Staging Degenerative Myelopathy
I like to divide DM into five stages. This helps when tracking how the disease is progressing and allows my clients to set objective benchmarks to use in making quality-of-life decisions . None of the stages is exact, as every patient is different and will progress at a different rate through these five stages. The stages provide good benchmarks for what to expect, but there can be some overlap in terms of clinical signs.
The average age at which clinical signs begin to appear is eight to 14 years. Typically, the patient will progress through all the stages within a 12- to 18-month time frame. The cumulative oxidative damage to the spinal cord white matter doesn’t appear until later in life, which explains why dogs with DM don’t respond to treatment. By the time the dog displays symptoms, the damage is already done.
The number-one question about DM that I hear from clients is about bladder and bowel function. These are generally normal in the early stages of the disease, but, as the disease progresses to the mid- to late stages discussed below, urinary and fecal incontinence will develop in conjunction with hind-limb paralysis.
The Five Stages of Degenerative Myelopathy
Most dogs with degenerative myelopathy initially present with clinical signs of spasticity and general proprioceptive ataxia in the pelvic limbs. This varies from patient to patient based on the stage at which the dog is brought in for clinical evaluation. As we discuss below, the first time we see a patient with DM, it will typically fit into the early-stage to mid-stage categories in terms of clinical signs.
1. Early Stage
Clinical signs include:
The photo above of the hind-limb paw of a dog with degenerative myelopathy shows the worn-down, inner-most nail, which can be a clinical sign of the disease.
2. Early to Mid-stage
The clinical signs in early to mid-stage DM include:
The photo above is of a dog demonstrating a neurologically compromised standing position on the left hind limb that’s usually referred to as knuckling.
The clinical signs of mid-stage degenerative myelopathy include:
3. Late Stage
The clinical signs of late-stage disease include:
Complete urinary and fecal incontinence
4. Final Stage
The clinical signs of final-stage disease include:
If you have any questions about Degenerative Myelopathy please contact the team at VTA today [email protected] or fill out the form here: https://www.veterinaryteachingacademy.com/contact-us
For a full extensive at-home program for Degenerative Myelopathy: https://www.veterinaryteachingacademy.com/caninerehabondemand-degenerativemyelopathy
© Author: Dr. John | Veterinary Teaching Academy, Canine Rehab Teaching Academy, Canine Rehab on Demand
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