Treatment options include corticosteroids, enforced rest (cage confinement), acupuncture and surgery. The ideal option depends on the location of the IVDD, whether the dog is a small or large breed, severity and duration of the clinical signs and recurrences. Most surgeons agree on several general treatment protocols. Most small and large breed dogs with cervical IVDD are treated initially with corticosteroids, enforced rest or acupuncture. Surgery is reserved for patients with more severe clinical signs (intractable pain and or motor dysfunctions such as staggering) or recurrent episodes.
Treatment for small and large breed dogs with thoracolumbar IVDD varies depending on the clinical signs. In general dogs with a first episode that are able to walk are treated non-surgically, with enforced rest for 4-6 weeks being the most important aspect of the treatment. Small breed dogs that cannot walk should undergo surgery. Surgery is used to remove the herniated disc and decompress the spinal cord. Surgery should be performed as soon as possible.
Prognosis is dependent upon the severity and duration of clinical signs and treatments utilized. Dogs with cervical (neck) IVDD, causing pain but no neurologic deficits, have a fair prognosis when treated with enforced rest although recurrences are common. Dogs with cervical IVDD treated surgically have an excellent prognosis.
Dogs with thoracolumbar (back) IVDD that are not able to walk, but have deep pain perception (able to feel pain when the toes are pinched with an instrument) have a 98% recovery rate. Approximately 50% of dogs that have lost deep pain perception will recover with surgery.