IVDD in Dogs: Conservative Treatment vs Surgery – What’s the Best Option for Intervertebral Disc Disease?

IVDD in Dogs: Conservative Treatment vs Surgery – What’s the Best Option for Intervertebral Disc Disease?

When your dog shows signs of spinal pain or weakness, it can be one of the hardest moments for any pet parent. You might see your dog wobble when they walk, arch their back, or even fall over because of pain. In some cases, your dog might lose control of its legs or bladder. These symptoms are common when your dog has an issue called Intervertebral Disc Disease (IVDD) or an injury to the disc inside their spine.

As you search for answers, you will likely hear two main options suggested by veterinarians: surgery or conservative treatment (rest and medication). In this blog post, I will explain what these conditions and treatment options are, look at important research, and answer the big question: can conservative treatment be just as effective as surgery? Spoiler alert: In many cases, the success rates for both are almost identical.

What Are IVDD and Spinal Disc Injuries?

Spinal disc injuries happen when the discs - cushions between the bones in your dog’s spine - become damaged or move out of place. This can press on the nerves or even the spinal cord. There are several types of disc problems:

  • Intervertebral Disc Disease (IVDD): A common problem, particularly in breeds like Dachshunds and French Bulldogs. The disc degenerates and herniates, pressing on nerves.

  • Disc Protrusion: The disc bulges slightly without breaking apart. In these cases it is the swelling and inflammation of soft tissue that is putting pressure on the nerves, not the disc material itself.  It is often seen in French Bulldogs and Dachshunds.

  • Disc Prolapse: A more severe condition where the disc material breaks through completely. This happens less often—only about 5% of the time. These types of symptoms of intense pain or paralysis affects them very quickly (1min- 1 hour).

In all these conditions, something in your dog’s spine is putting pressure on the nerves or spinal cord, leading to pain, weakness, or even paralysis.

How Do These Injuries Cause Symptoms?

The symptoms can be grouped based on the area that is compressed:

  1. Nerve Root Compression:

    • Symptoms: Extreme pain (your dog might scream or yelp), difficulty raising the head, skin twitching, and mild paralysis in the back or even one of the front legs (if the neck is involved).

    • How It Happens: Swelling or disc material compresses the nerves as they exit the spine.

  2. Spinal Cord Compression:

    • Symptoms: Less pain than nerve root compression but includes wobbliness, weakness or dragging of the back legs, incontinence (cant control bladder or bowel).

    • How It Happens: Pressure from inflammation or disc material is putting pressure on the spinal cord and disrupts the signal flow from the brain to the muscles.

Seeing your pet in pain and not knowing which route to take can be heartbreaking for any pet owner.

Treatment Options: Surgery vs. Conservative Care

When your dog is diagnosed with a spinal injury, your vet might recommend one of two main treatments: surgery or conservative management. Let’s break down each option in simple terms.

Surgical Option

What Happens During Surgery:
The most common surgical procedure for IVDD is called a “Hemilaminectomy.” During this surgery, the veterinarian removes a small section of the bone from the spine to access the area that is pressing on the nerves. The surgeon then removes the damaged or swollen disc material. Often, they will also perform a “Fenestration,” removing the central portion of the disc (the nucleus pulposus) to lower the chance of future problems.

Why Surgery Is Recommended:

  • Immediate Relief: The procedure can quickly relieve the pressure on nerves and the spinal cord.

  • Direct Removal: It allows the damaged tissue to be removed directly, reducing the risk of further injury.

  • High Success Rate: According to a study published in the Journal of the American Veterinary Medical Association (examining 831 cases from 2000–2007), the long-term neurologic outcomes for dogs that underwent surgery were very promising.

A Key Point:
The statistical success of surgery in helping dogs recover from spinal compression has long been used as the go-to recommendation. However, recent evidence has shown that the success percentages for surgery and conservative management are almost the same.

Conservative Option

What is Conservative Treatment?
Conservative treatment avoids surgery altogether. Instead, it focuses on strict rest combined with medications to reduce pain and swelling. This method gives your dog's spine time to heal on its own.

What It Involves:

  • Strict Rest: Your dog is kept in a crate or confined space to limit movement and prevent further injury.

  • Medication: Pain relievers and anti-inflammatory drugs help manage pain and reduce swelling.

  • Alternative Treatments such as Acupuncture and Infrared Laser Therapy: Once improvement is noted, acupuncture and Infrared laser therapy can be extremely beneficial along with controlled exercise may be added to help rebuild strength.

  • Natural Spinal Supplement 

    - To reduce inflammation and support spinal strength.

Why Conservative Treatment Is a Valid Option:
A recent study published in the Journal of Veterinary Internal Medicine (2024) looked at small, non-brachycephalic dogs that were treated conservatively after an acute thoracolumbar disc extrusion. The recovery data showed that these dogs regained the ability to walk at rates that were almost equal to those seen in dogs that underwent surgery.

The Big Takeaway:
For many dogs, especially those that match the profile of the study, conservative treatment offers nearly the same success rate as surgery without the risks and costs associated with an operation.

Which Option Is Best for Your Dog?

Every dog is unique, so the decision between surgery and conservative treatment depends on several factors:

  • Severity of the Injury:

    • Mild to Moderate Injuries: If the spinal cord isn’t severely compressed, conservative treatment will almost certainly be enough.

    • Severe Injuries: When there is significant pain or complete limb paralysis, action needs to be taken, surgery could be an option, but it doesn’t have to be surgery. 

  • Breed and Age:

    • Breeds like Dachshunds and French Bulldogs are prone to IVDD; their anatomy might make one treatment option more favorable than the other.

    • Older dogs may handle surgery less well than younger dogs.

  • Owner’s Situation and Finances:

    • Surgery can be expensive and requires longer recovery time.

    • Conservative treatment, while more economical, means strict home care and close monitoring.

  • Risk Factors and Quality of Life:

    • Some vets might suggest surgery as the default, while others recognise that a well-managed conservative approach can be just as effective.

    • The research shows that both methods have very similar success rates. For many dogs, conservative treatment can work just as well as surgery - leading to similar recovery outcomes.

What the Research Tells Us

Historically, immediate surgery was seen as the best course of action for dogs with IVDD, thanks to studies showing promising outcomes after procedures like hemilaminectomy and fenestration. The Journal of the American Veterinary Medical Association study of 831 cases is a prime example of this, demonstrating strong results from surgical intervention. Grade 1 (mild case) through to grade 4 (paralysed but can feel their back legs when pinched) had a 95% success rate of surgery, and the Grade 5 (paralysed and cannot feel anything in the back legs at all) 52% of cases improved after surgery.

But here's the striking fact from newer research: the 2024 study from the Journal of Veterinary Internal Medicine found that conservative treatment - with just rest and medication - resulted in recovery percentages that are nearly identical to those obtained by surgery in small, non-brachycephalic dogs. Only dogs that were completely paralysed were part of this study. So the Grade 4 affected dogs (paralysed but can feel their back feet) had a  96% success of recovery of their ability to walk and function normally. Of the grade 5 (paralysed but cant feel their back feet) 48% recovered.

This means that for many cases, the non-surgical route can be just as successful as the invasive surgical one. 

In simple terms, if your dog meets the criteria described in the conservative management study, you might expect similar recovery results without exposing your pet to the stress and risks of surgery. Both treatment methods can work very well; the percentages of success nearly overlap.

Understanding the Risks Involved

Both treatment options come with their own risks and challenges:

Risks of Surgery

  • Anesthesia: Any surgery carries a risk, particularly in older or small dogs.

  • Post-Surgery Complications: Infections, bleeding, or other complications can occur.

  • Extended Recovery: Surgery requires a longer, more careful recovery process.

  • Cost: Surgical treatments are usually very expensive and may not be fully covered by pet insurance.

Risks of Conservative Management

  • Strict Confinement: Your dog must remain very still to avoid making the injury worse, which can be challenging.

  • Gradual Recovery: The progress requires close monitoring, but the healing time is similar, with the surgical option requiring strict crate rest as well post surgery.

  • Incomplete Recovery: In some cases, conservative treatment might not resolve all the issues completely, and this is where additional treatments such as acupuncture, and infrared laser therapy can be very effective to assist their feeling, sensation and strength to improve.

What are the Chances of it Happening Again?

The risk of a recurring disc injury or protrusion seems to be quite high if surgery was performed: A study looked at the recurrence rate of spinal injuries causing intense pain or paralysis over a period of years after the initial injury and surgery and found over 52% of cases had another incident, and of those second injuries 50% of them happened in the first 12 months (Dominique Leu, 2023).

There are limited studies on cases with conservative treatment and the recurrence rate, but from a clinical point of view, it is my experience that recurrence can also occur in conservatively treated cases as well -  if there are no actions or protocols in place to reduce the risk of another episode happening again. Actions that can reduce the risk of a recurrence includes: 

  • Changing the environment at home to reduce the risk of another injury, like avoiding stairs, and avoiding jumping down off couches. 

  • making sure they are getting regular exercise but no ball chasing on slippery floors.

  • Keeping them at a healthy weight and not letting them get over weight.

  • Getting regular intermittent treatments of acupuncture and infrared laser therapy (every 6-12 weeks) as a preventative to help keep the spine healthy BEFORE a major issue.

  • Taking spinal supplement to strengthen the ligaments around the spine and to increase collagen production in the body. 

Final Thoughts

When it comes to treating IVDD and spinal injuries in dogs, the decision between surgery and conservative treatment isn’t clear-cut. Both options, as the research indicates, have almost the same success rates. 

The Key Point Is:

  • Research shows that conservative management - rest, medication, and careful monitoring - can be just as effective as surgery for many dogs.

This is encouraging news for pet owners who are looking for a less invasive, less expensive option without compromising the chance for a full recovery. Whether your dog requires surgery or can heal with conservative care, the ultimate goal is to restore their quality of life and help them get back to being active, happy pets.

As you consider your options, continue discussing concerns with your veterinarian. Ask about the specifics of your dog’s case and how the results from recent studies compare. Whether you opt for surgery or conservative treatment, being informed and guided by trusted research will help you make the best decision for your beloved companion.

 

Neil Barnsley BAppSc TCM, GradDip Vet Acu, CVCP

Animal Holistic Therapies (Head Practitioner)

Canine Vital (Founder)

 

Note From The Author

As an alternative treatment specialist, I have dedicated my career to specialising in the treatment of IVDD and spinal injuries, particularly involving paralysis. In my experience, the statistics mentioned above hold true when no additional treatment options are employed. 

However, when acupuncture and infrared laser therapy are incorporated, both the recovery rate and overall quality of recovery improve dramatically. For example, in grade 5 cases - where there is complete paralysis and no sensation in the hind legs - the recovery success rate can increase from 50% to between 80–90% when these therapies are added. For lower grade, the success rate is even higher up to 98%.

It is also important to note that if surgical intervention does not yield the desired results, even with adjunct treatments such as acupuncture and laser therapy, the recovery success rate tends to remain around 50%. This is often due to the extent of scar tissue formation and other complications that can arise from surgery.

Regular daily supplements specifically formulated for spinal health play a critical role in maintaining spinal strength and overall function. Standard joint supplements simply don’t cut it!! You need one that targets the spine, reduces inflammation naturally, and supports collagen production.

In my experience, patients who have successfully recovered from a spinal paralysis incident but then discontinue regular, ongoing supplement use and treatments are at a much higher risk for another injury or paralysis episode. Unfortunately, a second incident is often more challenging to recover from than the first.

References:

 

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