Non-Surgical Management of Canine Intervertebral Disc Disease (IVDD): Indications and Treatment Strategies 

Abstract
Intervertebral disc disease (IVDD) is a common cause of spinal cord dysfunction in dogs. While surgical intervention remains the standard of care for many cases, non-surgical (conservative) management plays a critical role in treatment, especially for patients with mild neurologic deficits, surgical contraindications, economic concerns or as an adjunct to post-operative recovery. This article outlines the indications for conservative treatment, goals of therapy, and practical approaches to maximize outcomes in affected dogs.

Introduction
IVDD is characterized by degeneration and herniation of intervertebral discs, resulting in varying degrees of pain, paresis, or paralysis. Non-surgical management—also referred to as conservative treatment—aims to optimize comfort, restore function, and prevent complications in dogs for whom surgery is not indicated or feasible. This review summarizes when to initiate conservative therapy and provides a comprehensive approach to its implementation.

Indications for Non-Surgical Treatment
Non-surgical management may be selected under the following circumstances:

• Mild Clinical Signs: Dogs exhibiting only mild neurologic deficits (e.g., pain, mild ataxia) and retaining ambulatory function.
• Contraindications to Surgery: When surgery is not feasible due to financial limitations, lack of surgical availability, anesthetic risk, or owner preference.
• Trial Prior to Surgery: Owners may choose to attempt conservative management before considering surgical intervention.
• Adjunct to Surgical Recovery: Following spinal surgery, dogs often require weeks to months for optimal neurologic recovery and may benefit from continued non-surgical therapies to regain mobility and function.

Goals of Conservative Management
The primary objectives are:

• Maximizing patient comfort and pain control
• Facilitating return to standing and ambulation
• Supporting restoration of bladder and bowel control
• Preventing secondary complications, such as skin sores, urinary infections, and behavioral disturbances

Core Components of Non-Surgical Management

1. Pain Management - pharmacologic
   Pharmacologic pain control, guided by the veterinarian, is the cornerstone of conservative therapy. This may include steroids, NSAIDs, muscle relaxers and analgesics.

      2.Pain Management – non-pharmacologic

• Ozone Therapy: reducing inflammation, improving oxygen delivery to tissues, and promoting tissue repair. It works by modulating oxidative stress, stimulating the immune system, and potentially shrinking the herniated disc.
• Photo biomodulation – also known as “Laser Therapy” reducing pain and inflammation, and promoting tissue healing and regeneration. It works by stimulating cellular activity and boosting ATP production, the energy source for cells, which is crucial for repair and regeneration.
• Acupuncture: reducing pain, inflammation, and promoting nerve regeneration, ultimately improving mobility and quality of life. It works by stimulating specific acupuncture points on the body, which can trigger the release of endorphins, reduce inflammation, and improve blood flow to the affected area.
• Pulsed Electromagnetic Field Therapy: The pain reduction, anti-inflammatory effects, and enhanced healing offered by PEMF therapy can significantly improve a dog's overall quality of life, mobility, and comfort when dealing with IVDD.

3. Activity Modification
• Strict rest, particularly in the initial phase, to minimize exacerbation of injury
• Avoidance of high-risk activities (e.g., running, jumping)
• Controlled, supported ambulation (using hands or a hindquarter sling)
• Brief, low-frequency exercise and toilet breaks to prevent fatigue
• Prevention of compensatory behaviors, such as dragging, which may impede functional recovery

4. Nursing Care
• Maintenance of hygiene, with frequent cleaning and turning for recumbent patients
• Sling support for mobility and toileting when necessary
• Assisted bladder expression if voluntary control is impaired
• Provision of attentive, individualized care

5. Mental Stimulation
• Structured daily routine to reduce stress and boredom
• Engagement with toys, gentle games, or supervised outings in a stroller to promote psychological well-being

6. Nutritional Support
• A balanced, high-quality diet tailored to the patient’s needs
• Caloric management to prevent weight gain during periods of reduced activity

Discussion
Conservative management of IVDD demands a coordinated, multifaceted approach involving pain control, environmental modification, attentive nursing care, and owner education. The success of non-surgical treatment depends on early recognition, consistent implementation of management strategies, and ongoing assessment of neurologic function.

Conclusion
Non-surgical therapy remains an essential component of IVDD management, whether as primary treatment or in support of surgical recovery. Individualized care plans, diligent owner participation, and regular veterinary follow-up are key to optimizing patient outcomes.

References

1. Brisson BA. Intervertebral disc disease in dogs. Vet Clin North Am Small Anim Pract. 2010;40(5):829–858.
2. Levine JM, et al. Prognosis for dogs with thoracolumbar myelopathy undergoing conservative treatment. J Am Vet Med Assoc. 2007;230(11):1674–1679.
3. Mann FA, et al. Conservative vs. surgical management of acute intervertebral disc herniation in dogs. Vet Surg. 2016;45(7):S46–S54.
4. Jeffery ND, et al. Intervertebral disc degeneration in dogs: Treatment and prognosis. J Small Anim Pract. 2013;54(6):339–347.