Abnormal Gait

OH! My aching back!

Well, it has finally come to fruition that I suffer from a disease I readily see in our canine patients. Fortunately, it is not infectious (so no quarantine needed!) and it can be corrected. Unfortunately, I have had to learn the hard way the degree of discomfort some of our four-legged friends have had to deal with (and quite admirably, I might add) What is this often debilitating problem? Inter-vertebral disc disease (IVDD). Some big words for a relatively little, but much needed and ungraciously overlooked (at least in my case) cushion in our bodies.

What is IVDD

Inter-vertebral discs are the cartilage pads that connect the vertebral bones of our spinal column. The disc's job is to act like a shock absorber and spread out the compressive forces we subject our vertebrae to every second of every day and night. Interestingly, they account for 16 percent of the length of the articulated column in dogs and about 25 percent in humans! They are also one of the organs in our body that consistently show degenerative changes with advancing age. Each disc is composed of two parts: the nucleus pulposus (central part) and an outer anulus fibrosus. The nucleus is a semi-fluid tissue that is maintained under pressure by the encircling bands of fibrous tissue of the anulus fibrosus.

Insidious changes occur to both the nucleus and anulus relatively early in life.  Calcification of the nucleus can occur which decreases its shock absorber abilities which imparts less flexibility of the spine. In humans and pets this is noted by a stiff, and possibly guarded, gait.  Pain is not uncommon either, often from surrounding muscles that spasm. Mircofragmention of the anulus may also occur which allows the nucleus to bulge or escape completely ("bulging or herniated disc"). The nucleus most commonly escapes in the direction of the spinal cord where it may compress nerve roots (nerves that innervate our peripheral body) - usually termed "pinched nerve" - or it may cause inflammation or, worse, compression of the spinal cord. Let me tell you from personal experience a herniated disc HURTS!!! Besides pain, it can also cause muscle fasciculations (not visible to the eye), tingling, numbness, paresis (weakness), or even paralysis.  Degenerative changes can occur in any disc, but the effects are most severe in the regions that are most mobile: the neck and the lumbosacrum.

Who is Predisposed

There are particular breeds of dogs that are genetically predisposed for developing IVDD and they typically fall under the category "chondrodystrophic breeds". Some of these are: dachshunds, beagles, Pekingese, basset hounds, and shih tzus. These breeds have a genetic disorder with their cartilage and bone development, hence abnormally developed discs may form. However, any breed can develop a disc problem, so any abnormal gait ("stilted walk", "holding neck funny"), PAIN!, or any weakness or non-use of a leg or legs should prompt an immediate visit to your veterinarian.

How it's Treated

Diagnosing a pet with IVDD is often straight-forward with information gleaned from the physical exam and, often, survey radiographs.  Many cases are mild and can be managed with anti-inflammatory medication (often steroids, since they are POTENT at reducing inflammation), pain control, muscle relaxers, and most importantly, STRICT REST - ideally, the pet is crated. More severe cases are referred to a veterinary neurologist or orthopedic surgeon where surgery may be indicated to extrude the herniated disc material and then fusion of the 2 adjacent vertebrae. Many of these pets recover remarkably well following spinal surgery. 

After my recent disc herniation, I have a renewed and deeper empathy of the pets we see for neck and back pain. Neurologic-related pain is INTENSE and should not go untreated.  We are here to help diagnose and treat the ones that can be managed medically, and we also have 2 specialty groups, Veterinary Specialty Care and Charleston Veterinary Referral Center, in the Charleston area that provide surgical care for those cases that need it.