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What is Degenerative Myelopathy or CDRM in Dogs?

What is Degenerative Myelopathy or CDRM in Dogs?

Degenerative myelopathy (DM), also sometimes known as chronic degenerative radiculomyelopathy (CDRM), is a progressive, and very sadly, incurable neurological disease. Degenerative myelopathy is the gradual degeneration of the spinal cord. It typically begins in the hind limbs and progresses over time. Dogs affected by degenerative myelopathy may initially show signs like weakness and unsteadiness when walking. This means that sometimes they are mis-diagnosed for arthritis or other age-related conditions.

Dog Wheelchairs Here

Degenerative Myelopathy in Dogs

Degenerative myelopathy (DM) is generally associated with a genetic abnormality in dogs. It is a slow-onset, non-painful destructions of the nerves in the spinal cord, which are associated with conduction. In degenerative myelopathy, both the thoracic (upper and middle back) and lumbar (lower back) parts of the spinal cord are affected. 

As the disease progresses, a dog will gradually develop weakness and an abnormal gait in their hind limbs. Usually, it is not completely symmetrical, so your dog will struggle with more weakness on one side of their body than the other. As degenerative myelopathy advances it causes progressive paralysis of the hind limbs. Very sadly the entire spinal cord will eventually become affected—causing forelimb paralysis and problems with breathing, continence and eating.

Prognosis is poor, typically around one year after onset of the first symptoms, a dog is unable to walk on their hind limbs.

Signs and symptoms of Degenerative Myelopathy

A dog suffering from degenerative myelopathy will initially be weak in their hind limbs, this can lead them to have difficulty getting up from sitting or from their bed, for example. As it progresses your dog will start to lose feeling in their hind limbs, which can cause your dog to drag their paws, they may knuckle over at the paws or have abnormal gait or paw placement. As a result of this, you may notice that your dog has scuffed toenails and/or the tops of their paws. Similarly, when walking you may notice your dog stumbling or crossing their hind legs where previously they did not.

As degenerative myelopathy progresses further, a dog will become ever more limited in the use of their hind quarters. This means that their hind legs may shake when standing due to weakness. They will not longer be able to perform tasks which they previously used to, such as jumping into the back of your car or climbing the stairs etc. Muscle wasting is often observed at this stage, sometimes this is asymmetrical but generally after a while becomes symmetrical. Inevitably incontinence issues arise, as they lose control of their bladder and bowels.

Very sadly, the paralysis which effects the hind quarters progresses to include the forelimbs and brainstem. This leads to full paralysis and the development of problems with essential daily functions such as breathing, eating and drinking.

Stanley, has degenerative myelopathy

Stanley, has degenerative myelopathy

"Staffy Stanley, 13 years old, has degenerative myelopathy. Although he is still able to use his back legs at the moment his mobility is deteriorating quickly. Although Stanley has to get used to them, they will improve his quality of life."

Staffy Dog Wheelchair

The Four Stages of Degenerative Myelopathy

Degenerative myelopathy is typically divided into four stages to describe the progression of the disease. These stages are based on the severity of clinical signs and the level of disability. It's important to note that not all dogs will progress through these stages at the same rate, and some may skip certain stages. Below Stages 1-4 are described.

Stage 1: In this initial stage, the symptoms of degenerative myelopathy are often subtle and may go unnoticed for some time. Dogs may experience mild hind limb weakness or a slight loss of coordination. They might stumble occasionally or have difficulty getting up after lying down for a while. There may be knuckling of the paws, dragging of the feet/wear on the toenails, and stumbling/crisscrossing of the hind limbs. Often owners may attribute these symptoms to normal ageing or arthritis, and they may not seek veterinary attention at this point. Stage 1 can last for several months to a year.

Stage 2: In this stage, the clinical signs become more noticeable and concerning. Dogs exhibit moderate hind limb weakness and may drag their hind feet when walking, with increased level of paralysis. They will increasingly struggle to rise from a lying or sitting position. Muscle wasting (atrophy) in the hind limbs will become apparent. Dogs may or may not still be able to walk but will have an unsteady gait. Many dogs in this stage require mobility aids such as wheelchairs to move around. Incontinence of both bladder and bowels often becomes a problem. This stage can also last for several months.

Stage 3:  This stage is characterised by significant loss of coordination and hind limb paralysis. Dogs will struggle to stand without assistance and fall over when attempting to walk. They may drag themselves using their front legs when unable to walk or stand properly. The hind limb muscle atrophy becomes pronounced. Front limbs often start to become noticeably affected also, with increased weakness. Faecal and urinary incontinence and a change in bark or other vocalisations may be noted. This stage can last several months. Euthanasia is sometimes considered to prevent further suffering.

Stage 4: This is the most severe stage of degenerative myelopathy. The dog is generally completely paralysed in all four limbs, has muscle atrophy affecting the entire body, has faecal and urinary incontinence, change in vocalisation, difficulty swallowing food/water, and difficulty breathing. Dogs in this stage typically experience a significant decline in their overall quality of life. Euthanasia is often felt to be appropriate to prevent further suffering.

Daisy, 8 year German Shepherd

Daisy, 8 year German Shepherd

Daisy started dragging her back paws, first on one side and then on both. She was diagnosed with Degenerative Myelopathy, as her illness progressed a wheelchair was the best way to keep her active

German Shepherd Dog Wheelchair

What causes Degenerative Myelopathy?

What causes degenerative myelopathy is not fully understood, there is a known genetic factor, however not all dogs who test positive for this genetic abnormality go on the develop degenerative myelopathy, which indicates there are other contributing factors which, at this time, are not known.

It is thought the most common form is due to a genetic mutation in a gene coding for superoxide dismutase 1 (SOD 1). Dogs who carry either one or two copies of the mutated SOD 1 gene, have an increased risk of going on to develop degenerative myelopathy. Superoxide dismutase is a protein responsible for destroying free radicals in the body. While free radicals are part of the natural defence mechanism, they become harmful when they are produced in excessive quantities. Excessive quantities of free radicals, causes cell death and a variety of degenerative diseases, of which degenerative myelopathy is one.

While a dog with two copies of the mutated SOD 1 gene is at an increased risk of developing degenerative myelopathy, it is not guaranteed. This has led vets and scientist to conclude that there must be further contributing factors, which we are not yet aware of at this time. DNA testing is available, this can help to identify those dog who are deemed as ‘clear’, ‘carriers’ or ‘at risk’. This is sometimes used by responsible breeders to determine whether or not to breed from their dogs, however it is good to remember that a genetic test does not confirm degenerative myelopathy. So, while it is considered extremely irresponsible to breed from a dog which is flagged as a ‘carrier’ or ‘at risk’ of degenerative myelopathy, it is not a certainly that they will go on to develop it in their lifetime.

What Dog Breeds get Degenerative Myelopathy?

Normally degenerative myelopathy affects dogs in later middle age, typically around eight years of age. Seeing degenerative myelopathy in a dog younger than five years of age is extremely rare.

Previously degenerative myelopathy was predominantly regarded as a disease of German Shepherds however, in recent years the disease has been identified in many other breeds of various sizes and is no longer considered a “large breed” problem. It can affect any breed of dog however, those which are considered most at risk are:

  • Poodles
  • Boxers
  • Borzois
  • Pembroke and Cardigan
  • Welsh Corgis
  • Bernese Mountain Dogs
  • Cavalier King Charles
  • Spaniels
  • Great Pyrenean Mountain Dogs
  • Rhodesian Ridgebacks
  • Shetland Sheepdogs
  • Chesapeake Bay Retrievers
  • Golden Retriever
  • Nova Scotia Duck Tolling Retrievers
  • Soft-Coated Wheaten Terriers
  • Kerry Blue Terriers
  • Wire Fox Terriers

Treatment for Degenerative Myelopathy

There is no definitive test for degenerative myelopathy except through post-mortem analysis of tissue samples. Instead, diagnosis of degenerative myelopathy often involves ruling out all other possible causes of similar symptoms, such as spinal cord tumours or intervertebral disc disease. Genetic testing for the SOD1 mutation can help contribute to diagnosis in some cases but does not give a definitive diagnosis.

Because very sadly there is no cure for degenerative myelopathy, treatment primarily focuses on managing the symptoms and maintaining the dog's quality of life. This may involve physical therapy, the use of mobility aids such as wheelchairs or slings, and managing urinary and faecal incontinence.

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Q: Hello, I have a 13 year old Whippet with Arthritis and possibly now Degenerative Myelopathy.  The vet thinks it may be a hip/disk Arthritis issue.  Either way her back legs, particularly her back left, has very little strength or power to it.  She also drags that paw a lot and can't crouch long enough to poo/wee or eat so I would like to help support her with this. I would be very grateful for your advice and suggestions about what would help her move about generally as well as being able to be outside and toilet herself.

A: Thank you for your email, and yes we can help.

There are a few options:

  • If your Whippet is otherwise fit and well and you think will live a year or more, you should consider purchasing a dog wheelchair. We have many owners whose dog has degenerative or other spinal/hind weakness issues but otherwise have two good front legs and just need help getting around. These wheels can be used outside, on walks or around the house. They can completely transform a dog’s life, they get fitter, stronger and get great quality of life again.

  • If the prognosis for your Whippet is poor however and she is unlikely to do much longer and you need only help with toileting etc, you would be best opting for a very comfortable GingerLead sling. These are easy to use, you slip them underneath their tummy and then can help them out into the garden or on walks.

Q: Hello, my dog has hind leg weakness which is causing her back legs to spay out, is there something which you can suggest which would help prevent this?

A: We have the Walkin Traction Dog Socks, these have a strong non-slip, waterproof silicone base and they would help to stop your dog from slipping or splaying out. They also have Velcro around the top of the sock part to help keep them on.

Q: Hi, I am looking for some advice please. My 8 year old dog has just been diagnosed with degenerative hind weakness, he is a still able to walk but his back legs appear to become weak and wobbly at times.

A: If your dog is likely to have permanent degeneration (such as Degenerative Myelopathy or Pug Myelopathy or similar) and will not be able to use his back legs again, it would be best you get him into a wheelchair sooner rather than later. This will allow him to still exercise and go on walks like normal and have a good quality of life, but the dog wheelchair will take the weight off his back legs. They are able to still move/use their back legs to some extent which will help to maintain muscle tone for as long as possible, but the weight will be taken off them.

Q: Hello, we have a King Charles Cavalier who is 9 years old and has Degenerative Myelopathy. We were advised to put him in a wheelchair during the early stages by our vet, which we have done. The wheels have been great, as they have allowed him to still use his back legs as much as he is able and giving him the opportunity to still enjoy life. However as he is increasingly losing strength in his back legs, his feet are really dragging and knuckling. Is there something we can do about this?

A: Thank you for your email. Degenerative Myelopathy can be such a hard disease but increasingly we are finding from owners and vets, that the sooner dogs are put into a wheelchair, the better. To help with the knuckling and dragging of your dog’s feet, we recommend Maximus Skates. These protect the paws from scuffing but also allow your dog to support their natural walking position. When worn, it means they can balance better in their wheelchair and maintain muscles and mobility.

Q: Hello, we have a Labrador who has just been diagnosed with very early stages of degenerative myelopathy. At the moment he just has some very slight weakness in his left hind leg but we have been warned by the vet that he will only get worse. We are wanting to be prepared and be able to support him with his progressive hind weakness, what can you recommend please?

A: Thank you for your query about your Labrador who is in the early stages of myelopathy. We're sorry to hear about his diagnosis, but here are some things which you can have a look at which hopefully will be helpful.  Firstly, we would recommend these anti-slip socks that may give him more purchase when he's getting up from laying down, particularly if you have wooden floors.

In terms of further support, you could also consider a Walkabout rear lift harness to help give him support as he gets up. This harness will aid with lifting or carrying your dog or to aid you to walk dogs with rear leg weakness. It wouldn't however provide support on its own. This one can be left on all day, if necessary:

We have a range of back braces such as the Biko Brace which are aimed at dogs with degenerative myelopathy however our customer feedback is that these are not particularly helpful. In addition, the progression of degenerative myelopathy can be fast and so they can ‘outgrow’ its usefulness relatively quickly.

Lastly, this is not something which is suitable for your dog currently as sounds like he is still able to get around fine but is worth thinking about as things progress. For dogs that are weak or paralysed in their back legs, the dog wheelchairs are a great option to keep them mobile, as the wheelchair will totally support your dog's weight. Their back legs can be put up in the stirrups or they can still use their back legs if they have a bit of movement and you want to help maintain muscle. 

Barley, using the Biko Brace

Barley, using the Biko Brace

"Our German Shepherd was diagnosed with DM. His Physiotherapist suggested a Biko Brace. For the last six months my boy has enjoyed his walks and been mobile again. It is not a cure but it has given him extra time."

Biko Brace Here

Degenerative Myelopathy, DM or CDRM in Your Dog - Early Signs, Symptoms, Stages, Treatments & Life Expectancy

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