Degenerative myelopathy (progressive rear limb weakness or paralysis) was first described in 1973. The age at onset is five to fourteen years. It has been reported in almost all large breeds of dogs.
The classic symptoms are a painless, slowly progressive rear limb weakness or paralysis. There may be discomfort due to arthritis in the hip or lower back area, but this usually improves with activity. Over days, weeks, or months the dog becomes progressively weaker as is evidenced by shuffling of the rear limbs and lack of coordination. Finally, full paralysis coupled with faecal and urinary incontinence develops.
The treatment of degenerative myelopathy involves four basic approaches:
Minimization of Stress
Exercise is extremely important in maintaining the well being of affected dogs, maximizing muscle tone, and maintaining good circulation and conditioning. This is best achieved by an increasing schedule of alternate day exercise. Since many dogs have lost muscle tone prior to their diagnosis, it is important to gradually build up their level of activity. The goal is to do aerobic exercise for thirty minutes twice a week and one hour once a week. This can begin with walking and gradually progress to a faster pace. While not all patients can reach this goal, it is important to strive to do so. Running loose on the owner’s property is not adequate exercise. Regular periods of programmed, continuous exercise are required.
It is equally important that the patient with degenerative myelopathy be allowed to rest on the day exercise is not scheduled. This will allow strained muscles and tendons to heal and will increase muscle strength. The dogs do not have to be confined but merely discouraged from any strenuous exercise on days of rest. Consistent, controlled building of muscle tone through exercise will help delay the progression of degenerative myelopathy.
Vitamin support may be useful in delaying degenerative myelopathy symptoms. Some recommend that patients receive 200 IU of vitamin E daily and one high potency B vitamin (B-1) twice daily. Synthetic vitamins are cheaper and just as effective as natural vitamins. No other supplementation of a balanced diet is needed or indicated in the treatment of degenerative myelopathy.
Degenerative myelopathy progresses at different rates in each animal. Stress plays a role in its advancement. Minimizing stressful situations is important. While anesthesia does not appear to cause problems with degenerative myelopathy, even minor invasive surgical procedures can result in a marked increase in clinical signs. Therefore, we recommend caution in considering major surgery in patients with degenerative myelopathy. The worsening caused by surgical stress can be irreversible.