What is a hernia?
Disc herniation, or hernia of the intervertebral disc, is a disease of the back (spinal hernia) or the neck (neck hernia) in which the intervertebral disc protrudes. In the dog, the spine up to the pelvis is made up of 7 cervical vertebrae, 13 thoracic vertebrae and 7 lumbar vertebrae. These vertebrae are separated from each other by intervertebral discs. The intervertebral discs are somewhat elastic and therefore contribute to the shock absorption in the spine.
In case of extreme shocks to the spinal column, for example due to a collision, the intervertebral disc can be moved and therefore press on the spinal cord and the spinal nerves. The spinal cord runs through the holes present in the upper part of the vertebrae and is located exactly above the intervertebral discs. The spinal nerves run from the spinal cord through openings of the vertebrae to the various organs and muscles. (Figure 1: side view of a piece of spine with disc hernia. Figure 2: side viewed from below: with indications of the different structures.)
figure 1: side view of a piece of spine with disc herniation:
Figure 2: Side view from below (with indications of the different structures):
- Spinal cord
- Dorsal nerve root
- Nerve knot
- Ventral nerve root
- Spinal nerve
- Intervertebral disc: cartilage ring
- Intervertebral disc: jelly core
- Vertebral body
Disc herniation is a neurological condition as it involves damage to the nervous system. In fact, it is the most common neurological condition in dogs.
Smaller dog breeds with short legs and relatively long backs are more likely to develop a hernia. (for example: Dachshund, Shih Tzu, Laso Apso, Corgi, and Pekingese) A wrong movement when walking stairs, chasing a ball or jumping off a chair can already result in an intervertebral disc displacement.
What are the symptoms of a hernia?
The severity of the hernia depends on the pressure that the intervertebral disc puts on the spinal cord and spinal nerves. For example, hernias are classified into 4 types, according to the severity of the pressure on the nervous system. With type 1, the pressure is minimal, but enough to cause damage. In type 4, the pressure is so severe that all nerve functions have failed.
- Type 1: Very bad pain. The dogs literally scream in pain and don’t want to walk anymore. They keep their necks or back cramped. Any movement is extremely painful.
- Type 2: Also severe pain, but you notice that the dog starts to drag slightly with the legs. They are less sturdy and fall over more easily.
- Type 3: Pain is less severe than in the first 2 types, but still present. They sag their legs and can sometimes no longer stand. They still feel pain in the feet when you squeeze them.
- Type 4: No pain and complete paralysis. Incontinence of urine and faeces also occurs.
It should be clear that the chance of complete recovery is much greater with type 1 than with type 4 hernia.
20% of hernias are in the neck area. In that case paralysis symptoms will be present in both the front and rear legs.
80% of the hernias are located in the back behind the front legs. In this case paralysis symptoms are limited to the hind legs.
How do you know it’s a hernia?
Hernia-like symptoms can also be caused by a blood clot in the blood vessels at the spinal cord, infections such as Lyme and tumors.
By means of an X-ray and / or MRI you can determine whether it is a ‘real’ disc hernia.
What is the regular treatment?
Regular treatment consists of fast-acting corticosteroids. With the aim of reducing pressure on the spinal cord and spinal nerves as quickly as possible. In addition to the displacement of the intervertebral disc, in most cases there is also swelling due to the trauma. This is reduced by the corticosteroids.
- With type 1 hernia, recovery normally occurs within a few days and the pain has disappeared.
- With type 2 and 3 hernias this takes longer but usually within a few weeks. Surgery may be considered to surgically release the pressure. However, this is being done less and less, given that treatment with medication has usually proven to be equally effective. With type 3 it can happen that the recovery is not 100% and that the dog always remains a bit weaker in the legs.
- With type 4 the chance of recovery is very small.
Holistic view of a hernia:
Acupuncture is an alternative therapy that has the same swelling-reducing effect as corticosteroids according to several studies.
The advantage, however, is that acupuncture does not have the unwanted side effects that are seen with the corticosteroids.
From a holistic viewpoint, a hernia is an obstruction in the energy flow through the meridian that runs across the spine. Long-standing hernias can also affect the energy of certain organs depending on their location in the spine and the possible initial effect of certain acupuncture points. Long-term damage in certain structures can also lead to energetic weakness in the associated organ. For example, the nervous system is linked to the kidneys. So long-term nerve weakness can lead to energetic kidney weakness. Conversely, this coupling can also be important: tendons and ligaments around the vertebrae must be strong in order to be able to absorb the hernia as well as possible. A weakened liver energy (liver is linked to the tendons and ligaments) can slow down the recovery from a hernia.
Acupuncture and holistic medication is aimed at restoring the energy flow in the meridian over the spine and, where necessary, strengthening and repairing energetic organ weaknesses and their linked structures.