Degenerative Myelopathy (DM)

Degenerative Myelopathy(DM), is also known as Chronic Degenerative Radiculomyelopathy (CDRM) is a progressive disease which affects the spinal cord, resulting in slowly progressing hind limb weakness and eventually paralysis.

 

What is DM and how does it progress?

DM is Degenerative Myelopathy and is often referred to as the canine version of ALS (Lou Gehrig’s disease). It is progressive disease that eventually becomes fatal. The disease progresses slowly, however research shows that dogs typically lose the ability to walk 6-9 months after the start of symptoms. It can progress from hind limb paralysis to front limb paralysis, loss of bowel and bladder control, as well as difficulty swallowing or breathing.

 

Signs and Symptoms

Early to intermediate stages:

-Loss of coordination in hind limbs- Wearing down the top of the toenails due to dragging the hind feet-Bearing weight through the knuckles instead of the pads-Difficulty getting up from a lying position-Difficulty climbing stairs, walking or getting into the car-Urinary or fecal incontinent

As they move to more advanced stages, DM leads to paraplegia or paralysis of the hind limbs as well as weakness in the front limbs. While it can be troubling to see your pup struggle with daily activities, know that it is not a painful disease, but weakness is the main problem.

 

How is it diagnosed and what breeds are mostly affected?

DM is a diagnosis of exclusion, meaning the only way to diagnose it is by ruling out other. Other conditions to rule out include IVDD, trauma, infection, tumor, hip dysplasia and arthritis. This is often done via diagnostic testing including blood and urine testing, advanced imaging (MRI/CT), physical and neurological exam by your veterinarian. There is a gene that is often associated with DM, so that is often tested by your veterinarian. The only way to definitively diagnose DM is through a spinal cord biopsy, which can only be completed post-mortem.

It is an inherited disease, no exact cause is known. Typically, middle aged and older dogs are affected the most, as symptoms start to progress. Breeds most commonly affected include German Shepherds, Chesapeake Bay Retrievers, Boxers, Welsh Corgis, Bernese Mountain Dogs among others.

Typical age of diagnosis is between 5-14 years old.

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How is it treated and will rehab help?

Currently, there is no cure for the disease, however there is some research to support the use of intensive physical rehabilitation as a means of increasing the lifespan, especially when integrated early on in the progression. Rehabilitation combined with paw protection, nursing care, pressure sore prevention, and urinary infection monitoring can all improve the quality of life. To aid with mobility you may consider the use of adaptive equipment such as slings, harnesses, booties and doggy wheelchairs. Please remember the disease process itself it not painful, it is just a loss of motor control, but watching the dog declines very challenging for you as the pet parent. If you are caring for a dog with DM, know that you are not alone, please consider different coping methods including joining online support group or speaking with a mental health professional who address grief resulting from pet loss.

Research shows the use of therapy and modalities helped to delay the progression of the disease, but every dog and situation is different. Therapy is no guarantee that the disease will progress slower, but it will help your pup stay strong for as long as possible.

What does rehab look like

Rehab will focus on maintaining proper range of motion and maintaining the current level of strength. It will focus on exercise, massage, stretching and assisted walking as well as assistive device management. We may use modalities such as laser or PEMF.

During our evaluation, we determine what exercises should be done and walk you through the exercises. Within 48 hours of the evaluation, we will send you a link to a portal that has the prescribed pictures and videos for you to continue to do exercises at home. THE HOME EXERCISE PROGRAM IS THE BIGGEST COMPONENT OF SUCCESS. CARRYOVER IS ESSENTIAL.

Every case and situation is different, and rehab is expensive. We encourage you to do an evaluation and determine what you’re able to do at home and what is financially feasible. Weekly or monthly visits may be appropriate.

We do offer wheelchair rentals for $25/month and Help ‘em up harnesses for $25 month. Both have the option to purchase with rental payments going towards the purchase if that is the way you want to go. There is no pressure either way. This is a difficult time and a difficult decision and we want to help your pup be as mobile as possible for as long as possible.

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