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Intervertebral Disk Disease (IVDD) in Dogs | Causes, Prevention, Symptoms, and Treatment Options

October 12, 2018 20 Comments

Intervetebral disc disease in dogs (IVDD) - Explanation, symptoms, causes, prevention and treatment options - by DJANGO - djangobrand.com

This article was last updated in June 2021.

When we first got 10 week old Django, Mike and I (Steph) would take him outside every 2-3 hours in our Brooklyn neighborhood for bathroom breaks. Most of these trips consisted of Django sitting in the middle of a busy NYC sidewalk and staring up at strangers until they came over to pet him. We met so many wonderful owners and fans of dachshunds. Surprisingly, so many of these New Yorkers had an unsolicited story to tell us about their dachshund and intervertebral disc disease (IVDD).

To be completely honest, I never really thought much about IVDD until recently. Django turned 3 in August, and I suddenly remembered an IVDD statistic: dachshunds and other "at-risk" breeds (typically those with short legs and long backs) are most likely to get IVDD between ages 3 and 6. Although Mike and I have done our best to protect Django's back (i.e. we don't let him jump on and off furniture), sometimes IVDD just happens. As Django gets older, I can't help but pray that he never experiences disc disease.

So what exactly is IVDD? I did a LOT of research so I could better understand IVDD: causes and symptoms of the condition, prevention, and treatment options. 

Here is everything you need to know.

What is IVDD in dogs?

Intervertebral disc disease (IVDD) is a condition where intervertebral discs between a dog’s spinal vertebrae bulge or burst. Bulging or bursting intervertebral discs can enter the spinal cord space and put pressure on spinal nerves. This can cause wobbling and incoordination, pain, nerve damage, and even lower body paralysis.

If you’re lost, don’t worry! We were too before researching canine spines and IVDD. Let’s start with the basics…

The spine is made up of individual vertebrae bones. Dogs have 30 vertebrae running from the neck to the tailbone. All canines have 7 cervical vertebrae (neck), 13 thoracic vertebrae (chest), 7 lumbar vertebrae (lower back), and 3 sacral vertebrae (pelvic).

Image 1: The spinal vertebrae from a dog's neck to lower back have intervertebral discs

The vertebrae between the neck (cervical) and the lower back (lumbar) have soft cushions between them called intervertebral discs. Intervertebral discs are made of cartilage and allow the neck, chest, and lower back to bend. They also act as shock absorbers. When a dog jumps off a couch or bed, intervertebral discs are cushioning the fall—they are preventing the dog’s spinal vertebrae bones from touching or banging together.

The spinal cord, which is made up of spinal nerves, runs through the vertebrae.

Image 2: Example of a canine dog spine with intervertebral disc disease (IVDD)

There are two types of intervertebral disc disease:

Type 1 disc disease

Type 1 intervertebral disc disease, also known as a “slipped disc”, occurs when the middle part of the intervertebral disc (nucleus pulposus) breaches the outer part of the disc (annulus fibrosis) and enters the spinal cord space. The “slipped disc” can occur on any part of the spine, but a majority of cases target the middle of the back.

Small- and medium-sized dogs are most affected by Type 1 disc disease. Unlike Type 2 disc disease which often affects older dogs, Type 1 often affects dogs between the ages of 3 and 6. The condition can be brought on by sudden impact to the spine (i.e. impact from jumping off a bed or sofa) that bursts the intervertebral disc.

Type 2 disc disease

Type 2 disc disease occurs when the outer layer of the intervertebral disc (annulus fibrosis) bulges and enters the spinal cord space. This spinal cord compression can happen slowly over time and may not cause pain right away. Older mid- and large-sized dogs are most affected by Type 2 disc disease.

IVDD in dogs: There are two types of canine disc disease including Type 1 and Type 2

What causes intervertebral disc disease in dogs?

Age

All dogs grow more susceptible to back problems as they age, including non-chondrodystrophic breeds. Over time, intervertebral discs can degenerate and/or calcify (harden). This reduces disc and back flexibility and increases the risk of serious injury. Recall that Type 2 IVDD is largely age-related and can happen slowly over time, resulting in few symptoms at first.

Genetics

Certain breeds are more genetically at risk of IVDD due to their skeletal structure. Chondrodystrophic breeds, most known as dogs with short legs and long backs (but not always), are most susceptible to prematurely aged disks. These breeds tend to have bone and cartilage abnormalities and include: dachshunds, bulldogs, basset hounds, beagles, corgis, cocker spaniels, pekingese, shih-tzus and even poodles.

Obesity

Whether chondrodystrophic or not, obesity significantly increases the risk that a dog will develop IVDD or other back problems.

Sudden trauma

Sudden trauma to the back, even jumping off a bed or sofa “wrong”, can cause an already weakened (degenerated or calcified) intervertebral disk to bulge or burst.

Prevention: How to minimize your dog's risk of IVDD

While it is important to follow the below steps to help prevent IVDD in your dog, remember that sometimes IVDD unfortunately just happens. With that said, these precautions will definitely help reduce the likelihood of a disc disorder in your dog:

Limit Jumping.

So many IVDD cases result from 'normal' day-to-day activity. Several of our doxie friends mentioned their pup suddenly got IVDD after jumping off an arm chair and landing "wrong".

While some dogs are born jumpers, it's best to limit jumping for those dogs that are at increased risk of IVDD (particularly chondrodystrophic breeds, senior dogs, and pups that have already experienced IVDD). Sudden shock to a dog's back, especially from jumping down, will put extra stress on a dog's spine.

Not sure how to limit your dog's jumping? Consider investing in a high quality pet ramp or pet stairs if your dog is able to jump on and off furniture including beds and sofas.

DJANGO Review: The Most Popular Pet Gates, Dog Ramps, & Bedside Stairs

Maintain a healthy weight.

Whether chondrodystrophic or not, obesity significantly increases the risk that a dog will develop IVDD. Extra weight puts unnecessary strain on the spine and also increases the risk of intervertebral disk calcification.

Good nutrition is key.

Strong bones and good muscle tone are incredibly important in the fight against IVDD. A nutritious dog food high in protein (meat should be the first ingredient) will help maintain your dog’s weight and strength and reduce the risk of IVDD.

Harness or collar?

The question of which is better to prevent IVDD—a high quality dog harness or a collar—is widely debated. Dogs that already experienced cervical (neck) IVDD would do better in a harness. For other dogs, harnesses may actually encourage pulling, straining and jerking while on a leash. No matter what your dog is wearing, pulling and straining increases the risk of IVDD.

The most important thing you can do is teach your dog to walk nicely on a leash without pulling. This is obviously much easier said than done. Django is 3 and very well-trained, but he still has moments where he pulls on the leash like a sled dog (especially when he's excited!).

The best thing to do is regularly train your dog to heel, or walk in sync with you just alongside your left leg. Django is 3 and we still practice heeling on the busy NYC sidewalks every week. It never hurts to remind your dog, no matter what his or her age, how to walk without pulling ahead.

Keep your dog horizontal.

Chondrodystrophic breeds genetically have sensitive backs. For this reason, it is incredibly important to "support the butt” whenever lifting your dog. It’s advised to never lift a dog by putting your hands beneath the front arms (i.e. lifting your pup like a human baby), as this will put stress on the spine.

So how should you pick up your IVDD-prone dog? Put one hand beneath the dog’s chest and cup your other hand around the dog’s tail and butt. Lift both arms together, ensuring the dog’s back remains straight. Make sure to place your dog back on the ground this same way, supporting both ends and keeping him or her horizontal.

Just remember, keep your dog horizontal and SUPPORT THE BUTT :)

Avoid rough play.

Dachshunds and other chondrodystrophic breeds are by no means fragile. Dachshunds of course are muscular little dogs bred to hunt badgers and other woodland game! With that said, it’s always a good idea to avoid play or activity that can cause unnecessary strain or twisting of your dog’s back. Avoid extreme rough housing and any “jumping” motions that could stress your pup’s back.

Signs and Symptoms of IVDD in your dog

Intervertebral disc disease can result in one or several symptoms. The symptoms can come on suddenly or appear gradually over time.

  • Wobbling when walking
  • Reduced activity level; unwillingness to jump or even stand up
  • Weakness or incoordination in the rear legs
  • Paralysis; dragging one or both rear legs when walking
  • Whimpering or crying, especially when moved or touched
  • Muscle spasms and/or stiffness in neck or back
  • Arched or hunched back (sign of cervical disc problem)
  • Reduced appetite
  • Lack of control over urination or defecation (incontinence)
“I think my dog is showing signs of IVDD. What do I do?”

If your dog is displaying signs and symptoms of IVDD, please call your vet immediately. Assuming IVDD is indeed the culprit, have your vet immediately recommend a neurologist and arrange an appointment with this new doctor. Time is of the essencethe sooner you diagnosis IVDD, the greater the probability of a full recovery via strict crate rest and/or spinal surgery.

Treatment Options for IVDD in dogs

Non-Surgical Treatment Options

Dogs diagnosed with minor IVDD—when there is very little loss of control of the back legs, if any—can sometimes make a full recovery without surgery. Your dog's neurologist may recommend 6-8 weeks of crate rest, basic at-home rehabilitation exercises, physical therapy, and hydrotherapy (water therapy).

While the idea of no surgery sounds ideal for your dog, unfortunately there is a high probability that IVDD will occur again in your dog’s life. By not removing the intervertebral disc material that has entered your dog’s spinal cord space, there is a strong probability that the same disc material will pose a problem again later in life.

IVDD Surgery

Time absolutely matters with canine IVDD. The sooner you diagnosis your dog's IVDD, the greater the probability of a full recovery via spinal surgery. According to Veterinary Surgical Centers (VSC), "surgery is successful in the majority of dogs with acute disc herniations (success rate of approximately 90 percent in dogs who still feel their toes)." In other words, most dogs with minor IVDD can see a complete recovery with surgery. This means they'll be back to walking, running and playing like they were before the condition struck.

Dogs with chronic IVDD may also benefit from IVDD surgery, but they are unfortunately less likely to see a full recovery. A bulging or burst intervertebral disc that goes unaddressed can put consistent pressure on the dog's spinal cord. Such spinal cord compression can eventually cause permanent nerve damage or paralysis that cannot be reversed.

The goal of IVDD surgery is to remove the ruptured or bulging intervertebral disc so that it never poses a problem again. In some cases, a neurologist may also recommend removing another suspect disc during the same operation.

So what does IVDD surgery entail? According to VSC, "The most common surgery done to remove disc material from around the spinal cord is called a laminectomy. The spine is approached through an incision in the middle of the back and using a special drill, a window is made in the bone of the vertebra immediately above the disc. The disc material underneath the spinal cord can then be gently removed."

Recovery will vary from dog to dog, but your pup will likely stay in the hospital for a few nights after surgery for monitoring. Once your dog is home, expect an average 6 weeks of crate rest. Crate rest means your dog will be restricted to his or her crate with the exception of bathroom breaks.

Your neurologist will also recommend at-home rehabilitation exercises. Rehabilitation exercises are extremely important during the recovery period and usually start immediately after surgery. These exercises are likely to include massages, gentle stretches, resistance exercises, and assisted walking. Other exercises such as hydrotherapy (water therapy) are also often recommended to assist in recovery.

"What is the cost of IVDD Surgery?"

The average cost of IVDD surgery ranges and depends on geographic location and surgery complexity. IVDD surgery costs can range anywhere from USD 6,000 to 12,000 for small or medium dogs and as much as USD 8,000 to 14,000 for large dogs.

Keep in mind that your total IVDD bill will include both surgical and non-surgical items related to your dog's care and hospital stay. The cost of imaging scans, anesthesia, pain killers and other medications, the length of your dog's hospital stay—all of these items will likely be put on one invoice and billed simultaneously. In fact, most animal hospitals that perform IVDD surgery will require that you pay a significant deposit upfront, i.e. 30% of your dog's total expected bill.

In order to determine if surgery is needed, a magnetic resonance imaging (MRI) scan will be done first to locate the intervertebral disc(s) in question. Canine MRIs can cost as much as USD 1,500 to 3,000 in the United States. Again, prices will vary based on several factors including your geographic area.

Questions? Comments?

We'd love to hear from you and learn from your own IVDD experiences. Leave a question below or share your IVDD experience with the DJANGO community.

Additional resources





20 Responses

DJANGO
DJANGO

October 02, 2021

@QUINN It’s nice to hear from you, although I’m sorry to hear your puppy has a genetic predisposition to IVDD. Please know that we are not licensed canine neurologists nor veterinarians, so we are not in a position to offer any medical opinion or advice. Since you have information about your puppy and his/her predisposition to IVDD, I would definitely recommend calling a canine neurologist with your question. You may be able to speak to a nurse or doctor who can provide better insight into IVDD probability based on your dog’s variant.

My unprofessional opinion is that your dog will not necessarily develop IVDD; he or she may simply be more prone to IVDD than another dog who does not carry the variant you mentioned. Dachshunds are a great example. Almost all dachshunds are prone to IVDD given their skeletal structure (long and low bodies). With that said, not all dachshunds get IVDD. I believe about 1 in 4 or 1 in 5 dachshunds get IVDD in their lifetime, and many make full recoveries after injury.

It definitely makes sense to take preventative measures to protect your dog against IVDD and future back problems. We include tips on IVDD prevention in dogs above within this article. Prevention includes minimizing jumping from high places (i.e. furniture, bed, sofa) and even minimizing the use of stairs, if possible.

Again, a canine neurologist who deals with IVDD would definitely be the best person to answer your questions. We aren’t familiar with inherited genes that increase IVDD risk factors.

Hope this helps in some way. Best of luck to you, and congratulations on the new puppy!

Quinn
Quinn

September 30, 2021

Hello our family recently have a Coton de tulear mix puppy and we did a health DNA check with Embark and the result came back showing that the pup inherited one copy of a variant and have increased risk of type 1 ivdd. My question is will the pup eventually develop ivdd with this condition or it’s something that can be prevented? Thank you!

DJANGO
DJANGO

June 06, 2021

@JESSE H & MILO First and foremost, please know I am thinking of Milo and wishing him a very successful recovery after his recent IVDD surgery. I hope he is feeling stronger and better with each day that passes. Thank you so much for your comment and for sharing cost information about Milo’s surgery and MRI. It’s incredibly helpful to know just how high the costs of IVDD (vet visits, neurologist visits, MRI scans, IVDD surgery) can be.

Wishing you and Milo only the best!! Give him a hug for me. – Steph

Jesse H & Milo
Jesse H & Milo

June 05, 2021

Our 2 year old frenchie Milo is 3 weeks post op from his IVDD surgery. This disease should be talked about more, it’s so common and so scary. Responsible breeding and knowledge can save suffering. Thanks for your article. The cost of our surgery in total was $11,000. No that’s not a typo. His MRI alone was 3,000.

DJANGO
DJANGO

February 10, 2021

@JOCELYN It’s nice to hear from you, and thank you for sharing your story about your chiweenie Sniper! I’m so glad to hear he is doing well after a few recurring incidents with IVDD – that’s so wonderful to know his health has improved with an adjustment in activity, diet and supplements. Hope he continues to enjoy a healthy life in his older age.

Jocelyn
Jocelyn

February 10, 2021

My pups and I love you Django! My middle child and baby Sniper is a larger Chiweenie. As a pup he would play ball for hours. He developed IVDD and we had 3 very scary reoccurring incidents. He has lost weight (from 25 lbs to 16). He is hypothyroid as well. Good food, supplements, and taking it easy have done wonders. He will be 12 years young this year. Holy pup, I know! He’s an old man but will forever be my baby!

DJANGO
DJANGO

February 10, 2021

@ANA MARTINEZ Hello and thank you for reaching out! We received your email about your 8lb chihuahua. I’m so sorry to hear about his cervical spinal cord injury after a fall. We are not licensed medical professionals and strongly advise taking your chihuahua to your vet if you have not already. You vet is the best person to treat him and may even recommend a neurologist.

If you are concerned about affording medical treatment for your little one, here are two good resources from the Humane Society. Definitely take a look at these!
>>> https://www.humanesociety.org/resources/are-you-having-trouble-affording-your-pet
>>> https://www.humanesociety.org/resources/having-trouble-affording-veterinary-care

There are several organizations that provide financial assistance to pet owners in need. You can find a list of many organizations within those links. There may also be veterinary school in your region that provide subsidized care for those in need.

I hope these resources help you! Wishing you and your chihuahua all the best. We hope his health situation only improves from here.

DJANGO
DJANGO

February 10, 2021

@JANIS THACKER Thank you so much for sharing your experience with our community. I’m so sorry to hear about Buddy’s ongoing health problems (and likely disc problem), but it is incredibly heart warming to know he has two very loving people taking such good care of him. We’ll be thinking about you and Buddy and hope his situation improves. Thanks again for reaching out and sharing your story.

Ana Martinez
Ana Martinez

February 10, 2021

I already send my dog situation, just like to have a recommendation of what to do if I do not have money, what else can I do?

Janis Thacker
Janis Thacker

February 10, 2021

Thanks for the information about IVDD.
I have 2 cairn terriers 12 yo, half siblings. Sammy, the girl, n d Buddy my boy. Buddy has been what my husband calls spoiled. Always wanting to be carried, and likes to complain alot. He lays on my chest with his head under my neck and like his tummy and back rubbed for hours.
One day we came home from being gone a couple hours, and when I picked him up, he was screaming in pain. It was of course the weekend, so I took him to the Emerency Vet. $25].later I was told without an MRI it was impossible to tell, but his body language and the exam told the Vet it was most likely a disc problem. I was given Gabapentin and sent home. I took him into our Vet as soon as I could. She said it was probably IVDD, or something worse.
that was w months ago and we’ve been doing most of the things you’ve mentioned. He still can walk on his own but sometimes preferred to be carried. He is incontinent and can go every w to 3 hours around the clock. I haven’t been getting alot of sleep. We know it isn’t his fault.
We don’t create him as that causes him anxiety. We do have steps to the beds and furniture. There is a ramp to the dog run as well.
He crys when either his tummy is upset from the meds, or pain as the meds run out.
I’m doing the best I can with limited income, and my own maladies.
It makes me sad.i wish he would get better, but actually it could be so much worse.
I sometimes wonder if he sould be put down for both our sales, but I think I can do this. It’s getting harder as my sleepdepravation is getting to me.
I love my dogs. I just wish there was some way I could help him more.
Thanks for the info. .

DJANGO
DJANGO

February 10, 2021

@PAM ECONOMIDES Pam, hello! Thanks for reaching out. I am sorry to hear about Truffle’s IVDD diagnosis and recent loss of function in his back legs. I would definitely take Truffle back to the specialty hospital since they recently diagnosed him with IVDD and already advised you on his care and recovery. Given the severity of Truffle’s physical state (losing balance, not putting pressure on back legs), I would take his condition seriously and revisit the specialty hospital ASAP.

Best of luck to you, your husband and Truffle!! We’ll be thinking of him and praying for his full physical recovery.

Pam Economides
Pam Economides

February 10, 2021

I am concerned about my 14 year-old cairn terrier, Truffle. We have done flyball for the past 5 years, but 2 days after our last tournament, he did not want to move. Because it was Memorial Day, I had to take him to the veterinary specialty emergency hospital. They diagnosed him with a mild case of Type 1 IVDD, and said it could be treated non-surgically. They gave us meds and told us no activity for Truffle for 4 weeks. After that, he seemed fine, but since then has also been moving more slowly and laying down a lot more.
Two days ago, Truffle was trying to get up and he lost his balance. He kept trying to get up but couldn’t put any weight on his back legs, so he just kept wriggling until I picked him up. I set him down and he was fine, but he lost his balance again a few minutes later.
Today I took Truffle to his regular vet and told him about the IVDD diagnosis and what had happened with him losing his balance. After examining Truffle, the vet said nothing about IVDD and focused only on arthritis management. After reading your article and talking it over with my husband, I’m wondering if I should take Truffle back to the specialty hospital for their opinion. What do you think?

DJANGO
DJANGO

February 10, 2021

Hi Kimberly! Thanks so much for reaching out. I’m so sorry to hear about Rusty’s IVDD diagnosis, but that is great he is already under your vet’s care. Please know that while we have extensively researched IVDD, we are not vets or medical professionals. For that reason, we ask that you consult your vet with ANY questions you have about Rusty’s care and recovery. Your vet knows Rusty best and his unique IVDD diagnosis, and he/she will definitely provide you with the most accurate and useful information.

With that said, I can tell you that dogs may lower their heads in response to neck pain or discomfort. Sprained muscles, pinched nerves and/or neck vertebrae injuries (i.e. IVDD-related issues) are common causes of such discomfort. Did your vet confirm that Rusty’s IVDD is located in one of his cervical (neck) vertebrae? If so, any neck pain Rusty feels right now could make it difficult for him to keep his head raised.

Again, we definitely advise you call your vet about Rusty’s head lowering. Since they’ve already met and diagnosed Rusty, they will be able to address this question (and any others) most accurately.

Thanks again for reaching out, and best of luck to you and Rusty! We hope he sees a speedy and very successful full recovery <3

Kimberly
Kimberly

February 10, 2021

Our dog Rusty who is 2.5 yrs old and is a Cavalier King Charles Mix was recently diagnosed with possibly having IVDD. We think this happened when he was jumping off our bed (like super dog). My question to you is, he seems to be doing ok on the pain, prednisone and muscle relaxant and we do see a difference in him. His hind legs work fine and he is not wobbly. He does however at certain times during the late afternoon lower his head a bit, is it normal recovery to have some good and some days where the head lowers. His tail is constantly wagging and it only stops when the pain meds hit him. Thank you for any info u can provide. We are at only 12 days with this and vet said it could take 6-8 weeks.

DJANGO
DJANGO

February 10, 2021

@YVETTE COTTEN Hello Yvette! I’m sorry to hear about your dog’s litter mate. IVDD is considered genetic since chondrodystrophoid breeds – ones whose bodies have been altered genetically for the short/stout stature commonly associated with dachshunds, corgis, etc – are at higher risk for this disease due to their physical structure. Just because your pup’s litter mate has been diagnosed with IVDD does not necessarily mean your little one will also get IVDD, BUT it does suggest there may be an increased risk of IVDD in the family due to their physical makeup. Also keep in mind that IVDD can result from several factors including physical trauma (i.e. jumping off a tall piece of furniture and landing ‘wrong’).

In any case, the fact that Pancake is fit, healthy, AND not a jumper is wonderful! The best thing you can do for him is to keep him at a healthy weight and continue preventing him from any physical activity that would put excess strain on his back. You also may want to follow up with Pancake’s vet to see if he has additional tips for keeping Pancake safe. We’ve done a lot of research around IVDD, but we’re not medical professionals and wouldn’t want to accidentally leave out any tips that could benefit Pancake’s well being.

Regarding pet insurance, it is our understanding that most brands will not cover IVDD costs once a dog has been diagnosed with the condition. For that reason, it is definitely a good idea to consider pet insurance now while your dog is healthy. Your pup is approaching the ‘at risk’ years for IVDD (3 to 6 years of age), so now is a great time to be proactive and protect yourself financially with pet insurance.

Hope this helps! Don’t hesitate to reach back out if you have any follow up questions.

Yvette Cotten
Yvette Cotten

February 10, 2021

I received a email from the breeder who we got our male from. Pancake is only 2.5 yrs old & one of his brothers from his litter has just been diagnosed with the early onset of IVDD. Is IVDD a genetic disorder too? Our Pancake is definitely not a jumper at all, sits on the couch or bed & cries till you lift him off, but he is fit & not overweight. He runs with my husband. I have been advised by breeder to get comprehensive pet insurance that covers IVDD. Your expert advice will be much appreciated. Thanks 🙏🏻

DJANGO
DJANGO

February 10, 2021

@ MORGAN RENSHAW Thank you for your comment, and I’m so sorry to hear about Elvis! How heartbreaking. It’s definitely scary to think that even if one IVDD problem is fixed (i.e. one bulging/burst disc is addressed with surgery), another could always post a problem in the near or distant future. I’m so sorry you and Elvis had to deal with IVDD and cancer – what a poor little guy <3

Morgan Renshaw
Morgan Renshaw

February 10, 2021

I wish I had this article 3 years ago when my Dachshund Elvis had IVDD. Truly the best article on IVDD I’ve read, truly written for the average person to understand and yet so detailed and informative. Elvis needed surgery as nothing else was working but the surgery was successful and he went back to normal in about a month. Sadly, just about a year later, he had another IVDD and that’s how the cancer was discovered :-(
Shout out to Django for the fantastic illustrations!!!

DJANGO
DJANGO

February 10, 2021

@LEIGH DINGWALL Thank you for your comment Leigh, and I’m so glad you found this IVDD article useful! Hopefully it’s a good sign that Nora is already 6 with no signs of back issues. And that’s great she’s on a diet! Until doing research for this article, we didn’t realize just how much of a leading factor obesity is with IVDD. Here’s hoping both Nora and Django never have to experience what’s in this article <3

Leigh Dingwall
Leigh Dingwall

February 10, 2021

Hey Steph, just wanted to let you know that this was the best, most comprehensive (without being overkill) explanation of IVDD I’ve ever seen. Like you, I worry constantly that Nora will get it. She’s 6, but she’s also on the porky side (and on a diet). Thanks for putting this together!

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