- What is a disc?
The disc is like a water balloon and sits between two vertebrae (the bones that make up the spinal column). The disc acts like a shock absorber to protect the vertebrae from hitting each other - like when you jump up and down on a hard surface. If you were to jump from a great height and injure the disc then the first reaction is that the disc would swell. This is an acute disc or a "hot" disc.
- What is a disc bulge?
A disc bulge is like a water balloon with too much water in it. There is a weakening in the wall of the disc and a small area protrudes further out than the normal wall of the disc. It is similar to when a child blows up a balloon with to much air, then lets the air out and blows up the balloon again. If you notice a little "bleb" on the surface that never deflates all the way - that is what a disc bulge is like. This bulge can push against the spinal cord or spinal nerves.
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- What is a disc herniation?
A disc bulge still has the water inside the disc wall but a herniation is when the water balloon breaks and the water (the contents of the disc) comes outside of the disc wall. This material can push against the spinal cord or spinal nerves.
Please note: A veterinarian may use the word "herniation" to refer to both a true herniation and a disc bulge. The chiropractor will make a distinction between the two words. If the contents of the disc has ruptured and the contents has come out from the disc wall and is pressing against the spinal nerve or spinal cord - I cannot help the animal. This is a true herniation. This situation requires surgery to actually remove the material. But if a disc is only bulging against the spinal nerve or spinal cord then I have been very successful in helping to retract the bulge from against the nerve or cord. The contents of the disc have not broken through the wall of the disc and this condition is only a disc bulge not a herniation, in the true sense of the word.
- If there is a disc bulge - what can be done?
The first option is to do nothing. There is a small percentage of animals (and people) that have disc bulges and would never know it unless a MRI is performed. This small group of animals do not have pain nor present with any signs or symptoms. And within this small group, a smaller group will never have any problems their entire life! But most disc bulges create some presentation of signs and symptoms eventually.
It will be the subtle sign or symptom of a disc bulge that will initially bring you into the veterinarian clinic. There may be a slight limp, a change in the animal's gait, the feeling of heat on his back or neck in one localized area or he isn't his usual "self" that will bring you to the next option. It is in this option two, that Dr. De Grasse feels many errors are made.
Option two is to treat the disc bulge in the most non-invasive manner that is possible. Medication and surgery are considered invasive because they "enter into " the body. It is logical to try non-invasive procedures before disturbing the natural balance of the animals's body. However, when invasive procedures are necessary or indicated, Dr. De Grasse supports them completely.
Chiropractic care and physical therapy are non-invasive therapies that can be used to effectively treat the disc bulge. Chiropractic techniques can gently move the bulge away from the spinal cord or spinal nerve. Physical therapy can help to prevent the disc from moving "out of place" again. And together, these therapies can reduce the pressure of the disc bulge against the spinal nerve or cord.
There will certainly be times when the swelling of disc bulge and the surrounding tissues needs medical intervention. There are several medications and one holistic supplement that effectively assists to draw off the excess water from the disc. Depending upon the degree of swelling and the size of the disc bulge, these medications may need to be used prior to or in conjunction with the chiropractic care, to ease the disc back into place.
It is in this "grey" area of option two that Dr. De Grasse feels many mistakes occur. The animal's owner sees minor or very subtle changes in the behavior, action or movement of the animal. The veterinarian does not see "anything" on the xray and perhaps a short course of anti-inflammatory medication is prescribed. The animal progresses well (due to the medication) and the body adapts to whatever condition exists that created the subtle change.
But, in a few months or a year later is when the animal then presents with a marked limp, cries when picked up or is constantly "chewing" at his extremities. Muscles have developed spasms and perhaps the bowel movements are slower and harder to pass. This is when Dr. De Grasse usually begins to see the animal. The slight disc bulge has grown into a larger disc bulge and the surrounding tissue has become very inflamed. A minor, chiropractic adjustment would have been preventative but now a major, corrective chiropractic adjustment is needed.
(If you don't understand - think of it this way. If there is a tire on your car that has slightly less air in it than all the others - well, you can still drive and may not even feel the difference in the ride. But, a year later, when the tread of the tires is checked, all four tires may need to be replaced because the road wear was uneven upon the surfaces of the tires. Checking the air pressure was preventative but having to change all four tires is corrective. You might even have to change your brake pads because the uneven tire pressure caused the car to "pull to one side" as you braked and thus, wore out the brake pads unevenly. Preventative care is always less costly And with the physical body - we just can't buy new discs!)
Dr. De Grasse applies gentle, low force techniques that correct small spinal alignment issues in an effort to prevent a disc bulge from developing in the first place. For example, if a young puppy cannot lie on its stomach with the back legs extended (like a frog) then there is a rotational misalignment of the spinal column that is present. There may be no disc bulge at present but if left untreated, may develop into a more significant problem as the animal grows. The chronic misalignment puts constant pressure on the disc and with the exuberant activity of the young puppy, a disc bulge may be caused to form over a long period of time.
It is important to note that Dr. De Grasse usually sees the animal displaying some limitation of movement and/or pain at 2-4 years of age. Upon taking a history, the owner usually states that the young animal did not "frog" (lie on its stomach with the back legs extended) and it is in her opinion that this ability is very important in the young animal as an indicator of spinal health.
Option three is to surgically cut the bulging part of the disc away from the spinal nerve or spinal cord, This material leaked out from the disc wall when the wall ruptured (herniation). This is an invasive surgical procedure which generally requires a MRI prior to the surgery. Usually the MRI requires a full anesthetic to prevent movement of the animal for about one to two hours while the MRI is performed. Chiropractic care cannot remove the extruded disc material from the spinal canal or from against the spinal nerve. Usually the animal is in extreme pain, ( not relieved with steroids and muscle relaxants) and time is of the essence to prevent permanent paralysis. Dr. De Grasse has an established protocol with Loma Linda Animal Hospital to identify, in a very timely manner, the paralyzed animal that can be helped with chiropractic care and to provide immediate referrals for the animal requiring spinal surgery.
- What are the signs and symptoms of a disc bulge?
The most common signs and symptoms are listed below:
Limping or lameness while standing, walking or running
Constantly licking an extremity or after the licking; the appearance of an ulcer of the skin (lick granuloma)
Loss of control of bladder or bowel
Paralysis (front legs only, back legs only or both)
Difficult birth (mother and offspring)
Some injuries that mimic a strain/sprain injury
Pain or some behavioral problems ( for example - biting at the tail or back when touched)
Difficulty getting up or walking
Gait disturbances (for example - walking in a circle)
Wobblers (whiplash)
Some diagnosis of hip dysplasia
Some diagnosis of arthritis
Some conditions of nausea/vomiting or constipation/diarrhea
Some conditions of mega-esophagus
Some conditions of allergy
Torticollis (wry neck)
Some circumstances of infertility
Inability to jump or climb
Yelping or crying out in pain
Unable to turn head or to look upward
Seizures - some conditions
Area of heat on body when touched or specific area of hair loss
Spinal misalignment as noted on xray
"Dead tail" or gait abnormalities
Atrophy of muscle
- How do I know which option is right for my animal?
Dr. De Grasse has developed the following criteria from over 18 years experience working with animals with spinal injuries. At present, she has returned over 630 paralyzed animals to full movement and continues with her paralysis research.
Option one, (to do nothing), in this doctor's opinion, should rarely be selected. Instead, Dr De Grasse recommends 'preventative care". This entails gentle, low force chiropractic techniques that correct small spinal alignment issues in an effort to prevent a disc bulge from developing in the first place. For example, if a young puppy cannot lie on its stomach with the back legs extended (like a frog) then, in Dr. De Grasse's opinion, there is a spinal rotation problem that is present. There is no disc bulge present but a misalignment within the spine, that if left untreated, may develop into a more significant problem as the animal grows. This chronic misalignment puts undo pressure on the disc and can cause a bulge to form over a period of time.
It is important to note that a certain percentage of animals with spinal rotation (cannot go into a "frog" position for example) will never display a sign or symptom of pain nor develop any problems with movement. Perhaps they "grow out of " the spinal rotation but there is a larger number of animals that will display some limitation of movement and/or pain as they age. I usually see this display in the 2-4 year old animal and discover, upon taking a history, that indeed the animal never was able to "frog" when it was young. Often, then, the owner will state, "I noticed that but I didn't know what to do about it". But it is at this time that the animal is brought to me with a chronic limp and I will discover a mild to moderate disc bulge that has developed. And now the animal requires corrective chiropractic care to prevent further disc deterioration. It is my opinion that this ability of the young animal to "frog" is a very important criteria to assess as an indicator of spinal health.
Option two is preventative care, and in this doctor's opinion, should be the bulk of animal chiropractic work. But it isn't! Please go to the menu box "Posture Analysis" to see a list of postures that I have found that may indicate a need for chiropractic care as a prevention to disc damage.
Option three is corrective care and is the bulk of this doctor's practice. Once an animal displays any pain, alteration of movement or uncharacteristic behavior then an evaluation of the spine should be performed. Subtle pressures upon spinal nerves or the cord can display organ dysfunction, all levels of pain and behavior or personality changes. Please refer to the menu box "Indications for Care" for examples of when to seek chiropractic care for your animal.
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