Practice patterns in the management of acute intervertebral disc herniation in dogs

Abstract

Objectives: Acute intervertebral disc herniation is commonly managed by veterinary neurologists and surgeons. Anecdote suggests that patterns of management vary considerably and there is controversy surrounding many aspects of treatment. The goal of this study was to document patterns in management of acute spinal cord injury caused by acute intervertebral disc herniation among these two groups to aid in future discussions on best practices.

Methods: A survey querying diagnostic, medical and surgical practices for dogs with acute intervertebral disc herniation was distributed to diplomates on the databases of the American College of Veterinary Surgeons and the American College of Veterinary Internal Medicine (Neurology).

Results: Responses were received from 314 board-certified veterinary surgeons and neurologists. Both groups handled timing of decompression, surgical approach, and most postoperative recommendations in a similar fashion. Case volume differed between groups, with 77% of neurologists and 18% of surgeons managing ê50 cases of acute intervertebral disc herniation per year. MRI was used most frequently as a diagnostic tool by neurologists (75%), while CT was used most commonly by surgeons (58%). Corticosteroids were routinely administered as a neuroprotective strategy by 34% of surgeons and 11% of neurologists. Disc fenestration was performed "always" or "most of the time" by 69% of neurologists and 36% of surgeons.

Clinical importance: Understanding the common practices in the management of canine acute intervertebral disc herniation can provide a springboard for future discussions regarding the best practices in diagnosing and treating this disease.