Introduction:
As Dachshund owners, we’re all too familiar with the dreaded words “intervertebral disc disease” or IVDD. This condition, which can cause paralysis in our dogs, has long been a source of fear and heartbreak in the Dachshund community. But a new study published in the Journal of Veterinary Internal Medicine offers a ray of hope for dogs affected by this condition, especially when surgery isn’t an option.
The study, led by Sam Khan and colleagues at the University of Cambridge, challenges some long-held beliefs about the treatment of acute thoracolumbar disc extrusion (TL IVDE) in small dogs. Let’s dive into what this research means for our Dachshunds and how it might change the way we approach spinal injuries in these dogs.
Understanding the Study:
The researchers looked at 72 small, non-brachycephalic dogs (mostly Dachshunds) who had suffered from acute TL IVDE. These dogs were unable to walk and were treated conservatively – meaning without surgery – for 12 weeks. The dogs were divided into two groups: those who still had feeling in their back legs (deep pain positive or DPP) and those who had lost feeling (deep pain negative or DPN).
Key Findings:
1. Recovery Rates:
– 96% of dogs who still had feeling in their back legs (DPP) regained the ability to walk within 12 weeks.
– 48% of dogs who had lost feeling in their back legs (DPN) also regained the ability to walk.
2. Time to Recovery:
– DPP dogs took a median of 11 days to start walking again.
– DPN dogs took a median of 25 days to start walking again.
3. Spinal Cord Compression:
– Over the 12-week period, the amount of pressure on the spinal cord decreased in most dogs.
– Interestingly, this decrease in pressure wasn’t necessarily related to whether the dog recovered or not.
What This Means for Dachshund Owners:
These findings are significant for several reasons:
1. Hope for Non-Surgical Cases:
Many vets have long believed that surgery is the best or only option for dogs who can’t walk due to IVDD. This study shows that conservative management can be successful in many cases, especially if the dog still has feeling in its back legs.
2. Time Frame for Recovery:
The study gives us a clearer picture of how long recovery might take. While some dogs recovered quickly, others took several weeks. This information can help owners and vets make more informed decisions about treatment and prognosis.
3. Understanding Spinal Cord Compression:
The finding that recovery isn’t necessarily linked to the reduction in spinal cord compression is intriguing. It suggests that other factors, such as the initial severity of the injury or the body’s healing processes, may play a more significant role in recovery than previously thought.
4. Options for Those Unable to Pursue Surgery:
For many Dachshund owners, the cost of spinal surgery can be prohibitive. This study offers hope that with proper care and time, many dogs can recover without surgery.
The Conservative Management Approach:
So what did this “conservative management” entail? The study outlines several key components:
1. Pain Management:
Dogs were given a combination of pain medications, including NSAIDs, acetaminophen, and gabapentin.
2. Strict Rest:
Dogs were prescribed 4 weeks of strict cage rest, with only short leash walks for toileting.
3. Physical Therapy:
Owners were instructed in basic massage, passive range of motion exercises, and assisted standing exercises.
4. Bladder Management:
For dogs unable to urinate on their own, owners were taught to express the bladder manually.
This approach, while demanding for both dog and owner, proved successful for many of the dogs in the study.
Implications for Treatment Decisions:
This study doesn’t suggest that surgery is never necessary for IVDD. Indeed, there are likely cases where surgery provides the best chance for recovery. However, it does challenge the notion that surgery is always necessary for non-ambulatory dogs.
For Dachshund owners faced with a diagnosis of IVDD, this study provides valuable information to discuss with their veterinarian. Factors to consider might include:
1. The presence or absence of deep pain sensation
2. The severity of the spinal cord compression
3. The overall health and age of the dog
4. The financial resources available for treatment
5. The ability of the owner to provide intensive home care
The study suggests that even in severe cases (those without deep pain sensation), there’s still a chance for recovery with conservative management. This information could be crucial for owners who are unable to pursue surgical treatment due to financial constraints or lack of access to specialised veterinary care.
Comparing to Surgical Outcomes:
One of the most striking aspects of this study is how the recovery rates compare to those reported for surgical treatment. The authors note that the proportions of dogs recovering in this study (96% for DPP and 48% for DPN) are similar to those reported after decompressive surgery.
This doesn’t mean that conservative management is always equivalent to surgery. Surgical treatment may lead to faster recovery in some cases, and there may be other benefits not measured in this study. However, it does suggest that conservative management can be a viable option in many cases, particularly when surgery isn’t possible.
The Role of Spontaneous Decompression:
One intriguing aspect of the study was the measurement of spinal cord compression over time. The researchers found that in many dogs, the amount of compression decreased over the 12-week period, even without surgery. This phenomenon, known as spontaneous decompression, has been observed in humans but hasn’t been well-documented in dogs until now.
However, the study also found that this decompression wasn’t necessarily linked to recovery. Some dogs recovered without significant decompression, while others showed decompression but didn’t recover. This suggests that other factors, such as the initial severity of the spinal cord injury or the body’s own healing processes, may play a more important role in recovery than previously thought.
Limitations and Future Research:
As with any study, there are limitations to consider. The study focused on small, non-brachycephalic dogs, so the results may not apply to larger breeds or brachycephalic dogs (like French Bulldogs). Additionally, the study period was limited to 12 weeks, so we don’t know about longer-term outcomes.
There are several possible areas for future research:
1. Direct comparison of surgical and non-surgical treatments in a controlled study
2. Investigation into which dogs are most likely to benefit from surgery versus conservative management
3. Exploration of new treatments to reduce spinal cord inflammation or promote healing
4. Study of long-term outcomes and quality of life for dogs treated with different methods
5. Investigation of genetic factors that might predispose some Dachshunds to disc problems
Such research could further refine our understanding of IVDD and help vets and owners make more informed treatment decisions.
Practical Advice for Dachshund Owners:
While this study focuses on treatment after injury, prevention remains crucial. Here are some tips for Dachshund owners:
1. Maintain a healthy weight for your dog. Excess weight puts additional stress on the spine.
2. Be aware of the signs of IVDD, which can include reluctance to move, crying out in pain, hunched back, and weakness or paralysis in the legs.
If you suspect your Dachshund has suffered a spinal injury:
1. Keep your dog as still as possible and seek veterinary care immediately.
2. If surgery isn’t possible or recommended, follow your vet’s instructions carefully for pain management, rest, and physical therapy.
3. Be patient. Recovery can take time, and some dogs may take several weeks to show improvement.
4. Don’t give up hope. This study shows that many dogs can recover, even in severe cases.
Conclusion:
This study provides valuable insights into thoracolumbar disc extrusion in small dogs and challenges some long-held beliefs about its treatment. For Dachshund owners, it offers hope that even in severe cases, recovery is possible with appropriate care and time.
However, it’s important to remember that every case is unique. While this study provides encouraging results for conservative management, the decision between surgical and non-surgical treatment should always be made in consultation with a vet, taking into account the individual circumstances of each dog and owner.
The field of veterinary neurology continues to evolve, and studies like this one contribute to our understanding and ability to treat conditions like IVDD. As Dachshund owners, staying informed about these developments can help us make the best decisions for our beloved pets.
Remember, whether through surgery or conservative management, many Dachshunds can and do recover from IVDD.
