Retrospective Study Evaluating the Outcomes of the Surgical Versus Conservative Treatment of Dogs Diagnosed with Intervertebral Disc Disease in the Years of 2007 and 2008 at the Veterinary Teaching Hospital Anhembi Morumbi
F.C. Cardoso; M.M. Jericó; R.D. Lepiani; A.C. Oliveira; R.T. Rocha; L.A.M. Silvano
The most common cause of paraplegia in dogs is the acute herniation at the thoracolumbar site in the spine knowing as Hansen type I which is usual in chondrodystrophic breeds, such as Dachshunds, Poodle, Lhasa Apso, Maltese and Cocker Spaniel with ages between 3 and 6 years. The Hansen type II is present later in life, between 5 and 12 years old and the dogs are in the group of non chondrodystrophic breeds, such as Rottweiler, German Sheppard, Grand Dane, Mastiffs, and others (Garibaldi, 2003; Olby et al., 2005). The goals of a rehabilitation protocol for injuries at the medulla presenting neurologic deficits are improvement of neuromuscular function, restoration of atrophied muscles, proprioceptive enhancement and better ambulation status of the dog. All those goals could be achieved with a physiotherapeutic approach and treatment (Olby et al., 2005).
Materials and Methods
In a retrospective study, 76 dogs with back pain was evaluated at the rehabilitation facility at the veterinary teaching hospital Anhembi Morumbi in the years of 2007 and 2008. They were classified in groups of age, sex, breed, diagnose and the treatment of choice, surgical or conservative. The ambulatory status of those animals at the end of the program was also evaluated. The rehabilitation protocol performed included electroacupuncture, electrotherapy (TENS and NMES), hydrotherapy, proprioceptive exercises, laser and therapeutic ultrasound. All those modalities were adjusted to better attend each case, and were applied weekly or twice a week regarding the owner acceptance to bring the dog for treatment. Dogs with cervical injuries or with immune suppression issues were not treated with hydrotherapy.
Of the 76 dogs with back pain due to intervertebral disc disease and ambulatory deficits, 35.53% (n = 27) had a surgical treatment, 49% (n = 64) and had the conservative treatment. In the conservative group 38.78% (n = 19) regained ambulatory capacity versus 51.85% (n = 14) in the surgical group. There was no significant differences among sex with 55.26% (n = 42) males and 44.74% (n = 34) females, the average age lies between 2 and 6 years and the most prevalent breed was the dachshund with 46.05% (n = 35).
Discussion and Conclusions
The post surgery rehabilitation should begin as soon as possible due to the fact that the time had great influence in the duration of signs and rehabilitation outcome (Garret & Brown, 2002). The conservative treatment was able to restore function regarding the time of evolution in the signs of the disease. A comparative study between those treatments was observed a better recovery and quality of movement in dogs submitted to surgery in those cases with severe neurologic deficits and the dogs treated conservatively had more recidivism of the paraplegic status (Bray & Burbidge, 1998). The rehabilitation for treatment of dogs with neurologic deficits should be more employed to achieve a faster regain of function and ambulation. This modality of treatment has become more popular to improve the quality of life in dogs with paraplegia and has showing god results especially in the post operatory care.
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