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Understanding IVD & Discolysis

 
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Please spread this information. It was copied from the University Veterinary Hospital’s pamphlet in Berkeley, CA. I have copied this information for your primary research review for your pet having spinal cord disease or injuries. This information is not known by most vets and is very hard to locate.

My 5-year old female Dalmatian, Liza, had an acute IVD attack 4 months before I knew about this procedure. Liza’s hind legs were paralyzed. She just had the injections and I am hoping for the best. If I would have known about this procedure 4 months ago and acted quickly, Liza would have had a much more certain and positive future. Two days after the injections, she simultaneously lifted 1” her hind legs and curled her tail with more bounce! Now, she is resting comfortably and we hope for a full recovery.

I want this information available to you because the sooner you act after your pet’s acute attack or onset of chronic symptoms, the better chance your pet has of recovering. I cannot underscore enough that time is of the essence – If you love your pet, you should call Dr. Biggart immediately, discuss your situation, and if appropriate, do not hesitate in driving your pet to his practice from wherever you live. I took Liza up from southern California to Berkeley. Dr. Biggart and his staff are phenomenal in terms of capability, kindness and caring. Your pet is in wonderful hands.

These effective injections have been available to humans for decades in Commonwealth countries, Europe and around the world. Strangely, I now recall 30 years ago, that my grandparents living in San Marino, CA and their friends having to go out of the country for this very effective treatment – back in the 1970’s! Dr. Biggart has been doing these injections on pets for over 30 years.

Do not lose hope. And even if your pet should remain paralyzed and in no pain – be sure to get a trolley. They will love it! They do not know the word “disability” and will wonderfully adapt with your love, encouragement and care. I wish you and your pet great happiness and health together. John W. De Witt, Huntington Beach, CA.

 

Understanding Discolysis

The Chemical Dissolution of Intervertebral Disc Material
By James F. Biggart, II
D.V.M., M.S., A.C.V.S.

Intervertebral Disc Disease (IVD) is the progressive dehydration of the nucleus pulposus and eventual rupture of disc material into the spinal canal. Severe pain, paresis and paralysis can result from disc herniation.

The purpose of drug therapy is to reduce swelling of the affected tissues, resulting in relief of pressure on the spinal cord. Herniated (protruding) disc material can be removed by a (surgical) procedure called laminectomy in order to decompress the spine and nerve roots which are associated with the spine.

Discolysis, or disc injection, relieves pressure on the cord by dissolving protruding disc material. A proteolytic enzyme is injected into the disc space to disrupt the waterbinding properties of the nucleus, causing the disc space to collapse.

With loss of interdiscal pressure, the protruded discs with an intact annulous recede as intradiscal pressure is lost. Even though radiographic narrowing may not be evident for several days, biochemical changes can occur within 30 minutes.

Clinical relief from pain can be immediate, or may take weeks or months to return to normal, the same as if (surgical) laminectomy was performed. Discolysis produces about the same neurological outcome as laminectomy.

Clinical Usefulness:

Since disc-dissolving enzymes can be injected percutaneously with a needle, this technique offers several major advantages over surgery:

1) Many more discs can be injected than be surgically removed at one session.
2) The risk of infection is less than with surgery.
3) The cost of injection may be less than surgery, since many injections can be performed on an out-patient basis.
4) Discs can be reinjected if the initial session fails.
5) Previous injections of a prolapsed disc do not rule out subsequent surgical treatment.

Disc injection usually requires myelography to verify the location of disc prolapse and to distinguish rupture from other forms of spinal cord pathology such as infection and tumors.

Candidates for Discolysis:

Candidates for discolysis include ambulating dogs with pain or mild paresis that have not responded to conservative care for one or two weeks. A positive myelogram showing disc prolapse usually precedes disc injection. Non-ambulating dogs usually require discolysis treatment earlier, as with laminectomy.

In general, the indications for discolysis and laminectomy are the same, except that we can treat symptoms earlier with discolysis, since risks of treatments are fewer and discolysis is more easily tolerated than surgery. Also, patients with false negative myelograms can be diagnosed and treated by discography and discolysis. In fact, we might be reluctant to risk an exploratory laminectomy on the same patient.

There are a few contraindications for disc injection:

  1. One of the two effective enzymes, chymopapain, can theoretically produce an allergic reaction.
  2. Dogs with a suspected allergy to chymopapain, an enzyme originating in papayas and an ingredient in meat tenderizers, are injected with collagenase.
  3. Dogs with previous durotomies or other dural deficits are not injected with proteolytic enzymes if the dural deficit is adjacent to the affected disc.
  4. Intact duras provide greater protection from the toxic effects of proteolytic enzymes on the cord.

For the majority of patients with intervertebral disc disease, discolysis provides a less traumatic and equally effective treatment to laminectomy.

Biography of Dr. James F. Biggart, III; D.V.M., M.S., A.C.V.S.:

Dr. Biggart received his D.V.M. degree at Texas A&M University in 1971, and then interned at the Animal Medical Center in New York City.

His interest in surgery stimulated, he went to Colorado State University Surgical Laboratory for a Master’s Degree.

He arrived in Berkeley, CA in 1974, where he completed a surgical residency at the Berkeley Veterinary Medical Group. He became a Diplomate, American College of Veterinary surgeons in 1977.

Dr. Biggart specializes in orthopedic, spinal and general surgery, manages the Veterinary Surgery Service, Inc.

University Veterinary Hospital
810 University Avenue (just east of I-80)
Berkeley, CA 94710
510-841-4412
510-841-3019 (fax)

Website: www.uvhberkeley.com

University Veterinary Hospital (UVH) provides sophisticated soft-tissue and orthopedic surgery for small companion animals. Working with the (nearby) Emergency Clinic, UVH provides critical care for animals injured in accidents. UVH also treats dogs and cats suffering from operable cancers, and developmental deformities.

UVH provides the latest diagnostic and surgical techniques for the treatment of herniated discs, back pain, hip dysplasia, cruciate ligament tears in knees, and other orthopedic injuries and diseases. UVH’s patients come from all over the country and as far away as Japan.

 

 
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