Embark for Veterinarians

Applied Clinical Genetics Case Library
Case 4

Signalment & History
Signalment:
  • 13-years-old 
  • Neutered male
  • Presumed Shepherd mix
History:
  • Progressive ataxia
  • At visit 6 months ago, patient had hip and stifle radiographs, full CBC, chemistry, UA, and thyroid testing; at the appointment the dog took an abnormally long amount of time to wake up from sedation.
  • Currently taking daily NSAID and intermittent opioid and gabapentin administration.
Presenting Complaint
  • Dragging of the hind feet
  • Nail scuffing
  • Hind-end muscle mass loss
  • Degenerative Myelopathy
  • Hansen Type II IVDD
  • Lumbosacral syndrome
  • Spinal cord neoplasia
  • Orthopedic Disease
Physical Exam
  • BCS: 6/9
  • Mildly decreased range of motion of the hips with crepitus
  • No cruciate ligament abnormalities
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  • Radiographs

  • Proprioceptive positioning during PE
    • Determined neurologic rather than orthopedic
  • Referral to neurologist for MRI Scan-these do not reveal changes

  • Bloodwork is normal
  • Radiographs are normal
  • MRI normal–ruled out a tumor, fracture, or infarct
  • Diagnosis of DM through elimination–using PE findings and supportive genetic test results
  • Keep at healthy weight
  • Methods to maintain muscle mass, and reduce risk of injury were implemented. Avoid drugs (or certain doses of drugs) that require p-glycoprotein. Will have quality of life discussion. Implement lifestyle changes to keep this dog comfortable. Physical medicine modalities with a certified canine rehabilitation practitioner, a sturdy harness and boots, oral antioxidant therapy, and placing ramps in this dog’s home where beneficial.
  • Because various commonly acquired compressive spinal cord diseases can mimic DM by compromising the upper motor neuron and general proprioceptive pathways, a definitive diagnosis of DM can only be accomplished postmortem by the histopathologic observation of axonal and myelin degeneration, which can occur at all levels of the spinal cord.

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