Diagnosis and management of dogs with degenerative myelopathy: A survey of neurologists and rehabilitation professionals

Teryn V Bouché; Joan R Coates; Sarah A Moore; Dominik Faissler; Mark Rishniw; Natasha J Olby

doi:10.1111/jvim.16829

Diagnosis and management of dogs with degenerative myelopathy: A survey of neurologists and rehabilitation professionals

J Vet Intern Med. 2023 Sep-Oct;37(5):1815-1820. doi: 10.1111/jvim.16829. Epub 2023 Aug 22.

Authors

Teryn V Bouché¹, Joan R Coates², Sarah A Moore³, Dominik Faissler⁴, Mark Rishniw⁵, Natasha J Olby¹

Affiliations

¹ Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, North Carolina, USA.
² Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA.
³ Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA.
⁴ Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts, USA.
⁵ Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA.

Abstract

Background: Antemortem diagnosis of degenerative myelopathy (DM) in dogs is presumptive and there are no accepted guidelines for the management of this condition.

Hypothesis/objectives: Describe current practices of neurology clinicians and physical rehabilitation professionals in the diagnosis and management of DM.

Animals: None.

Methods: Online surveys examining diagnosis and management of DM were constructed and distributed via neurology and rehabilitation listservs.

Results: One hundred ninety neurology and 79 rehabilitation professionals from 20 countries participated. Most neurology (142/189) and rehabilitation (23/39) respondents required genetic testing for the superoxide dismutase 1 (SOD1) mutation and 82/189 neurologists also required spinal magnetic resonance imaging (MRI) for presumptive DM diagnosis. Most neurology respondents recommended exercise (187/190) and physical rehabilitation (184/190). Over 50% (102/190) of neurology respondents perform rechecks on dogs diagnosed with DM. Rehabilitation respondents reported preservation or improvement of strength (78/79) and coordination (77/79) as therapeutic goals. At-home exercises (75/79), underwater treadmill (64/79), gait training (55/79), and strength building exercises (65/79) were used to maintain strength (58/79), coordination (56/79), muscle mass (56/79), and improve overall wellbeing (54/79). Neurology respondents reported that owners elect euthanasia when dogs become nonambulatory paraparetic whereas rehabilitation respondents report euthanasia when paraplegia and incontinence develop.

Conclusion and clinical importance: The majority of dogs diagnosed with DM have not undergone advanced imaging, the combination of history, neurological findings, and genetic testing is heavily relied upon. Whereas the diagnosis of DM is frequently made by veterinary neurologists, continued care is often performed by rehabilitation professionals or primary veterinarians.

Keywords: SOD1; amyotrophic lateral sclerosis; degenerative; rehabilitation; spinal cord.

MeSH terms

Amyotrophic Lateral Sclerosis* / genetics
Amyotrophic Lateral Sclerosis* / pathology
Amyotrophic Lateral Sclerosis* / veterinary
Animals
Dog Diseases* / diagnosis
Dog Diseases* / genetics
Dog Diseases* / therapy
Dogs
Humans
Mutation
Neurologists
Spinal Cord Diseases* / diagnosis
Spinal Cord Diseases* / therapy
Spinal Cord Diseases* / veterinary
Superoxide Dismutase-1 / genetics

Substances

Superoxide Dismutase-1