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DM
Degenerative Myelopathy
 
 

Degenerative myelopathy (DM) is a disorder of dogs characterized by progressive spinal cord disease.  The first sign of a problem is often wobbly or weak rear legs, sometimes just scuffing of the rear toes or odd nail wear. Eventually, the rear legs lose all function, there can be loss of bowel and bladder control and the front legs can become weak. DM is not thought to be a painful process. Some breeds of dogs, such as German Shepherds and Corgis are genetically predisposed to this condition. The age at onset had been reported as 5-14 years.

DM interferes with communication of brain and limbs - the white matter of the spinal cord is affected, usually starting in the thoracic spinal cord region. These nerve fibers transmit movement information from the brain to the limbs and sensory information from the limbs to the brain.

A diagnosis is reached by a process of ruling out other diseases such as tumors of the spinal cord or intervertebral disc disease. Radiographs can reveal spinal structure and help exclude tumor or infection, but advanced imaging such as a myelogram or MRI may be needed for spinal cord structure.

There is no treatment to reverse DM, but by combining supportive measures, progression can be slowed and dogs can maintain a good quality of life. Modalities that we may include for a DM patient at APMC include:

Physical Rehabilitation Therapy (PRT):

Daily Home PRT: A 2006 study showed that dogs who received intensive daily therapy (short sessions, 3-5 times daily) lived 4 1/2 times longer than dogs that did not have therapy. The study also showed that dogs who received therapy remained able to walk on their own longer than dogs without therapy. The exercises described are simple activities that we can coach a client to perform at home. These include passive range of motion, massage, walking and other therapeutic exercises.

Office-based PRT: Including regular visits for PRT can complement the home therapy program by adjusting activities, adding assistive devices and using hydrotherapy. Walking in an underwater treadmill at least once weekly can benefit DM patients. The dog’s weight is partially supported by the buoyancy of the water, while the water resistance allows for strengthening and gait training.

Traditional Chinese Veterinary Medicine:

While acupuncture has not been shown to directly inhibit DM disease, we incorporate acupuncture into a DM support plan to generally improve patient attittude, appetite, and pain management. Herbal therapy is often used for DM patient support, utilizing herbal formulas from Jing-tang pharmacy.

Medications:

Two compounds, aminocaproic acid and acetylcysteine (an anti-oxidant) have been used to help slow the progression of DM. We work with West Labs pharmacy in Florida for these products.

Even though DM, itself, is not thought to be painful, we often explore pain medication trials. Spinal pain and arthritis in other areas of the body can be a significant limiting factor for a dog as they struggle to get up and around.

Weight Control:

Maintaining an ideal body weight is extremely important. DM dogs are challenged enough without extra weight to haul around. PRT visits are a good time for weight check-ins and dietary coaching.

Home Environment Review:

Slippery surfaces must be covered to minimize slips and falls. Carpet runners or mats can help. Ramps and steps can be used to help a DM dog in and out of the car and onto furniture.

Assistive devices:

Harness/rear end support - the use of these can help caretakers help their dogs while minimizing their own personnal injury potential.

Boots - dog boots can help the patient gain traction on floors as well as prevent scuffed toes and nail wear.

Mobility Aids - includes braces to reduce paw knuckling and help with paw placement as well as carts to assist with mobility and encourage independence.

 
 
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