The signs of degenerative myelopathy are similar to hip dysplasia in stages 1 and 2, and initial clinical signs may mimic other spinal conditions, such as intervertebral disc disease (IVDD) (see article in PCM, Fall 2022 page 36), or a slow-growing tumor of the spine.
14 Disorders that often mimic and coexist with DM include degenerative lumbosacral syndrome, intervertebral disc disease, spinal cord neoplasia and degenerative joint diseases such as hip dysplasia or cranial cruciate ligament rupture.
It is often said that DM can be identified by a lack of pain, but this is very misleading. DM may be painless, but most dogs with severe chronic pain will display no signs. Therefore, I have also seen cases of severe hip dysplasia, cruciate ligament rupture or arthritis get mistaken for DM.
One of the most common signs of mobility loss in a dog is struggling to stand up or push themselves up off the ground. Dogs with degenerative myelopathy will struggle to get their back legs underneath them when they attempt to stand, which may make them slow to rise or unable to stand up without assistance.
Diagnosis of Myelopathy
Diagnostic tests your doctor may include are: A spine X-ray to rule out other causes of back or neck pain. Spine MRI or spine CT, to show areas of pressure on the spinal canal. Myelography, to determine location and presence of abnormalities of the spinal cord.
As cervical myelopathy presents with such a variety of symptoms associated with other conditions, it can often lead to a delay in diagnosis and, sometimes, misdiagnosis in primary care. For example, sciatica can mimic certain symptoms of cervical myelopathy in the lower limb.
Degenerative Myelopathy in dogs can progress quickly, especially when it reaches its final stages. Signs of late-stage DM appear to happen overnight or within a few days. Changes to be aware of during the final stages of DM: Dog is unable to bear any weight on its rear legs for any length of time.
The disease can progress quickly, often getting worse within a few months. It's common for dogs to start dragging their hind legs after being diagnosed with degenerative myelopathy. Ultimately, they will find it challenging to walk or even stand on their own.
Mobility loss, leg weakness, and eventual paralysis are all guarantees in dogs with Degenerative Myelopathy. It's not a matter of if, but when your dog will need to use a dog wheelchair to stay active.
Degenerative myelopathy usually affects dogs older than five years of age and typically older than eight years of age. Your dog may begin to show initial clinical signs such as a non-painful and subtle weakness of one hind limb.
There's still much to be discovered and learn about DM and its causes. The genetic test isn't 100% foolproof, but it provides a common-sense prediction of which dogs are at risk—and the degree of risk—and which dogs aren't. The classic clinical signs of DM are: Sudden onset of clinical neurological signs without trauma.
Degenerative Myelopathy has a slow, insidious onset with a slow progression of weakness. It is not uncommon for the signs to progress slowly, plateau, and then start to progress again.
Cervical radiculopathy can result in pain, numbness, or weakness in the shoulder, arm, wrist or hand. Patients with myelopathy presents with weakness, problems manipulating small objects, and difficulty with normal gait. Your doctor will perform physical examination to diagnose cervical myelopathy.
STAGE 4 – LMN tetraplegia and brain stem signs (~ over 36 months) – At the end of the disease, the degeneration can progress to involve neck, brain stem, and brain. Patients will not be able to move all four limbs, have trouble breathing, and have difficulty with swallowing and tongue movement.
Symptoms of Neurological Disorders in Dogs
Knuckling over of the feet. Unusual, rapid eye movements (nystagmus) Head tilt or circling. Difficulty walking.
Staging Degenerative Myelopathy
The stages provide good benchmarks for what to expect, but there can be some overlap in terms of clinical signs. The average age at which clinical signs begin to appear is eight to 14 years. Typically, the patient will progress through all the stages within a 12- to 18-month time frame.
Red flags particularly suggestive of cancer, infection, or inflammation are malaise, fever, unexplained weight loss, pain that is increasing, is unremitting, or disturbs sleep, a history of inflammatory arthritis, cancer, tuberculosis, immunosuppression, drug abuse, AIDS, or other infection.
MRI scans are the preferred diagnostic method for cervical myelopathy, but other methods can also be used to help rule out other conditions. Cervical myelopathy is best treated with spine decompression surgery.
Background: Degenerative myelopathy (DM) in dogs is a progressive neurodegenerative condition that causes white matter spinal cord lesions. These lesions are undetectable on standard magnetic resonance imaging (MRI), limiting diagnosis and monitoring of the disease.
Diagnosis. There is no specific test to diagnose DM while a patient is living. Several tests may need to be performed to rule out other potential spinal cord diseases. Testing may include a neurological exam, blood work, X-rays, MRI or CT scan, and spinal fluid analysis.
Cervical myelopathy occurs in the neck and is the most common form of myelopathy. Neck pain is one of the symptoms of cervical myelopathy, but not all patients experience it.
Physical examination results commonly in long tract signs such as spasticity, hyperreflexia and abnormal reflexes. Hoffmann, Babinski, and clonus are frequently tested reflexes. Someone with myelopathy has a positive Hoffman and/or Babinski and/or clonus test.