IVDD recommendation get more complicated

A Comparative Analysis of Clinical Presentation, Prognosis and Outcomes in Paralytic Dogs with a Compressive and a Contusive Intervertebral Disc Disease

Anna Kurtscheidt 1, Stefan Rupp 2, Ute Müller 3, Franck Forterre 1

Background
Intervertebral disc disease (IVDD) in dogs, encompassing compressive intervertebral disc extrusion (IVDE) and acute non-compressive nucleus pulposus extrusion (ANNPE), frequently results in spinal cord injury, pain, and paralysis. Despite similar clinical presentations, these conditions differ in etiology and pathology. The study hypothesized that dogs with either condition would have comparable outcomes if presenting with the same neurological grade, particularly regarding regaining ambulation.

Methods
This retrospective study analyzed clinical records from 2017 to 2023, selecting 50 dogs with surgically confirmed IVDE and 45 with presumptive ANNPE diagnosed via MRI. All dogs were acutely paralytic at presentation (Sharp and Wheeler grades 4 or 5). Data included signalment, clinical signs, diagnostic imaging, treatments, and outcomes. Long-term follow-up was conducted via owner interviews at least 8 months post-diagnosis. Outcomes were defined as successful (independent ambulation, no incontinence) or unsuccessful (failure to walk, persistent incontinence, or euthanasia).

Results
There was no significant difference in long-term outcomes between groups: 80% success in IVDE and 71% in ANNPE. ANNPE dogs were significantly older and heavier, presented earlier, and had a higher incidence of vocalization and trauma at onset. IVDE dogs were more likely to exhibit worsening neurological signs pre-referral and had longer hospital stays. Imaging showed more severe lesions in IVDE. Despite different treatment approaches—surgery for IVDE and conservative management for ANNPE—the duration to regain ambulation and incidence of persistent deficits were similar. Most lesions affected the T3-L3 spinal cord segment.

Limitations
This single-center retrospective study was limited by inconsistent data due to varied record-keeping and lack of standardized neurological assessments. ANNPE diagnosis was presumptive without pathological confirmation. Small sample size and potential misclassification of disease types may limit generalizability. The study also acknowledged that compression and contusion mechanisms often coexist in both conditions.

Conclusions
Despite different pathophysiological mechanisms and treatment protocols, paralytic dogs with compressive (IVDE) and contusive (ANNPE) IVDD had similar prognoses when matched by neurological grade. These findings suggest that both surgical and conservative approaches can yield favorable outcomes, emphasizing the role of individualized treatment planning based on clinical presentation rather than presumed etiology alone.

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