Summary: In part II of this series on IVDD in dogs, a miniature Dachshund named Tango receives conservative medical management to treat intervertebral disc disease. Integrative veterinarian Dr. Julie Buzby recounts Tango’s non-surgical treatment plan and shares why surgery for IVDD correlates to the severity of IVDD symptoms. For Part 1 in this series, please read, “IVDD in Dogs: Why it Happens.” The answer may surprise you.
Can a dog recover from IVDD without surgery?
The answer is a conditional “yes.”
IVDD (intervertebral disc disease) is graded on a scale of 1 through 5, based on symptoms. In grade 1, the dog is painful but has no change in gait and no neurologic deficits. In grade 2, the dog experiences pain, weakness, and decreased conscious proprioception (sense of body position). Grades 3, 4, and 5 worsen incrementally. By grade 5, the dog can no longer move the back legs (and front legs too if the disc is located in the neck), cannot urinate normally, and does not feel his back legs. (Note: If your dog has lost the ability to walk, do not wait. Seek make an emergency vet visit immediately. Time is of the essence.)
As an integrative veterinarian, whether I recommend conservative medical management or surgery for treatment of IVDD, directly correlates to the severity of symptoms a dog is displaying.
The best way for me to illustrate this decision is by continuing the story of Tango, a 4-year-old miniature Dachshund whom I diagnosed with Grade 2 IVDD. (In Part I of this series, IVDD in Dogs: Why it Happens, I introduced Tango, shared why IVDD occurs, and explained the neurologic examination that led me to an IVDD diagnosis.)
Tango’s IVDD treatment plan: 3 critical non-surgical solutions
Tango’s mom sat in my exam room trying to hold it together. Understandably so! Her dog was in a lot of pain, and, as a Dachshund owner, she knew back surgery might be in Tango’s future. Not only is surgical treatment of IVDD invasive with a long recovery period, but it also costs $3,000 to $8,000.
“Can a dog recover from IVDD without surgery?” Tango’s mom asked.
“Yes,” I replied encouragingly. “And I would not recommend surgery for Tango at this point. Since this is Tango’s first IVDD episode and since it is a grade 2, I think medical management is reasonable.”
Tango’s mom looked visibly relieved.
But I needed to create realistic expectations, so I continued, “However, if Tango worsens, then we will talk about the next step, which would be surgery.”
She nodded solemnly. Having provided that disclaimer, I proceeded to explain how we would treat Tango.
Treatment of IVDD without surgery involves three critical components:
- Strict rest
- Pain management
- Supportive nursing care/physical therapy
1. Strict crate rest is critical to managing IVDD
My plan to treat Tango was simple. The most important aspect was REST. In my experience as a veterinarian AND a pet owner, I have come to appreciate how hard it can be to crate rest a dog. Some dogs do fine in a crate, and some dogs enjoy lying around sleeping all day.
Tango was NOT one of those dogs.
He’d never been crated, and he was super active. He typically spent his days chasing squirrels in the yard and dashing through the house barking like a madman as the guardian of his home.
Crate rest with a herniated disc is absolutely the single most important aspect of home care. Without rest, the disc can cause more trauma to the spinal cord, leading to paralysis and a need for emergency surgery.
As a result, Tango’s mom and I had a long conversation about Tango’s lifestyle. Since he was so used to being active and he’d never been crated, we decided to treat him with a combination of gabapentin and trazodone.
Medications to promote relaxation and sedation
Gabapentin for dogs is a drug used in humans for seizure control. It also has anxiety relieving, sedative, and analgesic (pain relieving) effects. It seems to particularly help relieve pain associated with the nervous system (neuropathic pain), which is much of where the pain of a slipped disc originates. The disc is compressing the spinal cord, resulting in pain. Gabapentin is a perfect choice for treatment of IVDD since it helps an anxious, active patient rest, and it relieves nerve pain.
Trazodone for dogs is another drug used in humans, mostly as an antidepressant and anxiety-relieving medication. Used in combination with gabapentin, the additional sedation and relaxation can help keep an active dog still and calm.
That took care of the most important aspect—strict crate rest (for at least one month).
3. Medications to treat the pain of IVDD
But I wanted to make sure that Tango’s pain was well controlled too. To manage the pain associated with IVDD, I prescribed a non-steroidal anti-inflammatory medication (NSAID). This class of drugs decreases inflammation and relieves pain. NSAIDs are similar to aspirin and ibuprofen for humans (which should NOT be used in dogs). Drugs in this category include carprofen, meloxicam, firocoxib, and piroxicam. I chose carprofen for Tango.
As an aside, when I graduated from veterinary school 20 years ago, the popular treatment for IVDD dogs was steroids. Older editions of veterinary pharmacology manuals advise doses of dexamethasone for IVDD. However, this information is outdated. There is no scientific evidence that steroid dosing improves outcomes for dogs with IVDD. Thus, because of lack of efficacy plus potentially serious gastrointestinal side effects, steroids like prednisone for dogs are no longer recommended for dogs with intervertebral disc disease.
Muscle spasms often contribute to the pain associated with IVDD in dogs. So I added a muscle relaxant—Robaxin (methocarbamol for dogsl )—to Tango’s treatment plan. In my experience, this is one of the most valuable drugs for managing IVDD in dogs, especially for IVDD in the cervical region (neck).
3. Supportive care
Tango’s mom was ready to do whatever she needed to do to help him. I explained to her the importance of the following instructions: he could not be on furniture, he could not run and chase squirrels, and he needed crate rest—to stay in his crate at all times except for potty breaks on a leash.
Post-recovery for IVDD dogs: Putting a plan in place for lifestyle modifications
We discussed adding ramps to the house for when Tango was recovered—up to the porch, onto the couch, and into the bed. This would help him avoid jumping and further injury. We also revisited his weight problem, which I’d discussed with her at previous visits. I hoped that this would now make Tango’s plight clear, and we could follow weight management tips to get the extra pounds off.
The last thing I did was apply ToeGrips® dog nail grips, to help give him traction on hardwood floors. It would prevent him from slipping and falling, possibly worsening the herniated disc.
Tango’s mom left that day with a bag of medications and two pages of instructions. As I watched her go, carefully carrying Tango in her arms, I hoped very much that I wouldn’t be seeing them back any time soon.
How can a dog recover from IVDD without surgery?
You may be wondering, how can a dog recover from IVDD without surgery? How can the disc just get better? Why didn’t Tango need surgery to remove it?
In some cases, the body will break down the herniated material by a process called phagocytosis, relieving the compression on the spinal cord. Additionally, as the inflammatory process resolves over time, healing occurs.
Exciting new research in non-surgical IVDD treatment
Interestingly, this concept of breaking down the disc to resolve IVDD is the basis for a clinical trial being conducted at Texas A&M Small Animal Teaching Hospital. The trial involves injecting a specialized enzyme into the disc of small breed dogs who, due to IVDD, have been unable to walk without support for less than 48 hours. This enzyme effectively dissolves the disc in a matter of hours, relieving the spinal cord compression.
It has already been successful in one dog, a dachshund named Oscar (whose story is told in the article linked above). I’m excited to see where this leads in the future! Hopefully it provides a less expensive and less invasive alternative to surgery with comparable results, but it is too early to know for sure.
Hyperbaric oxygen treatment for IVDD
Though I have no personal experience with it, I also want to mention that hyperbaric oxygen treatment is reportedly quite helpful for dogs with IVDD. Oxygen therapy has a long history of success in treating neurologic conditions.
Teri Swanson, CEO of All Creatures Hyperbaric Care in Salado, Texas, reports dramatic success with hyperbaric oxygen and conservative medical management for IVDD—almost 200 successful outcomes, six partial recoveries, and only two “failures.”
To learn more about hyperbaric oxygen treatment, please watch this before-and-after video of Bristol, a dog who suffered a spinal injury and was paralyzed. With no time to spare, Bristol was rushed to All Creatures Hyperbaric Care for treatment as recommended by his veterinarian. The amazing results in this video were seen after only five treatments.
Success rates for IVDD surgery and medical management
I want to stress again that the reason my answer was affirmative to Tango’s mom’s question, “Can a dog recover from IVDD without surgery?” was because he was grade 2 on the IVDD scale and it was his first episode. Since Tango was only suffering pain and weakness—but could still walk and control his bladder—he was a good candidate for conservative management.
Had Tango been a grade 5, I guess the answer might technically still have been yes, but a full recovery without surgery would be statistically much less likely. Surgery would have been my recommendation, and here’s why:
Studies have shown that with surgery for Grade 1-4 cases, more than 90% of dogs recover successfully. However, with Grade 5 IVDD, success drops to only 50-60% if the surgery occurs within 24 hours of symptoms. Additionally, if surgery is performed after that initial 24-hour window, the success rate drops dramatically.
Contrast that with medical management for cases where dogs have Grade 1 IVDD (ie. pain only). Studies suggest a 50% success rate, a 30% rate of recurrence down the road, and a 20% “failure” rate.
Tango’s return to the exam table
Sadly, we will see the latter in Tango’s story. Despite the best intentions, Tango’s parents were unsuccessful at confining Tango to strict rest.
In part III of our series on IVDD in dogs, Tango returns to my exam table unable to move his hind legs and we explore surgical management of IVDD. Don’t miss out! Please sign up for Dr. Buzby’s Barkworthy, my weekly dog health email, so you’re sure to receive “the rest of the story” delivered to your inbox. Plus, when you sign up now, you’ll receive my free e-book, Seven Ways to Love Your Senior Dog.
What questions do you have about non-surgical treatment of IVDD in dogs?
Please comment below. We can all learn from each other.
Hi there my datchund had an IDVV operation 6 months ago. Ons Sunday she started shaking and crying and 6 days later she was unable to stand on her back legs. I took her to the vet and he injected her with cortisone. A few hours later she was able to stand on her legs again while eating and going to toilet. Will she be able to recover without a second operation only with cortisone treatment and crate rest?
Hi Ilse,
I am sorry your Dachshund has been battling IVDD. I wish I could give you a definitive answer but there is no way for me to know what the future will hold. It does sound promising that her body responded so favorably to the steroid injection. How are things today? Hoping all is well and wishing you both nothing but the best.
my six-year-old little girl who is not overweight she’s 8 1/2 to 9 pounds is Level three has function of her bodily fluids. She’s been on crate rest for a month now the vet is doing extra puncture and electrodes and she is on a herbal supplement. Hopefully she’ll get full mobility back. If not, we’ll get her her wheels. Where is the best place to get a wheelchair for Miniature dachshunds app?
Hi Jo,
I am sorry your little pup is living with this difficult condition. She is lucky to have you taking such good care of her and advocating for her well-being. I think it is great you are planning ahead and trying to be prepared for the “what ifs”. I am not sure there is one specific brand I would choose over another. Each has its own benefits and drawbacks. The custom carts seem to function best but, of course, are more expensive. The brands I have the most experience with are Eddie’s wheels and K9Carts. Hoping you can continue to offer supportive care and praying for healing and a full recovery for your sweet girl.
Dr Buzby,
Thank you for sharing this story. I have a bulldog with a cervical IVDD. I was wondering if you offer online appointments?we have the MRI results.
I look forward to your reply!
Hi Jovana,
I am sorry your Bulldog is facing this difficult diagnosis. Unfortunately, I am not available for online appointments. Veterinary telemedicine is still not legal in every state and is regulated by each state’s veterinary board. I am flattered that you would ask for my opinion about your pup. My best advice is to schedule a consultation with a veterinary neurologist. They can review the MRI results and offer options for treatment. Wishing your boy all the best at a full recovery. Keep up the good work!
Hi Dr. Buzby,
I have a 9 year old Pit Bull who was perfectly fine 2 days ago and out of nowhere lost movement in both of her hind legs. She was taken to the vet and they prescribed her some inflammatory and pain pills to last 2 weeks. They did state that she has sensation still, just no movement. She is starting to eat and drink a little more. What do you suggest in regards to at home recovery? The surgery expensive is just not in budget but I don’t want to dish out money or keep her in pain? Do you believe she can recover? We will began doing movements after a few weeks of her resting so it’s not too much on her body so fast. Also, should I purchase a back brace and sling for her to start using now or wait? She has not gone to the bathroom and we will start assisting her the manual way. Any advice would be great!
Hi Shariah,
I am sorry your senior girl is struggling with the effects of IVDD. While dogs can sometimes recover without surgery, it does take quite a bit of work (and time) to get them there. I highly recommend getting your girl involved with a veterinary rehabilitation specialist. They can offer guidance and monitor your girl’s progress. Without playing a personal role in her medical care, it is hard to offer specific conclusions and advice. Each dog is different and heals at a different pace. I wouldn’t want to recommend something that could cause more harm than good if applied at an inappropriate time. Wishing you all the best as you navigate this tricky path and praying for a positive outcome.
Hi my Frenchie Blue is 4 years old an suffered a really bad episode from his IVVD one month ago, he has been on anti inflammatories from the VET and he has improved alot he is able to walk again, still can’t bend his back legs and is not back to how he was before I would say roughly 60-75% recovery of his movement. The real issue appears to that he cannot control his bladder. He is wearing nappies to stop him from urinating in the house, however as soon as you change it or it comes of, wee just drops onto the floor non stop. He used to be able to hold his toilet for upto 10-12 hours and has never wee or poo in the house before but He cannot squat or cock his leg but the issues seems to be that he cannot control his bladder, my concern is will this return to normal is this a nerve issue from the IVVD episode that will not come back. Very worrying!
Hi Stuart,
I am sorry Blue is having so many urinary issues since his latest episode of IVDD. This does sound like a neurological problem related to the IVDD and I am not sure if it will resolve. Please make sure your vet is aware of this new development. There are some different medications you can try to help with incontinence. It may also be a good idea to get Blue started with physical therapy and rehabilitation. Hoping he can continue to heal and improve. Wishing you both the best of luck.
I have a 5 yr old Frenchie with mild IVDD. He was crated when he was younger, but hasn’t been crated in years. He is a bit of a couch potato. Is it possible for him to be on the couch if I’m with him to ensure he doesn’t jump off instead of crating? He also sleeps in the bed with us. He sleeps next to me and doesn’t move around during the night. Thank you!
Hi Kathleen,
I understand your concern for your Frenchie and think it is great you are reaching out for advice. The goal of crate rest is to ensure activity is limited to allow the inflammation around the spine to decrease. If your pup is willing to rest and be still when out of the crate (and you can ensure proper supervision) then I see no issue with letting him sleep on the couch or the bed. Hoping this helps a bit. Wishing you all the best of luck and praying for a full recovery for your boy.
Hi my 17 year old maltipoo they believe has ivdd. Obviously at this age no surgery.and no going under for mri. Definitely arched back and muscle degeneration in mid back. Haha stumbles mostly in back leg when walking. Can’t get up stairs which we now don’t allow. She’s on steroid for ibs and now gabapenten. She while is not crated really sleeps majority of the day, walks mostly for potty and water. What else should I do? I got paw stickies which helps. At night sometimes she thinks her back leg like spasm. Is that pain? She never cries or yelps but hates when I touch it. Just trying to see what else I can do? Is it recoverable? Or am I just managing so she isn’t worse? Are there braces you used to help keep the back straight and more stable?
Hi Aleaha,
I understand your concern for your pup and am so sorry you are facing this difficult situation. Without personally examining your girl it is hard to make specific conclusions and recommendations. My best advice is to talk with a specialist (neurologist) and see if they can offer insight to these leg spasms and give any additional information on treatments that may be available. If surgery is not warranted at this time, you may also see a great benefit from working with a veterinary rehabilitation professional. There are no back braces for dogs that I am aware of but there are several different kinds of devices and harnesses that can help with rear limb weakness. Hoping you can find the answers you need to ensure your girl maintains her quality of life. Wishing you all the best and praying your pup can make a full recovery.
Hi Dr. Buzby,
My 3 year old mixed terrier was diagnosed with stage 5 IVDD, 3 days ago. He was perfectly healthy and fine and then bam, this freak accident. He is paralyzed from the waist down. Can’t walk, stand, or go to the bathroom in his own. He’s in pain. I love animals, and I don’t want them ever to be in pain, usually I’d put him down, but because he’s so young and I’ve been working with him every day, every minute, and today he ate a lot and drank a lot of water. There was a some movement in his tail. I was talking to him in his sleep, and his tail kept moving. I know that’s a great sign. Unfortunately surgery is out because across the globe. I go back to the vet in 4 days for check up. What are his chances at recovery? I know it could take months but I don’t want him suffering. Also , how can I get him to go potty, other then applying pressure on his bladder? Any other home remedies I can try? Please let me know what you think and what would you do if you were in my shoes?
Thank you kindly
Megan, NV
Dear Megan,
My heart aches for you as you face this tragic situation with your young pup. Without the proper function of the nerves from the spinal cord, there won’t be any way to get your boy to go potty by himself. The only way to empty the bladder is to apply pressure and express it manually or have a urinary catheter placed (higher risk of infection). With the severity of his injury, the odds of him making a recovery are very low, but there is always hope! My main concern is that you mentioned your boy is painful. If his pain cannot be controlled, I do think it would be cruel to wait months for signs of progress. I know you want to do anything you can to keep him with you as long as possible, but we wouldn’t want to have him suffer needlessly. If you can ensure your boy is comfortable, then I’d say give rehabilitation a try. If not, then saying goodbye may be the most loving option. Hoping you can get the advice you need to find a clear path forward. Praying for strength and clarity. Bless you both.
Hi Dr. Buzby,
It’s Megan again, and my 3 year old spunky, stage 5 IVDD. I have amazing news. Today my boy went to the bathroom, 1 and 2 by himself. And it seems that his pain is controlled by these drugs.
He’s on Rimadyl 25mg and Gabapentin 100mg. I give him CBD oil as well!!! I’m trying to get the faith that he will recover! How’s that for a faster recovery?
Hi Megan,
Yay!!! This is the BEST news! Your boy definitely has a shot at regaining some function and I am thrilled that his pain is under control. This could be a good time to connect with a veterinary rehabilitation professional and see if they can give you some exercises to work on at home to help strengthen those weak rear leg muscles. Praying for continued healing and forward progress. Please keep us updated on how your sweet boy is doing!
Will do. Thank you so much for responding back and all your advice. Really appreciate you! 🙂
Hello, so some bad news… he hasn’t been eating and drinking since yesterday… we go to the vet on Tuesday… I also wanted to ask you, he lost his voice, when he tries to bark there’s no sound. What does that mean?
This whole situation is so hard and sad. We will probably end up putting him down on Tuesday. It just really sucks because he’s only 2 years old and he was so healthy prior to this. 😥
Hi Megan,
Goodness, your poor boy! I am so sorry he is facing these setbacks. Honestly, the loss of his voice has me puzzled. I am used to seeing that with older dogs when they develop laryngeal paralysis, but they usually have many symptoms before this occurs (extreme panting, gagging, trouble with coughing when eating and drinking, etc.). I am not sure what the next few days have in store for your pup, but I am hoping he can keep fighting. I understand you may have to make an impossibly tough decision at the appointment on Tuesday. So just in case, I wanted to share some links to other articles that may offer guidance and peace. Praying for strength and clarity. Bless you and your sweet boy. ♥
1. Using a Quality of Life Scale for Dogs
2. How Will You Know When It’s Time to Euthanize Your Dog? 5 Caring, Heartfelt Messages
3. Dog Euthanasia: Knowing When to Say Goodbye
4. Preparing for Your Dog’s Euthanasia: 10 Thoughts for Peace
Dr. Bushy,
I have the worst news. So my boy passed today at home. He was laying in his bed and twitched two times and then he was gone. 😓
I’m left so heartbroken and confused to how this disease could kill a 2 year old dog. It took 7 days exactly. IVDD FOR 7 days and then BAM, dead dog! Does this happen often? How is this possible? It just makes no sense and it really just gets under my skin that something so tragic can happen so quickly!!! I’m left heartbroken, confused and he just went downhill in the blink of an eye!!! 😓😓😓
Dear Megan,
Oh, how my heart is just broken for you. I am so sorry for the unexpected loss of your boy. Without seeing him myself, it is hard to make specific conclusions, but I am suspicious about a condition called myelomalacia. It is when the damage to the spinal cord starts to progress forward toward the head and eventually causes paralysis of all the muscles including those that are responsible for breathing and the heart. This is rare and usually only seen in dogs that have suffered a grade 5 injury. I would not have expected this for your boy since he initially showed that little bit of improvement, but things like this just can’t be predicted. Please don’t blame yourself for how this progressed. If this was truly myelomalacia, then there was nothing you could have done to prevent this outcome (not even surgery). I hope with time your grief can begin to fade and your heart can start to heal. Take comfort in knowing your boy was deeply loved and I am certain he knew how much he meant to you. May his memory stay with you always and be a blessing in your life. ♥
Hi
My 7 year old Cockapoo Jax was very healthy, but after jumping onto the bed one morning it was obvious he was uncomfortable and by 3am the next morning we had to rush him to emergency in severe pain, arching his back very stiff, and panting terribly. The hospital gave him pain medication, no tests, but suspected IVDD. They prescribed Gabapentin, steroids and trazadone . The vet subscribed 4 week crate care which we did when ever we were out of the same room as Jax. Jax’s walking was wobbly for a couple weeks, but could still do the bathroom stuff on his own. He had an enormous appetite and thirst from the steroids, We used a buggy for out walks, carried him up and down stairs and restricted furniture and bed jumping. It has been 6 weeks now and have just started to take him for shorter walks. We still carry him up and down stairs. It seems as though he is back to normal, but we do not know how much we should be restricting him from normal dog activity. We have a bed ramp now that he uses and steps to all the furniture. He has about 5 more days of Gabapentin left and we are alternating days at this time. Please advise what we should still be restricting. Is it ok to let him start on stairs or should we always restrict this. What level of IVDD would Jax be classified in. Thank you in advance for any advice 🙂
Hi Tracy,
I am sorry Jax experienced this painful back injury, and I understand your concern for him moving forward. Without examining him myself it is hard to make specific recommendations. In general, after having an IVDD episode, it would be ideal for him to avoid stairs until all the inflammation has resolved. You could err on the side of caution and just not allow him to climb stairs anymore, but I understand in some circumstances that is not an option. Jumping on and off furniture is probably one of the activities that would put him at highest risk for another issue. Here are links to other articles with more information:
1. IVDD in Dogs: Why it Happens
2. IVDD Surgery: When Your Vet Recommends Surgery for Your Dog
Hoping Jax is doing well and is on track to make a full recovery. Best wishes to you and your sweet boy!
Hi! Came across this article while doing some research! I have a dachshund, 12 years old. She had well managed grade 2 for about 3 years. This last week took a turn, starting limping so I immediately did crate rest for 48 hours, until Friday when she lost function of her back legs. Still has bowel/bladder control, no pain, totally herself just no function of her back legs. When I squeeze her back feet there’s no response. She was on meloxicam for many years. The vet told me to stop the meloxicam and just use gabapentin and a steroid to see if that will work. Would the NSAID not help the steroid?
She’s comfy cozy, no pain and unfortunately surgery isnt offered in my city we’d be travelling 6 hours.
Would love thoughts!!
Vanessa & Daisy
Hi Vanessa,
I am sorry your Dachshund is experiencing this worsening of her IVDD. If she has truly lost deep pain sensation, then the odds of her regaining function without immediate surgery are very low. Some dogs do great with carts/wheels and can go on to live happy lives. I would recommend you have your girl evaluated by your vet to confirm the situation and then you can make a plan for how to proceed. The reason your vet wants you to discontinue the NSAID (the NS stands for Non-Steroidal) is they interact negatively with steroids and can cause stomach ulcers and severe GI bleeding. Hoping you can find the answers you need to ensure your pup maintains a good quality of life. Best wishes and feel free to leave an update if you have a chance.
my long hair doxie had no deep pain researched and surgery is not always answer took her to an amazing vet who does choirpractor care Lazer and acupuncture we started water therapy now she can stand for over a min has deep pain and can feel someone touching her fur lightly don’t give up
Hi Lorie,
This is such good news! Thank you for this encouraging and hopeful comment. I appreciate you being willing to share your experience and offer support to others. Best wishes to you and your sweet girl. ♥