Overview
Thoracolumbar intervertebral disc degeneration involves the deterioration of discs in the mid-to-lower back, often leading to spinal cord compression and neurological deficits in both humans and animals, notably dogs 1.Diagnosis
Neurological examination to assess motor function, sensory deficits, and reflexes 1.
Imaging studies such as MRI or CT scans to visualize disc herniation and spinal cord compression 1.
Pain assessment using composite pain scales and sensory testing devices 1.Management
First-line treatments:
- Multimodal analgesia including opioids (methadone subcutaneously or transdermal fentanyl) 1.
Adjunctive treatments:
- Early physiotherapy and mobilization to prevent complications 1.
- Surgical intervention for severe cases with significant neurological deficits 1.Special Populations
Dogs: Subcutaneous methadone and transdermal fentanyl provide adequate postoperative analgesia without necessitating intravenous access, facilitating early mobilization 1.Key Recommendations
Consider subcutaneous methadone or transdermal fentanyl for postoperative pain management in dogs post-thoracolumbar disc surgery to avoid the need for intravenous catheters 1 (Evidence: Moderate).
Utilize multimodal pain assessment tools in dogs postoperatively to evaluate pain effectively 1 (Evidence: Moderate).
Facilitate early physiotherapy and mobilization in dogs post-surgery to enhance recovery 1 (Evidence: Expert opinion).References
1 Schütter AF, Verhoeven A, Tünsmeier J, Kästner SBR. Subcutaneous methadone is not different than transdermal fentanyl for postoperative analgesia in dogs with thoracolumbar disc disease, a prospective, randomised, blinded clinical study. BMC veterinary research 2025. link