Important information regarding dogs needing back surgery:

In general, for chodrodystrophic dogs with acute TL discs:

Back pain only: 85% resolve with cage rest; 95%+ resolve with surgery

 Paraparesis (still walking): 65% resolve with cage rest; 95%+ resolve with surgery

 Paraplegia with intact deep pain: 40% resolve with cage rest: 95% resolve with surgery

 Paraplegia with loss of deep pain: 5% resolve with cage rest: 50% resolve with surgery if over 48 hour the chance to recover is 5%

 As you go down the list, the need for surgery becomes more urgent.

 The other factor that's very important is the onset. Patients that go down quickly (e.g. normal at 8 am, nonambulatory at noon) are more urgent than those in which the signs progress more slowly (e.g. back pain Monday, ataxia Wednesday, nonambulatory Friday).

 I try to weigh the beneifit of urgent surgery vs. the problems associated with after hours surgery and decide if the patient is likely to be harmed by waiting until the next day. Basically, the 2 patients I don't like to wait on are:

 -- No deep pain. There's some thought that the prognosis goes down even further if surgery is delayed more than 24-28 hours. I think of these cases as the clock is ticking, and we don't know when the cord will go from a recoverable state to irereversable damage.

 -- Intact deep pain but absent voluntary movement. I don't like to wait on these because the next thing to go is deep pain, and as you can see from the list, once deep pain is gone the prognosis goes down significantly. So we don't like to wait until they lose deep pain.

 For the others, I consider the rate of onset. I'm more worried about a patient that goes down quickly vs. over a few days.

 if patient cannot walk, then this can be a neurological emergency and needs to be seen as soon as possible.

 We have about a 30 percent reoccurence rate also.

 As you go down the list, the need for surgery becomes more urgent.