INTERVERTEBRAL DISC DISEASE (IVDD) SURGERY

MY PET HAS BEEN DIAGNOSED WITH INTERVERTEBRAL DISC DISEASE.  WILL SURGERY BE NECESSARY?

Surgery is typically recommended for pets with significant pain, nerve deficits, and paralysis.  Surgical decompression of the spinal cord will give your pet the best chance of walking normally again.

** Please note: We are not performing spinal or other neurosurgery at VOMC at this time.

WHAT HAPPENS DURING SURGERY?

For herniated discs in the middle to lower back, a procedure called a hemilaminectomy is performed.  For this surgery, a window is made in the bone of the vertebrae right over the affected disc in order to expose the spinal canal and spinal cord.  This allows for removal of herniated disc material and examination of the health of the spinal cord.  If the herniated disc occurs in the cervical spine (neck), a procedure called a ventral slot is typically performed.  The main difference with this procedure is that the window created to the spinal column and spinal cord is created on the underside of the disc and vertebrae.  The removed bone is not replaced; however, a fat graft is placed over the window to help protect the exposed spinal cord.

WILL MY PET IMPROVE AFTER SURGERY?

Recovery after surgery will depend on the severity of nerve deficits that are present prior to surgery.  Dogs who are able to move their legs and have pain sensation in their feet before surgery, will often have an excellent recovery and return to normal function in 2-3 months. Recovery in dogs who are paralyzed and have lost pain sensation have a 50% chance of recovering full function of their legs.  

WHAT ARE THE POSSIBLE COMPLICATIONS WITH SURGERY?

As with any surgery, complications are possible. Surgery for ruptured discs is performed commonly with few problems. Complications can include infection of the surgery site, worsening of neurologic signs, and ongoing spinal cord damage (myelomalacia).  If a myelogram was performed, seizures can develop which is usually a reaction to the injected dye.  Spinal cord irritation may occur when the disc material is removed, so in some cases, neurological symptoms may be worse temporarily after surgery.

HOW SOON CAN I TAKE MY PET HOME AFTER SURGERY? DO I NEED TO PREPARE MY HOME?

How soon pets go home depends on their level of discomfort and how much care is needed. Home care after surgery is an important part in maximizing your pet’s long-term recovery. You will need to monitor the skin incision for redness and swelling, signs of infection. Some pets will need help urinating by manually expressing the bladder. The team at VOMC will demonstrate the technique and make sure you are comfortable helping your pet urinate before sending them home. If your pet is not walking and/or urinating independently, the VOMC team will also help you with a plan for general cleanliness and maintaining normal eating and drinking routines.

Your pet should be confined to a small area inside for at least 6 weeks after surgery. If your pet is able to walk, they will need to go outside on a leash 4-5 times a day for urination/defecation only. Stairs, slippery surfaces and interactions with other dogs should also be avoided. After the initial period of restriction, you will be instructed on how to slowly increase activity.

We understand that even the best patients are not always fully cooperative with exercise restriction, and it can seem like an impossible undertaking. The team at VOMC will help guide you during this period. It is important to remember that a few weeks/months truly is a short time compared to your dog’s total lifetime. Perseverance and patience during the post-operative period eventually lead to a great outcome in most patients.

WILL MY PET NEED REHABILITATION THERAPY AFTER SURGERY?

There is much evidence that therapy guided by a rehabilitation-trained veterinarian can speed recovery and improve long-term outcomes.  If your pet is not walking, they will benefit from passive range of motion, moving the joints of the legs to mimic normal walking, exercises to maintain normal joint movements. Muscle massage and stretching can also increase blood flow and decrease stiffness. 

Rehabilitation therapy plans are individualized for each patient but may also include LASER treatments to decrease inflammation and assist healing, acupuncture treatment to manage pain and therapeutic exercise sessions to promote weight bearing, muscle strengthening, balance and coordination.