Understanding Degenerative Myelopathy (DM) in Dogs

Understanding Degenerative Myelopathy (DM) in Dogs

Watching my dog blow bubbles in a water dish is how it all began nearly 7 years ago.

In 2005, I laughed watching my 4- year- old Welsh Pembroke Corgi, Denby, blow bubbles in a bowl of water while visiting a neighbor one hot August night. “What a talented dog,” I thought, until my neighbor pointed out something unusual. Despite Denby’s “lapping” at the water, the water level hadn’t changed. Was it possible he wasn’t drinking a drop of water? 

Suddenly, I thought back to the late nights I heard Denby’s dog tags clanging against his metal water bowl, yet every morning the bowl was still full. Alarmed now, I searched the internet for “dogs blowing bubbles” and found several videos celebrating such behavior. Even now, years later, I often think back to that initial internet search and realize what a terrible mistake I made by just searching online to see what the internet says about Denby’s newly noticed skill. I realized a short time later that if you see something unusual with your pet, don’t search the internet for answers; take your pet to see a vet.

At my husband’s urging, I scheduled an appointment with our vet,  Dr. Robert Fryer. I told the veterinarian  what Denby was doing and he said, “Show me.” A bowl of water was brought into the room and Denby willingly demonstrated how he would completely submerge his nose underwater and blow bubbles. Dr. Fryer smiled;, the vet tech laughed. I was relieved. If they thought it was cute then I had nothing to be concerned about., but little did I know that visit would change Denby’s life forever.

After the bubbles came a brief exam, and then Dr. Fryer spoke the words every pet owner dreads hearing:, “Your dog is very sick. - Denby exhibits abnormal cranial nerve responses and I suspect that he has a fast - growing brain tumor.” 

How could that be? Just that afternoon, Denby had been energetically catching a  Frisbee. How could he possibly be so ill? And what else hadn’t I noticed these past weeks?

Dropping Denby off the next day at the vet’s office for further testing, I held out hope that the vet 

was mistaken.  But when I went to pick Denby up, Dr. Fryer showed me Denby’s lack of normal cranial nerve responses. He was unable to control his tongue. He no longer blinked his eyes and he could not make any facial expressions. In stunned silence, I took Denby home trying to make sense of what I had just seen. 

While we were trying to find the cause for Denby’s loss of cranial nerve function, I needed to find creative ways for him to eat and drink, since it was apparent now that Denby was losing weight and becoming dehydrated. Together, Denby and I worked on ways he could get hydrated like swallowing crushed ice or tiny watermelon pieces that I hand- fed to him.  I tried  giving him water with a syringe, but he coughed too much. Then, I hand fed him chunks of dog food, but most of it would drool out of his mouth.  It was quickly becoming apparent that my efforts were not working. I needed to make a decision about Denby’s future.

But before I made any decision, Dr. Fryer encouraged me to take Denby to a neurologist in Tustin, CA for  an MRI. When the neurologist called to say that there was no tumor, I was elated but shocked, since we all knew something was clearly wrong with Denby. I soon found out that while the MRI ruled out a brain tumor, Denby had “irreversible idiopathic cranial nerve damage,”  which is just a fancy way of saying that, for some unknown reason,  Denby could no longer eat, drink or blink. Unless something was done quickly, Denby would die of dehydration and malnutrition.  I knew I had to make decisions right away, so I looked at Denby's demeanor and how he was adjusting to all of these changes. 

Denby’s determination to adapt to the changes he was experiencing only encouraged me to help him as best I could. It was then that Dr. Fryer suggested I consider surgically implanting an esophageal feeding tube in Denby. “Put a feeding tube in a dog!” I remember saying in disbelief. I didn’t even know that was possible. But after watching Denby’s condition worsen for several weeks, the decision was easy. I said yes to Denby’s first esophageal feeding tube.

Now, when Denby hears the blender mixing his special food, he 

runs to the couch, plops himself on a pillow and waits for me to begin feeding him.  It is a process repeated 3 or 4 times a day, 365 days a year, and it takes about 30 minutes. I can also give Denby water and his medications through his tube.

While he’s totally dependent on me for food and water, Denby is no different than any other dog except for that floppy little red tube sticking out of his neck. Despite obedience lessons when he was a pup, he  pulls me down the street on our nightly walks, chases critters from our yard and, leaps several feet into the air when grabbing his Frisbee. Surprisingly, Denby can deflate a squeaky toy in seconds, and I like to call that Denby’s physical therapy for his now droopy mouth muscles. Craving attention, he wiggles his Corgi stub at anyone who passes by, waiting for a pat on the head or a rub of the tummy. Almost unbothered by all of the changes and challenges he’s been through, Denby is living the life of a happy dog.

Does this mean that Denby hasn’t had his share of medical challenges? Not at all. There have been many others, but the most challenging was in 2008. Denby suffered a severe corneal tear and I had to make the decision on whether or not to try and save his eye. I knew I made the right decision to let the vet remove the damaged organ when, the day after surgery, I tossed a Frisbee into the air without thinking.  To my great surprise, Denby jumped in the air, catching it without hesitation. Yes, even a one-eyed dog can catch Frisbees!

Do I have any regrets about saving Denby? The easy answer is - “No." - While it may not be the right decision for other pet owners because of the high financial and emotional cost, it has been for me. 

Although modern veterinary care often means you can extend the life of a sick pet, should you?  It is not a simple answer.   For me, Denby’s quality of life has always been my compass.  It has definitely been a balance of the heart and the head. But as long as he is able to lead the life of a happy dog, I will provide Denby with all the care he needs and deserves as a treasured member of our family, keeping a promise we make to our pets when we bring them into our homes and into our hearts.

Addendum, - Spring 2012

Denby’s story took an unexpected turn in. December 2011 when I noticed that he was having hind leg problems I heard the normal clickety-clack of his nails on our nightly walks, but his right rear paw began knuckling under. This time, I didn’t look to the internet for advice;, I took my brave Denby to the vet.

The appointment suddenly took on an all- too- familiar tone when I heard the list of possible diagnoses. Dr. Fryer knew of Denby’s previous challenges, but this time his likely diagnosis was more devastating: degenerative myelopathy, also known as DM.

While Denby’s rear paw knuckling under could be symptomatic of a back injury, it could also be part of DM. Unfortunately, I had read a news story by Colleen Cason about another Corgi named Dylan who had it, and I knew that Dylan had not recovered from the horrible disease. 

Hoping it was only a back injury, I contacted Wiggleless about a back brace to help him walk comfortably. Before I knew it, Lisa and Cindy had made Denby a custom back brace which Denby happily wore for several weeks. However, his symptoms did not improve and the “knuckling under” of his rear paw became more pronounced and his hind legs began to visibly wobble. That is when I realized our degenerative myelopathy  journey was real.

Since the diagnosis of DM can only definitively be made at necropsy, it is a diagnosis made by excluding other possibilities in a living dog.. Degenerative myelopathy  is a fatal nerve disease similar to the human form of ALS (Lou Gehrig’s disease). It develops by ,  slowly robbing the dog of the ability to stand, then walk, then eliminate waste on their own, eventually leaving the dog unable to move without assistance.  Because of the difficulties in caring for a dog with this illness, most owners make the decision to euthanize their pet early on.

While an expensive MRI would demonstrate if Denby had a back injury, a more affordable alternative was to test Denby’s DNA to see if he had the affected genes that would indicate a DM diagnosis. Thanks to extensive research and funding by AKC breed groups, a DNA test has been developed that shows if a dog has the genes suggesting the likelihood of developing DM. The test, while not a definitive diagnosis, would be a piece of the puzzle.

 Sadly, the DNA test revealed that Denby does have the “affected genes,” making it very  likely, "given his symptoms" that he has this dreadful, silent killer of a disease. 

Ironically, I had just reread Mitch Albom’s Tuesdays With Morrie, the inspiring story of Morrie Schwartz who battled ALS, which is similar to DM. As Schwartz’s disease progressed, she said, “Don’t let go too soon, but don’t hold on too long.” With these words ringing in my head, I knew that Denby’s and my journey with DM meant we would have some hard times in our future, but that it was not yet time to let go. 

And Denby’s journey is not over yet. He happily celebrated his 11th birthday and his DM is relatively stable for the moment. As is common with neurological disorders like degenerative myelopathy, Denby is more comfortable running than walking. I watch him running and playing, oblivious to why he sprints around the yard so often now.  He still stands guard over his backyard, guarding it from intruders with a protective bark. Denby is also still able to jump up on the couch to be fed, but our walks are now shorter and take place on grass instead of concrete sidewalks to protect Denby’s rear paws. 

Our future may be rolling rather than walking. I have been told by fellow Corgi owners whose pets are living with DM that I should fit Denby with a cart while he is still able to stand.  Knowing Denby, I am sure he will adapt to having wheels for rear legs. I can see him now, rolling down the street while I run to catch up. So much for those obedience lessons!

Denby is now a tube- fed, one- eyed, wobbly- legged dog, but my favorite picture is of him wearing his Super Denby costume. On the back of his cape it says, “Wonder Dog,” and I can’t imagine what strangers think when they see a disabled, one-eyed Corgi hobbling down the street wearing such an outlandishly inappropriate label. But anyone that meets Denby quickly realizes that no truer words were ever written about such a brave, determined dog.