The variety of possible diseases of the spine offers challenges to modern veterinary diagnostics in all its facets. Holistic, clinical diagnostics with orthopedic and neurological background must, depending on the case, be supplemented by sensible imaging diagnostics. Contrary to traditional doctrines, all diseases mentioned here are also pain disorders and not just a phenomenon or an ancillary finding. They must be understood as such and be integrated into an adequate therapy concept, regardless of whether they are identified individually or together with other pain disorders. A good understanding of the respective disease creates the knowledge to develop a suitable and often a multimodal therapy program.