Integrative Treatment of Dogs with Intervertebral Disc Disease
R.M. Clemmons, DVM, PhD
Although intervertebral disc (IVD) disease in chondrodystrophic breeds
(like Dachshunds) is a surgical disease. See Paralysis
of the Rear Legs. There are a number of things which might help delay
the degeneration of the IVD and minimize the effects of herniation of the
IVD if it happens. Vitamin E is a potent anti-oxidant which, when given
before spinal cord injury, can prevent or markedly reduce the effects of
spinal cord trauma. Spinal cord signs from IVD disease are due to two factors:
1) the presence of space-occupying compression from the herniated IVD material
and 2) internal damage of the spinal cord due to vascular damage and subsequent
expansion of that damage from ischemia (diminished blood flow) and tissue
destruction secondary to lipid peroxidation and oxidant free-radical production.
The latter effect is where vitamin E acts. Unfortunately, effective levels
of vitamin E require several days to achieve; so, while vitamin E given
before an injury is effective, it is ineffective when given during or shortly
after the trauma.
The IVD represents one of the "joints" for connection of vertebrae.
While the metamorphosis which takes place in the nucleus pulposus is genetically
programmed, the degeneration occurs secondary to the decrease in IVD elasticity.
This transmits greater shock to the IVD causing progressive damage. It
may not be possible to completely stop this process of damage, but reducing
inflammation caused by this damage and providing nutrient support to the
cartilaginous structures in the IVD has the potential to delay the onset
of IVD disease. Recent studies have shown that there is regeneration of
disc material. As such, IVD disease is because degeneration wins out over
the natural regenerative (healing) process. Increasing the changes of regeneration
(healing) may be the only choice other than surgery. This will not happen
overnight and must be part of the of the patients life-long treatment.
Don't forget that while a number of dogs will recover from IVD disease
with cage rest for a minimum of 30 days or 3 weeks beyond the time it takes
them to return to normal function without the aid of medication, early
surgery gives the best chance for them to regain neurologic function. This
is particularly true if they are paralyzed. If they have sudden or rapid
onset of paralysis with decreased or absent pain sensation caudal to the
lesion, then emergency surgical intervention is critical to optimize their
chances of recovery. This will include giving IV anti-oxidant, corticosteroids
(Solu Medral or Solu Delta Cortef). On the other hand, once the initial
problem is treated, the patient still must heal. The principles of integrative
medicine apply, demanding that all modalities which are available be employed
in returning the dog to health. As such, besides conventional medicines
and surgery, attention must be given to physical therapies (including physical
therapy, acupuncture and message therapy) and dietary and nutritional support.
Even though dietary supplementation may help prevent IVD disease development,
it is also important in speeding the recovery of the patient once IVD herniation
The following recommendations will be broken into preventative measures
and also into treatment once IVD disease has developed.
The "Wiener Dog" Diet:
The dietary and nutritional requirements for chondrodystrophic dogs
are those of all dogs. In that regard, they need adequate amounts of soy
bean products (such as tofu) which are high in lecithin (important in myelination
of nerves), bioflavonoids (containing anti-oxidant properties) and phytoestrogens
(which help maintain healthy bone and joint development). They should receive
regular supplementation with dry garlic and dry ginger to provide anti-inflammatory
actions and may assist in preventing joint (including IVD) degeneration.
Vitamin B complex helps support nerve function and repair which will aid
in balancing the nervous system. Anti-oxidant therapy (Vitamins E &
C, selenium and carrots) will help stabilize blood vessels and reduce oxidative
damage within the IVD from degeneration. Other anti-oxidants like ginkgo
and grape seed extracts may also be useful and will improve microcirculation
in the IVD and spinal cord. As the patient ages, ginkgo will help maintain
cerebral circulation in the later stages of life. Green tea contains bioflavonoids
which are protective to certain kinds of cancer and lower blood cholesterol
levels. It also provides an energy boost from its theophylline content.
The ginsengs (Siberian and American) provide adaptogenic functions acting
as body tonics in aging patients. American ginseng also has anti-cancer
and immunostimulating properties. Dong quai offers a tonic for female dogs
much like American ginseng does for males. In addition, dong quai has phytoestrogens
which may help maintain bladder function in older female dogs and may help
support healthy bone structure in aging dogs.
While there is anecdotal data to suggest that obesity plays a role in
IVD disease, the real problem is being born with the genetic potential
to developed IVD degeneration. It may be the "jumping-off-the-couch" which
precedes IVD herniation; yet rupture of the disc occurs in many patients
even without predisposing factors. In general, dogs live healthier lives
if the maintain a lower body weight. Giving healthy food and planning regular
aerobic exercise can help maintain optimal body weight. During periods
of less activity, reduce food intake to compensate. Weekly weight monitoring
can help adjust body weight before it becomes a factor. Your veterinarian
can help determine your dogs ideal body weight.
Should IVD disease occur in dogs not on the "prevention" diet, staring
it will be helpful in speeding the patient's recovery. Certain additional
supplements may also help them recover and prevent complications from the
paresis or paralysis. These measures do not take the place of conventional
therapy including anti-oxidant steroids (such as Solu Medral or Solu Delta
Cortef), surgical decompression of the spinal cord, IVD fenestration or
strict cage rest. Switching to fresh, raw garlic will provide antibacterial
and antifungal protection against infection. Switching to fresh ginger
will protect against stomach upset and calm the gastrointestinal tract.
Adding a natural product called deglycyrrhizinated licorice (DGL) to protect
the lining of the stomach and duodenum. Licorice has excellent soothing
and healing properties in cases of ulcer, but whole licorice contains a
fraction (glycyrrhizin) that can raise blood pressure. This is removed
to make DGL extract. The dose is two tablets of DGL extract chewed slowly
before meals or between meals, or one half teaspoon of the powder swallowed
at the same times. You can use this remedy as long as symptoms are present.
It will also help protect against the gastrointestinal irritation cause
by corticosteroids. A useful native plant that is an immune-system booster
is purple coneflower (Echinacea purpurea and related species). The
root of this ornamental plant is held in high esteem by herbalists, naturopathic
doctors, and many lay-people because of its antibiotic and immune-enhancing
properties. You can buy echinacea products in any health food store as
tinctures, capsules, tablets, and extracts of fresh or dried roots. Although
few medical doctors in America are familiar with echinacea, much research
on it has been done in Germany, and the plant is in widespread use as a
home remedy in Europe and America. Follow the directions for adult dosing
and continue until recovery is complete. A Chinese herbal remedy with similar
properties comes from the root of a plant in the pea family, Astragalus
membranaceus. This plant is a relative of our locoweed, which is toxic
to livestock. The Chinese species is nontoxic, the source of a very popular
medicine called huang qi that you can buy in any drugstore in China for
use against colds, flues, and other respiratory infections. Recent studies
in the West confirm its antiviral and immune-boosting effects, and preparations
are now available in most health food stores here. Follow the directions
for adult dosing. Coenzyme Q also called Co-Q-10, is a natural substance
that assists in oxidative metabolism. It may improve the utilization of
oxygen at the cellular level, and patients with heart, muscle and nerve
problems may find it worth trying in doses of 30-100 milligrams a day.
Some human beings report that it increases their aerobic endurance. Coenzyme
Q may help stabilize blood sugar in people who have diabetes, and to slow
heart disease. It also maintains the health of gums and other tissues.
There is evidence that coenzyme Q can prolong survival in women with breast
cancer, too. Coenzyme Q is harmless, but not cheap. It is probably not
worth supplementing your dog with Coenzyme Q, if it is healthy. However,
patients who suffer from nervous system problems, such as IVD disease,
should receive 30-100 mg Coenzyme Q daily until they have recovered. Finally,
if they the patient is uncomfortable from muscle spasms, passion flower
(which is the herbal equivalent of diazepam) may be useful in relieving
the pain and calming the dog. Try once capsule three times a day.
Additional Measures for Treatment of IVD Disease:
While acupuncture cannot prevent IVD disease and should be used with
the same caution as relieving pain by conventional measures in acute IVD
herniation, acupuncture provides many beneficial effects in treating chronic
IVD disease or following surgical correction during the healing process.
Acupuncture is widely accepted as a method to provide analgesia without
the side-effects of drugs. It can also help treat gastrointestinal and
urinary tract dysfunction following IVD herniation. It stabilizes the adrenal
gland function and may increase endogenous corticosteroid secretion without
the side-effects of exogenous steroid medication. Electrical acupuncture
will stimulate reflex activity, improving muscle strength and allowing
more rapid return of function. Post-operatively, needle acupuncture is
useful to reduce muscle spasms with drug intervention. Generally, acupuncture
is given over several treatments. If it does not provide benefits within
3-5 treatments, then further therapy may not be warranted. Acupuncture
should be performed only by a veterinarian who is trained and certified
in its use; your veterinarian should be able to refer you to a qualified
veterinary acupuncturist in your area.
Veterinary Chiropractic is a rapidly emerging field in treating equine
patients and is expanding in its role in treating small animals. It should
be performed by a licensed Veterinary Chiropractor. In general, veterinary
chiropractic involves the manual adjustments of the vertebrae to correct
chiropractic, vertebral subluxations. It is felt that these subluxations
result in a series of events beginning with vertebral misalignment and
sequentially progressing to neuropathy, kinesiopathy (changes in normal
vertebral movement), neurologic or biomechanical dysfunction, and tissue
degeneration. Correcting these subluxations may reverse this process and
The application of chiropractic manipulations to dogs with chondrodystrophy
early in life may help prevent the development of IVD disease by maintaining
vertebral flexibility. On the other hand, it is likely that the dietary
changes and supplements discussed above will be synergistic with this effort.
Since chiropractic is limited to manual spinal column adjustments, you
will need a veterinarian who can integrate these methods.
Physical & Massage Therapy:
Once IVD disease as already occurred, chiropractic manipulations should
not be performed during the acute phases, but be limited to the assistance
of recovery following surgery or once the patient has sufficiently healed
so that manipulations will be less likely to cause further IVD herniation.
This may be only after "strict rest" has been enforced for 3 weeks after
the patient is normal. I do not advise chiropractic manipulation for at
least 14 days following an acute IVD herniation.
While physical therapy and massage therapy probably will not prevent
IVD disease, they are very useful in help patients recover from spinal
cord injury. In fact, these methods may be as important as any other factor
in ensuring maximal recovery. Using the methods, as part of play while
the dog id healthy, may help make them more acceptable to the patient when
they are needed. One of the reasons why IVD disease is best treated with
surgery is that physical therapy can be begun immediately after surgery.
In cases where surgery is not performed, physical therapy and massage therapy
must be limited to the least aggressive methods.
Massage therapy improves muscle and joint flexibility, increases blood
supply (improving nutrient delivery and waste removal), and help prevent
or breakdown scar tissue formation. It also helps relax muscle spasms and
aids in patient comfort levels. Massage therapy for animals should be performed
by massage therapist trained in animal behavior and anatomy, under the
supervision of your veterinarian. Many of the basic principles can be learned
by the owner under proper instruction.
Physical therapy is often initiated by your veterinarian, who will instruct
the owner in how to continue the therapy at home. There are several physical
techniques which are beneficial in returning patients to function. Initially,
passive movement of all joints of legs which are paralyzed needs to be
performed. Each joint should be gently brought through its full range of
motion for at least 5 minutes per day. This will stimulate blood circulation
and help maintain muscle and joint flexibility; so that, when neurologic
function returns, the muscle and joints will be capable of response. The
importance of passive movements continues until voluntary movements begin
to return; at which point, they are no longer necessary. One way to accomplish
these passive movements is to bring the entire leg through circular extension
and flexion movements, similar to "riding a bicycle" exercise. Shortly
after the start of passive movement therapy, standing exercises are important
to build muscle strength. The paralyzed limbs should be positioned naturally
and the weight of the animal used against muscle resistance. Initially,
this resistance will be minimal; but, with increasing time and exercise,
the resistance will allow the animal to stand for brief periods. The standing
should be continued, increasing resistance by pressing down upon the animal's
back, until the muscles tire. Muscles must fatigue to gain strength. Standing
exercises should be continued until strong walking movements are present.
Within 3 days of surgical correction, hydrotherapy can be begun. Using
warm water, hydrotherapy helps loosen muscles and increase circulation.
Hydrotherapy also can be combined with passive movements during the early
stages increasing the benefits of each. By removing gravity, voluntary
movements may be easier for the patient to initiate. Hydrotherapy is beneficial
until voluntary movements have begin and standing exercises have increased
muscle strength significantly. If the patient is treated without surgery,
physical therapy should be limited to passive movements and standing exercises
until the herniation has healed (minimum of 10-14 days).
Healing touch is based upon the capacity of human beings to pass "life-force"
from themselves into others willing to accept this gift. Although many
forms of healing touch are taught in the West, they represent teachings
of the same physical process. Many studies have indicated that human contact
can help lower blood pressure, reduce stress and improve the state of well-being
of the recipient. Human contact has also been shown to increase the immune
resistance of others. These principles can be used to help animal patients
heal, as well. While it is not easy to demonstrate measurable results in
all cases, certainly healing touch does no harm. When done as taught by
practitioners of healing touch, it does not cost the "giver" personal energy,
since the "giver" acts as a conduit of "universal" life-force which is
freely available from a limitless supply of life-force within the cosmos.
The "recipient" is free to accept and use this life-force energy. Most
Eastern philosophies of healing are based upon the concept that living
beings are based upon energy which flows in the body. When the energy level
is low or there is a blockage of energy flow, disease develops. Healing
touch, by providing life-force energy above or below this blockage, can
re-establish the natural flow of energy, allowing healing to take place.
While healing touch has a spiritual aspect, it is not a religious practice
nor does it require any particular belief by the giver or recipient. What
is required is a recognition by the giver that this process can occur and
for the giver to practice the technique to establish pathways for energy
flow from them to the recipient. Distant healing touch can also be beneficial
to patients. In this form of healing touch, the giver establishes a "psychic"
connection with the recipient and mentally visualizes offering the life-force
to the patient. Many double blind studies have shown that prayers directed
at patients in human intensive care units reduce the complication rates
of those patients and their ultimate length of stay in the intensive care
unit. Distant healing touch and prayer seem to work through similar mechanisms,
in their benefits to patients. On the other hand, belief in any specific
religion is unnecessary to practice healing touch. Any person can learn
and practice healing touch. In fact, most people perform healing touch
without knowledge of doing so. For information about the practice of healing
touch see Dr. Weil's web pages and
search for "healing touch". For a discussion of healing touch, see
Healing touch may be helpful to maintain normal health in dogs who might
develop IVD disease. It also will assist in speeding and maximizing recovery
once IVD herniation has occurred. Since this can be done without risk of
injury, it will do no harm; yet healing touch may increase the chances
of full recovery. It also helps develop the human-animal bond. The outcome
of healing touch is non-judgmental. It is a gift which is shared between
the patient and healer.
Disclaimer: The information presented here is for educational
usage. It is not an endorsement of any particular product. You will need
to discuss the measures and natural alternatives with your veterinarian.
If the problem worsens or new signs develop, discontinue medication and
seek appropriate veterinary medical care. This material represents the
views of the author and does not necessarily reflect the views or policies
of anyone else.
Copyright Dog2Doc.com 1997
All Rights Reserved
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Last updated 28 August 2002