Summary
A recent discussion among veterinary experts highlights the evolving approach to managing acute thoracolumbar intervertebral disc disease in dogs. The conversation centers around the implications of a 2022 consensus statement from the American College of Veterinary Internal Medicine, which aimed to clarify treatment options for this common condition. The consensus emphasized the importance of distinguishing between surgical and conservative management, particularly for dogs exhibiting varying degrees of severity in their symptoms.
Professor Paul Freeman from the University of Cambridge has been at the forefront of research into conservative management, challenging the long-held belief that surgical intervention is always the best course of action. His studies have shown promising outcomes for dogs managed conservatively, even those previously thought to require surgery. Notably, a significant percentage of dogs that were deep pain negative—traditionally viewed as unlikely to recover without surgery—demonstrated improvement with conservative treatment. This has sparked a broader conversation about the necessity of surgery and the potential for alternative therapies, such as the use of chondroitinase injections, which are being explored as a less invasive option.
The dialogue also touches on the need for better understanding of the pathophysiology behind disc disease and the factors influencing recovery. Experts agree that while surgery remains a valid option for certain cases, particularly those that are rapidly progressing or exhibit severe symptoms, there is a growing recognition of the efficacy of conservative management strategies. This shift in perspective aims to alleviate the pressure on pet owners to make immediate surgical decisions and encourages a more measured approach to treatment. As research continues, the veterinary community is hopeful for more definitive guidelines that balance the risks and benefits of both surgical and conservative options.
Show Notes
Joining us in our virtual study we are delighted to be joined by not one but two neurologists. Professor Paul Freeman from the University of Cambridge and our own Associate Professor Joe Fenn. Paul, a Cambridge graduate, after 21 years in practice starting in mixed practice and then orthopaedic and neurology referrals, undertook an alternative track neurology and neurosurgery residency. Joe likewise is an RVC graduate, and after a few years in practice returned to the RVC to complete his post graduate training in neurology and neurosurgery and is no stranger to the podcast, discussing acute vestibular disease (pod 39) Levetiracetam (pod 50) Hypophysectomy (pod 70) and MUO (pod104). We discuss decision making in management of acute thoracolumbar intervertebral disc disease and in addition the use of intradiscal chondroitinase, which seems to be keeping Prof Freeman busy recently. We hope that you enjoy.
Prof Paul Freeman’s bio: https://www.vet.cam.ac.uk/people/professor-paul-freeman
Assoc Prof Joe Fenn’s bio: https://www.rvc.ac.uk/about/our-people/joe-fenn
Links to some relevant papers: https://pubmed.ncbi.nlm.nih.gov/39051966/ https://pubmed.ncbi.nlm.nih.gov/28190499/ https://pubmed.ncbi.nlm.nih.gov/40043683/
Current ACVIM consensus statement on the diagnosis and management of acute canine thoracolumbar intervertebral disc disease: https://pmc.ncbi.nlm.nih.gov/articles/PMC9511077/
To Cite this podcast as: Dom Barfield. RVC Clinical Podcast 156 Conservative management of acute thoracolumbar disk extrusion with Paul Freeman and Joe Fenn. Published on Oct 30 2026
If you have any comments about this podcast, please get in touch: email [email protected]; or [email protected] or Instagram @rvcclinicalpodcast. We would greatly appreciate your time to rate us on Apple podcast, Spotify or whatever platform you listen from and kindly write us a review. Hosted on Acast. See acast.com/privacy for more information.
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