Richard A. LeCouteur
The spinal column is made up of a number of small
bones called vertebrae that are lined up like building blocks. A hole in
the center of each vertebra forms a tunnel in which the spinal cord
lies. The spinal cord is extremely important as it carries the messages
from the brain to the rest of the body. The spinal cord is extremely
delicate, and being surrounded by the bony vertebrae helps to protect
it. Between each pair of vertebrae, just underneath the spinal cord, is
a little cushion, called an intervertebral disk. Disks cushion the
vertebrae from one another and provide flexibility to the spine during
movement.
As a part of the normal aging process, these disks
deteriorate, resulting in so-called disk disease. Normally, each disk
consists of an outer fibrous ring and an inner gelatinous center (a good
analogy would be a jelly doughnut). With age this ring becomes
fragmented an the inner "jelly" center hardens to a
consistency of hard cheese. The fragmented outer ring may no longer be
able to hold this hard center in place, and movement of the vertebrae on
either side may suddenly squeeze the disk out of its normal position.
Unfortunately, this material usually moves upward and comes to rest
against the spinal cord, bruising it in the process. This
"slipping" of the disk often occurs explosively, causing
significant damage to the spinal cord and pain to the animal. In this
abnormal position the disk presses against the spinal cord, causing
further damage.
This type of disk disease may occur in dogs and cats
of any age or breed but occurs most commonly in the
"short-legged" breeds (e.g., dachshund, French bulldog, Welsh
corgi, Pekingese) and some other small breeds such as the poodle and
cocker spaniel. It may also occur in larger breeds of dog, including
Doberman pinschers.
The parts of the spine most commonly affected by
"slipped" disks are the neck and the middle to lower back.
When a disk "slips" out of place and pushes against the spinal
cord, it usually causes the animal significant back pain and frequently
the damage to the spinal cord interferes with the normal functions of
the front and/or rear legs (depending on the location of the disk
rupture). In addition to being in pain, the affected dog or cat may be
lame, uncoordinated, and/or paralyzed.
These symptoms (pain, incoordination, and possibly
paralysis) indicate that the dog or cat has a problem affecting the
spinal cord but not the exact location or cause of the problem. Disk
disease, a tumor of the spine, or an infection of the spine may all
produce similar symptoms. Tests are needed to determine the exact
location and cause of the problem and to decide on the appropriate
therapy. In order to accomplish this, the patient must be anesthetized
for x-rays and collection of fluid from around the spinal cord. "Myelography"
is an x-ray study in which a special dye is injected into the fluid
surrounding the spinal cord. This then allows any disk material pushing
against the cord to be identified on the x-rays. Analysis of the fluid
around the spinal cord helps to rule out other causes of the problems
such as infection.
In most cases disk disease is a problem requiring
surgery to remove the disk material compressing the spinal cord.
Occasionally, animals with disk disease are not treated by means of
surgery. In these animals, strict cage confinement and immobilization
are used. Usually this approach is used for a first bout of back pain in
animals that do not have problems walking. Although strict cage
confinement does not correct the spinal cord compression, it may
temporarily reduce some of the pain and swelling around the spinal cord
and permit the ruptured disk to "heal." As time goes on, it is
not uncommon for animals treated without surgery to suffer repeated
bouts of pain, lameness, and paralysis as additional disk material slips
and compresses the spinal cord. With each bout of disk disease the
spinal cord suffers additional permanent damage. Surgical removal
of disk material from the spinal canal is the only treatment that
provides rapid and maximal recovery of spinal cord function.
Cortisone administration to animals with disk disease
is of therapeutic value only during the first 8 hours after the initial
spinal cord injury. Current scientific evidence does not support the use
of cortisone beyond this time. Furthermore, the adverse effects of
cortisone (e.g., stomach ulcers) must always be kept in mind.
The surgery used most frequently to remove disk
material from around the spinal cord is called a laminectomy. For
animals undergoing a laminectomy, the speed of recovery and the extent
to which normal function of the legs is regained depend on many factors,
including the degree of the damage to the spinal cord and the length of
time that the spinal cord has been compressed by the disk material.
Animals exhibiting severe neurologic signs (e.g., depressed feeling in
their toes), a rapid onset of symptoms (hours), and a long period of
time before surgery generally have a prolonged recovery period and may
have varying degrees of permanent damage.