Neuro Corner Answers

Dr. Jared Galle
DVM Diplomate ACVIM (Neurology)
Dogwood Veterinary Referral Center

Primary interests include intervertebral disc disease, spinal trauma, wobbler syndrome, inflammatory brain disease, and developmental brain abnormalities (hydrocephalus and Chiari malformation).

Question

JODY:  Good day doctors,
I have a 12 year old female dachshund. Last week, she was diagnosed by a veterinary neurologist as having IVDD, following an MRI and a lumbar puncture as well. The lumbar area shows one disc that is of concern. His first line of treatment is Metacam for 3 weeks and then return for an appointment. I took her to this veterinarian subsequent to a very quick and almost un-noticeable episode of her dragging her left back leg for about one second. Having had a number of dachshunds I wanted to have her assessed before a crisis arose.

My question is this, looking now at the literature I am seeing that corticosteroids are being used rather than NSAIDs, so I am a bit puzzled at his choice. I would like to read your thoughts before I make an call to him to ask him to help me understand his decision to use the NSAID rather than another medicine.  Thank you very much.

ANSWER

Hi Jody, this question certainly opens a can of worms concerning the medical treatment of IVDD in dogs.

I should begin by saying that there is no study to support using corticosteroid (steroids) or NSAIDs for treating IVDD in dogs. Older recommendations to give high-dose, injectable steroids immediately after spinal trauma (ex. IVDD) were based on large human studies. The current recommendation in people is to not give high-dose, injectable steroids with spinal trauma. Based on this, most veterinary neurologists do not give injectable steroids.

On the veterinary side, you will find three medical treatments for IVDD:

• 1. Oral steroids
• 2. NSAIDS
• 3. No medications

The recommendation to treat IVDD in dogs with steroids or NSAIDs is often a personal preference since there is no study to support either drug.  Both medications are used to treat pain caused by inflammation.  Some neurologists will recommend NSAIDS because there are fewer side-effects when compared to steroids. You should ask the neurologist why he/she recommended NSAIDS over steroids. He/she may have a good reason.

The most important component when treating IVDD medically is to keep your pet crated.

Dr. Jared Galle, DVM
Diplomate ACVIM (Neurology)