Hello Friends of Scout’s House,
Well, the leaves are turning color and the smell of fall is in the air—time for the Autumn newsletter from Scout’s House.
In this issue, we take a look at degenerative myelopathy (DM), an all-too-common neurological disease in dogs that’s similar to Lou Gehrig’s disease (ALS) in humans—and every bit as heartbreaking. What are the symptoms of DM? Is it possible your dog has been misdiagnosed with DM? Are researchers close to finding a cure? Read on to find out.
And “In The Spotlight” this issue features some hard-won wisdom about dealing with DM from our longtime client Lila Lippow, who used remarkable creativity to help her Corgi Jack deal with the debilitating effects of the disease.
As always, if you have any questions about your pet’s special needs, please let us hear from you.
We’re here to help—and heal!
What is Degenerative Myelopathy?
Degenerative myelopathy, or DM, is a progressive neurodegenerative disease that affects the spinal cords of older dogs. Although it’s commonly found in Welsh Corgis, Bernese Mountain Dogs, German Shepherds, and Chesapeake Bay Retrievers, it also appears in many other breeds, including Boxers, Rhodesian Ridgebacks, Labrador Retrievers, and even mixed breed dogs.
Many people first notice something’s wrong when they hear their dog’s toenails scraping on walks, and when they looked closely at their dog’s rear feet, they see that the nails are worn down, particularly on the two middle toes. Other people report first noticing their dogs develop a wobbly walk; this is known as ataxia, which is a loss of coordination in the rear limbs.
In time, the dog’s walk will worsen, progressing to the point where his rear legs start to cross when he walks or he drags his feet or “knuckles” when he walks, which means he starts to walk on the tops of his feet. Eventually, a DM dog’s rear legs become very weak, making it difficult for the dog to stand or walk. DM is often accompanied by urinary and/or fecal incontinence, and if left to progress, the disease will affect the dog’s front legs and respiratory system as well.
Is It DM—or Something Else?
One of the most frustrating things about DM is that there’s no way to definitively diagnose it while the dog is still alive. So veterinarians usually rule out other issues that can cause similar symptoms to arrive at a DM diagnosis.
But as veterinary neurologist Dr. James Lavely of the VCA Animal Care Center in Rohnert Park, California, explained , there is a possibility that many dogs believed to have DM are actually misdiagnosed.
“Probably 50%-70% of the dogs presenting with suspected degenerative myelopathy really have chronic disk disease,” says Dr. Lavely. It’s difficult to know for sure because the presenting signs for both diseases are basically the same.
“If we see obvious signs of back pain in a dog, that would suggest intervertebral disk disease, but not every dog with IVDD will appear painful,” and it’s in that subcategory of dogs where the misdiagnosis may occur: it could be degenerative myelopathy or it could be IVDD.
Another condition that may cause similar symptoms to DM is dying back neuropathy. Dr. Lavely explains: “Degenerative myelopathy is a spinal cord disease, whereas a dying back neuropathy is a condition affecting any neuron. Specifically, a dying back neuropathy refers to any condition in which the neuronal or axon fiber (whether in the peripheral nervous system, spinal cord, or brain) dies off in an upstream, or backward, manner. So the term describes how the neuron dies off but does not necessarily indicate the cause.”
Many conditions can be dying back neuropathies, Dr. Lavely adds, such as organophosphate toxicity, thiamine deficiency, and Vitamin E deficiency. But is it possible that a dying back neuropathy could be confused with DM?
“If said dying back neuropathy is affecting the spinal cord, then yes,” Dr. Lavely says. “Initially, signs could be similar and it depends on the severity of either condition. Polyneuropathies may present for muscle weakness, stiff gait, and may have decreased reflexes, whereas with DM typically the pelvic limbs are affected and usually reflexes are normal until signs become advanced. However, if the dying back neuropathy is primarily affecting the peripheral nerves, I would be surprised as clinically polyneuropathies tend to present differently than spinal cord conditions.”
Is There A Cure?
Not yet, but Dr. Joan Coates of the College of Veterinary Medicine at the University of Missouri is currently working to establish biomarkers, or markers for the disease progression. Dr. Coates, who helped identify the genetic mutation associated with the disease, says: “Currently, there are no validated biomarkers by which to follow degenerative myelopathy. We need to develop a ‘yardstick’ to better define the histopathology, CSF findings, electrophysiologic findings, imaging findings, and functional deterioration. These markers will help us monitor the disease during therapeutic interventions.”
Along with her colleagues, Dr. Coates continues to pursue Genome Wide Association Studies to evaluate for modifying genes, work that’s being funded by the AKC Canine Health Foundation. And what happens once she’s developed that yardstick? Will she create therapeutic interventions or test those developed by other researchers?
“We are working on a proof of concept study right now,” she says, adding that she plans to collaborate with other ALS researchers in the future.
How Can You Help Your Dog?
Although there is no cure for DM, a study by I. Kathmann et al published in the Journal of Veterinary Internal Medicine reported that daily rehab therapy was effective in slowing the progress of the disease.
According to the study authors, “Results of the study reported here indicate that daily, controlled physiotherapy prolongs…survival time of affected dogs up to an average of 255 days. A physiotherapy protocol, including daily gait exercise, massage, passive joint movement, and hydrotherapy, seemed to be the most important factors in preserving ambulatory status in dogs with DM.”
To help keep your DM dog comfortable and safe, consider getting a ramp or steps for getting into cars or up onto beds or sofas, and a harness with a handle, such as the Ruff Wear Web Master or the WalkAbout rear harness, to keep him steady when he walks or to help him stand up from a sitting or prone position. And eventually, most DM dogs will benefit from protective footwear to keep them from getting sores on their feet or other traction aids to maintain mobility.
In The Spotlight
In this issue, we talk with long-time Scout’s House client, Lila Lippow, who, with her Welsh Corgi Jack, showed us just how important creativity and a positive attitude were in improving the life of a dog with DM.
SH: What was your philosophy in dealing with Jack’s DM?
Lila: When I knew that we were dealing with DM, I felt the best thing I could do for Jack was to keep his world as normal as possible. He needed to keep doing all the things that made him happy—and that was a long list! He continued to track and train in obedience, even when he was in a cart. Trips to the beach, to the park, even to the farmer’s market—every day needed to be a good day (a dog’s mental outlook is just as important as his physical well being). And when even a cart became difficult for him, we switch to a stroller. Jack was always out with people and always happy. To sum up a philosophy… Find joy in every day.
SH: What resources did you find most helpful in dealing with Jack’s DM?
Lila: One of the best resources was other people with DM dogs or those who have dealt with DM dogs. These are the people who know the answers to everyday questions, such as scuffed feet, incontinence, harnesses, carts. The best resource was perhaps an online group that I joined, and of course Scout’s House. At Scout’s House I learned so many ways to help him.
SH: Do you think rehab therapy helped Jack?
Lila: I definitely think it made a huge difference for Jack. It kept his muscles strong and his brain in tune with his legs. Jack and I used all that we learned at Scout’s House every week and developed our own daily routine that we did at home. I also started swimming him at home in a life vest in a hot tub, which I think was so beneficial to him. Even after he could no longer walk, he could swim and he was also using his legs in the underwater treadmill every week at Scout’s House. All of this kept him in great shape and up and using his cart for years. I do think it extended his life, and it gave him a great quality of life. And I have to say… Jack loved his weekly visits with Krista!
SH: What advice would you give to someone whose dog has just been diagnosed with DM?
Lila: My motto has always been “Don’t look down the road too far.” With this disease it is one day at a time. I would wake up in the morning and think “Jack is fine today, and he will be fine tomorrow.” Don’t worry about what will happen a year or two or three from now… we can’t predict that for any of us. The owner’s mental outlook is very important in dealing with DM. You need to let your dog live his life, and your purpose is to make that life as rich and full as possible. DM dogs are very special… and you need to look at this as time together that you’ll cherish.