Signalment & History
- Neutered male
- Presumed Shepherd mix
- 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.
- Dragging of the hind feet
- Nail scuffing
- Hind-end muscle mass loss
What is on your differential list?
- Degenerative Myelopathy
- Hansen Type II IVDD
- Lumbosacral syndrome
- Spinal cord neoplasia
- Orthopedic Disease
- BCS: 6/9
- Mildly decreased range of motion of the hips with crepitus
- No cruciate ligament abnormalities
What diagnostics will you run?
- Proprioceptive positioning during PE
- Determined neurologic rather than orthopedic
- Referral to neurologist for MRI Scan-these do not reveal changes
What is your assessment?
- 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
What is your plan for this patient?
- 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.
Learn More: Diagnosing DM
- 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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