Clinical management of dogs with presumptive diagnosis of thoracolumbar intervertebral disc disease: 164 cases (2006-2017)

Abstract

This study aimed to identify dogs with presumptive diagnosis of cervical intervertebral disc disease (IVDD) submitted to clinical management and to evaluate the outcomes. Data were obtained from the medical records of patients with neurological dysfunction assisted at a University Veterinary Hospital from 2006 to 2017. In addition to the patients’ records, dog owners responded to a questionnaire on the success of therapy. Four hundred and thirteen neurological records were evaluated, and 164 met the inclusion criteria of the study. The most common breed was Dachshund, followed by mongrels. Classification of neurological dysfunction in the study sample was as follows: 15.9% with grade I, 25.6% with grade II, 26.8% with grade III, 8.5% with grade IV, and 23.2% with grade V. Outcome was satisfactory in 71.6% of the dogs and unsatisfactory in 28.4% of them. Recurrence was observed in 27.7% of those with satisfactory outcomes. The clinical treatment of dogs with thoracolumbar IVDD is satisfactory, particularly for animals with milder disease grades (I, II, and III). There is possibility of recurrence with conservative therapy and clinical signs may be more severe.

ACVIMconsensus statement on diagnosis and management of acute canine thoracolumbar intervertebral disc extrusion

“…Several retrospective studies include a subgroup of dogs treated with anti‐inflammatory doses of corticosteroids but do not report the effect of this treatment on outcome 61,64,67,73‐77 . However, there is limited evidence that corticosteroid use is associated with poorer outcome and decreased quality of life 63 as well as a higher rate of recurrence compared to nonsteroidal anti‐inflammatory drugs (NSAIDs) in ambulatory dogs managed medically 62 .…”

“…Several retrospective studies include a subgroup of dogs treated with anti-inflammatory doses of corticosteroids but do not report the effect of this treatment on outcome. 61,64,67,[73][74][75][76][77] However, there is limited evidence that corticosteroid use is associated with poorer outcome and decreased quality of life 63 as well as a higher rate of recurrence compared to nonsteroidal anti-inflammatory drugs (NSAIDs) in ambulatory dogs managed medically. 62 Despite insufficient evidence to support corticosteroid use for neuroprotective purposes in dogs with TL-IVDE, antiinflammatory doses of corticosteroids may be of benefit in some cases with ongoing spinal pain potentially related to epidural inflammation.…”

“…Expected outcomes for dogs with TL‐IVDE managed medically or surgically are summarized in Table 3. Recurrence rates for medical management range from 15% to 66% compared with much lower rates for dogs managed by both hemilaminectomy and fenestration (covered in more detail under fenestration) 60‐66,72 . There is a group of dogs that present with severe spinal pain and lameness because of lateral extrusion of disc material into the intervertebral foramen for which little is currently published 65 .…”

“…Recurrence rates for medical management range from 15% to 66% compared with much lower rates for dogs managed by both hemilaminectomy and fenestration (covered in more detail under fenestration). [60][61][62][63][64][65][66]72 There is a group of dogs that present with severe spinal pain and lameness because of lateral extrusion of disc material into the intervertebral foramen for which little is currently published. 65 These dogs represent a unique group that might not respond to medical management.…”

Prognostic Factors in Canine Acute Intervertebral Disc Disease

“…The timing of recovery of pain perception is important, because once it is present, the prognosis for recovery of ambulation is excellent. One study found that 62% of dogs (10,(12)(13)(14)(15)(16)(17)(18)(19)(20)(21). that did recover DPP recovered it within 4 weeks, another 30% by 12 weeks and one dog (8%) recovered it at 36 weeks (16).…”