there is leakage it is complete when it rarely is if paralysis also exists.

    I’d like to see that stats on surgery vs. time and stage of injury when you get a chance to put them up. I’ve seen some but also quite a bit of disagreement about what the numbers are.

    Sounds like a very good seminar.

    • C-Myste says:

      We had to be very careful to express Juneau’s bladder frequently; every two hours (day and night) at first. In googling the Doctor’s name, I saw a study using cranberry pills vs. placebos they were asking people to enroll their dogs in. It wasn’t discussed during the seminar.

      I was misremembering the statistics last night, which is why I didn’t post my guesses. I’m going to ask Lani if she has it in her notes.

  2. Richelle says:

    Leave it to Ethan to be rare, so unfortunately. The initial surgeon, Dr. Sicard, who reviewed the MRI showed several lesions along his spinal column, so he’d had many “minor” injuries we didn’t even know about. We still wonder, since Dr. Sicard said the most disc material was on the left, if the leg injury he seemed to have last year was actually related. Vets guessed arthritis rather than ligament problems, but it still seemed odd. He would play in the yard, chasing his basketball, come in and hang out for awhile, then go to his crate. A couple hours later before we went to bed, we’d get him out and he’d limp on the left rear mostly, but sometimes it was hard to tell what side. By morning, he’d get up and be fine. It was very odd and now I wonder if it was back problems, perhaps pressure on his nerves and cord way back then. I’ll never know and always wonder, but doubt this was ever really in my control.

    Was the doctor iffy on chiropractic for healthy dogs not exhibiting symptoms?

    Also, would you mind sending detailed pictures of your bed stairs and couch ramp, please? The girls are getting some new tools to use. We’re also blocking off all but the shortest sides of the deck.

    • C-Myste says:

      1) Leg pain: an emphatic “yes”. I forgot to mention that and it was discussed. It can be like sciatica in a human. A dog may hold a front leg up, thinking that his leg is hurting, or a rear leg. They often have to diagnose whether they are dealing with a back problem or a torn ligament.

      2) Chiropractic: while he didn’t exactly say “never do it” that would be my take. A dog may have degeneration and be asymptomatic until the back is stressed. But then if the dog is asymptomatic the owner would generally not be thinking of taking him to a chiropracter.

      3) Steps/ramp: Tom, can you draw up some plans and instructions that we can post?

  3. Bobbie Mayer says:

    Did he talk at all about jumping off things and stairs?

  4. Megan says:

    So with a dog exhibiting leg pain, what is the best method to determine if it is a ligament issue or back issue? Greta still occasionally limps on one of her front legs. What Richelle described with Ethan’s back leg sounds describes Greta exactly, only on the front instead of the rear. With very real possibility of IVDD being genetic, and knowing that Sage (Greta’s litter brother) mom’s vet already found changes to Sage’s spine, it makes me wonder (and fear) that she actually has something going on in her back. When we took her to our vet, they diagnosed a simple soft tissue injury and prescribed Rimadyl and rest. Which is what we have done. However it’s been nearly a year and she still gets very gimpy from time to time. Is she simply re-injuring it repeatedly due to too much activity or is there something more sinister going on…

    Is MRI the only way to go? Where does one go for that and what does it cost? And the even bigger question that comes to mind, is if there is any point in doing one since there isn’t going to be a lot I can do to stop the degeneration in her back, if that is in fact what we are dealing with. I already limit her activity. No jumping. No getting on the furniture by herself.

    Yikes. Feels like a giant can ‘o worms…

    • C-Myste says:

      More often it is probably a soft tissue injury, especially with an active dog who is straighter in the shoulder than optimum.

      The doctor didn’t say it was
      difficult to diagnose, just that you can’t assume it is one or the other.

      And yes, I believe it is a can of worms.

      I have to check back with Kathy and remember if it was xraya or if she actually did an mri. My take was that we have corgis, there will be calcification. And that calcification is not the problem. They don’t do surgery to clean that up.

      • Richelle says:

        And, for you, you could probably go to the vets we took Ethan to in Clackamas. They truly were wonderful and did all they could. Anyway, you don’t want to do MRIs willy-nilly. The cost of MRI alone, not including sedatives, etc. was $1585 from what I can tell from the bill.

  5. Bobbie Mayer says:

    I don’t know the answer to the best way to determine what’s causing the pain and lameness, but if a cruciate ligament is completely ruptured the vet should be able to tell by manipulating the joint. If it is just injured it would be harder to tell. However, I do think it would be important to know because if it IS a ligament and your dog starts favoring it it puts more stress on her back and even if this is a soft tissue injury she could also have back issues. That might be a good question to email to the speaker, Dr. Longshore. There is contact info on this page.. http://gcvnn.com/about-us/neuro-team/

  6. Susan says:

    Did the dr. mention any added risk factors related to jumping on/off furniture or going up/down stairs?

    • C-Myste says:

      No, the doctor did not seem to think it mattered. As Mandy just said to me “if it’s gonna blow it’s gonna blow”. Someone asked if he saw more problems now that agility is so popular and the answer was “no”. Most injuries caused by agility are osteo injuries, not disk ruptures.

      With the short legs and lack of shock absorbers, IMO they are going to be more prone to injuries, even if it isn’t directly related to back injury. So to play it safe, I’m going to keep using steps.

      • Richelle says:

        We plan to go more to the safe side. We’re blocking off the side of the deck Ef liked to leap from when chasing squirrels or barking at beagles and we won’t let Libby, in particular, jump off the bed…even though it’s been lowered. I think Ethan showed many signs over the years that he had problems, but we just didn’t know it. And, worst case scenario is usually surgery and therapy, not what happened with Ethan.

  7. C-Myste says:

    New question. On the subject of predisposition to disc ruptures being hereditary: if it turns out to be true that all corgis equally carry whatever gene it might be that leads to the degeneration, we will be unable to breed away from it without crossing with other breeds so that they are no longer achondroplastic dogs.

    Musing: what would be the ethics involved in continuing to breed them as they are.

    Note: I know that not all go down. I don’t even know what percentage do. I’m just throwing out some thoughts.

    • Bobbie Mayer says:

      I don’t think all achondroplastic dogs are susceptible as I don’t believe all Pems are. We don’t see nearly as much IVDD in Pems as you do in Cardis which suggests a hereditary basis. And in Pems it definitely seems to appear in some lines (I know of at least one, anyway.)

      So maybe at least you could breed away from it by crossing to Pems, if they can find some genetic marker and if I’m right and some Pems don’t have it.

      Of course, that’s a lot of ifs… if they find a marker, if some Pems are clear, if it is inherited in a way that would allow you to introduce it that way. (Although if some Pems are clear I’ll bet some Cardis also are.)

  8. Kathy M. says:

    RE: Sage – We did not have an MRI done, just an x-ray. At this time he has absolutely NO symptoms that would cause one to think that anything was wrong with his back or his legs. We happened upon his issues by accident. We thought there was the possibility that he may have eaten a rock. I took him in to have an x-ray to check for that. Thankfully, there was no rock, but the vet was very surprised at the condition of his spine. There are two vertebrae showing slight calcification and you can see where the disc material is starting to leak. It is hard to really see much detail in an x-ray, but it was enough for the vet to know that his condition was certainly abnormal for a dog of his age. At this time, Sage is in no apparent pain or discomfort, but the vet said that the degradation was more consistent with a dog of 7-8 years of age than one that is only 2 years old.

    She also said that there is no way to know how things will go in the future. Many dogs with this level of damage remain relatively stable and do not worsen throughout the course of their lives, while others can have traumatic episodes. She did caution us not to allow him to jump down from furniture, etc. Sage has had steps for the two pieces of furniture on which he’s allowed.

    I will post pictures of his spinal x-ray, and a link to the steps that we got for him on my blog http://forpaws.wordpress.com/ The steps are great. They are wider (deeper treads) than a standard step, which is great for long dogs.

    In thinking back, there were two things that I saw when Sage was a young puppy that caused me to wonder about his back. In the area of the two affected vertebrae, he had a roach when he was very young. He has outgrown that during his second year. The other thing, which I do think is related, is the fact that when he stretches in the “downward dog” pose, arching the back into a deep “C”, Sage doesn’t stretch into a C shape. His back remains relatively straight. When Denali does this, she is clearly more flexible and drops into a very deep “C”. I didn’t think too much of it until the spinal x-ray results.

    • Richelle says:

      Did either Sage or Denali give you any grief about using these stairs? I think I may get a two step set. We lowered the bed long ago, so these would be perfect for it, as well as the couch. Another plus is that they’re on sale now with free shipping. I think they might also travel better than something we make ourselves.

      • Bobbie Mayer says:

        I think ramps are better than stairs for being easy on the back. (Sometimes impractical for length but if you can fit one they are easier for dogs to use.) My mom cannot get her corgi to use stairs to the bed.

      • Julie says:

        Richelle, I have stairs for my bed and ultimately I had to put an x-pen around the bed. My cardi Bug would take the stairs going up but insisted on jumping off. It is a shorter x-pen (32″) and my Schnauzer sometime jumps it, but Bug has enough self preservation he uses the stairs now.

      • Kathy M. says:

        Like any other new behavior, training a dog to use the steps is definitely a process. They won’t do it on their own. I started by training Denali and Sage to go UP, rather than down, as it is easier. Once they had the confidence to go up in response to the command “steps,” we started with down. They’re getting it and Denali actually used the steps on her own the other day. Since we have a waterbed, it isn’t that high and they’re willing to take a shortcut and jump when they’re in a hurry. Again, as in training any behavior, it is consistency. If I am there and give them the command, they will go down the steps. Soon they’ll be doing it on their own, but it does take time and patience. No question that using treats in response to the desired behavior would speed up the learning process. Essentially it is similar to training a dog to take a jump in rally or obedience. 1. Break the behavior into manageable pieces and choose a command word. 2. Reward each piece and string the behaviors together. 3. Reward the behavior consistently at first, then wean them off of the reward intermittently to cement the behavior.

        • Kathy M. says:

          One more comment: For a corgi, or other long-backed dog, I can certainly see a reluctance to use stairs. They’re just too long to use stairs with a standard tread depth easily. Having the wider treads on the steps that I posted on my blog makes it a lot easier. I agree with Bobbie that a ramp is the easiest, but not always a viable solution in a limited space. My dogs did learn to use a ramp much more quickly.

  9. Kathy M. says:

    P.S. For obvious reasons, I was very interested in this seminar. If there is more information that you’re able to share with me when you get home and have the time, I’d be very appreciative. While I don’t intend to tempt fate by putting Sage in a situation that would cause him to put undue stress on his back, the fact is that he’s an active, playful dog. Within reason, I am going to allow him to live his life, being mindful of his activities. He will have the opportunity to compete in Rally, jumping 8″ jumps, but isn’t a candidate for agility in my mind. Just seems like common sense.

  10. Jen M says:

    Very interesting, Carolyn – thanks for posting. I am confused, however – is IVDD the same thing as DDD (degen. disc disease)? Also – is there any way to manage IVDD? Glucosamine supplements? What about Adequan shots, or HA/steroid shots?

    I suspect our grand old man’s herniated disc was a Hansen’s Type I. His surgeon at NW Vet Specialists called K’s rupture “one of the most remarkable ones he’d ever seen,” with an “impressive” amount of material, and K was about 5? years of age at the time.

    • C-Myste says:

      Same thing, Jen. IVDD is the more common name I believe.

      The Doctor specifically said that Glucosamine supplements do nothing for IVDD, nor do any other supplements. Supplements or drugs that work on soft tissue or on joint membranes have nothing that will do anything for degenerating bone in discs.

      I know that we all want to be able to “do something” so that our dogs won’t suffer this fate. From the information in the seminar it doesn’t really sound like there is much to do. There are no supplements, there are no pre-rupture surgical solutions, the weight and condition of the dog doesn’t matter, nor does its activity level.

      I will continue to use steps/ramps, but that is even more important for joint and growth-plate protection than it is for their backs.

      On steps: when we have tried some of the smaller “regular” steps our dogs have had difficulty negotiating them. You can see the steps to our bed here. Note that each step is long and we turn it sideways to fit the bed.