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Healing & Alternative Health
Dr. Carson's Holistic Animal Care:
Integrative Treatment of
Canine Intervertebral Disc Disease
by Kathleen M. Carson, D.V.M |
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Canine intervertebral disc disease (called I.V.D.D.) is a common orthopedic problem seen by veterinarians. The discs are thick plate- or disc-like cushions which lie between the bony vertebrae in the spine. They are composed of a fibrous outer layer called the annulus fibrosus and a pulpy, gelatinous center called the nucleus pulposus. They help to cushion the spine as a dog walks, trots, runs, twists, and jumps.
As time goes by, the discs start to degenerate. The blood supply to the discs decreases, so the tissues are not so vital and resilient. The soft, gelatinous central material is replaced with harder cartilaginous material.
What causes I.V.D.D.? Part of the answer is genetics. Certain breeds, called the chondrodystrophic breeds, have discs which degenerate much faster than in non-chondrodystrophic breeds. (Chondrodystrophic means “abnormal cartilage”.) In fact, degeneration can start as early as 6-12 months in some chondrodystrophic dogs! (Examples of chondrodystrophic breeds are the Dachshund, Pekinese, Lhasa Apso, Shih Tzu, Basset Hound, Beagle, and Poodle.)
Other factors which cause or worsen the degeneration are the 2.) the wear-and-tear associated with an active life; 3.) obesity; and 4.) a poor diet.
Disc disease is of two types: Type I and Type II. Type I consists of a sudden, large tear in the degenerated, weak outer layer of the disc which causes the degenerated, hard center to explode up into the spinal canal.
Members of the chondrodystrophic breeds get Type I I.V.D.D. Since degeneration of the discs occurs earlier in these dogs, Type I I.V.D. usually shows up first between 4 to 6 years of age, and the signs of the condition (discussed below) come on acutely.
In Type II disc disease, the tear in the outer layer is smaller and tends to occur gradually over a period of time. The central material tends
to bulge up into the spinal canal but then will fall back into place between the vertebrae. This second Type tends to occur in breeds with normal cartilage. Since the degeneration in these dogs occurs more gradually, Type II I.V.D.D. usually shows up first between 8 to 10 years of age, and the signs can come and go over a period of weeks, months, or even years.
What are the signs of I.V.D.D.? When the nucleus pulposus material comes out of its normal place in the center of the disc and tears through the outer annulus fibrosus layer into the spinal canal, it presses against the nerve roots as they come off the spinal cord. Pain results from this pressure on these spinal nerve roots and from damage to nerves in the annulus fibrosus. Pain also results from spasm of the muscles surrounding the area where the disc(s) rupture(s).
When the inner disc material presses or explodes into the spinal canal, it causes mild to severe damage to the spinal cord, for there is little or no room within the canal for the cord to move away from the invading foreign matter. As mentioned above, in Type I I.V.D.D., where the disc material breaks out with great force, trauma to the cord can be extensive. Things are further complicated when the cord swells in reaction to the blow. Traumatic hemorrhage within the cord damages it further. Paresis (weakness) or paralysis will come about if the damage is severe enough.
Putting this all together, what would you see if your dog had I.V.D.D.? If your dog is one of the chondrodystrophic breeds, the symptoms tend to be more acute (sudden). Pain, the most common symptom, can be manifested in several ways, from shivering to reluctance to move to muscle rigidity to lameness to screaming. In addition to pain, your dog could suddenly be weak or wobbly in the front and/or hind legs. If spinal/nerve damage is severe, your dog may be paralyzed, unable to stand or walk (paralysis). If your dog is paralyzed, he or she also may be unable to urinate or defecate.
If your dog is one of the non-chondrodystrophic breeds, the symptoms tend to be less acute. That is, they come on more gradually, and they can come and go (as the disc material bulges in and out). Both pain and signs of nerve/cord damage (knuckling over, dragging of feet, partial or complete paralysis, incontinence) are seen. The symptoms also tend to be less severe, although this is not always the case.
Discs tend to rupture most commonly in areas of the spine where there is the most movement. This occurs in areas of transition in the spine, ie, the cervical/thoracic (base of the neck), the thoracolumbar (“waist”), and the lumbosacral (lower back/pelvis) areas. The vertebrae in the thoracic area are rather rigid in terms of movement. The sacral vertebrae are fused and therefore rigid. In contrast, the vertebrae in the cervical and lumbar areas are more loosely connected to each other.
There is more of a chance of a shearing movement in these transitional areas that connect the looser and more rigid sections of the spine, and this type of movement can cause a disc to rupture. It doesn’t take major trauma for a disc to rupture. A very simple movement, such as going down a small step, turning suddenly, or even straining to defecate can cause a tear in a weakened disc. The movement has probably occurred hundreds of times before, but this one time the right set of circumstances come about to lead to a ruptured disc or discs.
Conventional treatment of I.V.D.D. consists of enforced rest, anti-inflammatory drugs (usually corticosteroids or drugs related to cortisone), pain medication, muscle relaxants, and sometimes tranquilizers (if needed to keep the patient quiet). If this fails, or if there is paralysis, surgery is often done. Surgical intervention relieves pressure on the cord and nerve roots by either scraping away disc material from underneath (done in the neck area) or removing part of the vertebrae forming the bony spinal canal (done in the back area). (Remember, when the disc material explodes into the closed spinal canal, the spinal cord/nerves have nowhere to go, for they’re tightly enclosed in the bony vertebral canal.)
If surgery is to be successful in Type 1 disc ruptures, it needs to be done quickly, preferably within the first 24 to 36 hours after the signs are noticed. Surgical intervention prevents further damage to the cord as pressure is relieved, but it cannot heal the damage already done to the cord and nerves.
Alternative treatments such as acupuncture and/or chiropractic can be very helpful in I.V.D.D. They can be done separately or together, and they can be combined with drug treatment and/or surgery or can replace the more conventional treatments (especially in mild/early cases).
Acupuncture, like drug treatment or surgery, has the most success if done soon after the disc ruptures. Chiropractic adjustments are not done in the immediate area of the injury while things are still “hot” (acutely inflammed), but they can be done above and below it to treat the compensatory muscle spasm and vertebral misalignments in other areas of the spine. Once things have a chance to “quiet down” in the immediate area, gentle chiropractic adjustments can be done there as well.
How do acupuncture and chiropractic help a dog with I.V.D.D.? Let’s first discuss acupuncture. After over 30 years of investigation in the West, we know that acupuncture stimulates nerves, relieves muscle spasms, and increases blood circulation, as well as causing the release of endorphins (for pain) and cortisol (for reducing inflammation).
From a Traditional Chinese Medicine (TCM) point of view, the stimulation of various points on the channels (called meridians) along which the body’s energy flows helps to restore the flow of energy which was interrupted by trauma or other factors. The return of a more natural energy flow allows healing to take place so that more normal function can return and pain can be relieved. Thus, in addition to helping relieve the symptoms of I.V.D.D. (such as pain and muscle spasm), acupuncture can help heal the damaged spinal cord, nerves, and other tissues.
Fine needles are most commonly used to stimulate the acupuncture points, but pressure, laser or other high-intensity light, electrical stimulation, and a healing herb treatment called moxibustion can also be used. Most dogs don’t mind acupuncture; in fact, as time goes by and they realize the treatments make them feel good, they even look forward to them!
The wonderful thing about acupuncture is that it utilizes the body’s ownhealing forces. It doesn’t have the serious side effects sometimes seen with drugs and surgery. It will enhance your dog’s chances of recovery, especially if started right after the injury. If some time has passed since the injury, the likelihood of success for acupuncture decreases, but this does not mean it cannot help at all. Your veterinary acupuncturist can help you evaluate the chances for success with acupuncture for your dog.
Chiropractic care helps I.V.D.D. in a different way. A dog with I.V.D.D. usually has what are called subluxations in the vertebrae of the spine. These are misalignments between vertebrae, or, in simpler terms, the vertebrae don’t exactly line up with one another. These subluxations or misalignments come about through injury, poor posture, and various other insults to the spine. These subluxations put abnormal pressure on the discs, further increasing the likelihood of a rupture. Once the disc rupture takes place, the subluxations get worse, exaggerated through spasm of the spinal musculature and the odd positions the body takes as it tries to compensate for the injury. These misaligned vertebrae also further pinch the spinal cord and nerve roots which are damaged when the disc ruptures, resulting in more pain and impairment. Chiropractic adjustments help to re-align the vertebrae, relieving pressure on the cord, nerves and discs. It is even more effective when combined with work on the muscles, which reduces the muscle spasms which cause or contribute to the subluxations.
As mentioned above, adjustments are not done over the area of injury when it first occurs. However, adjustments and muscle work are very helpful in other areas of the spine immediately following the injury. These treatments can be wonderfully effective in relieving pain and helping to restore function. When the injured area has stabilized somewhat, chiropractic work in that area further promotes the return to better functioning.
When acupuncture is combined with chiropractic, the results are synergistic; that is, they each enhance the other treatment.
Initially, these alternative treatments are done one or more times a week. As improvement occurs, the time between treatments is increased. If a dog is brought for treatment soon after the injury occurs, fewer treatments are usually needed.
With acupuncture and chiropractic, as with drugs and surgery, the chances for recovery depend on how severe the injury to the cord and nerves is to begin with. As you would expect, animals with mild damage have a good chance of complete recovery. Animals with severe damage may only have slight or partial recovery.
Note: it is important that the acupuncturist or chiropractor treating your dog have adequate training for working on animals. Ideally, he or she should be a veterinarian. If not, he or she should have extensive training approved by veterinarians, and your veterinarian needs to refer you.
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Dr. Kathleen Carson, DVM
Veterinarian & Author
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Dr. Carson received her Doctor of Veterinary Medicine degree from the University of California at Davis in 1968. She's been a small animal practitioner (dogs and cats ) for all the years since, except for a short stint at the San Diego Zoo when she first graduated.
She belongs to the American Veterinary Medical Association and the American Holistic Veterinary Medical Association.
Since 1974 she's lived and practiced in the South Bay Area near Los Angeles. She started the area's first house call practice in 1976 and the first pet crisis/loss group in 1989. The human-animal bond is of special interest to her.
She started exploring complementary veterinary medicine in 1987. Her practice became 100% holistic in 1996. She utilizes acupuncture, herbs, supplements, Bach Flower Remedies, homeopathic remedies, nutrition and medications for her patients in her practice.
She's currently taking a leave of absence from her house call practice due to health reasons but continues to do phone consultations and to write.
E-mail:
Critterhlr@aol.com
website:
http://www.holistic
vetconsult.com
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