Degenerative Myelopathy (DM), An UN-Nerving Disease. Here is Oliver's story:
Christina Lehner
Here is bright-eyed & still-spry super senior 12 year old “Oliver”. Nearly a year ago, he was diagnosed with Degenerative myelopathy (AKA DM).
DM is a slowly progressive, neurodegenerative disease that affects the spinal cord and thus a dog's ability to walk. Although not exactly the same as ALS or Lou Gehrig’s disease, it has similar manifestations. It is caused by a DNA mutation and there is a DNA saliva test to screen for this mutated gene. On a structural level, myelin, which surrounds the nerve fibers & carries signals to the muscles of the body, degenerates and this results in a lack of coordination and communication so the nerve’s signals to move are not “heard” by the muscles. It typically begins in the mid to lower spinal cord, and progresses up. Visually, progressive weakness & lack of coordination of the hind legs is noticed first: toe scuffing when walking (wearing of the toe nail tops), dragging rear feet, unsteady gait, etc. In time, muscle atrophy (weakness), and paralysis of the hindlegs occurs. Many pets also become incontinent. It will eventually move upwards along the spinal cord can eventually affect the muscles that innervate the chest cavity and thereby affects breathing and front limb muscles. Most pets are euthanatized before this occurs, and most within by 12 months of initial diagnosis-- but Oliver is defying the majority...and hopefully your pet will too!
Oliver’s timeline of DM Progression: Here is Oliver’s progression, but keep in mind each situation is different, based upon rate of progression and where the degeneration first began.
-11 months ago: Oliver was showing signs of hind leg weakness, it seemed like the Left rear leg was weaker than the Right in general
-8 months ago: Oliver became paralyzed in his hindlegs. He would still “push” or paddle with his back paws occasionally
-7 months ago: Oliver’s family began acupuncture and chiropractic therapy- doing 2 sessions of each monthly
-6 weeks ago: Oliver began defacating more in the house, right now it is a few times a week that he will have an accident. He has only had a few urinary accidents.
-2 weeks ago: Oliver’s family decided to get him a cart- it is currently being made. He stills wants to run and be active, so hopefully the wheelchair will be a great way for him to continue to do the things he loves!
Oliver still loves to be engaged mentally- he loves his treats and chasing bunnies outside. His family supports him with a sling and tries to encourage him to use his legs as much as possible. He loves massage & his mom gently does range of motion on his legs. He still goes for walks daily, and is known to pull his mom (as she holds his back legs up in a sling) as he chases after bunnies!
Fortunately, dogs with DM do not appear to be in pain, however because there is weakness in muscle groups, it can cause strain on the healthy muscles and joints, so joint supplements and arthritic pain control, as well as massage & chiropractice care may be helpful.
Unfortunately no treatment has been shown to reverse the signs, but one study concluded:
“affected dogs which received physiotherapy remained ambulatory longer than did animals that did not receive physical treatment.”
By keeping the nerves stimulated & maintaining muscle mass as much as possible, progression may be slowed & quality of life maintained. In Oliver's situation, and as a veterinarian, I am impressed with how much quality of life, muscle tone, and function he has maintained. Here is a list of helpful ideas:
- Exercise such as walking and swimming should be encouraged
- Keep your pet mentally engaged as much as possible & learn to play interactive games with them
- Gentle passive range of motion exercises can be so helpful in keeping the joints lubricated
- Easy, partially or completely supported balance drills: This can be done on grass or other soft surface, with a slight deviation in the ground surface to encourage balance (a treat to focus on with these exercises is a great way to encourage participation from your furry friend!)
- Booties over the toes may be helpful to prevent them from further scuffing
- Acupuncture, which encourages stimulation of the nerves, has been shown to help slow down progression
- Use carpet runners, ramps, etc to allow for extra grip on slippery floors
- Make sure soft bedding is available, and that you are rotating your pet frequently to stave off pressure sores
- Urine leaking and bowel control are common as paralysis sets in, close attention to this & aiding in cleaning your pet is important
- Once the dog reaches the non-ambulatory state, pressure sores, urine leaking, and loss of bowel control are likely to occur—so close attention to cleaning the surroundings and your pet are needed