Degenerative myelopathy is a progressive disease of the spinal cord. First symptoms include loss of coordination in hind legs.
When faced with a particularly difficult challenge in life, I have always felt the best weapon of combat is knowledge. Along with that is keeping a positive attitude.
As a physical therapist, dealing with canine patients diagnosed with degenerative myelopathy is both rewarding and heart-wrenching. Information and access to management tools are essential to the optimization of care.
What is degenerative myelopathy?
Degenerative myelopathy (DM) is a PAINLESS, chronic, slowly progressive weakening starting in the hind limbs and lumbar region.
The effects of degenerative myelopathy include:
- diffuse muscle atrophy (wasting)
- knuckling
- loss of coordination
- dragging legs
- difficulty walking
The condition tends to progress over 5-6 months.
DM is most common in certain breeds of dogs such as:
- German Shepherds
- Welsh Corgis
- Chesapeake Bay Retrievers
- Boxers
- Collies
- Rhodesian Ridgebacks
The onset and diagnosis of DM
First signs of degenerative myelopathy typically appear at 7-14 years of age.
The diagnosis is “by exclusion” in ruling out other causes. Radiographs will be negative for dysplasia, IVDD, arthritis, tumors.
In the near future, the diagnosis may be more definitive. A blood test that detects genetic markers for DM might emerge. OFA may be able to provide some DNA testing information for you, your breeder and veterinarian.
What happens with degenerative myelopathy?
DM is quite similar to multiple sclerosis in human beings.
Some dogs experience a form of it similar to ALS (Lou Gehrig’s disease). These dogs can experience the loss of function of the cranial nerves which control swallowing, facial movements, etc..
What causes it?
The cause is unknown although recent research has found a possible genetic link through a mutated gene. The mechanism is non-inflammatory and “demyelinating” (stripping) of the nerves in the spinal cord.
The theory is that DM is auto-immune in origin whereby the immune system attacks the myelin sheath. The myelin sheath is the outer covering of the nerves. It works like insulation over electrical wires. Without it, the nerve communication decreases (similar to when your computer slows down because of ‘noise “on your cable).
What are the available treatments?
The bad news is that at the present time there is no cure for DM.
The good news is that the disease is not painful for the dog. Coping is generally harder on the dog parents than the dog.
There are decisions to make at various stages of the disease regarding the quality of life. With the right manegement, the dog will generally stay content and happy.
I can’t stress enough the importance of a commitment from the family. Because DM is a difficult condition to manage, it is best when family members work as a team. For older members, it can provide routine and fulfillment. For younger family and kids, it can build responsibility. If everyone pitches in, the workload will be less and the dog will feel like a superstar.
You will need a reality check concerning therapeutic goals. Regression is inevitable. DM is a progressive condition.
Degenerative myelopathy management
Specialty hospitals can provide
- inpatient care
- diagnostic tests
- and rehabilitation services to initially “maximize” the dog’s condition
They can also help formulate a home treatment plan, order equipment, etc.
If inpatient care is too expensive or not available, many veterinary facilities now offer rehabilitation services as an outpatient.
There are also independent canine rehab practitioners/physical therapists, who offer care in their offices or in your home.
Rehab should include:
- ambulation
- intervention using a range of motion
- stretching
- massage
- gentle strengthening using resisted bands
- physiorolls
- rocker boards
- sensory input techniques
- sling-assisted walking, etc
Other helpful modalities include electrical stimulation.
Hydrotherapy
Aquatic therapy is also very helpful and important in maintaining mobility via canine swimming pool programs or underwater treadmills.
Water buoyancy can benefit walking, standing and swimming should be done in short bouts.
Management of incontinence
Your vet can help you learn about:
- bowel and bladder management,
- manual bladder expression
- keeping a schedule
- cleaning your dog
- checking for soiling or urine “scalding”
Shaving the region can sometimes help to prevent infections.
Reasonable comfort
Consider using a padded and possibly elevated dog bed for comfort and ease of on/off.
Help your dog with frequent turning to avoid pressure sores.
Bring the dog outdoors and keep them moving but avoid overexertion, heat and limit their exposure to the sun.
Mobility assistance
Slings and harnesses assist the dog transferring from lying to sitting, to standing, during walking, and while turning.
Identify and avoid danger zones in the home such as:
- stairs
- uneven floors
- slippery surfaces
Carpet runners or non-skid mats help your dog move around more safely.
Protecting feet
Routinely check the dog’s skin for scrapes or sores, infections, abnormal wear of nails, pads.
Booties are available for foot protection when the hind limbs drag and also offer anti-slip control. Consult your vet, PT an, groomer for suggestions.
Nutrition and weight management
Ask the vet or other pet experts about proper nutrition, protein consumption, hydration, and weight management.
Ensuring your dog’s ability to use food and water bowls includes considerations for:
- proximity
- non-skid mat
- proper height
Wheeled carts
Wheeled carts can be helpful for your dog’s mobility.
Standard rear-wheeled carts are fine if the forelimbs are strong. If the rear legs show “knuckling”, the feet and hocks need support by a sling or stirrup in the back of the cart.
In many other cases, especially where the trunk and forelimbs become weakened, a “counter-balanced” cart is more effective. Start with neutral and progressing to full-counter balancing (this refers to a forward shift in the axel position).
Some companies offer a variable axle, which can be adjusted by the dog owner. Engineering, quality, and workmanship are so important when choosing a company to make the cart. I highly recommend Eddie’s Wheels, in Massachusetts, USA.
Related articles:
Canine Wheeled Carts: Mobility Aids – Wheelchairs for Dogs
Further reading:
Degenerative Myelopathy in Dogs
Degenerative Myelopathy Leads to Paralysis of Dog’s Hindquarters