I mentioned degenerative myelopathy in a post last week and then got to thinking that I should have done more to explain the condition. So, here’s the information that my practice provides to the owners of dogs that have been diagnosed with the condition.
What is degenerative myelopathy?
Degenerative myelopathy of dogs is a slowly progressive, non-inflammatory degeneration of the white matter of the spinal cord. It is most common in German Shepherd Dogs and Welsh Corgis, but is occasionally recognized in other breeds. The cause is unknown, although genetic factors are suspected.
Affected dogs are usually greater than 5-years-old and develop non-painful weakness of the hind legs that causes an unsteady gait. Early cases may be confused with orthopedic injuries; however, proprioceptive deficits (inability to sense where the limbs are in space) are an early feature of degenerative myelopathy and are not seen in orthopedic disease. Signs slowly progress to paralysis of the back end of the body over 6-36 months, although severity of signs may fluctuate. An MRI or CSF analysis is performed to rule out other causes of spinal cord dysfunction.
How is degenerative myelopathy treated?
Treatment with aminocaproic acid, vitamin supplements, and exercise has been recommended, but the safety and efficacy of these treatments has not been documented. Physical therapy, acupuncture, or supportive casts/braces may also be beneficial.
What symptoms can present as degenerative myelopathy progresses?
- Progressive weakness of the hind limbs
- Worn nails
- Difficulty rising
- Knuckling of the toes
- Scuffing hind feet
- Wearing of the inner digits of the rear paws
- Loss of muscle in the rear legs
- Tremors of the rear legs
- Persistent early stages
- Urinary and fecal incontinence
- Eventual front leg weakness from compensatory strain
- Mental stress and anxiety
- Pressure sores on boney prominences
- Inability to rise
- Muscle atrophy
- Poor hygiene - soiled appearance
- Organ failure
Crisis — Immediate veterinary assistance needed regardless of the disease
- Difficulty breathing
- Prolonged seizures
- Uncontrollable vomiting/diarrhea
- Sudden collapse
- Profuse bleeding — internal or external
- Crying/whining from pain*
* It should be noted that most animals will instinctually hide their pain. Vocalization of any sort that is out of the ordinary for your pet may indicate that their pain and anxiety has become too much for them to bear. If your pet vocalizes due to pain or anxiety, please consult with your tending veterinarian immediately.
What is the prognosis for degenerative myelopathy?
The long-term prognosis is poor and most animals are euthanized within 6 months to 3 years of diagnosis as the disease progresses. When the patient can no longer walk, and mobility carts are not an option, long-term hospice care or euthanasia should be considered.
A personalized treatment plan is important to slow the progression of degenerative myelopathy and maintain quality of life. Talk to your veterinarian regarding the best treatment protocol for your pet.
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Dr. Jennifer Coates