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Degenerative Myelopathy in a German Shepherd Io, a 12 year old German Shepherd, has been a patient at Paws of the Rockies Animal Hospital for nearly three years. Io first came to our hospital when he was 9 years old and has been seen regularly for his annual examinations and preventative vaccination and heartworm care. In the years that we have been caring for Io, we have seen him for gradual worsening arthritis in the hind legs. About 1 year ago, Io came in to the hospital for a sudden onset of weakness and pain in the hips. He seemed to have incoordination while walking and was falling when attempting to climb stairs. Io’s physical exam showed that he was stiff in his hips and could not extend his hips fully. Io was also knuckling and slightly dragging his hind legs when attempting to stand and walk. When he did walk, he seemed to have a stagger. Io was started on prednisone, a steroid, and referred to a neurologist. Io was seen at a neurologist and a suspected case of degenerative myelopathy of German shepherds was diagnosed. Io was placed on 2000 IU of vitamin E as well as the prednisone. After several months of therapy on the prednisone and vitamin E, there was no real improvement that the owner could see. Io’s owner decided to try acupuncture in an effort to exhaust all the possible treatment options. Io was first seen weekly for 5 sessions of acupuncture. Then Io was seen every 2 weeks for 2 months. We now see Io on a monthly basis for acupuncture treatment.
Early symptoms include ataxia (stagger or drunken walk), and weakness of the hind legs. The onset is quite insidious, and an owner may confuse the early signs of degenerative myelopathy for hip arthritis. Knuckling of the feet and dragging of the toes and an incoordination of the gait are very common signs. The hind legs may actually cross when the patient walks and the hind end may sway during walks. If an animal is forced to turn quickly, a dog may fall in an outward direction. Degenerative myelopathy affects both hind legs at the same time, however one leg may appear worse than the other. These animals are very healthy in all other respects. Diagnosis of degenerative myelopathy is made through exclusion of other diseases of the spinal cord. There is not one definitive test for this disease. Although radiographs (x-rays), myelograms, MRI and CSF (cerebrospinal fluid) sampling may be performed, diagnosis is generally based on symptoms.
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Io has been on joint supplements for quite some time which have helped to keep his arthritis under control and reduce his stiffness. Once his arthritis significantly worsened, he was placed on non-steroidal anti-inflammatory medication to reduce his pain and improve his comfort and mobility.
Degenerative myelopathy is a slowly progressive degenerative disease involving the middle to the tail end of the spinal cord. The disease was first diagnosed in 1973 and appears to affect older German shepherd dogs. These dogs are usually 6-9 years of age when symptoms are first recognized, however dogs as young as 4 years of age have been diagnosed. It occurs almost exclusively in large breed dogs, however similar syndromes have been seen in other breeds. The cause of degenerative myelopathy is unknown. Some theories suggest that this is a nutritional deficiency, while others insist that it is an immune disorder similar to multiple sclerosis in humans. Since German shepherds are the most common breed to be affected, clearly genetics play a role.
Because the cause is unknown, no specific treatment is available. Patients generally respond poorly to steroids, nonsteroidal anti-inflammatory medications, and nutritional supplementation. In Io’s case, he has responded well to acupuncture. This is possibly because of the stimulation of the spinal cord and peripheral nerves to the hind legs. Acupuncture may also be improving blood flow to the hind legs. Finally, acupuncture can be anti-inflammatory, which may be a reason to the response seen with Io. Io’s owner set realistic goals for his response to acupuncture. Io’s owner really wanted him to be able to go on short walks without problems. She also wanted him to be able to get his “car legs” back. He was having a very difficult time maintaining his balance while he was going for car rides. Io’s owner has been very pleased with his response. While he still does have an abnormal stance and gait, he is able to get around well. He has regained his ”car legs” and can go with his owner on car rides. Io’s condition has stabilized to a point where his owner feels he can be maintained on monthly acupuncture treatments. He does still receive daily glucosamine supplementation as well as Rimadyl, a common NSAID medication for his arthritis. Io’s owner is very pleased because she has been given valuable, quality time with Io beyond what was expected.