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We sit down with Drs. Paul Freeman and Nick Jeffery to discuss a treatment for down dogs that’s changing outcomes and conversations: percutaneous intradiscal chondroitinase injections that act like chemical fenestration, reduce extruded disc material, and help non-ambulatory dogs recover without opening the spine.

We walk through the origin of the idea, the ethical hurdles, and the growing dataset behind safety and effectiveness. You’ll hear why deep pain–positive dogs with acute disc injuries often do as well with enzyme injections as with decompressive surgery, and how careful case selection can minimize risk. We get practical about inclusion criteria—currently focused on dogs under 15 kg, with French Bulldogs now included under close monitoring—and the technical realities of needle placement, imaging guidance, and when to add MRI. We also dig into the strategy of treating three to five disc levels to lower recurrence, and why this multi-level approach could outperform single-site surgery over the long term.

The conversation doesn’t dodge the hard calls. We compare large compressive lesions versus primarily contusive injuries, discuss when early surgery still makes sense, and share early experiences expanding to cervical cases with ultrasound and fluoroscopic checks. Looking ahead, we explore research priorities: defining time windows for chronic presentations, tracking recurrence across breeds, and building the evidence to place chondroitinase correctly in the treatment pathway. We even touch on how AI could one day use imaging data to predict which dogs need urgent decompression and which can safely recover with enzyme-first care.

If you’re an ER vet, GP, or neurologist looking to offer owners real choices, this is a grounded, data-informed guide to a less invasive option that can preserve mobility and reduce euthanasia driven by cost. Listen, share with your team, and help more “down dogs” stand again. Subscribe, leave a review, and tell us: where would you place chondroitinase in your spinal care protocol?

JAVMA article: https://doi.org/10.2460/javma.24.12.0790

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