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Dog back pain and herniated disc symptoms
The incidence of herniated discs in dogs is very low in the general canine population: occurring in only 2% of dogs. A whopping 73% herniated discs occur in chondrodystrophic (dwarf) breeds of dogs. This is due to a genetic mutation that causes premature degeneration of their intervertebral discs. The severity of back pain and dysfunction in dogs is graded on a scale of I-V. This grading system helps to determine if surgery is needed and prognosis for recovery. Chondrodysplasia is a genetic phenotype of dogs with shortened legs. Some dogs have a genetic mutation that is called chondrodystrophy. This mutation codes for a phenotype of short legs and premature degeneration of their intervertebral discs.
Chondrodystrophic dogs and intervertebral disc disease
Of the chondrodystrophic dogs that develop a herniated disc one quarter of them are in the Daschund breed. Other more commonly affected breeds are: beagles, cocker spaniels, ShihTzus, Pekingese, Lhasa apsos, Welsh corgis and poodles.
This is a more complete list of dogs appropriate for testing for the genetic mutation that increases risk for disc herniation provided by the Veterinary Genetics Lab at UC Davis.
Alpine Dachsbracke, American Cocker Spaniel, Australian Shepherd, Basset Hound, Bavarian Mountain Hound, Beagle, Bichon Frise, Boykin Spaniel, Cardigan Welsh Corgi, Cavalier King Charles Spaniel, Chesapeake Bay Retriever, Chihuahua, Chinese Crested, Clumber Spaniel, Coton de Tulear, Dachshund, Dandie Dinmont Terrier, Danish Swedish Farmdog, English Springer Spaniel, Entlebucher Mountain Dog, French Bulldog, German Hound, Havanese, Jack Russell Terrier, Maltese, Pekingese, Pembroke Welsh Corgi, Pinscher (Miniature), Poodle (Miniature and Toy), Poodle (Standard), Portuguese Water Dog, Pug, Rat Terrier, Russian Tsvetnaya Bolonka, Schweizer Laufhund, Schweizerischer Niederlaufhund, Scottish Terrier, Sealyham Terrier, Shih Tzu, Skye Terrier, Yorkshire Terrier
Intervertebral discs function as shock absorbers (like rubber between the bones of the vertebral column) and stabilizers of the spine. Intervertebral discs start to lose elasticity and may calcify as the discs age. This is called intervertebral disc disease (IVDD). This degenerative process of losing the normal “squishy elasticity” of the disc can lead to a “bulging or slipped disc”. This is when the disc’s thick outer annulus (like car tire ) bulges into the spinal canal. This presses on the spinal cord. A herniated disc is caused by a sudden tear in the disc’s outer annulus. This causes the creamy toothpaste-like center to suddenly shoot into the spinal canal, injuring the spinal cord.
Sadly this disease affects most dogs in the prime of their life. Disc herniation in dogs occurs most commonly between the ages of 2 to 7 years, with a peak incidence of 5 years. The two biggest factors for developing IVDD are: breed and the presence of calcification in the discs. Chondrodystrophic dogs are most at risk for back pain and disc herniation because their discs start to degenerate early.
Symptoms of IVDD in dogs
IVDD’s most common symptom is back pain. Pain occurs secondary to discs that are starting to bulge into the spinal canal. This causes inflammation and discomfort as they irritate the surrounding nerves and cause compression. Herniation (explosion of material from the center of a disc into the spinal canal) is more likely to cause severe symptoms.
Back pain can be centered in the cervical spine (the neck) or the thoracolumbar spine. Cervical spinal IVDD causes pain which looks like a stiff gait in the front legs. Dog may lower their head and guard their neck. Sometimes there are shoulder spasms. Inflammation of the nerve that exits the spinal column in the neck can lead to a limp in one front leg and sometimes both front legs. This is called a nerve root signature. Weakness (paresis) and paralysis (in ability to move) is less common in this area but can occur.
Back pain in the thoracolumbar spine (bottom of the neck to the tail) can cause varying degrees of back pain. Physical symptoms may include arching of the back, wobbliness when walking, weakness when walking, and knuckling on the back legs. The weakness can progress to the point that a patient can’t physically walk . They may be too weak to walk but able to voluntarily move their legs or they may be paralyzed.
Other ancillary symptoms can include decreased appetite, vocalization and urinary dysfunction. Dogs with back pain from IVDD can have trouble emptying their bladder. This is due to impairment of the nervous function to the bladder. This is called “upper motor neuron bladder”. Paralyzed dogs must have their bladders manually emptied by pressure on the belly.
Dog herniated disc cost of treatment:
Conservative therapy for dogs with disc disease with minimal diagnostics averages around $300- $800.
Conservative therapy following advanced diagnostics (such as an MRI) would average $1500-$3000.
Surgical costs vary depending on factors such as anesthesia time, use of emergency personnel, on-call fees, length of hospitalization and relative costs in the area where the surgery is performed. An estimated range is $4000-$9000.
Prognosis for IVDD in dogs
A dog’s degree of neurologic dysfunction from back pain episodes are graded I-IV based on severity of signs. This correlates with prognosis for their recovery to normal function.
Grade I disc disease is characterized by spinal pain only and no neurologic impairment
Grade II disc disease is characterized by mild to moderate weakness (paresis). The patient can still walk but has proprioceptive deficits (diminished ability to know where their feet are).
Grade III disc disease is neurologic weakness so severe the dog cannot walk. These dogs can still move their back legs however. They may also have difficulty urinating.
Grade IV disc disease is paralysis with urine retention. The dog can still feel sensation to their back legs with a pinch on their toes.
Grade V has the most grave prognosis because there is complete paralysis and lack of sensation of deep pain.
Dep pain fibers run deep inside the spinal cord. Loss of the ability to detect pain in the back legs indicates more severe compression of their spinal cord. Loss of deep pain sensation in a dog with disc disease carries a very guarded prognosis for return to function.
How do you treat a dog with a herniated disc?
Conservative medical management at home is appropriate for dogs that present with grade I symptoms. These are dogs that have back pain symptoms only but no weakness or diminished ability to walk.
Conservative treatment at home is also appropriate for dogs with grade II symptoms. Dog with back pain and mild weakness and proprioceptive deficits.
However, any dog with grade I or grade II symptoms that are worsening should be re-evaluated quickly.
Surgery is recommended for all dogs in grade III and IV IVDD
For dogs that present with stage V IVDD the prognosis is guarded even with surgery. If the loss of deep pain occurred recently, surgery within 24-48 hours has the best chance for return of function. Immediate surgery for dogs that present with no deep pai will provide the best chance of return to function. Generally regard these patients as having a 50% chance to regain the ability to walk again.
Can a dog recover from a herniated disc?
In a meta-analysis of 20 studies of IVDD dogs that had grades III and IV disc disease:
93% of these dogs were able to walk again after emergency surgery.
However, only 61% of dogs who went to emergency surgery after losing deep pain sensation were able to walk again.
Of those dogs that were stage III and IV and treated conservatively with medical management alone had poorer outcomes depending on the severity:
70% of dogs were able to regain the ability to walk if they presented with grade III signs (Unable to walk but still able move their legs)
62% of dogs were able to regain the ability to walk if they presented with grade IV signs (unable to walk or voluntarily move their legs)
Only 10% of dogs were able to regain the ability to walk again if they presented with grade V signs.
Can a herniated disc fix itself?
A dog that suffers from a herniated disc or a slipped disc can recover. They need time for the disc to seal again and time for the swelling to subside. The bruising and swelling of the spinal cord can slowly heal , but it depends on the degree of impairment to the spinal cord. Cues regarding the degree of damage to the spinal cord are based on the grade of spinal dysfunction.
Dog slipped disc home treatment
The mainstay of home therapy is to strict confinement for up to 6 weeks to enforce inactivity and rest. Rest helps the damaged disc to seal up and allow time for swelling to subside.
A crate should be large enough for your dog to stand and turn around, eat and drink. The confinement area should be well padded to prevent pressure sores. If your dog cannot urinate easily, manual bladder expression may be necessary 3 to 4 times a day. If the bladder cannot be adequately emptied often enough permanent damage to the urinary bladder can occur. The bladder wall muscle can become stretched and cause permanent incontinence.
Physical therapy can help maintain muscle and joint health. This includes standing and balancing exercises and passive range of motion drills.
How to pick up a dog with a slipped disc
You will need to assist your dog to go outside. The use of a rehab harness that can help provide a gentle lift can be indispensable to aid in recovery. Here are three good products available on Amazon.
Another dog lift harness with a washable vest
How to make a dog comfortable with a slipped disc:
Pain relief: Gabapentin. 10mg/kg by mouth every 8 to 12 hours . Gabapentin is used for spinal pain because it blocks pain-inducing neurotransmitters in the spinal nerves. It can be combined with an anti-inflammatory for additive effects.
Anti-inflammatory medication: A tapering course of prednisolone 0.2mg to 1mg/kg over 5-7 days or a non-steroidal anti-inflammatory pain reliever can be used. NSAIDs should never be used with steroids as this can cause life threatening gastro-intestingal ulceration or perforation.
Opioids: Opiods may also be prescribed such as tramadol, fentanyl patches, methadone or Tylenol 3.
Muscle relaxation medication: Methocarbamol (15 to 20mg/kg po q 8 hours) or diazepam 1.1mg/kg po q 8 hours.
Acupuncture for dog back pain: Acupuncture has been shown to improve a dog’s recovery from IVDD. Adding this treatment modality can accelerate healing from IVDD surgery.
Prevention of back pain and IVDD in dogs:
Unfortunately there are no proof positive preventative measures. Limiting running and jumping is recommended along with maintaining a lean body weight. The tendency to develop disc calcifications is genetic. Dogs with disc calcification are at increased risk of further disc herniation. Scandinavia has advised not to not breed dachshunds who have 5 or more disc calcifications. These dogs are at increased risk for disc herniation.
Progressive myelomalacia: a grave prognosis
This is a rare but grave condition that occurs in 2% of dogs following disc herniation that is usually fatal. Even after a successful emergency disc surgery, the spinal cord may develop a progressive softening of the spinal cord. This injury can travel up and down the length of the cord and is called myelomalacia. It impairs respiratory function as the condition ascends to higher levels of the spinal cord. There is no treatment for myelomalacia.
The majority of dogs are diagnosed with this condition within 2-3 days of treatment. However, in some cases, the disease can take from 5 days to 2 weeks to progress.
In a study of dogs with myelomalacia, no dogs with grades 1 or 2 IVDD at admission were affected. Myelomalacia occurred in 0.6% of dogs with grade III IVDD. 2.7% of dogs with grade IV IVDD were affected. The highest numbers (14.5%) were in dogs with grade V IVDD at admission.
Recurrence rate for disc disease in dogs
Recurrence rate of IVDD in dogs is thankfully low in dogs that undergo surgical decompression. The recurrence rate is about 6 percent. Dachshunds, unfortunately, have higher rates of recurrence at 10 to 20%
Summary
The two biggest factors determining the likelihood of disc herniation is whether the dog is chondrodystrophic and whether calcifications are present in their intervertebral discs.
When disc herniation occurs, the grade of dysfunction will help determine the best treatment path and the prognosis for recovery.