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Tip of the Month - February

1 February 2019


Neurology

A suspected thoracolumbar slipped disc

When to refer a dachshund with a suspected thoracolumbar slipped disc?

For dachshunds with sudden onset spinal pain or neurological deficits in the pelvic limbs, the most likely differential is a thoracolumbar intervertebral disc extrusion (slipped disc).

We grade intervertebral disc herniations into 5 grades and the outcomes are listed below for both conservative and surgical management:

 

Tip of the Month - February

 

We recommend surgery for dogs with Grade 3, 4 or 5 (i.e if they are not walking) as this significantly improves the chances of recovery, although if they retain pain sensation they can still recover with conservative management if referral is not an option.

For dogs with grades 1 or 2 injuries we recommend surgery if they are painful despite conservative management or have worsening neurological deficits. Some owners will elect for surgery in these dogs regardless to reduce the risk of relapse or risk of deterioration.

Alongside surgery we can also fenestrate the adjacent discs which reduces the risk of recurrence at the same or different disc space.

Conservative management consists of 4-6 weeks of strict crate rest with 5-minute walks for toileting purposes several times daily and analgesia consisting of non-steroidal anti-inflammatories and additional medications if required. We do not advise the use of corticosteroids in these cases.

 

Tip of the Month - February

Both thoracolumbar T2 sagittal MR images

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