Degenerative Myelopathy: Understanding the Disease, Treatment Options, and How to know when it’s time for Euthanasia

Degenerative Myelopathy (DM) is a progressive neurological disease that affects the spinal cord of dogs, leading to a gradual loss of mobility and, eventually, paralysis. As it progresses it also causes fecal and urinary incontinence. It is most commonly seen in older dogs and is more common in certain breeds, such as German Shepherds, Boxers, Corgis, and Siberian Huskies.

Dogs with degenerative myelopathy are often diagnosed with arthritis, often because they often ALSO have arthritis, but they continue to get worse despite arthritis medications. If your dog was diagnosed with arthritis but they are also scuffing their hind nails, seem wobbly and weak when they walk (ataxia), or sometimes stand with their hind legs crossed, they may have DM.

It can be hard to know when it’s time for euthanasia with this disease. Dogs with DM are often eating great and not acting sick! However, they are often very frustrated and in significant distress from being unable to walk and incontinence. They can also become really challenging to manage especially if they are larger. I hope this guide can help you maximize your dog’s quality of life and help you make end of life decisions.

How Degenerative Myelopathy is Diagnosed

There is no definitive test for DM, but veterinarians typically follow a process of elimination:

1. Physical Examination and History – The vet assesses the dog’s walk, reflexes, and muscle tone and strength.

 

2. Genetic testing – A DNA test for SOD1 can identify dogs predisposed to DM. This is suggestive but not definitive (dogs can have the mutation and NOT have DM).

 

3. Advanced testing – MRI, X-rays, CT, and spinal taps can be performed to RULE OUT other illnesses that may resemble DM, such as tumors or herniated discs. Most of the time we don’t perform these tests because we can make a tentative diagnosis based on age, breed, and symptoms.

Treatment Options for Degenerative Myelopathy

Nothing can stop the progression of DM, but there are some things you can do to help improve your dog’s quality of life.

1. Provide Comfortable Bedding – Orthopedic beds help prevent pressure sores and provide comfort.

 

2. Traction support – yoga mats, carpeting, grippy booties for your dog, or grippy pads that stick to your dog’s paw pads can help prevent your dog from slipping on the floor and help with traction.

 

3. Harness for support – the Help-em-up harness can help you safely give your dog a little extra support to get up and down, during walks, and helping them with stairs.

 

4. Bladder and Bowel Management – Dogs with DM frequently develop urinary and fecal incontinence as the disease progresses.
   1. Frequent bathroom breaks can help them empty their bowels and bladder and feel more comfortable

    

   2. Diapers can be helpful if dogs will tolerate them and they do not develop diaper rash.

    

   3. Diaper pads can be placed under your dog to help prevent damage to your home

    

   4. Dogs with urinary incontinence are predisposed to urinary tract infections, so regular checking with your vet for UTIs is also important.

    

5. Pain Management – While DM itself is not painful, joint pain from immobility can occur. Anti-inflammatory medications may be helpful.

 

6. Acupuncture – acupuncture can help some dogs feel more comfortable.

 

7. Frequent Position Changes – As the disease progresses, if your dog is lying down most of the time and unable to rise, you may need to reposition your dog every few hours to avoid pressure sores. To be honest, if you are getting to this point, it is likely time to consider euthanasia.

 

8. Physical therapy, hydrotherapy, and rehabilitation – taking your dog to the physical therapist and having your dog exercise on an underwater treadmill can help them maintain muscle mass for longer. Some dogs love it! However, not all dogs enjoy it and it can be time consuming and costly.

 

9. Dog wheelchairs – wheelchairs can allow dogs with hind limb paralysis to remain active. While this may help extend the time a dog can remain active, many dogs may not like the wheelchair or take a long time to adjust to it.

How to Know When It’s Time for Euthanasia

DM can be a particular challenging disease for making end of life decisions. First of all, we often need to make decisions based on quality of life even though dogs are often still eating and acting well in some respects. In addition, DM, especially in larger dogs, can put a significant burden on the caretaker. It can even become impossible to properly care for dogs if they cannot walk.

Some criteria to consider when making decisions about euthanasia:

1. Breed and size – A chihuahua that is having trouble walking can easily be carried for some time, while a large Labrador cannot be carried. In addition, some breeds are couch potatoes and don’t mind not being able to run around (bulldogs or toy breeds, for example) while others get incredibly frustrated when they can’t run around and play (border collies, German shepherds, Labs, and other active working breeds).

 

2. Layout of home – If you live in an apartment building with an elevator or a single story home with no steps, it may be easier to take your dog on walks as their mobility declines. However, if your dog needs to navigate steps to get outside or move around the home and is too large to be carried, decisions often need to be made sooner.

 

3. Owner considerations – This is often a taboo subject but it matters. A small older woman living alone with a 80 pound dog may have to make a decision sooner than a large 30 year old man. Humans with disabilities may be unable to care for a dog that even need a little support. If you are like myself and work 12 hour days and live alone, it may not be fair to leave your dog alone for long stretches if they cannot get up themselves. Everyone’s situation is unique and it is okay if personal limitations make you have to say goodbye sooner. Dogs don’t care how long they live, they only care that they are happy every day they are here.

 

4. Mobility factors – euthanasia should be considered for any dog that can no longer move or support themselves, even with assistance. In particular, once DM is starting to affect the front legs in addition to the back legs, euthanasia should be strongly considered as this often will precede breathing difficulties.

 

5. Incontinence issues – Some dogs, particularly smaller dogs, can do well in diapers. However, if dogs are developing frequent, painful UTI’s, or if they seem painful from holding in their pee or poop, are crying and panting and getting uncomfortable right before they have an accident (they will sometimes do this because they are holding it in because they are trying not to soil themselves or the home), it is likely time to start to think about euthanasia from a quality of life perspective.

 

6. Loss of Interest in Life – Dogs who no longer show interest in food, play, or social interaction may be suffering emotionally.

 

7. Difficulty Breathing or Swallowing – As DM progresses, it can affect the breathing and swallowing muscles. If you are noticing any breathing or swallowing issues I recommend making a decision to euthanize before it gets any worse. You do not want your dog to pass away because they are struggling to breathe.

 

8. Pain from Secondary Conditions – While DM itself isn’t painful, associated conditions like arthritis or sores from immobility can cause significant suffering.

 

Conclusion

Degenerative myelopathy can be a heartbreaking diagnosis. If you would like more guidance, schedule a 45 minute teleconsult with one of our compassionate veterinarians who can review your pet’s medical records and history and help you formulate the most compassionate and loving plan for your family.