Possible degenerative myelopathy.

Dr. Marie replied:

Oh, I am sorry to hear that Princess is having these problems. German Shepherds are wonderful dogs, but they often do get problems with their joints or nerves as they get older.

What you have described sounds really typical of degenerative myelopathy. As you have likely discovered in your reading, DM is most commonly found in German Shepherds (although any dog can get it).

What happens with DM is that the nerves affecting the back end are affected. At first it is difficult to tell the difference between DM and arthritis. And, as many Shepherds have arthritis in their hips, many dogs with early DM will be treated for arthritis. Really, this is not a bad thing because most dogs with DM have some arthritis as well, so if we can make the dog more comfortable regarding the arthritis then this will help.

The knuckling that you have described is really typical of degenerative myelopathy. When a dog knuckles her hind legs this means that there is a problem with the nerves traveling down the spinal cord. Then, the weakness very slowly gets worse. We start to see more muscles in the legs being affected. Eventually, as the disease progresses most dogs will lose control of their back legs.

When this happens some dogs can do ok in a wheelchair for a while. However, often the disease continues to progress and it can affect the muscles that are needed for breathing. Unfortunately DM is a disease that is usually fatal but it can take a long time to get to this point.

I should mention that we can see similar symptoms (knuckling and weakness) if a dog has severe arthritis in their spine, or a problem with a bulging disc in the spine. However, given that Princess is a Shepherd, DM is much more likely.

Until recently we haven't had a test for DM. Apparently there is a new test available. However, most vets do not run a test because the disease is usually easy to diagnose on physical exam.

Unfortunately there are not any drugs that will slow down the progression of the disease. I will usually use the types of drugs that Princess has been on to help, but at some point we usually end up talking about euthanasia.

I'm so sorry for this bad news. Please let me know if you have more questions.

Dr. Marie.


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Dr. Marie replied:

You're very welcome. Unfortunately the fecal incontinence is likely part of the DM as well. This is one of the steps of the progression of DM.

Ultimately the decision on whether or not to use the gabapentin should be made between you and your vet. Gabapentin is best for dogs with pain related to their nervous system. Degenerative myelopathy is not painful. But, if there is arthritis pain along with the DM then the gabapentin may help. I have had mixed results with it. So, if you do not feel that it is helping then likely your vet will advise you to stop it. You have to be careful to wean a dog off of gabapentin and not stop it all of a sudden as a sudden stop can cause some dogs to have seizures.

I always hesitate to answer questions about life expectancies, but I can tell you about some of my experiences with dogs with DM. I have had some dogs who have lived for years with mild DM symptoms. However, in my experience once we start seeing a noticeable decline in the ability to walk, and especially if we are seeing fecal incontinence the disease tends to progress even faster.

Your vet will be able to help you with decision making and to help you determine what kind of quality of life Princess has.

I wish I could give you more positive information.

Dr. Marie.

Dr. Marie replied:

You are very welcome. Princess is blessed to have such a loving owner.

Dr. Marie.