Front Matter

448 Canine Sports Medicine and Rehabilitation

Management overview

The efficacy of pharmacotherapies including
drugs and nutritional supplements for canine
DM have been based on empirical observation
with a lack of evidence‐based medicine
approaches. The long‐term prognosis of DM is
poor. To date, no prospective studies have
established whether exercise has a beneficial
effect in DM‐affected dogs. Kathmann and col­
leagues (2006) reported survival data from 22
DM‐affected dogs that received varying degrees
of physiotherapy. Dogs that received intensive
physiotherapy had significantly longer sur­
vival times (mean = 255 days) compared with
dogs that received moderate (mean = 130 days)
or no (mean = 55 days) physiotherapy. The
physiotherapy regimen consisted of active and
passive exercises without taking into account
disease stage or UMN/LMN signs. Although
study limitations included lack of randomiza­
tion and definitive diagnosis, a small group
size, and bias from client perception, results
warrant further investigation into the efficacy
of rehabilitation in DM‐affected dogs. Caution
must be taken when rehabilitation, especially
therapeutic exercise, is considered as these
dogs can be easily exhausted and return on
effort, without care, can be counterproductive.

After the discovery of mutations in the SOD1

gene, DM is being now recognized as a natu­

rally occurring, progressive, adult‐onset neuro­

degenerative disease that has many similarities

to human ALS and may serve as an important,

novel disease model for therapy development.

A spontaneous canine disease model offers a

ready clinical population on which therapies

can be evaluated in a setting closely mimicking

human clinical trials. This approach has proven

successful in developing cancer chemothera­

pies in canine patients, which have then been

applied to humans. We propose that canine DM

will serve as a potentially useful intermediate‐

sized model of ALS, which could be valuable

for temporal studies of disease progression and

evaluation of ALS‐ and DM‐targeted new ther­

apeutic/diagnostic regimens.

In face of inevitable gradual progression,

regardless of various therapeutic modalities, it

is important to realize the emotional support a

client can provide to maintain quality of life for

their pet. As a DM‐affected dog progresses

through the disease stages, the client encounters

the challenges of at‐home management and

providing appropriate daily care for their dog.

Ultimately, the client will need to make the

decision for humane euthanasia, which often is

guided with assistance from their veterinarian.

Case Study 17.2 Degenerative myelopathy

Signalment: 9 ‐y.o. M/N German Shepherd Dog with

progressive asymmetrical incoordination of the

pelvic limbs.

History: Toenails dragging for about 1 month.

Difficulty rising from sit and down positions.

Examination: Patient bright and alert. Incoordination

and worn nails evident in both pelvic limbs.

Neurological examination:

● Bright and alert

● Cranial nerves WNL

● General proprioceptive ataxia present in both

pelvic limbs. Worse left

● Foot placement deficits evident in both pelvic

limbs. Worse left

● Hopping responses reduced in both pelvic limbs

● Stretch reflexes present and symmetrical in all

four limbs

● Response to noxious stimuli symmetrical and

appropriate in pelvic limbs

● Crossed‐extensor reflex elicited on left when

flexor reflex performed on right

● No spinal hyperesthesia.

Neuroanatomic localization: T3 to L3.

Discussion: Chronic progressive presentation and

absence of paraspinal hyperesthesia establishes a

unique list of differentials. This patient manifested

paraparesis with intact spinal reflexes, typical for

upper motor neuron signs in the pelvic limbs. This

provides localization cranial to the lumbosacral intu-

mescence (cranial to L3). Thoracic limb function was

normal, placing the lesion caudal to the cervicotho-

racic intumescence (caudal to T3). A key finding is the

lack of paraspinal hyperesthesia, ruling out involve-

ment of pain‐sensitive tissues (e.g., nerve root, disc,

periosteum, joint, muscle). A neoplastic mass within the