Thoracolumbar myelopathy caused by acute intervertebral disk extrusion (TL IVDE) in dogs is a common presentation in both primary care and referral practice, and can cause loss of ambulation or even be fatal in some cases. For severe cases involving non-ambulation, surgical management is often considered superior but costs may be prohibitive, causing some dogs to be euthanised. However, dogs are known to recover using conservative management, which includes analgesia, movement restriction, physiotherapy and bladder management.
This prospective study explored the conservative management of TL IVDE in both deep pain-positive and -negative non-ambulatory dogs in the recovery of ambulation and its association with spontaneous decompression. Inclusion criteria included weight <15 kg, non-ambulation in the pelvic limbs, suspected TL IVDE, and owners unable to afford surgery. Brachycephalic dogs were also excluded because of an increased risk of regurgitation.
Of 72 client-owned dogs that met the criteria, 51 were deep pain-positive (DPP) and 21 were deep pain-negative (DPN). Forty-nine of the 51 DPP and 10/21 DPN recovered ambulation within the 12-week study period in a median time of 11 and 25 days, respectively. The resolution of spinal cord compression and persistent compression were seen in both dogs that recovered ambulation and those which did not.
Take home message: Conservative management should be considered for the recovery of TL IVDE in small, non-brachycephalic non-ambulatory dogs for which surgical intervention is not possible. Disk extrusions can regress, but regression and spontaneous decompression of the spinal cord are not necessarily required for functional recovery.
This work was published open access in the July 2024 issue of the Journal of Veterinary Internal Medicine and can be freely accessed here.