IVDD - extrusion

Question 1

Prevalence

Answer 1

• very common in dogs

Question 2

Predispositions

Answer 2

• predisposed in the chondrodystrophic breeds
• can affect either the thoracolumbar or the cervical spinal cord

Question 3

Presentation

Answer 3

• can manifest in a wide spectrum of CS from pain and paralysis, and can occur as single episodes or multiple recurrent episodes

Question 4

What 3 scenarios can it produce?

Answer 4

• acute compression
• concussion
• compression & concussion

Question 5

Diagnosis

Answer 5

• can only be made with advanced imaging, ideally MRI
• if the nucleus pulposus has undergone calcification prior to extrusion then CT can be used for diagnosis
• radiography may show evidence of disc degeneration but will not give an accurate diagnosis

Question 6

Prognosis

Answer 6

• for recovery of ambulation is generally good
• if there’s tetra/paraplegia with loss of deep pain sensation in the limbs then prognosis is poor

Question 7

Tx guidelines

Answer 7

• if there’s an acute onset non-ambulatory tetra/paraparesis/plegia then referral for advanced imaging and consideration of decompressive surgery should be considered
• if the CS are progressive then referral for advanced imaging and consideration of decompressive surgery should be considered
• if there’s spinal pain alone then conservative management can be considered in the 1st instance
• if financial concerns limit referral then conservative management can be considered in the 1st instance

Question 8

What does conservative management consist of?

Answer 8

• cage rest
• analgesia (as needed)
• bladder management
• good nursing -> including motivational therapy
• physiotherapy