Intervertebral Disc Disease
Why has my dog been recommended surgery?
The clinical signs of a disc extrusion can vary from pain to paralysis. More severely affected dogs that are unable to walk or use their back legs benefit from surgical decompression of the spinal cord. The main aim of surgery is to remove the compression on the spinal cord and prevent further discs from herniating using a procedure called fenestration. The chance of recovery depends how badly affected dogs are and we feel that dogs that cannot walk benefit from surgery.
Around 10% of dogs that present with no feeling in both back legs can unfortunately deteriorate further, going on to develop myelomalacia. This is an irreversible softening of the spinal cord that ascends the spinal cord and can start to affect the front legs and the muscles used for breathing. If we are concerned that there are signs of this developing, we would discuss this further with you.
What are the Percentages for Recovery?
Description |
Recovery Percentage |
Recovery Percentage |
Average Time Taken to Recover |
Average Time Taken to Recover |
---|---|---|---|---|
Surgery |
No Surgery (95% CI) |
Surgery |
No Surgery |
|
Walking but uncoordinated or painful |
More than 90% |
More than 90% |
Up to 2 Weeks |
3-6 Weeks |
Unable to walk but able to move |
More than 90% |
Around 80% |
1-2 Weeks |
6-9 Weeks |
Paraplegic |
More than 90% |
Around 60% |
1-3 Weeks |
9-12 Weeks |
Pain Negative |
Around 60% |
Around 10% |
3-12 Weeks |
9-12 Weeks |
What are the main risks associated with spinal surgery?
- Trauma to the spinal cord itself or the nerves that arise from the spinal cord
- Risk of entering the chest cavity when approaching the spine overlying the chest region which can create too much air around the lungs called a pneumothorax
- Increased risk of bleeding due to the nature of the vessels within the spinal canal as a mesh or ‘network’ of vessels rather than tubes
What happens after surgery?
Following surgery, your dog will be settled into our dedicated neurology ward and monitored to assess their level of comfort, ability to urinate for themselves and for any deterioration post-surgery.
Based on the recommendations made by your clinician, your dog will be assessed by our specialist team of chartered physiotherapists and they will design and implement a physiotherapy and rehabilitation.
How long will my dog need to stay in hospital?
This can vary and mainly depends on the level of nursing care required for your pet, such as bladder management and whether you feel confident at continuing this management at home. Generally, dogs tend to stay in the hospital until they can urinate independently. Upon discharge, you will have the opportunity to have an appointment with one of our veterinary physiotherapists whereby you will be shown how to perform the necessary physiotherapy techniques and exercises to ensure your dog continues to make progress at home.
What is involved in the aftercare?
The aftercare generally involves 4 weeks of strict rest and physiotherapy, where recommended. This may also include daily bladder expressions if required in dogs that are unable to urinate consciously by themselves. Bladder expression is not technically difficult, and our team of nurses will be able to teach you how to do this. Dogs with spinal cord injuries can also be prone to developing urine infections and therefore we would ask for you to monitor the colour and smell of your dog’s urine.
What is the prognosis long-term?
The prognosis for dogs that are able to feel their back legs is good to excellent. Some dogs may be left with retained deficits in 10-15% of cases; however these are usually mild and do not affect their quality of life. The prognosis for dogs that are unable to feel their back legs is 50-60% success rate for return to recovery. The majority of dogs that recover the feeling in their legs do so in the 3-4 weeks post-surgery, some dogs may take longer to recover, however some dogs unfortunately do not regain feeling and remain permanently paralysed. Some dogs that remain permanently paralysed are suitable for mobility carts and can still have a good quality of life.
The Rehabilitation Service
What are the treatment options?
Physiotherapy treatment is carried out depending on the package selected. This will either be discussed with you by your vet on admission or after your pet’s surgery. You can also discuss the best package for you with the nursing team.
Please see below the different packages we have to offer:
Premium |
Enhanced |
Tailored |
Standard |
|
---|---|---|---|---|
Initial Assessment |
X |
X |
X |
X |
1 Week Review Call |
X |
X |
X |
X |
3 x Inpatient Treatments |
X |
X |
||
Tailored Home Exercises |
X |
X |
X |
|
Discharged Call/Appointment |
X |
X |
X |
X |
4 - Week Review Call (Virtual) |
X |
X |
||
4 x Outpatient Appointments (either face-to-face or virtual appointments) |
X |
In the hospital
Whilst your pet is staying with us at Langford Small Animal Hospital they will be looked after in our dedicated neurology ward by our veterinary nurses, animal care assistants and physiotherapists where they will receive around the clock care, TLC, and medication such as pain relief as required.
The neurology ward is specifically designed to accommodate patients of all sizes, and we have a range of equipment to assist with mobilisation as well as a range of bedding options from duvets and blankets through to orthopaedic mattresses to ensure they remain comfortable during their stay. We often use a range of enrichment feeders such as snuffle mats and kongs© as well as toys and teddies to help our patients feel more at home during their stay.
These pictures show our general set-up for our spinal patients, we have small, medium and large kennels but the basic set-up for all dogs is the same.
All of our patients have regular outdoor time, either going for an assisted walk, or just spending time sat outside enjoying the fresh air. We have our own small garden area, and some very pretty areas within the grounds that allow for some sniffing and chill out time out of their kennels.
Nursing Tier |
Examples |
Daily Cost (Hospitalisation) |
Bladder Management inc. |
---|---|---|---|
Tier 1 |
1 person / basic nursing care time |
£122.20 |
£144.30 |
Tier 2 |
2 people / extra time required |
£170.60 |
£192.70 |
Tier 3 |
3 - 4 people / hoist requirement |
£219.00 |
£241.10 |
* Tiers may change during stay as patient requirements change.
* Not included in cost; blood samples, blood pressures, fluids and medications etc. (Maintenance fluids daily cost £52)
Rehabilitation Advice and Bladder Management
Bladder Management
A dog may lose their bladder control temporarily or permanently due to injury or illness, meaning that they may require additional intervention such as bladder expression at home.
Using this information alongside a physical demonstration by one of our vets or nurses, we can assist you with learning the technique. It will take practice, and trial and error, but we can offer lots of support and advice. There are also videos that can be found online that you may find useful.
Your pet’s bladder may need to be expressed 2 to 3 times daily, however this may vary between individual dogs.
Neurology Discharge Shopping List
Please ensure you have the following things in place prior to taking your dog home:
- A Crate or pen so that you can keep your dog in a small and safe area during their period of cage rest.
- Non-slip mats to place onto flooring such as vinyl or laminate so your dog has a grippy surface to stand/walk on. Yoga mats or children’s play mats can be a good option for this.
- Harness and slings can be purchased from us here at Langford vets. Our team would be happy to advise you on the pieces of equipment you will need for your dog. If you would like us to order a harness or sling from us then please let us know prior to discharge.
- Puppy training pads may be useful as your dog may not have full control over their bladder function. Similarly, if you are required to express your dog’s bladder these pads are beneficial.
- Stair gate if you are unable to prevent your dog from accessing the stairs.
- Puzzle feeders such as Kong’s© and snuffle mats can be a good way to entertain your dog during their period of cage rest.
Mobility Carts
Will your dog benefit from a cart?
Carts are an option for dogs who are paraplegic (unable to move their hindlimbs). It can allow your dog to have a more active and independent life.
What do you need to consider?
- We often do not recommend purchasing a cart until at least 3 weeks post-op. This is because we want your dog to try and use their hindlimbs and hopefully regain some function.
- It can take time for dogs to get used to a cart, a gradual introduction is beneficial and it may be 2-3 weeks before they are confident in using one.
Suppliers for carts
If you do decide to go ahead and purchase a cart for your dog, two places we would recommend are:
• Walkin Wheels (Standard Sizes) - http://walkinwheels.com/
• Eddies Wheels (Custom Built) - http://eddieswheels.com
How will I now which rehabilitation package is best?
Your dog will be assessed by the physiotherapy team, and we can guide you on what would be the best package to aid recovery.
What if my dog exceeds their number of inpatient sessions whilst they are in the hospital?
If your dog needs more inpatient physio sessions than allocated as part of their package, we will ring to discuss this with you. It may be that we put your dog on an additional inpatient physio package or we can charge each session on an individual basis.
What if I decide to change the package my dog is on?
We will be as flexible as we can to give your dog the best care. If you decide to or we need to change the package that your dog is on, we will first discuss this with you. Following this we will adjust your bill to match the cost of the chosen package. Please note, once inpatient physio treatments have been carried out, these cannot be removed from your bill.