Intervertebral disc extrusion (IVDE) is the most common cause of paralysis in dogs. It is especially common in breeds with short legs and long bodies, called chondrodystrophic breeds, such as Dachshunds, French Bulldogs, and Cockapoos. Most cases respond well to treatment, especially if the ability to feel pain in the limbs is not lost. Strict rest and excellent nursing care are essential to improve the chances of recovery and prevent complications, both before and after surgery.

What is intervertebral disc extrusion (IVDE) in dogs?

The spine is a long column of small bones, the vertebrae, which encase and protect the spinal cord. The spinal cord is a thick bundle of nerves that connects the brain to the rest of the body. To allow some degree of movement and shock absorption, there is a small supporting structure between each bone of the spine. This structure is called the intervertebral disc. 

The intervertebral disc has two components: an outer tough capsule and an inner jelly-like material. The jelly-like material gives it its cushioning and shock-absorbing properties. In dogs with IVDE, this material becomes dry and brittle, leading to disc rupture. As a consequence, the material that was inside the disc moves into the confined space where the spinal cord normally is. This leads to compression of the spinal nerves, causing severe pain and loss of nerve function. Depending on the severity and duration of the compression, the nerve damage may become permanent.

Causes of intervertebral disc extrusion (IVDE) in dogs

Multiple causes contribute to the development of IVDE, including:

• In chondrodystrophic breeds, a gene (FGF4) causes the material inside the disc to deteriorate much faster than in other dogs.

• Breeds with extreme conformation, such as French Bulldogs, often have abnormally shaped vertebrae, which may increase pressure on the intervertebral discs.

• Aging plays an important role, especially in other breeds. Age-related changes to collagen and other disc components contribute to the disc becoming more fragile.

• Traumatic injuries, like falls or road traffic accidents, can cause a disc to rupture, especially if it was already fragile.

• Mild impacts or repeated tension over time can also lead to disc damage. These can include jumping down from furniture or very demanding types of exercise, like agility. 

Symptoms of intervertebral disc extrusion (IVDE) in dogs

The majority of cases of IVDE happen in the mid to lower spine, called the thoracolumbar area, and so the symptoms usually affect the lower back, abdomen and back legs. The speed and volume of disc material escaping into the spinal space will affect the severity of the symptoms.

• The most consistent symptom is back pain, which is often severe. In the absence of other symptoms, it can be difficult to tell if a dog is suffering from back pain or tummy pain. 

• Dogs may arch and tense their backs, appear hunched, walk stiffly, and hesitate to move or jump. 

• They may become defensive when touched around their back or tummy.

• Often, the hind legs are affected. This can range from weakness and difficulty standing for long periods to unsteady or wobbly movements, to complete paralysis and loss of sensation.

• In severe cases, the ability to control urine and faeces will be affected. Depending on the area of the spine affected, dogs may develop incontinence or be unable to pass urine.

Dogs at a higher risk of developing intervertebral disc extrusion (IVDE)

• Being a chondrodystrophic breed is the most significant risk factor for IVDE. Commonly affected breeds include: 

  • Beagles

  • Cavalier King Charles Spaniels

  • Cocker Spaniels

  • Pembroke Welsh Corgis & Cardigan Welsh Corgis

  • Dachshunds

  • French Bulldogs

  • Miniature Poodles

  • Pekingese 

• Age is another important risk factor. Older dogs of any breed can develop IVDE, but large breeds are more frequently affected.

How do vets diagnose intervertebral disc extrusion (IVDE) in dogs?

• The vet usually starts with a thorough physical and neurological examination to locate the source of the problem and to ensure there are no other diseases or complications.

• If disc disease is suspected, Magnetic Resonance Imaging (MRI) is usually recommended. This is the best tool to visualise the discs, the spine and the damage that has occurred. It also provides information to help plan surgery. 

• Previously, X-rays and CT scans have been used, but they don’t provide as much detail or information.

Veterinary treatment of intervertebral disc extrusion (IVDE) in dogs

There are two main treatment options for IVDE: medical and surgical management. 

Medical management

• This is reserved for very mild cases or cases where surgery is not possible.

• Strict rest is the cornerstone of this approach: crate rest for several weeks to months.

• Medications are administered to manage pain and control inflammation.

• Careful nursing care helps prevent potentially serious complications. This includes assisted toileting, cleanliness, mental stimulation, and passive range of motion movements.

• Physical therapy at the appropriate stage of recovery may help return to normal function.

Surgical management

• Surgery is the recommended treatment for moderate and severe cases, particularly when dogs cannot walk, and those that are getting worse or not improving with medical management. It’s also recommended when there are further episodes after previously successful medical management.

• A common surgical procedure for thoracolumbar (in the middle/lower back) disc disease is called a hemilaminectomy.

• Surgery is performed to remove material that escaped from the damaged disc and create enough space for the nerves to recover. This usually involves removing a small portion of bone from the vertebrae around the damaged spinal cord.

• Dogs will need to stay hospitalised for several days after surgery to receive stronger medications during the most painful period of recovery. This also allows for close monitoring and professional nursing during the early, more challenging days.

• Careful nursing care and strict rest after surgery improve the chances of recovery and prevent complications.

• When appropriate, individualised physical therapy may be prescribed to support recovery.

How to look after a dog with intervertebral disc extrusion (IVDE) at home

• It’s fundamental that you carefully follow the instructions received from your vet.  This includes the medication prescribed, what your dog is allowed to do, and how to help them toilet if needed.

• Dogs usually need strict crate rest for 4 weeks after returning home. Good-quality, thick bedding is important for dogs that are still struggling to move, as it prevents the development of skin sores. Dogs should be encouraged to change position every 1-2 hours. 

• In most cases, going outside for toileting is permitted, but only with a lead and harness on. A sling may be necessary to help support the back end in dogs that are still weak or wobbly. These toilet breaks should be no longer than 5 minutes, up to 4 times per day.

• Jumping, climbing, playing, or longer periods outside the crate can cause serious complications and must be prevented. 

Prevention of intervertebral disc extrusion (IVDE) in dogs

• Genetic factors leading to IVDE cannot currently be prevented, but not buying puppies with extreme body shapes avoids incentivising the breeding of dogs with potential genetic issues.

• Obesity may increase the risk of spinal disease, and also makes recovery more difficult. Keeping a healthy body weight has many positive impacts on health.

• Gentle exercise and physical activity help maintain healthy joints and muscles, which support spinal stability and recovery from injury. 

• For at-risk breeds, it may be useful to introduce preventive measures that reduce repeated impacts on the intervertebral discs. If it’s not possible to prevent dogs from climbing on furniture, it may be advisable to train them to use ramps or steps.

When to worry about intervertebral disc extrusion (IVDE) in dogs

Speak to a vet immediately if your dog shows any signs of IVDE or if their symptoms are worsening despite treatment. Signs include:

• Severe back or tummy pain

• Unusual aggressive behaviour when approached around the lower back

• Weak or unsteady back legs, trouble standing up for more than a few seconds

• Wobbly back legs or knuckling (dragging the top of the toes on the floor) when trying to walk

• Trouble passing urine, or passing urine or faeces without realising it