Management and Care
ofĀ Degenerative Myelopathy
Keep your pet as mobile and as comfortable for the longest time possible
ANSWERING YOUR MOST COMMON QUESTIONS ABOUT DEGENERATIVE MYELOPATHY
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What exactly is Degenerative Myelopathy
...and how do we treat it?
Learn what all your options are and how you can help keep your pet as mobile and as comfortable as possible.
The Medical Explanation
Degenerative myelopathy, which is also known as chronic degenerative radiculomyelopathy (CDRM), is characterized by clinical signs of slowly progressive hind-limb weakness and paralysis. The symptoms are caused by the oxidative damage to and degeneration of the Schwann cells in the white matter of the spinal cord. This degeneration causes interference with both motor and sensory function of the white matter.
DM is similar to some forms of human amyotrophic lateral sclerosis (ALS), more commonly known as Lou Gehrig’s Disease.
The images to the left show a section of a spinal cord from a dog who had DM (left). The degeneration is seen as a loss of the blue color at the edges (arrows) compared with the spinal cord from a normal dog which is blue throughout (right). (Source: http://www.caninegeneticdiseases.net/dm/basicdm.htm)
The Clinical Signs Used to Diagnose DM
There’s a greater likelihood of DM if the patient is a high-risk breed and/or between 5 and 14 years of age.
Diagnosis is based on the exclusion of all other disorders, and the genetic test may assist in a diagnosis when used in conjunction with clinical signs to get a presumptive diagnosis. Unfortunately, the only truly accurate diagnosis can be made on post-mortem examination of the spinal cord.
Sudden onset of clinical neurological signs without trauma
No history of pain
Mild ataxia and paresis of the hind limbs without thoracic limbs being affected
Is Your Dog One of These Breeds?
Degenerative Myelopathy has been diagnosed in many different dog breeds, but most of the research has been focused on these breeds:
Boxer, Pembroke Welsh Corgi, German Shepherd, Chesapeake Bay Retriever, Rhodesian Ridgeback, American Eskimo Dog, Bernese Mountain Dog, Borzoi, Cardigan Welsh Corgi, Collie, German Shepherd cross, Golden Retrievers, Great Pyrenees, Kerry Blue Terriers, Nova Scotia Duck Tolling Retriever, Poodle (Miniature), Poodle (Standard), Pug, Shetland Sheepdog, Siberian Huskie
The Five Stages of Degenerative Myelopathy
THESE 5 STAGES PROVIDE
good benchmarks for what to expect in your pet with degenerative myelopathy, with possible overlapping of clinical signs.
Stage 1:
Early Stage
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Mild signs (Early Stage)
Most common signs and symptoms may resemble those of degenerative joint disease - and be confused with hip dysplasia. These include:
- Weakness in rear legs
- Slight change in gait
- Change in tail position
- Scuffing of rear-paw pads
- Wearing of innermost rear-paw nails
Stage 2:
Early to Mid-stage
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First signs of neurological deficits (Early to Mid-stage)
Most common signs include:
• Beginning to have difficulty standing up
• Swaying in the hind end when standing
• Tail movement becomes less active
• Rear legs start to cross each other when walking (worse on turns)
• May start to see urinary and fecal incontinence
• May start to see knuckling when walking, or delayed righting-reflex response times
Stage 3:
Mid-stage
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Partial paralysis (Mid-stage)
Most common signs:
• Loss of tail movement
• Jerky movement in the hind limbs when trying to walk
• Inability to walk
• Falling down when walking or standing (“drunken sailor” gait)
• Cross extensor response—when one rear paw is touched, the other rear paw moves
• Asymmetric weakness now progressing to paraplegia
• Easily falls over if lightly pushed
• Wobbling and unable to maintain balance when standing
• Knuckling of the hind paws when standing or trying to walk (very obvious when turning)
• Feet scraping on the ground when walking (constantly)
• First signs of urinary and fecal incontinence
Stage 4:
Late stage
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Complete paralysis (Late Stage)
Most common signs:
• Complete paralysis of the hind limbs and loss of all motor and sensory function
• Complete urinary and fecal incontinence
Stage 5:
Final stage
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Ascending paralysis to front limbs (Final Stage)
Most common signs:
• Front limb weakness
• Difficulty pulling themselves forward
• Start to see delayed righting-reflex response times
• Knuckling when walking in a supportive device (cart or sling)
• Difficulty breathing as diaphragm is now becoming compromised
Treatment
There’s currently no effective treatment for DM, although there are promising options to slow the progression of the disease. That being said, there are several things we can do to extend the life of a patient by months or even years. If we know early on that a dog is a carrier of or at risk for DM, we can make lifestyle changes so they might never show clinical signs of disease.
These changes include:
ā—»ļø¸ Not allowing the dog to become overweight
ā—»ļø¸ Feeding a diet high in omega-3 fatty acids and low in starches
ā—»ļø¸ Anti-oxidant supplements
ā—»ļø¸ Physical exercise
ā—»ļø¸ Physical therapy
ā—»ļø¸ Rehabilitation modalities
ā—»ļø¸ A patient in stage 3 or 4 may need a supportive device like sling or a cart when hind-limb paralysis is to the point that the dog is unable to stand or walk.
To Learn More On:
The Importance of Early Rehabilitation
Medical Explanation
Clinic Signs
Breeding Genetics
The Stages of Degenerative Myelopathy Treatment
Prognosis
Regenerative Medicine
Home Recovery Equipment
Download Your Free Care GuideFrequently Asked Questions
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Video Teachings and Knowledge
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Blogs, Resources and Articles
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The 5 Stages of
Degenerative Myelopathy
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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.
Diagnosing
Degenerative Myelopathy
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When it comes to testing for degenerative myelopathy, candidates are divided into three classes:
At-risk (A/A homozygotes)
Carrier (A/N heterozygous)
Clear (N/N genotype)
I helped develop the two tables below to assist my clients in making breeding decisions to prevent or limit the transition of the SOD1 mutation gene.
Read the Blog
Breeds Most Affected by Degenerative Myelopathy
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Canine degenerative myelopathy (DM) has been recognized for over 35 years. It’s a spontaneously occurring, adult-onset, spinal-cord disorder affecting dogs.
Degenerative myelopathy, which is also known as chronic degenerative radiculomyelopathy (CDRM), is characterized by clinical signs of slowly progressive hind-limb weakness and paralysis.
Read the Blog
WHY WE ARE SO PASSIONATE ABOUT
Degenerative Myelopathy
In loving memory of our Tova
Two decades ago our beautiful girl, "Tova", was diagnosed with Degenerative Myelopathy. Back then, even as trained veterinarians, we knew very little about what we could do to help her through this heartbreaking disease. Our desperate search for knowledge and information lead us down the path of seeking to learn more about the disease and how rehabilitative medicine could possibly help slow down its progression.
Canine Rehab On Demand and the at-home rehabilitation programs we offer were created for this purpose. We wanted to share our extensive research of information with others to provide the latest resources, tools, knowledge and treatment options to help you and your pet navigate your way through Degenerative Myelopathy.
We are passionate about helping others who are dealing with a pet with Degenerative Myelopathy, so you don't have to go through what we went through. This program will assist you through the challenges you will inevitably face, and hopefully, will give you and your pet a richer quality of life together.
