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Degenerative Myelopathy

By: Dr. Arnold Plotnick

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Degenerative myelopathy is a slow, progressive spinal cord disorder of unknown cause that is most commonly seen in aging German shepherds and a few other large breeds of dogs. Effective therapy has not been reported. Most dogs deteriorate over the course of 6 to 12 months and are eventually euthanized.

The cause of the condition is unknown, although it is believed to be an autoimmune disease – a condition in which the body's immune system begins to attack its own nerve cells. The age of onset is 5 to 14 years, with an average age of 9 years. Males are affected more than females.

The disorder is seen almost exclusively in German shepherds, although it has been diagnosed in a few other large breed dogs, such as Belgian shepherds, Rhodesian ridgebacks, standard poodle, Boxer, Chesapeake Bay retriever, Irish Setter, collies and Weimaraners. Other breeds affected include Pembroke and Cardigan Welsh corgi. The high incidence in German shepherds suggests a genetic basis for the disease.

The disease is slowly progressive. Affected dogs get progressively weaker and more uncoordinated as the disease process progresses. Many dogs progress over 4 to 6 months from the time of initial diagnosis.

What to Watch For

  • Progressive weakness of the hind limbs
  • Dragging nails
  • Difficulty rising
  • Difficulty jumping
  • Stumbling
  • Knuckling of the toes
  • Wearing of the inner digits of the rear paws
  • Loss of muscle in the rear legs
  • Tremors of rear legs
  • Eventual urinary and fecal incontinence
  • The front legs can be affected in late stages of the disease

    Diagnosis

    Diagnostic tests are needed to identify degenerative myelopathy and rule out other diseases with similar clinical symptoms. Diagnostic tests include:

  • Complete medical history and physical examination. Degenerative myelopathy should be suspected in any middle aged German shepherd with progressive weakness and loss of coordination in the rear legs.

  • A complete neurologic examination including assessment reflexes and pain sensation is key to making a diagnosis of degenerative myelopathy.

  • Routine x-rays should be taken to rule out orthopedic problems that may have similar signs.

  • X-ray contrast studies in which a dye is injected around the spinal cord may be necessary to rule out other causes of progressive weakness and loss of coordination.

  • A spinal tap may give some useful information for making a diagnosis.

    Treatment

    There is no effective treatment for degenerative myelopathy. A few treatments have been recommended, but no controlled studies have been performed to show any proven benefit.

    These treatments include:

  • Vitamins and other supplements
  • Aminocaproic acid
  • N-acetylcysteine
  • Glucocorticoids
  • Special homemade diet
  • Exercise and physical therapy program
  • Excellent nursing care including padded surfaces, slings, good traction and keeping your dog clean and dry.

    Home Care

    Give all medications and supplements as prescribed. Exercise appears to be helpful in delaying the progression of the disease. Dogs should be placed on an increasing, alternate-day exercise program including walking and swimming, if possible.

                                                                    

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