An update from Prof. Paul Freeman - Spring 2023

We are grateful to Professor Paul Freeman of the Cambridge IVDD Research Group for the article below which was originally submitted for publication in the Southern Dachshund Association Newsletter.

Intervertebral disc disease (IVDD) is a major cause of fear and anxiety for many dachshund owners. And no wonder, when we read and hear about cases which have caused long-term or permanent paralysis, incontinence or even death. The problem is all too common in dachshunds as well as some other popular breeds, and has only become more frequent since the explosion in dog ownership which occurred through the pandemic. Here at Cambridge University we have been researching various aspects of IVDD over the last couple of years with the financial support of Dachshund Health UK and Dachshund Rescue UK, with some very interesting and potentially exciting results.

Our initial interest was in the medical (ie non-surgical) management of cases of IVDD. There are many people involved in veterinary neurology who have had the feeling for some time that the current consensus of opinion which says that that dogs severely affected by IVDD need an (often very expensive) surgical procedure in order to recover may not be the whole truth. There is a wealth of scientific evidence around this subject, but it paints a very mixed picture with no definitive answers. Anecdotally we have known for years that even very severely affected dogs can recover without surgery, but there has developed a growing trend in recent years that surgery is both necessary and also a potential emergency. Our biggest concern is that this belief creates huge anxiety especially for people who may be unable to access specialist services or for whom the cost is simply prohibitive.

For this reason our primary focus has been to collect a group of dogs severely affected by IVDD but for whose owners surgical treatment was simply unaffordable, and to treat these dogs without surgery. We have been able to follow them closely with MRI at the beginning to confirm the severity of disease, and also after 3 months to see how the IVDD progresses. What we have found has surprised even those of us who were expecting good results. We are up to nearly 70 dogs now, and almost 100% of the dogs which retained their hindlimb pain sensation have made a good recovery ie they regained the ability to walk normally, were free of back pain and had full bladder control. (For those who are not aware, loss of ability to feel pain in the back feet is the one thing proven to be associated with a bad outcome ie we know that roughly only 50% of dogs which lose sensation will recover to walk after surgery). Even amongst the dogs in our group which lost pain sensation, almost 50% have recovered!

These results are really quite spectacular. And we are not claiming to have done anything unusual or different; we have not ‘invented’ a new treatment. We are simply providing adequate rest and pain relief, as well as owner support through a challenging time, and allowing nature to do the rest. This study is coming to an end shortly, but we are hopeful that we will be beginning a new study offering an exciting alternative treatment possibility, again for owners of dogs unable to afford the current standard of care treatment. More details will follow on our facebook page  https://www.facebook.com/CambridgeIVDD

Does this mean we are suggesting surgery is a waste of time and/or money? No, certainly not! We are still performing surgery on the more severely affected dogs at Cambridge. We are not in a position to be able to say precisely which dogs will really benefit from surgery and which will do just as well without, so for now if it is financially viable we are still suggesting to go ahead with surgery for dogs who lose the ability to walk. But we are also very happy to advise medical management if surgery is not an option. And we feel that the surgery is rarely if ever an emergency, which hopefully takes some of the stress out of the situation at least.

The second focus of our research is aimed at reducing the frequency of IVDD. We are very involved in the The Kennel Club/ Dachshund Health UK IVDD Scheme for Dachshunds (The Kennel Club IVDD Scheme for Dachshunds | Health | Kennel Club). This is a scheme encouraging all dachshund owners and especially breeders to have their dogs X-rayed in order to assess the number of calcified discs in the spine. It has previously been shown that dogs with more calcified discs at a young age are more likely to develop IVDD in their lifetime; we also know that disc calcification is an inherited trait in dachshunds. Therefore if we can progressively try to breed from dogs with fewer calcified discs, the hope is that the frequency of IVDD will gradually reduce. We also know that CT is a more sensitive method of finding calcified discs, so as part of our research we are also encouraging owners of dogs presented for X-raying to allow a CT scan to be performed at the same time. The uptake of this scheme since its launch last year has been slowly growing, and we are hopeful that more and more dogs will be enrolled in 2023 so that it has a real chance to be effective.

Our final area of interest is in the process of calcification of the discs. This is the way that the discs degenerate in dachshunds and other breeds, with calcium-based material forming inside the discs making them more likely to suffer IVDD. We have been studying this process with a view to gaining a better understanding of the causes and effects of the calcificaton. We have made some very exciting discoveries over the last 2 years which we are continuing to investigate. We are hopeful that we may be able to slow down or even prevent this process in the future. This would be a huge leap forward in terms of potentially preventing IVDD from occurring. It is perhaps too much to hope that we could see an end to this terrible disease, but even if we could reduce the number of dogs affected that would be a great result.

Prof. Paul Freeeman

December 2022