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Degenerative Myelopathy

Summary:
Degenerative Myelopathy is thought to be an autoimmune disorder in which the patient's own immune system attacks their central nervous system.  The immune attack leads to the loss of myelin (insulin around nerve fibers) and axons (nerve fibers).   When nerves do not have myelin, they cannot conduct neurologic signals, and the muscles and organs they innervate cannot function properly.  Degenerative Myelopathy (DM) in dogs is like Multiple Sclerosis (MS) in people and has a similar course of disease.  The patients may start to initially stumble or drag a foot.  The disease typically progresses in a waxing and waning fashion with the weakness and poor coordination leading to paralysis of the rear legs. DM is not thought to be a painful condition, but pets can get distressed by their lack of mobility.  Most patients are euthanized within 1 year of diagnosis because their rear limb paralysis greatly decreases their quality of life. 
Diagnosis:
A diagnosis of DM is made by a history of progressive weakness in the rear legs.  Often these signs can mimic other disease conditions such as Type II Disk Disease or a growth in the spinal cord.  An x-ray of the back and an MRI of the spinal cord can help rule out other disk or spinal cord problems. 
The Orthopedic Foundation for Animals offers a genetic test for dogs to help determine if a dog has the genetic propensity to develop DM.  It is important to note that not all dogs that test "At Risk" for DM will develop DM.  Also, there are some dogs with DM that show up negative on the test.  If a dog tests "At Risk" for DM, AND is showing clinical signs of the disease, a diagnosis of DM is made.  A test result of "At Risk" means that the dog is carrying the genetic defect leading to DM from BOTH their mother and father.  If they have just one set of genetic markers, then the dog is considered a carrier of the disease, but will likely not develop it.  Click here for information on how to interpret the DM genetic test.
Click here to read the research article on the DM test
Click here to purchase the DM test.  This is a cheek swab that is performed at home and sent to OFA.
Treatment:
1.) Rehabilitation Therapy
The only treatment that has been proven to be effective in the management of DM is rehabilitaton therapy (like physical therapy for humans).  Click here for a research abstract regarding rehabilitation therapy for DM.  
2.) Nutritional Supplements
Nutritional supplements and home-made diets aimed at reducing inflammation and the circulation of free radicals in the body are recommended by many neurologists for management of this disease.  It is important to note that use of these nutritional supplements has shown improvement only anecdotely, and has not been seen to be effective in clinical trials. 
Click here for an abstract showing that medication and nutritional supplementaiton was not helpful in treating DM.
Click here if you are interested in using nutritional supplements and a home-made diet as part of the management program for your dog with DM. This article was written by Dr. R.M. Clemmons, a well respected veterinary neurologist.   

Click here for more information on dosing and sourcing nutritional supplements

3.) Medication
Two medications have been offered up as part of a treatment regiment for DM.  Neither medication has been shown to be effective in clinical trials, but anecdotely they have been shown to be helpful. 
Aminocaproic acid: This medication is being used for it's anti-inflammatory properties.  The dosage is 10-15mg/kg every 8 hours. 
Acetylcysteine: This medication is considered an antioxident with neuroprotective effects.  The dosage is 25mg/kg given every 8 hours.  

If you are interested in using these medications, work with your veterinarian to have the medications compounded for your dog.
4.) Acupuncture
Acupuncture has been reported to be helpful in treating pets with DM.  Click here to read about medical acupuncture with Dr. Teresa Hershey
5.) Mobility Aids
As your dog's mobility declines, mobility aids such as the ones listed below, can help your dog stay mobile longer.
Biko Brace
Power Paws
Dr. Buzby's toe grips
Help em up Harness

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