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Post-op Crate Rest to heal the disc
After IVDD surgery, crate rest is needed to allow the disc to heal
Continue ReadingLibrela (bedinvetmab)
Neuro Corner Answers
Dr. Andrew Isaacs
DVM Diplomate ACVIM (Neurology)
Dogwood Veterinary Referral Center
Primary interests include intervertebral disc disease, seizure management, luxations/fractures of the spine, and surgery for brain tumors
Question
LINDA ASKS:
What is your opinion of Librela (bedinvetmab)? We are seeing some vets using it for pain with an IVDD disc episode. Everything I’ve read says it shouldn’t be used for IVDD.
ANSWER
Hi Linda,
As far as I’m aware Librela is not licensed for use in cases of IVDD, but rather osteoarthritis.
We do not use it in management of IVDD cases. I guess you could potentially make the case for its application if all other forms of pain management have been exhausted, but I’d only do so with caution and making sure the owners are aware it’s not labeled for this use.
Do supplements prevent disc episodes?
Neuro Corner Answers
Dr. Andrew Isaacs
DVM Diplomate ACVIM (Neurology)
Dogwood Veterinary Referral Center
Primary interests include intervertebral disc disease, seizure management, luxations/fractures of the spine, and surgery for brain tumors
Question
LINDA ASKS:
Do supplements help with preventing disc episodes?
ANSWER
Hi Linda,
Unfortunately, there is not a supplement that I am aware of that will help degenerative intervertebral disks. The most important factor in helping prevent intervertebral disk episodes is minimizing high impact activities.
hemilaminectomy bone removal
Neuro Corner Answers
Dr. Andrew Isaacs
DVM Diplomate ACVIM (Neurology)
Dogwood Veterinary Referral Center
Primary interests include intervertebral disc disease, seizure management, luxations/fractures of the spine, and surgery for brain tumors
Question
LISA ASKS:
My dachshund had a herniated disc and had surgery today. The bone pieces were removed….is something put in it’s place? I won’t see the surgeon for a few days and wondered and can’t find the answer online.
ANSWER
Lisa, the typical surgical procedure to address herniated intervertebral disk material in the lower back is called a hemilaminectomy. In order to access the herniated intervertebral disk material compressing the spinal cord a small window is created in the bone (laminectomy) on the side (right or left, hemi) with the greatest degree of compression.
The bone is not replaced, but after the herniated intervertebral disk material is removed a barrier (gelfoam or fat graft) is placed in the bony defect. This serves as a protective barrier between the spinal cord and the surrounding muscle.
Diagnosing FCE vs. IVDD
Neuro Corner Answers
Dr. Andrew Isaacs
DVM Diplomate ACVIM (Neurology)
Dogwood Veterinary Referral Center
Primary interests include intervertebral disc disease, seizure management, luxations/fractures of the spine, and surgery for brain tumors
Question
MAGGIE ASKS:
Is there anyway you can tell the difference between an FCE and IVDD without an MRI?
We had an incident at our house yesterday with our 6 year old lab—very healthy, no previous back/joint issues of any kind. She fell while playing and instantly couldn’t move her back legs. She instantly tried to get up and started dragging her back legs behind her. We rushed her to the ER about 20 min away. She didn’t seem in any pain and was regaining movement in her back legs by the time we arrived at the ER. The vet did an x-ray and said it’s most likely IVDD or FCE.
ANSWER
Sorry to hear about your Lab.
Unfortunately, there is no way to differentiate an FCE from IVDD without advanced imaging.
The classic textbook FCE is a large breed dog with an acute onset of tetra- or para-paresis with one side more effected than the other (significant dichotomy), vocalization initially, but on presentation for exam non-painful.
The classic textbook IVDD is a chondrodystrophic dog with an acute onset of tetra- or para-paresis, relatively symmetrical, with sustained discomfort.
The history and signalment make me more suspicious for an FCE versus IVDD.
I’m glad she is improving.
Please let me know if you have any additional questions.
Take care,
Andrew
Thundershirts and Cool shirts
Neuro Corner Answers
Dr. Andrew Isaacs
DVM Diplomate ACVIM (Neurology)
Dogwood Veterinary Referral Center
Primary interests include intervertebral disc disease, seizure management, luxations/fractures of the spine, and surgery for brain tumors
Question
LINDA ASKS:
What’s your opinion or if there should be any restrictions about using a Thundershirt® or Cool Shirt® with an IVDD dog?
ANSWER
There wouldn’t be any contraindications for an IVDD dog wearing a thunder shirt or cool coat. Especially a thunder shirt if it helps to calm them when trying to cage rest them.
We do not recommend braces, but both the thunder shirt and cool coats aren’t stiff like a brace and still allow enough range of motion.
Take care,
Andrew
Large breeds and IVDD
Neuro Corner Answers
Dr. Andrew Isaacs
DVM Diplomate ACVIM (Neurology)
Dogwood Veterinary Referral Center
Primary interests include intervertebral disc disease, seizure management, luxations/fractures of the spine, and surgery for brain tumors
Question
LINDA ASKS:
When you see a larger breed with a disc problem is it usually IVDD (actually calcified discs) or an injury? How often do you estimate a larger breed such as a lab, dalmation, golden etc. actually has calcified discs?
ANSWER
Most of the time in larger breed dogs disk problems are secondary to a degenerative disk and not a true injury (hit by a car, falling out of moving vehicle, etc.). There are exceptions, but in general most of the time a degenerative disk is to blame. The degree of degeneration varies and is sometimes difficult to assess fully with radiographs (x-rays). Now that more MRI’s are being performed we can appreciate different signs of degeneration (loss of hydration and soft tissue changes) that are not visible on radiographs. There are cases in larger breed dogs where a disk ruptures and the herniated disk material has not degenerated to the point where it causes residual spinal cord compression. Unfortunately, the only way to know if there is spinal cord compression (and surgery is required) is with advanced imaging (MRI/CT/myelogram).
Neck surgery consideration in certain circumstances
Neuro Corner Answers
Dr. Andrew Isaacs
DVM Diplomate ACVIM (Neurology)
Dogwood Veterinary Referral Center
Primary interests include intervertebral disc disease, seizure management, luxations/fractures of the spine, and surgery for brain tumors
Question
LINDA ASKS:
Is there ever a reason cervical surgery cannot be done because of where the herniation is in the neck?
Thank you
ANSWER
When intervertebral disks herniate in the neck the intervertebral disk material can end up in a variety of locations surrounding the spinal cord and nerves. The ability to remove the herniated intervertebral disk material can be more challenging in certain circumstances. It is usually not that surgery cannot be performed, but rather how difficult the surgery would be to perform and the risk associated with performing the surgery.
Andrew
head lifting during sleep
Neuro Corner Answers
Dr. Andrew Isaacs
DVM Diplomate ACVIM (Neurology)
Dogwood Veterinary Referral Center
Primary interests include intervertebral disc disease, seizure management, luxations/fractures of the spine, and surgery for brain tumors
Question
BEV ASKS:
Hello. My baby was diagnosed with ivdd 3 years ago and had surgery. He drunk walked for a bit but now he scoots around happy as can be. Eats, drinks, plays with his toys. I notice when he is laying down and sleeping his little head will bob up and down, some days are worse than others and sometimes it doesn’t happen at all. It’s not like a dream just goes up and down. Does this happen to other dogs? Thank you!
ANSWER
We see upregulated reflexes in the legs from a previous injury to the spinal cord leading to rhythmic movements. This is something reflexual and not voluntary control. However, a previous spinal cord injury should not cause movement of the head.
Andrew
Fat graft during surgery
Neuro Corner Answers
Dr. Andrew Isaacs
DVM Diplomate ACVIM (Neurology)
Dogwood Veterinary Referral Center
Primary interests include intervertebral disc disease, seizure management, luxations/fractures of the spine, and surgery for brain tumors
Question
DEANA ASKS:
What is the “fat graft” during surgery?
ANSWER
A fat graft relates to a component of the surgery for decompressing the spinal cord secondary to herniated intervertebral disk material.
A dog’s spinal cord is well protected. A major part of this protection are the bones of the spinal column (vertebrae). In order to expose the region of the spinal cord that is compressed some of the vertebral bone is removed. After the herniated disk material is removed there is a defect in the bone exposing the spinal cord. In order to facilitate the healing process and protect the spinal cord one of two materials is placed into the defect in the bone of the vertebra. The two materials are either fat from the surrounding tissue (fat graft), or man-made material (gel foam). The choice of fat versus gel foam is surgeon’s preference.
Andrew Isaacs, DVM
Diplomate ACVIM (Neurology)
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