Mar Vista Animal Medical Center

3850 Grand View Blvd.
Los Angeles, CA 90066

(310)391-6741

marvistavet.com

INTERVERTEBRAL DISK DISEASE: MEDICAL TREATMENT (NO SURGERY)

Page Break

Medical management of intervertebral disk disease means helping the patient without surgery. It is appropriate in many situations:

  • Symptoms are pain and/or minor reduction in nerve function (patient can still walk).

  • The owner cannot afford spinal surgery for the pet or will not be able to manage the post-operative care.

  • Anesthetic risk is deemed to great to chance it.

The most important feature of medical management is strict confinement.
Medications are secondary to rest. This cannot be over-emphasized.

MEDICAL/CONSERVATIVE TREATMENT (NO SURGERY)

It would be wonderful if there were a magic medication that could completely relieve the pain and inflammation in the spinal cord but, sadly, medications are merely of secondary importance here. While medication can be used to assist in recovery the centerpiece of therapy is CONFINEMENT. Confinement must be strict which means a cage or pen must be provided. This will be difficult as the dog will typically not want to be isolated and may cry or fuss. An owner will be tempted to say that the painful dog will confine himself. In reality, poor results in a dog are almost always traceable to inadequate confinement and if cage rest is not possible at home, consider boarding the dog at the veterinary hospital to ensure proper rest. The dog can be walked (or carried) outside to urinate and defecate but then must be walked (or carried) right back in.

THREE WEEKS OF CAGE REST IS A MINIMUM COURSE.
AFTER THIS TIME, THE PATIENT CAN TAKE ANOTHER
2-3 WEEKS TO GRADUALY RESUME NORMAL ACTIVITY.

 Dog laying on a bed in a pen(Photocredit: Diana2020 via Wikimedia Commons)

HOSPITALIZATION
After the diagnosis is reached and the patient has been deemed appropriate for medical therapy, it may be prudent to begin therapy in the hospital. This allows for medications to begin as injectables and for the initial progress to be professionally assessed and treatment plan modified as needed. Beyond this, however, hospitalization gives the pet owner time to prepare the home for the confinement period.

From the pet's perspective, confinement is bad enough but social isolation from the family is terrible. This means that the crated pet in another room may fuss and attempt escape, potentially causing more damage. You will probably need a few confinement areas in different areas of the house so that the pet can be with you and still be confined. Crates work well for smaller dogs. Larger dogs may need "corrals" which can be easily fabricated by stacking boxes or storage bins to create a sort of a stall. Having time to figure out these logistics can be very helpful and having the pet cared for early may well reduce the amount of nursing care required at home.

MEDICATION AND MANAGEMENT
Medications typically accompany confinement. Steroids, non-steroidal anti-inflammatories, muscle relaxants, and pain relievers are commonly prescribed. During the first 3-5 days of an acute episode, icing can be performed as many times daily as possible ultimately tapering to three times daily for the duration of the confinement (or for as long as there is pain). The patient may seem to feel better with a combination of pain medication and confinement but it is important not to release the pet from confinement prematurely or there is a risk of re-injury. Consider the pain medications as a way to improve comfort DURING CONFINEMENT; not as a way to reduce the confinement period.

MORE PHYSICAL THERAPY EXERCISES THAT ARE HELPFUL
DURING THE FIRST 3-4 WEEKS OF CONFINEMENT

  1. Massage the area gently to improve circulation to the area. This is done as many times a day as possible during the first 3-5 days and after that drop to three times daily.
  2. Sensory input is important to healing nerves. They heal best when given some stimulation. This entails tickling or lightly pinching the toes. (Ideally, you should see the foot pull away - an indicator that the nerves are functioning). We want the patient to become aware of of his or her feet.
  3. For lumbar (lower back) disk disease (but not neck disk disease), gentle traction on the tail at a natural angle for 30 seconds or so creates similar stimulation. This can be done 10 times daily to start, dropping down to three times daily by the third week.
  4. Also for lumbar (lower back) disk disease, many physical therapists advocate dangling the pet by picking him or her up by the armpits so that his or her weight helps reduce the disk collapse. This can also be done 10 times daily to start, dropping down to three times daily by the third week. Before adding this to your regimen, check with your veterinarian to confirm this is not likely to upset any disk issues higher up.

 

PHYSICAL THERAPY EXERCISES THAT ARE HELPFUL AFTER THE INITIAL 3-4 WEEKS CONFINEMENT PERIOD OR WITH MORE CHRONIC DISK CASES
Review these suggested strengthening exercises with your veterinarian.

  1. Stand the dog up and see how long it takes before he had to sit or lie down. Do not push the dog to exhaustion. For example, if he sits after 30 seconds then the standing exercise should be 20 seconds. Assist standing as needed.
  2. Stand the dog and gently push him to one side. Do 5 reps, 3x daily. This is a balance exercise.
  3. Have the dog sit and then stand. Do 5 reps, 3x daily. This is a strengthening exercise.
  4. While the dog is walking, follow along and gently pinch the tip of the tail. This also improves awareness of where the limbs and tail are.
  5. Walk the dog on lumpy ground. An obstacle course can be made by putting broomsticks or a ladder on the ground, setting up a wastebasket to walk around etc. The dog should be walked through this three times daily.
  6. Flexibility exercise involves 60 very small food treats. The dog is standing (assist if needed). The treat is held up (skyward) so the dog must reach for the treat. This is done 15 times. The treat is held down at chest level so the dog must reach down for the treat. This is done 15 times. The treat is held just at the shoulder blade so the dog must reach for it. This is done 15 times on the right and 15 times on the left. The treat is held back at the level of the hip so the dog must reach around for the treat. This is done 15 times for the right and 15 times for the left.

 

The dog should at no time be left free to run and jump during the recovery period even if he seems to be feeling good. Agility, jumping and fetching games or other performance activities are best removed from the dog’s lifestyle permanently lest another disk herniated.

Patients who have suddenly lost the ability to walk may be treated conservatively as above but their best chance at regaining the ability to walk is with surgery. Conservative management works best for dogs that are able to walk, have pain perception in their feet, and have both urinary and fecal continence.

Physical therapy for pets is a relatively new field of specialization and we are finding that rehabilitation exercises make a huge difference to patient comfort and ability in many situations. Our area is fortunate enough to have several rehabilitation clinics where therapy programs can be devised and/or carried out. We will be happy to refer you.

To find a physical therapist for your pet outside of the Los Angeles area, please use this link:

caninerehabinstitute.com/Find_A_Therapist.html

Page Break

Page last revised: 10/14/2025