Canine Intervertebral Disc Disease (IVDD)

7 Sep 2023 Canine

By Erica Tramuta-Drobnis, VMD, MPH, CPH

IVDD in dogs, what is it?

Intervertebral disc disease, or IVDD, is one of the most common spinal disorders seen in canine patients. These patients will commonly present with back or neck pain on physical exam. However, often owners do not actually appreciate this pain. Instead, owners see the pet hesitating to jump, not wanting to walk as far, or not wanting to play. Owners may miss a slightly off head carriage or an intermittent limp. They may not realize the different ways back, or neck pain can manifest. But they recognize that something is off, triggering them to take the pet to the veterinarian or osteopath for evaluation.

What is IVDD?

In IVDD, the intervertebral disc material in the spine ruptures, affecting the pet’s spinal cord. Think of the intervertebral discs as the cushions for the spine. Intervertebral discs, found between the bones (vertebrae) in the spine, act as shock absorbers helping to stabilize the spinal column (Béraud,2015; “IVDD In Dogs,” 2020).

The disc material or nucleus pulposus under healthy conditions is flexible and easily compresses to aid in the body’s movement. However, over time the material can become inflexible and brittle. Normally, bending with movement, these abnormal discs will bulge or rupture, putting pressure on the spinal cord’s nerves, causing various signs from mild pain to complete paralysis (“IVDD In Dogs,” 2020). While the disease progresses slowly over time, acute trauma to the spinal cord can suddenly cause this disc material to explode out of the space, sending the disc material fragments to the cord. This concussive action triggers the clinical signs (Béraud,2015).

Similar to when a human herniates a disc or ruptures a disc, IVDD affects various parts of the dog’s spine.

The cervical spine (neck)

Brooks (2019) reports that 15% of all disc herniations occur at the cervical spine level (neck). 80% of these cervical herniations (most commonly between C2-C3) occur in “dachshunds, beagles, or poodles” (para 8).

The thoracic and lumbar spine

Brooks (2019) notes that T11-T12 and L2-L3 are the most seen sights of herniation. However, we also commonly see low back pain L4-S2 in dogs. Extrusions in this area account for 15% of all cases of Type I IVDD in dogs. Continue reading for a review of the types of IVDD. In clinical practice, the author generally appreciates pain in 3 general locations: the neck region(cervical), around T13-L2, and the lumbosacral area (near the tail).

Causes of IVDD

In many cases, we have no idea what actually triggers the disc change at a specific moment. Owners may report that the dog fell off the couch or tripped down the stairs several days ago but had seemed fine. A day or even a week later started to limp or show other signs of pain or lameness.

Sometimes owners will report an episode where they heard the dog cry out. They may even have seen the dog limp for a day or two, and then it seemed to resolve on its own. But most of the time, we do not appreciate a specific incident to truly demonstrate a direct cause and effect.

Because dogs tend to tolerate pain differently from people, they often show it differently and may initially mask it.  Perhaps there was a full resolution of clinical signs. Or maybe they simply didn’t start showing signs of pain until it became serious enough to cause them to do so.

In osteopathy, we look at the whole patient. Knowing what risk factors your patient possesses from the get-go, including any known injuries or traumas, recognizing the breed predisposition, and any previous history of the disease, all help improve your diagnosis and treatment plan development moving forward.

Breed predispositions

Any dog of any body type at any age can develop IVDD. That being said, there are some poster children that veterinarians and veterinary professionals automatically think of when discussing this disease.

Large breed dogs

IVDD is frequently seen in large breeds such as German Shepherds and Labradors. While Dobermans are the poster children for a specific neck condition called wobblers (Gregory, 2018; “IVDD In Dogs,” 2020).

Small to medium breed dogs

Common small to medium breed dogs we think of may include the mini or toy Poodle and Cocker spaniels

Beagles are genetically prone to a specific rapid-onset type of IVDD and second only to dachshunds in the occurrence of neck IVDD. If you see a beagle, make sure to warn the owners as they can quickly progress to neurologic deficits (problems) (Bagley, 2006).

Chondrodysplastic breeds

Chondrodysplasia, a genetic abnormality secondary to abnormal cartilage growth, is common in several breeds. The bones grow at different rates leading to limb deformities and shortening of the limbs. These dogs can be disproportionately dwarfed in stature secondary to this abnormal growth. They can have additional abnormalities to various skeleton parts, including the ribs and spine (Cruz-Rincon, 2017,p.; Vetstream, n.d.). See Figures1b, 1d, and 1e for examples.

Classically many think of chondrodysplastic breeds first when they picture IVDD. While their confirmation alone can increase these types of dogs’ risk for IVDD, some dogs also have a genetic mutation. This mutation causes changes to the intervertebral disc’s metabolism, leading to early disc degeneration (Thomas, 2014).

These breeds often have long bodies on very short stubby legs with additional conformational issues that predispose them to IVDD. Dachshunds, Lhasa Apsos, Pekingeses, and Basset Hounds, for example, fit into this classification (“IVDD In Dogs,” 2020).

Dachshunds and beagles typically come to mind when thinking of IVDD for most veterinarians, but really IVDD can occur in any breed (Gregory, 2018).

Age of onset

While rarely occurring in dogs younger than1, it can occur at any age. It is often seen in ages 3-7 and then again in the older stages, ages 12 and up. Thus, age alone isn’t enough to suggest the presence or absence of the disease.

Hansen type I-III IVDD

The classification of the types of disc changes that occur have varied over the years but currently include Hansen Types I, II, or III.

Hansen Type I IVDD most commonly occurs younger in life and in chondrodystrophic dogs. Since genetics also plays a large role in this type of degeneration, it tends to affect younger to middle age dogs.

Type II IVDD tends to occur in older dogs secondary to normal aging processes and tends to occur in the larger breed dogs.

Type III AKA traumatic disc herniation, non-compressive IVDD, or high-velocity low-volume IVDD occurs at any age and in any breed. It causes the nucleus pulposus to suddenly shoot out a disc fragment into the spinal cord (Béraud,2015).

Clinical Signs

For a detailed review of the signs of pain in dogs, please review the blog entitled (Recognizing Canine Communication).

General signs of pain

Some dogs with IVDD may demonstrate classic generalized signs of pain such as

  • Hesitancy to jump onto or off furniture or in going up/downstairs
  • Decreased energy or desire to play or exercise
  • Change in behavior
  • Change in appetite
  • Vocalizing – Remember to educate your clients. Inform them that lack of vocalization doesn’t mean they aren’t in a lot of pain. For example, Pitbulls are often very stoic and may not show pain unless severe. On the other hand, Huskies are often wimpy and may stub a toe and behave as if they tore off an entire foot.
Possible signs of spinal pain

Other signs may be more specific or suggestive of back or neck pain. These may vary depending on where the disc abnormality resides in the spine.

Additional signs of pain or spinal cord damage may include

  • Holding the tail low, not wagging it normally or as often
  • Crouching or hunching postures (can mimic abdominal pain)
  • Chewing on the tail or a leg(even to the point of causing trauma)
  • Chewing can occur far from the actual injury site. This occurs due to referred pain, neurologic pain, or because it becomes a means for them to handle the pain.
  • Merely being more guarded or not normally engaging with the owners or other pets in the home.

Suppose the damage causes compression of the spinal nerve root. In that case, it can cause pain (radicular pain) to be referred from the spine itself down a limb or other areas. Be aware that sometimes back pain presents as lameness in the hind-limb(s) without overt backpain (Rossmeisl, 2013).

  • This author’s own dog, Isabelle, a Rhodesian Ridgeback/Labrador mix, didn’t know she was a 4-legged animal. She was active, athletic, in ideal body condition. She was long and lean and loved to stand on 2 legs. For 6 months, she was intermittently lame in her left hindleg. Radiographs were non-remarkable. Her physical exam revealed only muscle changes and tension bands along the spine, left hind leg, and intermittent strains to the iliopsoas muscles in the pelvic/groin area.
  • Using a combination of laser therapy, ultrasound, massage, and physical therapy in addition to pain medications, she improved. It wasn’t until 6 months later that she even showed any back pain signs and was only evident with the spine’s deep palpation.
  • Then, she responded to therapy and barely had real pain to severe back pain and vocalization overnight. She required surgical intervention and, thankfully, recovered, never looking back.

So, back pain can manifest in many ways. All too often, veterinarians FAIL to evaluate for it. Just because your patient went to the vet and the vet found nothing overtly wrong, make sure that you evaluate their gait and palpate for signs of back pain thoroughly on your physical assessment. Not everyone appreciates subtle signs of pain or thoroughly assesses for back pain, so take care to ensure you do so.

Neuropathy – Neurologic signs associated with IVDD

Additional clinical signs may suggest that your patient has a neurologic component and help you lean to a diagnosis of IVDD. These signs may include

  • Varying degrees of paresis (weakness)or paralysis (inability to use a leg/legs)
  • Crossing over with a leg when walking
  • Stumbling
  • Weakness
  • Dragging a limb

Traditional and holistic treatment options for IVDD

Traditional initial therapies
  • Medications and strict rest (2-4 weeks)
    • Medications such as
      • Gabapentin
      • Codeine
      • Anti-inflammatory medications
        • NSAIDs (Non-Steroidal Anti-Inflammatory Pain medications)- The names of NSAIDs used in dogs varies from country to country. Ensure that you can recognize the medications your patients are on.


        • Steroids such as prednisone.
        • NSAIDs and steroids SHOULD NEVER BE USED TOGETHER in our canine patients.
      • Amantadine (which prevents and or treats wind-up pain aka central sensitization)  – see pain blog for more information.
      • Tramadol (Alone, this medication provides insufficient pain control according to various studies and this author’s clinical experience. However, combined with other meds as above, it may be helpful as an adjunct) (Budsberg et al., 2018).
  • Surgery
    • Indications for surgery may include neurologic deficits (described above), severe uncontrollable pain, or the progression of clinical signs
  • Post-surgery rehabilitation
Adjunctive therapies

Thankfully, society is becoming more accepting of adjunctive treatments in the veterinary community and the lay population. Our clients want to avoid medications unnecessarily, and who wants their pet to have surgery if it can be avoided? Finally, these therapies provide a great addition to post-op surgical care.

  • Physical therapy (Physiotherapy) and rehabilitation exercises
    • Guided therapeutic exercises
    • Hydrotherapy (water therapy) – underwater treadmill, swimming
    • Massage
    • Manual therapies such as passive range of motion
  • Laser Light Therapy AKA Photobiomodulation– decreases inflammation and treats pain
  • Acupuncture
  • Ultrasound Therapy
  • Osteopathic therapy
  • Pulsed Electromagnetic Field Therapy (PEMF)
  • Electrical Stimulation
  • (Loria, 2017; Pancotto, 2020)
A multi-modal approach is a key to recovery

A combination of the various treatment options available should be employed to properly control pain and improve recovery chances. Sadly, factors including finances, access to services, dog acceptance of therapies, owner perceptions, and expectations play a role in what treatments are ultimately used and the success and failures of those therapies.

How can a canine osteopath help patients with IVDD?

A canine osteopath may be the first professional that an owner comes to see. The pet may have an off gait or simply be hesitant to exercise. So, the owner knows something is wrong but cannot discern where the problem lies. An osteopath can perform a physical and visual assessment and determine what parts of the body are painful, and discern probable causes for the problem.

  • An osteopath may localize the problem, provide manual therapy, and assist the pet in pain management and recovery.
  • In the initial stages of treatment and disease recovery, exercise rest recommendations are critical. Make sure to advise owners to leash walk only, taking the dog out to the bathroom and back (1-5 minutes) only.  Additionally, cautioning owners to not allow the pet to run, jump, and play alone or with other pets becomes critical during recovery. Ideally, they should be confined to a crate, small room, or pen for a minimum of 2-4 weeks while undergoing treatment to prevent clinical signs from worsening (Carrera-Justiz, 2020).
  • Part of an osteopath’s job includes reviewing with the owner signs suggesting a worsening of neurologic function and pain.
  • Always advise your clients to seek care immediately (either with the local veterinarian or emergency room, depending on the time of day)
    • If signs are progressing or deteriorating rapidly.
    • If the pain becomes so severe that the pet is suffering.
    • Ensure they know that if deterioration occurs, prompt medical intervention could be the difference between never walking again or having a relatively normal ability to get around in the future.
  • Advise the owners that if they feel that the pain is not sufficiently controlled with your therapy and the other treatments being used, they should see the veterinarian.
  • Finally, advise your owner that you can not definitively diagnose this disease. Your diagnosis is simply a possible cause based on your physical findings.
    • Inform owners that we can use a Cat Scan (CT) or, more commonly, Magnetic Resonance Imaging (MRI) or a Myelogram study for diagnosis. A myelogram is a series of radiographs taken before and after a dye is administered that highlights the spinal cord areas.
    • Are these tests necessary for a presumptive clinical diagnosis? NO. However, if signs progress or the pet requires surgery, advanced imaging will be required.

Alternatively, your pet may come to you already with a diagnosis of IVDD from a veterinarian.

  • They may be coming to you as part of the pet’s multi-modal pain management and care.
  • The pet’s signs may not be severe enough to warrant surgery.
  • The veterinarian may have recommended medical management, strict rest, and massage or osteopathic manipulation and treatment.
  • Finally, the pet may be coming to you for adjunctive therapy after post-surgical correction of IVDD.

Pain can occur due to disc disease, muscular, bone, meningeal pain (membranes that protect the spine), or radicular pain (travels along the spinal root nerve). So, while discussing IVDD specifically here, make sure to assess the whole patient as there could be more than one area of dysfunction.

IVDD could be the primary problem at, for example, the lumbar spine. But don’t forget to evaluate other areas for possible pain or dysfunction. When a dog attempts to compensate for pain, muscle tension and other biomechanical shifts often lead to pain in other regions of the spine, pelvis, legs, and musculature. These areas must not be forgotten as they too will significantly benefit from manual therapy, such that an osteopath can provide (Rossmeisl, 2013).

Prognosis with IVDD

There is no single-word answer for this. All cases differ. Various factors play a role in the successful recovery of a patient, including owner expectations, quality of life, remaining neurologic deficits, life-long limitations, or restrictions. Prognosis also depends on the owner’s commitment and willingness to follow strict adherence to the caregivers’ directions and recommendations. This includes the veterinarian, surgeon (if performed),osteopath, rehabilitation veterinarian, and others.

Critical to the patient’s recovery, all owners within a family need to follow all directions.

Some dogs may recovery 100% and never lookback. But many dogs will have a reoccurrence of the disease. Clinically, about 1/3of my patients have had reoccurrence at some point in their life. The presence of neurologic changes, uncontrollable pain, or an owner who fails to follow directions, a full return to function may not always be achievable.

NO MATTER WHAT WE DO, some pets will worsen and require surgical intervention due to clinical signs’ progression, worsening neurological function, or intractable pain.

Can IVDD be prevented?

Yes and no. Some animals are simply predisposed. Short of keeping them in a bubble and not letting them be dogs, well, we can never prevent it 100%.

Obviously, if you see a patient with this disease, we are a bit too late to prevent onset. However, with high reoccurrence rates, while we still want a dog to be a dog, there are a few steps that owners can take to lessen the chance of recurrence (Béraud,2015; “IVDD In Dogs,” 2020).

  1. Weight loss or maintain ideal weight  – See the following link for how to assess a dog’s body condition
  2. Regular structured exercise
  3. Prevent pets from jumping onto or off furniture.
    1. It is worse for them to jump off a bed or couch than jump onto something. It’s very jarring for the body to land on a solid surface.
    2. Suggest doggy steps or a ramp to the furniture/bed if an owner insists the pet have access.
    3. Better yet, have the owner provide a large, comfy, orthopedic-support dog bed instead.
  4. Restrict stairs when feasible.
    1. Do not allow running up and down.
    2. Ideally, controlled walking up and down the stairs is key.
    3. Some dogs may need to be put on a leash to control this and trained to walk slowly.
  5. NO tug of war games.
  6. Avoid certain positions for the pet –
    1. Discourage the begging position, where a dog sits on its rump like Buddh
    2. Discourage jumping up with the front legs onto furniture or counters or fences.
  7. Avoid neck leashes, choke collars, choke chains, and pulling on the neck or spine when walking. Ideally, use a safe walk harness where the leash attaches to the chest/ sternum area.
    1. These provide the owner the most control and minimize pulling and jarring to the spine.
    2. For IVDD, anywhere on the spine, neck collars, neck leashes, and any type of pulling could cause trauma in any part of the spine and should be avoided.
    3. Recommended harnesses may include various brands but will depend on where you reside in the global community. Ask your local veterinarian what brands they recommend.

Client education

Provide your owners with handouts. Client handouts are great to remind owners about your recommendations, including any exercise restrictions, at-home exercises, and MOST IMPORTANTLY. It provides something they can refer back to later. Exactly how much each owner retains is unknown, but we know that no one hears everything we say. This means that valuable information gets lost in translation. Additionally, not all family members maybe present at the visit, so the handout can educate them about what is recommended. This handout can help ensure the successful care of the pet.

What to include in your handout?
  • Include a description of your diagnosis, what IVDD is and what it means for the pet
  • Include a checklist of pain signs to monitor for at home, such as
    • Worsening lameness
    • Reluctance to move
    • Stumbling
    • Inability to use a leg, dragging a leg, or crossing over the legs (signs the brain doesn’t know where the legs are in space)
    • Extreme vocalization
    • Uncontrollable pain
  • What the owners can or should do in case the disease worsens – list emergency veterinary clinics in the area or who to call in case signs progress or are concerned with inadequate pain management.

Final Thoughts

Dogs with back and neck pain commonly lead owners to visit a veterinarian or canine osteopath. Many owners fail to recognize pain signs and often cannot localize pain to the back or neck. Your job as a canine osteopath includes evaluating the patient and determining via gait analysis, physical exam, history, and clinical signs, what the primary clinical problem may be. The pet’s signalment (age, breed, sex) may aid in your diagnosis. But remember that any breed of dog, at any age, and even an animal with an ideal body condition may present with clinical signs suggestive of IVDD.

Osteopathic therapy compliments the therapy provided by veterinarians, rehabilitation specialists, and surgeons (if surgery is indicated). Osteopathic therapy provides a crucial role in pain management. It can significantly assist your patients’ recovery and prevent further disease reoccurrence.

Works Cited

Bagley, R. S. (2006).Acute Spinal Disease. Western Veterinary Conference 2006, Las Vegas, NV.

Béraud, R. (2015, March 30). Intervertebral Disc Disease (IVDD) or Why I Love Dachshunds: Part II.

VIN. Com. 66th Convention of the Canadian Veterinary Medical Association, 2014, Centre

Vétérinaire Laval, Laval, QC, Canada.

Brooks,W. (2019, July 17). Intervertebral Disk Disease in Dogs. Veterinary Partner.

Budsberg, S. C., Torres, B. T., Kleine, S. A., Sandberg, G. S., & Berjeski, A. K.(2018). Lack of

effectiveness of tramadolhydrochloride for the treatment of pain and joint dysfunction in dogs

with chronic osteoarthritis. Journal of the American Veterinary Medical Association252(4),


Carrera-Justiz, S. (2020). When the Dog Can’t Walk! (SA257). Western VeterinaryConference 2020, Las

Vegas, NV.

Cruz-Rincon, S. (2017, August 8). Chondrodystrophy in Dogs []. Veterinary Partner.

Gregory, S. (2018). The Nerve of It! VIN. Com. Wild West Veterinary Conference2018, Reno, NV.

IVDD In Dogs: What You Need to Know. (2020). Emergency Vet 24/7.

Loria, K. (2017, May 19). Dogs, vets wait for progress on IVDD. Veterinary Practice News.

Muñana, K. R. (2002). Canine & Feline Myelopathies II: Surgical vs. Conservative Management of

Intervertebral Disk Disease in Dogs & Cats. VIN. Com. Western Veterinary Conference 2002.

Pancotto, T. E. (2020). Integrative Management of the Neurologic Patient: Surgery, Rehabilitation, and

Alternative Medicine. VIN.Com.2020 ACVIM Forum On Demand.

Rossmeisl, J. H. (2013). Approaching the Dog with Low Back Pain. VIN. Com. Western Veterinary

Conference 2013, Las Vegas, NV.

Thomas, B. (2014). VIN Boards—Hindlimb traumatic paralysis and chiropracter[sig] adjustment.

Vetstream.(n.d.). Chondrodysplasia in dogs. Vetlexicon Canis from Vetstream. Retrieved March 5, 2021,


Figure citations

Figure 1a. Fotojogodka from Getty Images [Photographer]. Lhasa apso portrait [Digital photo].


Figure 1b.VTLS from Getty Images [Photographer]. Dachshund standing. [Digitalimage]. Retrieved

Figure 1c.Ozgurcoskun from Getty Images [Photographer]. Cocker spaniel standingagainst a white

                 background. Retrieved from

Figure 1d.Fotojogodka from Getty Images [Photographer]. Pekingese dog in stand[Digital Photo].


Figure 1e.Studiotrapeza from Getty Images [Photographer]. Dog, basset hound, isolated[Digital Photo].