How Rehabilitation Can Help Dogs with Intervertebral Disc Disease (IVDD)

Dr Jenna, BAnVetBioSci DVM MANZCVS (Canine Rehab & Sports Medicine) CCRP - 30th September 2026

Intervertebral disc disease (IVDD) is one of the most common causes of back pain and neurological problems in dogs. Depending on the severity of the disease, affected dogs may experience anything from back pain, difficulty walking to complete paralysis.

What is IVDD?

The spine is made up of individual vertebrae separated by intervertebral discs. These discs act as cushions between the vertebrae and allow the spine to move normally.

With IVDD, a disc can degenerate, bulge or rupture, putting pressure on the spinal cord or spinal nerves. This can cause pain, weakness, loss of coordination and, in severe cases, paralysis.

How is IVDD graded?

The severity of neurological signs is commonly described using a grading system:

  • Grade 1: Back or neck pain only, with no neurological deficits.

  • Grade 2: Back pain with mild neurological deficits. The dog remains able to walk but may be wobbly or uncoordinated (ambulatory ataxia).

  • Grade 3: The dog is unable to walk normally but can still move the hindlimbs (non-ambulatory paresis).

  • Grade 4: Complete paralysis of the hindlimbs (paraplegia), but deep pain perception is still present.

  • Grade 5: Complete paralysis with loss of deep pain perception.

The higher the neurological grade, the more severe the spinal cord injury and the more guarded the prognosis.

Conservative Management

Treatment depends on the severity of the neurological signs, the location and type of disc injury, whether the dog is experiencing ongoing pain, and other individual factors.

Conservative management

Conservative or medical management may be appropriate for dogs with milder neurological signs, particularly those that are still walking.

It generally involves:

  • Strict activity restriction and controlled exercise

  • Appropriate pain relief and anti-inflammatory medication

  • Close monitoring for deterioration

  • A gradual return to activity

  • Rehabilitation

For dogs with mild disease, conservative management can be very successful. However, reoccurrence of disc extrusion can occur, and dogs with worsening neurological signs, severe or persistent pain, or more advanced neurological deficits may require surgery.

Surgical Management

Surgery aims to remove disc material that is compressing the spinal cord and relieve the pressure. The most common procedure for acute thoracolumbar disc extrusion is a hemilaminectomy.

Surgery is generally considered when neurological signs are severe or progressing, pain cannot be adequately controlled, or when the likelihood of recovery is improved by surgical decompression.

What are the chances of recovery?

Recovery rates vary between individual dogs and studies, but published evidence provides some useful general estimates:

These figures represent reported recovery rates rather than a prediction for an individual dog. The presence or absence of deep pain perception is particularly important when assessing prognosis in severely affected dogs.

How can rehab help?

Rehabilitation is an important part of recovery following IVDD, whether a dog is treated conservatively or undergoes surgery.

The goals of rehabilitation are to help your dog:

  • Support neurological recovery and functional movement

  • Maintain joint mobility and flexibility

  • Minimise muscle loss and rebuild strength

  • Improve balance, coordination and proprioception

  • Encourage appropriate weight-bearing and walking patterns

  • Help dogs regain independence with everyday activities

  • Reduce complications associated with prolonged immobility

  • Provide a structured and safe progression of exercise

  • Help owners safely manage their dog's recovery at home

This is consistent with the ACVIM consensus, which supports rehabilitation as an adjunct to IVDD treatment.

Rehabilitation can also help owners understand how to safely handle, exercise and support their dog throughout the recovery process.

Importantly, rehabilitation does not replace appropriate veterinary or surgical treatment when these are indicated. Instead, it forms part of a comprehensive treatment plan.

What might rehab for IVDD involve?

Every rehabilitation program should be individually tailored to the dog's neurological status, stage of recovery and specific goals.

Depending on the patient, rehabilitation may include:

Therapeutic exercise

Specific exercises can help rebuild strength, coordination, balance and proprioception. Exercises are progressed as neurological function improves.

Assisted standing and walking

Dogs that are unable to walk independently may benefit from supported standing and assisted walking to encourage appropriate limb use and weight-bearing.

Hydrotherapy

Underwater treadmill therapy can provide a supportive environment for dogs that are weak or unable to walk normally. The buoyancy of the water reduces the amount of weight the limbs need to support while allowing controlled movement.

Passive range of motion

Gentle movement of the joints can help maintain mobility in dogs that are unable to move their limbs normally. This is generally used as one component of a broader rehabilitation program rather than as a treatment on its own.

Balance and proprioception exercises

As neurological function returns, exercises can be introduced to challenge balance, body awareness and coordination.

Muscle strengthening

Progressive exercises can help rebuild muscle lost during periods of rest, weakness or paralysis.

Pain management

Rehabilitation may incorporate appropriate pain-management strategies and modalities alongside veterinary-prescribed medications.

Home exercise program

A carefully designed home program allows rehabilitation to continue between appointments while ensuring that exercise is increased gradually and safely.

Recovery takes time

Recovery from IVDD can be a gradual process, particularly in dogs with significant neurological deficits. Some dogs may begin walking again relatively quickly, while others require weeks or months of rehabilitation.

A tailored rehabilitation program can help maximise your dog's physical function, maintain comfort and provide a structured pathway back towards the activities they enjoy.

If your dog has been diagnosed with IVDD, one of our veterinary rehabilitation professionals can help determine the most appropriate rehabilitation program for their individual needs.