Degenerative Myelopathy

Question: i have had my dog for over 9 years, she is my baby. Over the last year she has developed arthritis, which isn't that bad, but over the last month she has been deteriorating rapidly, she was diagnosed with hip dysplasia and myelin deterioration in her lower spine. In the last month she has gone from just a little pain to not being able to walk since she can no longer control her hind legs. Our vet said that she isn't in pain from this, but I hear her whimpering, prob. due to frustration. I really love her and will put her to sleep if i have to, since our vet also said that there wasn't anything we could do about it. But is there really nothing we can do about it, what about accupuncture? I just can't imagine my life without her. Is there some kind of walker for dogs, she is a 9 1/2, 75#, white german shepherd mix. any assistance would be very much appreciated. shanah

Answer: Shanah-

Dr. Ludgren at Colorado State University and the neurologists are Washington State University (I think) collaborated on a study of large breed dogs with neurologic problems affecting their rear legs. In this study, MRI exams were done in order to rule out disc disease as a problem prior to concluding that the neurologic problems present in these dogs was due to degenerative myelopathy (this is probably the disorder of myelin degeneration that is suspected). This study supported the idea that many of the cases suspected to be degenerative myelopathy are actually cases of disc disease in which the disc herniation is difficult to find using plain X-rays or myelograms, which have been the standard method of looking for disc disease in dogs. For this reason, I think that it is best, whenever possible, to consider having an MRI exam done to rule out disc disease prior to deciding that the problem is degenerative myelopathy. Your vet may want to try to contact CSU or WSU and talk to the neurologists about this. If disc disease is present, surgery to alleviate the pressure on the spinal cord from the disc may help a great deal.

Degenerative myelopathy is not very responsive to treatment. There is a published treatment protocol by Dr. Clemmons at the University of Florida in which aminocarprioc acid is administered, along with Vitamin E and some other supplements. This treatment has not produced consistent results but it doesn't seem to hurt anything to give it a try. Especially since I know of no other treatment.

If the degeneration of the hip joints is contributing significantly to the weakness from neurologic disease, it can be helpful to treat with a pain reliever/anti-inflammatory medication such as carprofen (Rimadyl Rx) or etodolac (Etogesic Rx). Helping the hips sometimes provides enough additional strength to help a great deal, at least for a while.

I don't see any harm in trying acupuncture but degenerative myelopathy is not likely to respond to acupuncture (even according to the vets I know who do acupuncture).

If your dog can adapt to the use of a cart to support the rear limbs (K-9 Carts, others), this can help even if the problem is degenerative myelopathy and nothing can be done to regain rear leg strength. We have had a German shepherd in our practice who seemed to do well with a cart. She was the only big dog I can remember anyone trying out with a cart so this is a small test sample.

Hope this helps some. If you would consider surgery, an MRI really would be a good idea. The faster you can get this done, the better the prognosis for recovery is, if a disc is involved.

Mike Richards, DVM 4/13/2000

Degenerative Myelopathy possible

Q: I have just found your web page. It was worth the search. I have an 8 1/2 year old German Shepherd Dog. He was diagnosed as having hip displasia 1 1/2 years ago. I had him x-rayed and he did in fact show signs of it. I later took Baron to another vet and he diagnosed Baron as having Spondylosis. He has been on sphingolin (1600mg per day) for a month and Rimadyl (200mg per day) for two weeks. He has continued to get worse. The drugs have had no affect. Do you have any ideas? Thanks, David

A: David- I am not familiar with the medication sphingolin. I don't think that changes my impression of the situation, though. German shepherds are very prone to degenerative myelopathy. This is a condition in which the myelin sheath around the nerves degenerates, making it difficult for the nerve transmissions to get from the brain to the muscles. A progressive weakening of the rear legs occurs. It closely resembles the symptoms of hip dysplasia and can be very difficult to distinguish from hip dysplasia. This would have to be the number one rule-out in my opinion with the history of non-response to medications. Other possible problems include spinal cord damage or tumors and other neuromuscular disorders. Spondylosis only rarely causes clinically apparent lameness. It is a good idea to try to confirm this diagnosis, as well. A veterinary neurologist would be able to evaluate Baron for both conditions. If you have a veterinary school or veterinary referral center near you ask your vet about referral for a third opinion on Baron's problem. Mike Richards, DVM

Degenerative Myelopathy

Q: Hello Dr Mike, Our 10 year old Old English Sheepdog has been diagnosed as having Degenerative Myelopathy. She is not too bad walking straight but when she turns or tries to run her legs get "mixed up". She does not appear to be in any pain and is still very lively. After an initial course of steroids (PLT) the vet advised us to gradually decrease the dose to none and then give them to her when we thought she needed them. She is coping well so far. I have read about the uses of vitamins for DM especially vitamins E, C and B, and of Evening Primrose Oil. Have you heard any reports? If so, what dosage would you suggest? I would also like to hear about your experience of dogs with DM. Thanks

A: We have seen degenerative myelopathy several times in our practice. We have tried aminocaprioic acid (Amicar Rx) and Vitamin E in combination as described by Dr. Clemmons of Florida State University. His recommendation is to use aminocaprioic acid, 500mg every 12 hours and Vitamin E, 2000 IU daily. It is necessary to work up to the high Vitamin E dosage gradually since some dogs may have diarrhea if suddenly put on this high of a dosage. Vitamin B is given at the recommended dosage for the product being used (they vary).

I have not seen a recommendation for using the other things you wrote about so I can not report on dosage or treatment methodology.

We have discussed the success of the treatment with owners of the involved dogs and among ourselves and have not reached a consensus on whether or not we think it is beneficial. Some dogs did seem to do better and others we were not sure about.