Introduction
Canine degenerative myelopathy (DM) is a disease primarily seen in certain breeds of purebred dogs. It disrupts the normal communication pathways between the brain and the spinal cord, causing eventual pelvic paralysis and possible paralysis in all limbs. There is no cure or even any effective proven treatment currently available for canine DM. However, there are things that can be tried to help delay progression of the disease and thereby improve affected dogs’ quality of life.
Treating Canine Degenerative Myelopathy
Supportive Care
Meticulous nursing care is the best available therapy for canine DM. Smaller breeds may survive longer because administration of supportive care is much easier for their owners than it is for owners of large or giant breed dogs. Once a dog becomes unable to rise and walk (becomes recumbent or nonambulatory), owners must take a number of steps to provide supportive care. At home, dogs will need to be turned frequently to prevent pressure sores and possible lung collapse (called “atelectasis”). They will need extremely well-padded bedding, such as an air mattress, waterbed, lounge chair pad, regular human bed mattress, fleeces, sleeping bags, blankets, straw or other lofty and soft forms of bedding to lie on. The outer surface layers of bedding will need to be changed - and the dog will need to be cleaned and dried – frequently, in order to delay muscle atrophy and prevent urine scalding, skin ulceration and other lesions caused by urinary and/or fecal incontinence that can lead to nasty secondary infections. In long-haired breeds, the hair under the tail and around the rear end should be trimmed. Owners should manage their dogs’ diet to avoid excessive weight gain.
Physical Therapy
Exercise and other forms of physical therapy are very important to help delay the onset of disuse muscle atrophy associated with DM and to help affected dogs maintain mobility and strength in their pelvic limbs. This commonly involves what are called “range of motion” exercises (passive stretching and flexing of the rear legs by hand in a regular pattern). Activity seems to slow the progression of the disease, and as a result with regular physical therapy affected dogs are able to maintain strength, balance and the ability to walk for a longer period of time. Recently, hydrotherapy also has proven to be beneficial for dogs with this disease. This involves swimming exercises, underwater treadmill use and other techniques that help the dog exercise and use its muscles.
A viable management option for dogs that have lost mobility in their pelvic limbs is the use of a wheel cart – essentially, a wheelchair for dogs. As long as the dog is able to use its front legs normally, a wheel cart will keep it comfortable and mobile. Once the front limbs are severely affected, a wheel cart cannot be used. Your veterinarian can help you find a wheel cart suited to your particular dog.
Medication
No drug has proven effective in slowing or stopping progression of canine DM, including corticosteroids and other types of immunosuppressive medications. Vitamins and omega-3 fatty acid supplementation have been advocated as potential therapies but are not yet proven. Vitamin E, vitamin B complex and vitamin C are under investigation as possibly useful supplements for the management of this disease. Their efficacy also is unknown. Other chemical therapies are being studied, including administration of aminocaproic acid and the potent antioxidant, acetylcysteine. These experimental treatments have certain adverse side effects, are expensive and may require long-term use. Still, if no other treatment protocol helps a particular dog, these unproven “treatments” may be considered. Of course, a veterinarian is the only one able to assess and decide upon the right treatment regimen for an affected dog.