degenerative mylopathy

[Sandy2650]

My male ridgeback has been diagnosed with possible DM. No blood tests have been done to confirm. What is the best thing I can do to keep him mobile? Are there any nutritional supplements that might help him stay mobile?

[Jim Humphries, B.S., D.V.M.]

First let me say how sorry I am to hear this.  Two years ago I had to put our sweet Corgi to sleep because of this.  She was active and normal for 10 years, then we began to notice a bit of ataxia or "wobbliness" in her rear legs.  I assumed she had an IV Disc bulge.  After X-rays and MRI showed spine okay we came to the realization after watching her deteriorate it was Degenerative Myelopathy.  It also happens at various ages and rates of progression.  One day our dog was walking and playing our 40 acres, and the next day she was wobbly.  Months later she should not hold herself up.

DM is a diagnosis of EXCLUSION.  I.E. there is NO test for it.  You rule out all other things and watch signs develop and make the diagnosis based on rule outs and symptoms.  (Also certain breeds are highly suspect like Corgis, German Shepherds and unfortunately more breeds are being added to the list as it appears to be an inherited disease).   I personally know many families with Corgis that have developed DM just within my personal circle of friends.  It is very sad and the Corgis breeders are in a bit of a pickle.  Money is now being donated to various veterinary medical schools to learn of both the genetics and the patho-physiology of this disease.  

IF IT IS DM...The bad news is there is no cure.  The disease will progress.  He will eventually need a wheel chair and then will eventually not be able to control his bladder and bowls.  When our dog began to loose her "quality of life" we made the extraordinarily hard decision to put her down.  

Some veterinarians will simply put the dog on steroids (dexamethsone), however I can tell you it does not do much good (and they will pee a lot more!).  There is a veterinary neurologist in Florida that has formulated a mixture of two oral medications.  Frankly I did not know if they would work or not - but I tried everything.  These meds did seem to help her for a while.  We believe it was worth the cost and the trouble.  You will need to work with a pharmacy in Florida that will formulate these for you and they mail them to you every month.  

I have found that the average for a Corgi to completely go down after diagnosis is 6 months to perhaps a year.  Our Penny lasted 2 years!  So maybe the meds helped.  Or maybe we were "lucky" on the speed of progression.  

WITH big dogs it is more severe because you can't just pick them up and easily take them out, put them in their cart and do other normal nursing care things.  And the carts for large dogs are huge.  So it becomes a matter of managing the paralysis as practically as you can.    
  
You will need a good relationship with your DVM in terms of meds, nursing care, finding the right wheel chair for him, etc.  You can always post here and I'll do what I can to help you.  Clearly I have a soft spot in my heart for dogs with this horrible problem.  

You need to read and study this site!  

http://neuro.vetmed.ufl.edu/neuro/DM_Web/DMofGS.htm

Don't let all the supplements and diet info throw you.  You can follow this advice, or you can feed a high quality commercial food (as I did) and she lasted 2 to 4 times her life expectancy.  As you get to the bottom of the site you will see a reference to WestLab.  They are very nice and if you call them they are very used to helping dog lovers with this problem.  As he says in his site:  Over the last 2 decades, we have found 2 medications which appear to prevent progression or result in clinical remission of DM in many (up to 80%) of the patients.  I believe that is true.  These medications are aminocaproic acid (EACA) and n-acetylcysteine (NAC).  

Acetylcysteine is a potent anti-oxidant which has powerful neuroprotective effects.  The combination of aminocaproic acid, N-acetylcysteine, dietary supplements and exercise is the best treatment we have been able to discover to date. It corrects those aspects of the immune dysfunction which we can treat, based upon our belief that DM is an immune-mediated inflammatory disease.

Don't worry about the chemical names.  These two meds is what you have to use orally every day.  

I'm sure today there are even more resources on DM on the net.  Google it and learn to do all you can do for him.  

I hope we can find a cure to this disease soon.  But the Corgi world is "a buzz" about this because it is all through their dogs.  The Shepherd folks have known about it for some time.  

If I can help anymore, please let me know.  

[Jim Humphries, B.S., D.V.M.]

Please keep us posted.  This will be hard to go through as there is no cure.  He will progress in his inability to control bladder and bowls, stand and get up.  As long as life is manageable then you will do all the good nursing care you can for him.  The slow progression of this awful disease makes it hard, but you will know when it is time.  

You might want to start checking on the carts.  check k9-carts.com and at least consider this if he looses the ability to walk completely.  With big dogs it is much harder to manage.  

good luck and keep us posted.

[Sandy2650]

Thank you so much for your help. I do have my Ridgeback on aminocaproic acid . I did not know about n-acetylcysteine. I'll check it out and let my vet know. She has really been great through this. I have a friend who is a Ridgeback breeder and they have recently found that DM is very prominent in Ridgebacks now also. I will share your comments with her.