Ruptured Disc in the neck or Ventral Slot
Many dogs especially the miniature dachshund suffer a ruptured, slipped or herniated intervetebral disc. This can lead to paresis or weakness of the hind limbs and can be severe enough to cause a complete paralysis.
A through neurological examination can localize the lesion and generate enough information to determine the next step. Mildly affected dogs may get better with conservative treatment. Conservative treatment can include the use of a muscle relaxant, steroids(prednisone) or a non steroidal medication. The most important component of conservative treatment is exercise restriction. Over activity can lead to an unsuccessful outcome. Conservative treatment is most successful with disc disease in the thoracolumbar region. Disc disease affecting the neck or cervical region can have unrelenting pain that just does not improve without surgery.
More severely affected dogs require advanced imaging which can include myelogram, CT scan or MRI. While CT scans and MRI's can give great images and good information the vast majority of dogs can be diagnosed and treated based on a myelogram. Myelography is more readily available and remains much less expensive than more advanced imaging.
Once the lesion has been localized(determine the disc spaces affected) a surgical plan can be determined. Imaging that indicate a spinal cord compression are best dealt with surgically. If the lesion or disc is in the region of the cervical spinal cord a procedure called a ventral slot can be performed.
This is the procedure employed when a disc is compressing a nerve root or an area of the cervical spinal cord. The procedure is done through an approach to the underside of the neck. This allows the surgeon to access the ventral or underside of the cervical vetebral bodies. Once the surgeon has determined the disc space a surgical drill is utilized to make an opening into the spinal column. The size of the opening is critical it must be large enough to retrieve the disc but not to large as this can cause destabilization of the cervical spinal column.
The potential complications seen with this procedure are as follows:
- There is always the potential to damage the spinal cord with any spinal cord procedure. This procedure does not allow the surgeon good visualization. Although the chance of this occuring is minimal it is a risk.
- The venous sinus runs on either side of the laminectomy. It is possible to damage the sinus while removing disc material especially if the disc material is adherent to the fragile sinus. If the sinus is damaged significant bleeding will occur. This bleeding may stop or it may hinder the surgery in such a way as to not be able to retrieve all of the disc material. On a rare occasion the bleeding may be so great that a transfusion is required.
These patients require around the clock care. They are best managed in a facility that can provide them with 24 hour care. The more severely affected dogs will need to have their urinary bladder managed either through use of an indwelling catheter or expression. Postoperative patients require pain management that can be administered around the clock. The average hospital stay is 2-4 days.
It is for this reason that I perform these surgeries at Veterinary Care Specialists in Milford, MI.
- Exericse restriction is very important during the healing process. These dogs should be confined to a small room or a crate when unsupervised. This will allow them to remain safe and not overexert themselves in your absence.
- Medications prescribed should be given as outlined in your discharge instructions. These medications may include an antibiotic but will always include pain medication. We should be alerted to any adverse reactions your dog may have to any of the prescribed medications. These can be vomiting, diarrhea, inappetence just to list a few.
- When taking your dog outside to the bathroom it would be best to employ a sling to help support their hind limbs while they are regaining their strength. You may purchase a sling or employee a towel just in front of their.
- Your dog will have an incision which will need 10-14 days to heal. You should monitor this closely for signs of infection: redness, pain, swelling or oozing. Should you have concerns you should call immediately.
- Physical therapy can be very helpful while your dog is not ambulatory. In the beginning passive range of motion is important. Standing and rebuilding muscle strength. Once the incision is healed swimming is very good.
- We recommend that these dogs be walked with a harness in lieu of a collar.