How TCVM, homeopathy and other approaches can help treat spinal problems, including intervertebral disc disease (IVDD) and spondylosis, in dogs.
Spinal dysfunction in dogs is more common than you might think. I see it often in my practice. Someone brings in a dog that cannot use his hind legs; depending on which segment of the spinal cord is affected, he may also be unable to urinate or defecate with control. The primary causes of these problems are intervertebral disc disease (IVDD) and spondylosis.
Conventionally, treatment for these conditions includes pain medications and anti-inflammatories, surgery and total rest. But an integrative approach also adds TCVM, homeopathy and other alternative approaches.
Pinpointing the problem
In my integrative practice, I treat many pets with neurological conditions, including intervertebral disc disease (IVDD) and spondylosis. In my experience, localization of the spinal lesion can best be done by combining a conventional neurological exam with multiple holistic diagnostic approaches.
The veterinarian will evaluate the dog’s nervous system from head to toe. He/she will:
- Check for cranial nerve deficits.
- Palpate to test for painful areas along the vertebrae.
- Determine if the lesion is upper or lower motor neuron.
- Test the integrity of the proprioceptive pathways.
The TCVM practitioner will interview you, observe your dog, take his history and evaluate his tongue and pulse as part of the exam to determine:
- Preferences for hot or cold.
- Pain behaviors – is the dog in pain or is there weakness without pain?
- Wet or Dry presentation.
- Which acupoints are sensitive and what portion of the nervous system to try and modulate by stimulating the nerves and local humoral response.
From the above, the practitioner can differentiate between spondylosis and IVDD to select the most appropriate treatment.
- IVDD will generally present with a stagnation pattern of pain (in muscles or joints, and/or stiffness in the joints), and also present with Bi syndrome (see Table 1).
- Spondylosis is more chronic and slow to progress since it can develop as generalized Bi syndrome over a long period, reflecting spinal instability. Most commonly, the dog presents with ataxia but he/she may present acutely, showing weakness without pain due to loss of neurological function. This pattern is called the Wei syndrome. (Table 2)
The homeopathic veterinarian looks for idiosyncratic reactions that indicate the best remedy. Signs he/she will consider include:
- A fear of being touched.
- Temperature of the paws.
- Condition of the hair coat.
- Vaccination history.
- Reaction to stimuli.
- Past medical history.
After localizing the lesion area with a physical examination, an integrative veterinarian will move to the next phase of diagnostics – radiography. The newer digitized radiographs allow us to see late stage inflammatory changes, but not always all the pathology. If Magnetic Resonance Imaging (MRI) or Computed Tomography (CT) is going to be pursued, generally, surgery will be planned.
Treatment options for IVDD
Before discussing treatment options for IVDD, let’s review its pathology. Spinal vertebrae surround the spinal cord. Between the vertebrae sit eight joints, including an intervertebral joint, which contains the nucleus pulposus. This acts like a malleable ball bearing to equalize stress on the disc. With IVDD, calcification of the nucleus pulposus occurs (this can happen as young as three years of age). Quadrupeds have shear force along the spinal canal, versus compressive force in the human species; enough shear force can cause the nucleus pulposus to rupture up through the layers of annulus fibrosus lamina and into or around the spinal canal. Type I Hanson’s IVDD occurs acutely, most commonly in short-legged long-bodied dogs. Type II is more degenerative than explosive, often occurring in older dogs and larger breeds.
The conventional veterinarian will suggest surgery, anti-inflammatories and cage rest for IVDD. However, the integrative veterinarian has many additional tools for treating IVDD, including TCVM, homeopathy and spinal manipulation.
Acupuncture point selection is based on a pattern diagnosis to improve and modulate the nervous system. TCVM practitioners also include Chinese herbal medical formulations for anti-inflammatory and healing effects, as well as Tui-Na massage. A prescription of physical rehabilitation therapeutic passive exercises during exercise restriction can improve proprioception, motor pattern generators and reduce pain.
Spinal manipulation and stretching
Careful consideration is needed before using adjustments on a dog with IVDD. Is there movement in the intervertebral area, or is it too dangerous to gauge movement in the event of a possible nucleus pulposus rupture? Spinal manipulations can be used to add movement to other joints around the area, and stretching and trigger point massage can be used to relax spasmodic muscles.
When the homeopathic medicine matching the individual dog is administered, his body’s vital force begins a self-healing. First the dog will have improved mentation, appetite and energy. Then, even with total paralysis, he will begin to show a return of normal neurological function. Several weeks may be needed if treatment is begun shortly after diagnosis; several months if paralysis has not responded to surgery and drugs. Hypericum and Nux vomica are frequently indicated remedies.
Treatment and prevention of spondylosis
In spondylosis, the ligaments of the spine allow it to move within an acceptable range of motion. One of these ligaments – the ventral longitudinal ligament (VLL) – runs beneath the spinal cord and prevents hyperextension of the spine. The VLL can become stretched and unable to support the vertebral joints and spinal cord if the intervertebral joints move too far in any direction and/or the abdominal muscles are consistently weak. This chronic instability of the joints leads to inflammation and, finally, calcification of the ligament. Calcification causes a decrease in nerve health due to:
- Fewer nutrients, resulting from impeded blood flow.
- Decreased firing from lack of movement, a compensation to keep the spine from moving abnormally (from compromised muscle support, arthritis in the joints and ligaments, and tendons becoming stressed and then fibrotic).
Early fibrotic changes will appear on the radiograph as rounding, due to loss of calcification of the bone at those attachments.
The conventional approach of using anti-inflammatories and joint modifiers (glucosamine, chondroitin, milk proteins, hyaluronic acid) may not be enough to avoid spondylosis. However, an integrative veterinarian has a number of additional techniques to help reverse or stabilize the changes in the ligament that lead to this condition. Sometimes, even the entire mass of accumulated calcium can be dissolved.
Since inflammation triggers the production of calcium deposits, multiple modalities can both prevent and possibly resolve spondylosis, by ensuring movement and healthy blood flow to intrinsic muscles, tendons and ligaments. When the joints move freely, the nerves can fire adequately. Proper range of motion also keeps the intrinsic and paravertebral muscles healthy so they in turn can maintain postural input to the sympathetic and parasympathetic nervous systems. Successful approaches for spondylosis include:
- Regular chiropractic work.
- Spinal manipulation and adjustments.
- Stretching and flexion/extension exercises.
- TCVM – Chinese herbs, acupuncture and Tui-na.
- Homeopathy – individualized selection of remedies.
In conclusion, integrative care – including joint modification therapeutics, Chinese herbal formulas, and homeopathic remedies, combined with conventional medications in the acute phase – can improve the outcome of IVDD and spondylosis in dogs.