About Degenerative Myelopathy

Before I dive into the definitions of Degenerative Myelopathy, it’s essential that I pass on this sentiment from the Degenerative Myelopathy (DM) List, an online support group for people whose dogs are believed to have the neurodegenerative disease:

“There is life after a diagnosis of DM.”

The DM List on Yahoo includes more than 1200 members who share information on a daily basis and support each other through each phase of the disease. I want to start this three-part series on DM with this sentiment because it comes from hands-on experience of caring for a dog with DM and it offers motivation instead of the hopelessness people are usually dealt when their vet tells them that their dog may have the disease.

“Incurable,” “paralysis,” “three-to-six months” and “euthanasia,” are all words often used in a diagnosis of DM and together they represent the worst-case scenario. My dog Daley’s vet summed it up like this: There’s nothing you can do.

The good news is that’s not true.

Okay, time for the definitions. But I promise I’ll get back to the good news soon.

Degenerative Myelopathy is an incurable spinal cord disease that targets older dogs. DM first causes weakness in the back legs, then lack of coordination in the hind end and eventually paralysis. DM causes its damage to the spinal cord by first deteriorating the myelin that insulates the nerves. Then DM wears on the nerves themselves, which disrupts their workings. The degeneration of the nerves in the spinal cord continues until they can no longer transmit communications between the brain and the muscles in the back legs and the hind end becomes paralyzed.

The Merck Veterinary Manual estimates that from the onset of the disease, it can take anywhere from six to 36 months for a dog to become paraplegic. Eventually, the impact of DM also leads to weakness in the front legs and finally, respiratory failure.

DM was first clinically described in 1973. For decades, very little was known about the disease other than it was believed to be an autoimmune disorder that only targeted German Shepherds and could be compared to Multiple Sclerosis in humans. However, we know now that DM does affect several other large breeds (pure and mixes) as well as small breeds, notably Pembroke Welsh Corgis. DM occurs in both male and female dogs and studies say dogs are usually 8 years or older when the first symptoms appear.

There is a genetic test available now that will determine if your dog carries the gene for DM or is at risk for developing the disease. The cost is $65 but the test isoffered free of charge to certain breeds of dogs who are 10 years or older.

But it’s crucial to have your dog thoroughly examined if you suspect that he has DM. There are other issues that can affect the spinal cord, such as a herniated disk, and those need to be ruled out before you proceed with a working diagnosis of DM. I say “working” diagnosis because currently DM can still only be definitively diagnosed in a dog through a post-mortem examination of the spinal cord.

The Canine Genetic Diseases Network run by the University of Missouri’s College of Veterinary Medicine offers an easy-to-understand medical description of DM that includes key diagnosis information as well as information on the genetic test for DM. http://www.caninegeneticdiseases.net/DM/basicDM.htm

Okay, time for the good news.

Recent studies have revealed much about DM. Research that found that DM appears to be a genetic disease led to the announcement in early 2009 that DM is caused by the very same genetic mutation that causes Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s Disease, in humans. Researchers are now working to figure out why the genetic mutation takes place and all the particular factors that trigger DM. Hopefully the connection between the two diseases will speed up efforts to find effective treatments for both DM and ALS.

While presently there is no cure for DM and there is no getting around the fact that it will progress to specific ends, the advancement of the disease is unpredictable and differs from dog to dog. So each dog will ultimately have his own particular experience with DM and it is possible, in several ways, to shape that experience.

Degenerative Myelopathy is believed to be painless so if you and your dog are willing and able to embark on a dedicated care routine — and any other existing health issues can be managed — DM’s progression can be navigated and you and your dog can enjoy a quality life together along the way.

There is no specific treatment advocated for DM but a care routine that focuses on appropriate exercise, physical rehabilitation and diet is widely recommended, both by veterinarians who are familiar with DM and dog owners who have experience with the disease.

A study of 22 dogs with DM published in 2006 showed that a combination of “gait exercise, massage, passive joint movement and hydrotherapy” substantially increased their survival time. The study found that:

Dogs who received what was considered “intensive physiotherapy” survived, on average, 255 days from the start of the study.

Dogs who received “moderate physiotherapy” had an average survival time of 130 days from the start of the study.

Dogs who received no physiotherapy had an average survival time of 55 days.

For a good overview of DM and an introduction to physical rehabilitation for dogs, check out the AKC Canine Health Foundation video, “How to Care for a dog with Degenerative Myelopathy.” The video includes action shots of dogs in the different stages of DM. http://www.akcchf.org/news-events/multimedia/video/how-to-care-for-a-dog-with-degenerative-myelopathy.html

Once your dog starts having trouble walking, there are fantastic mobility aids available for a range of issues. Several products, including the Help ‘Em Up Harness and the offerings at Eddie’s Wheels, are particularly helpful for dogs with DM.

In the next two parts of this series on DM, I’ll talk about how to recognize the symptoms of the disease, how to move forward from the initial shock of a DM diagnosis, how to put together a care team for your dog, how to adapt to a DM lifestyle and how to remember to have fun!

To wrap up this introduction to DM, below are links to the studies I’ve referenced and resources that provide additional specifics on the nature of the disease. Some include care suggestions. There is a mix between information from doctors and researchers and sites run by dog owners.

Research studies:

“Genome-wide association analysis reveals a SOD1 mutation in canine degenerative myelopathy that resembles amyotrophic lateral sclerosis,” published 2.2.09 by Proceedings of the National Academy of Sciences of the United States of America http://www.pnas.org/cgi/doi/10.1073/pnas.0812297106

“Daily Controlled Physiotherapy Increases Survival Time in Dogs with Suspected Degenerative Myelopathy,” published July 2006 by the Journal of Veterinary Internal Medicine and posted here by Scout’s House, a physical rehabilitation center for animals. http://www.scoutshouse.com/wp-content/uploads/2009/12/RehabTherapyandDM.pdf

Resources:

American Kennel Club Canine Health Foundation is a charitable organization that raises money for canine health research. The research section of the site lists grants and current studies underway. Degenerative Myelopathy is in the Neurology section.http://www.akcchf.org

Canine Genetic Diseases Network http://www.caninegeneticdiseases.net/CGD_main.htm

The Merck Veterinary Manual http://www.merckvetmanual.com/mvm/index.jsp

The Degenerative Myelopathy List on Yahoo is a support group of more than 1200 people. Members post questions, share tips, talk about research and offer support to one another on a daily basis. You must have a Yahoo account to access the list, but it’s free to sign up for one. http://pets.groups.yahoo.com/group/degenerativemyelopathylist/

Marjorie Zimmerman’s web site is dedicated to her German Shepherd Jack Flash. Since she lost Jack Flash to DM in 1998, Zimmerman has worked to educate people about DM and has focused on efforts to find the cause and cure for DM. Hers is the first site people usually find when they begin their research into DM and it offers a wealth of information.http://www.mzjf.com/

Readings:

“Researchers Genetically Link Lou Gehrig’s disease in Humans to Dog Disease: Discovery could help identify therapy for humans and dogs” http://www.cvm.missouri.edu/news/coates09.html

“ALS, MS, MD — What’s the difference?” By Charles Plank. Published by The Center for Neurologic Study. http://www.cnsonline.org/www/archive/ms/ms-04.html

“Degenerative Myelopathy – diagnosis and treatment (proceedings)” by Joan R. Coates, DVM, MS, DACVIM (neurology). Coates is part of the team who has made several recent advances in DM research. http://veterinarycalendar.dvm360.com/avhc/Medicine/Degenerative-myelopathy-ndash-diagnosis-and-treatm/ArticleStandard/Article/detail/651356

Mobility Aids:

The “Help ‘Em Up Harness” with “Hip Lift” http://www.helpemup.com/

Custom made wheelchairs for disabled pets http://www.eddieswheels.com/

Tips from DM Dog Caregivers:

MaryBeth Alence Teicholz, whose Boxer, Clancy, is featured in “Senior Stories: Handsome Clancy and His Hot Wheels,” shares her instructions on how to customize boots for a dog who may need to use a cart but still has some use of his back legs. The idea is that with the boots affixed to the cart, the dog can continue to exercise his muscles without scraping his paws.

You can find MaryBeth’s instructions, titled “Clancy’s Pawz Shoe Goo Boots” and “Clancy’s Robo Boot Instructions” in the Files section of the Degenerative Myelopathy List on Yahoo. You must have a Yahoo account to access the list, but it’s free to sign up for one. http://pets.groups.yahoo.com/group/degenerativemyelopathylist/.

MaryBeth has posted photos to accompany the instructions inside the Clancy album of the list’s Photos section. You can watch video of Clancy and his Robo Boots in action here.

On MyDogHasDM.com Josh offers regular accounts of how he and his 10-year-old Boxer, Wrangler, negotiated the disease plus photos and videos of their adventures together in Vancouver, Canada as well as guest posts from other caregivers. Find MyDogHasDM.com here or on Facebook here. When you have time, read the recent post featuring Clancy’s mom’s article, “Dogs aren’t people too, but they deserve the same love,” here.

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