Intervertebral disc disease (IVDD)
We are seeing ever more cases of IVDD in the veterinary world, and many people come to me to see if acupuncture can help, so I thought I would run through the basics of this distressing condition.
A healthy spine is the perfect balance of rigidity and flexibility, with its main functions being protection of the spinal cord (the main trunk of nerves extending from the base of the brain and leading to every part of the body) and support for the musculoskeletal system. Central to this, along with the bony vertebrae, are the intervertebral discs – firm fibrous discs encasing a flexible gel substance, sandwiched between each vertebra. These provide shock absorption and allow each vertebral segment to move freely during any physical activity.
What is IVDD?
IVDD stands for Intervertebral disc disease and refers to any process causing damage to these discs, This can happen due to infection, inflammatory disease, trauma (such as a fall or collision), or degeneration – which is basically wear and tear. Usually when we talk about IVDD we are talking about a disc protrusion (so-called ‘slipped disc’ where the fibrous capsule weakens and presses on the spinal cord) or an extrusion (where the capsule ruptures, extruding the gel centre and causing inflammation with or without compression).
Sadly, our modern Dachshunds and Bulldog breeds are particularly prone to this condition, with indiscriminate breeding leading to genetic abnormalities in the structure of the vertebrae and/or discs. As these breeds have risen in popularity, we have seen soaring rates of the disease.
What does it look like?
Signs relate to the amount of compression of the spine or nerve roots nearby and can take the form of:
- pain – which can vary from mild back pain, eg. a reduction in activities like jumping or climbing, to a reluctance to move, to severe pain causing immobility or yelping. Sometimes it can be difficult to diagnose back pain and it can be mistaken for abdominal pain if the animal spends a lot of time in a hunched position or goes off their food
- neurological impairment – ranging from slightly drunken gait to knuckling over to sudden complete paralysis. Bladder and bowel control can also be impacted to varying degrees leading to incontinence, which can be very difficult to manage in a paralysed dog.
The more severe signs can obviously be very distressing to both dog and owner, and I have experienced many a panicked owner calling me in tears because they have witnessed their happy active pet suddenly disabled overnight.
If you witness any of the above signs it is critical you get your dog to a vet as soon as possible – usually the milder versions of the disease can be well managed with restriction and pain relief, but sometimes a mild episode can suddenly deteriorate. If a dog is unable to walk and has lost complete feeling in their feet (so-called ‘deep pain’), the situation can be critical and emergency surgery may be necessary to relieve the pressure on the spinal cord before the damage is irreversible.
IVDD has for many years been graded according to the ‘modified Frankel scale’ (table below), which not only allows a description of the dog’s disability but allows researchers to categorise those cases which may respond better to surgical or medical treatment – although this is far from straightforward as I discuss below.
Sadly, even with the emotional and financial investment of major spinal surgery, recovery is far from guaranteed and can involve months of rehabilitation to return to a reasonable quality of life. Not only that, but animals that have had an episode of disc disease can be predisposed to future episodes – once the flexibility of one segment of the spine is compromised, it puts the adjacent segments under extra strain.
This can lead to an owner who has gone through the heartache of supporting their dog through an episode of disc disease living in a constant state of anxiety every time their pet tries to jump on the sofa or run with another dog in the park – in short, doing what dogs do!
What are the treatment options for IVDD?
Surgery
Surgical treatment usually requires an MRI scan to pinpoint the affected disc(s) prior to surgery and this can increase costs significantly. Treatment can involve scraping out disc material (‘fenestration’), removing small portion of bone from affected vertebrae (‘laminectomy’) to relieve pressure on nerve roots, and/or applying rods to limit the movement of vertebrae. Sometimes pre-emptive fenestration of adjacent discs is also performed to limit the risk of recurrent disease. Following surgery the dog will need intensive rehabilitation: strict crate rest for several weeks combined with physiotherapy to reduce muscle loss and medications to manage pain and muscle spasms.
Medical therapy
Non-surgical medical management (often termed “conservative therapy”), consists of strict activity restriction, physiotherapy, analgesics and anti-inflammatory medications. Sometimes laser therapy, pulsed EMF and acupuncture are also employed.
Medical vs surgical treatment – which is best?
While the costs of surgical treatment often mean a lot of dog owners have to opt for the medical route, if insurance is in place it can be difficult to decide the best course of action. When I was at vet school I was taught that in the case of dogs who are non-ambulatory (grade 3 or below), surgical management is recommended as only 10% of these cases would recover with medical management. With lesser grades of disease the benefits of surgery over medical treatment are a lot less certain, and in both cases a significant recovery time is likely.
The 10% figure has recently been brought into question as it is based on data from referral centres (where very few dogs are managed medically) and most medically managed dogs do not have the MRI scan to cement the diagnosis – so we really can’t be certain that the data backs up this approach.
A study from the University of Cambridge showed a high proportion of grade 0 and 1 cases can recover with medical management.(2)
In addition, new therapies such as stem cell treatment and chondroitinase injections offer exciting promise in the medical management of this disease and probably we will probably see an increase in the recovery rate with medically managed cases as a result. It will take time for enough cases to be treated and the data to be collected and analysed to be sure.
Often, like with most scenarios, a frank discussion between veterinary clinician and dog owner about the pros and cons of either route needs to take place, to make the best decision for the individual patient, and of course this needs to take into account the financial options available to the owner.
How can acupuncture help in cases of IVDD?
Acupuncture has been shown to stimulate many mechanisms that may aid in the recovery of dogs with IVDD.
These include:
- Enhancing connections between the sensory and motor parts of the brain which control walking (6)
- Reduction in neuropathic (nerve) pain via altering nerve signalling pathways in the spinal cord, leading to more rapid return to activity (7)
- Reduction in inflammation and resulting nerve cell protection in spinal cord injury (8)
- Reduction in myofascial (muscle/connective tissue) pain (9)
However, finding studies proving that it is beneficial in real patients with spontaneous IVDD is more of a challenge, hampered by different patient factors, different treatment protocols, and lack of large-scale controlled studies.
This Knowledge Summary by Justin Ng (3) highlights the problem of finding good quality evidence but still concludes there is moderate evidence of benefit in terms of time to recovery of ambulation. A study published a year later (4) which did have a control group (physiotherapy + acupuncture vs. physiotherapy alone) showed 100% of dogs in the acupuncture group recovering independent walking vs 78% of dogs in the control group – however the authors state that the control group dogs had more severe dysfunction at the beginning so this is difficult to unravel. Another earlier study (5) showed that electroacupuncture was more successful than surgery in a small controlled study when there had been a delay in surgical treatment over 48 hours – this seems difficult to believe but maybe supports the idea that acupuncture reduces inflammation and promotes healing which is more important than the actual physical decompression in determining recovery after a certain injury time.
In summary, acupuncture certainly appears to have a beneficial effect in most patients treated either surgically or medically in reducing recovery time, and being very safe, is certainly a good option in those cases where advanced imaging and surgical treatment is not available.
How can we prevent IVDD?
As I said earlier, it is sadly certain breeds who are genetically at much higher risk, with some gene mutations having been identified. One large study showed that Dachshunds (15%) and French Bulldogs (20%) had the highest risk of developing IVDD over their lifetimes. Even if we wrap our pets in cotton wool and carry them around all day, we can’t prevent disc issues completely, in fact, the study just mentioned showed that having an active lifestyle actually reduced the risk.
It is wise to be considered in the exercise we allow short-legged and small breeds to perform. Avoid ball chuckers and stick to regular walks and gentler exercise like sniffing games and trails.
Being overweight has also been shown to be a risk factor in some studies, but not all.
In most cases though, genetics are against us and for the above breeds it can feel like a ticking timebomb, where we are just waiting for the inevitable. I strongly feel that this is a result of irresponsible breeding over many generations where we have created breeds that look cute at the expense of their health and wellbeing. By buying pups in their current form we have created a market for animals that are destined to have health problems, and breeders have no incentive to breed healthier dogs, and the only way to change this is to have more aware puppy buyers demanding change.
References (all accessed 3rd/4th July 2026)
- Downloaded from https://www.frontiersin.org/journals/veterinary-science/articles/10.3389/fvets.2024.1431843/full
- https://onlinelibrary.wiley.com/doi/pdf/10.1111/jvim.17149
- https://pmc.ncbi.nlm.nih.gov/articles/PMC13011108/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC12024266/
- https://pubmed.ncbi.nlm.nih.gov/20513202/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC11484309/
- https://www.tandfonline.com/doi/full/10.1080/10790268.2026.2687284#abstract
- https://doi.org/10.1016/j.nbd.2010.04.003.
- https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2024.1374542/full
AI Usage statement: This blogpost contains entirely original text by myself. AI was used to help gather the relevant references.