Conservative or Surgery
The information on this page was reviewed for correct medical information by Dr. Isaacs, DVM, (Neurology (ACVIM)
When surgery is a consideration:
- If your dog can’t walk OR with STRICT rest, neurological functions worsen and are lost (legs and bladder control)
- If STRICT rest is employed and after several attempts to go off of the anti-inflammatory, the pain returns
- If 100% STRICT rest had been employed and pain medications have been adjusted (dose, frequency, and mix of pain relievers) yet the pain can’t be brought under control
- If a dog is experiencing similar signs of neck or back pain, or mild neurological deficits for the 3rd or 4th time, meaning it may be the same disc is involved.
As damage to the spinal cord increases, there is a predictable stepwise deterioration of functions.
When the body begins to self heal nerves, often it follows the reverse order:
- Pain caused by the tearing disc & inflammation in the spinal cord
- Wobbly walking, legs cross
- Nails scuffing floor
- Paws knuckle under
- Legs do not work (paralysis, dog is down)
- Bladder control is lost (leaks on you when lifted)
- Tail wagging with joy is lost when specifically doing some happy talk to your dog
- Deep pain sensation, the last neuro function, a critical indicator for nerves to be able to self heal after a surgery or with conservative treatment..
- If surgery is not an option (for whatever reason) then the best option is conservative therapy.
Surgery can still be successful in the window of 12-24 hours after loss of deep pain sensation. Even after that window of time, there can still be a good outcome. Each hour that passes decreases that chance. Precious hours can be lost with a vet that gets DPS wrong. If surgery is an option for your family get to a neuro or ortho where ER hours are typical night and day.
General vets who may not see enough cases of IVDD daily, may not be proficient in giving the neuro exam and correctly interpreting what they see. Therefore precious time can be lost in wrongly identifying deep pain sensation. Only take the word of a board certified neuro (ACVIM) or ortho (ACVS) about DPS.