Degenerative myelopathy



It is a degenerative disease of the spinal cord, also called "German Shepherd Dog, degenerative myelopathy" pursuant to the occurrence of particular cases in this race. However, it is a disease described in other races, especially large or giant; It can also occur in the cat.
The MD gives rise to the first clinical symptoms between the ages of 5 and 14 years old, but may also occur in younger animals. Shows predilection for sex.


Etiology
The cause is still unknown.
There are several hypotheses, but none has proven a reliable scientific evidence.
These hypotheses range from the most reliable talking of nutritional deficiencies and problems, degenerative and autoimmune mechanisms. In fact, to support the first hypothesis, some patients with DM has been described in a concomitant chronic enteropathy associated with abnormal posterior proliferation of bacteria in the small intestine, bad absorcion and reduction in blood levels of vitamin E and vitamin B12.
However, the administration of vitamin B12 by injection in dogs, proved ineffective to curb the development of symptoms.
In addition, a recent study with 25 dogs with degenerative myelopathy, excludes the deficiencies of vitamin E of the possible causes of the disease.
The mediated immune hypothesis, however, rests on the finding of alteration of the responses mediated by cells and lymphocyte infiltrate in various organs in dogs with degenerative myelopathy.
Some authors, finally, believe that it is a degenerative disease in the late development of genetic basis.


The clinical symptoms
Proprioceptive deficits are significant, given the ataxia of the hind limbs and slight paraparesis.
The lack of coordination is much more evident in paralysis. This aspect allows the doctor to move toward a suspicion of degenerative myelopathy, rather than other diseases of the bone marrow.
The insignificant absence of a painful response to palpation of the spinal column and the set of factors such as responses to treatment with NSAIDs or corticosteroids, and the failure of the owner to determine the onset of symptoms, support the suspicion of degenerative myelopathy.
In the examination of the spinal reflex points in the early stages of the disease, can be seen normo or hipereflexia patellar and the most advanced lumbar hiporeflexia.
Sphincters control tends to be preserved.
The evolution of progressive worsening of clinical symptoms, occurs in a period of 6 to 36 months, but on average settles paraplegia in 12 months. In this case, many of these patients are subjected to euthanasia.


Diagnosis
Myelography of thoracic and lumbar spinal cord to exclude pathologies of compression and the examination of the cerebrospinal fluid are suitable to ensure the diagnosis.


Treatment
There is no proven treatment protocol.
A combination of exercise, vitamin supplements and amino caproic acid is used.
Moderate swimming and physical therapy they are useful in preventing the atrophy by disuse of the muscles of the hind legs.
The vitamins of the B complex and vitamin E reduces the degeneration of the nervous system.
Amino caproic acid seems to slow down the progression of the disease based on its antiproteasa activity.
The use of corticosteroids, immunosuppressive doses, to be used only in limited time periods and in the recurrence of symptoms.
The prognosis of these animals is bad.

There are products on the market as the Biko brace or the Special thermal blankets that they can help improve ambulation, improving clinical signs, reducing ataxia, not "cure" the disease but if symptoms improve.


Neuropathology
The histopathologic lesions ranged to the white matter of the spinal cord. These can affect any bone, but usually concentrate on segments of the lumbar, thoracic and cranial volume.
Some authors exclude the involvement of the brain, however, recently have been isolated from the brain stem injuries his involvement and clinical consideration is still not clear.

 

DRA. Annaluce Costabile

http://www.ortopediacanina.com

 

 

For more information about the treatment please consult this Article on the page of canine orthopedics.

http://www.ortopediacanina.com/content/35-que-hacer-con-un-perro-con-mielopatia-degenerativa?

 


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