How to Help a Dog With Degenerative Myelopathy
DISCLAIMER: I'm not a vet and I have no veterinary or medical background whatsoever. This information on degenerative myelopathy in dogs is not meant as a substitute or replacement for veterinary advice. It's meant for educational and informational purposes only, as a starting point for discussing the diagnosis and treatment of degenerative myelopathy with a qualified vet.
Dogs with DM tend to "knuckle" and drag their hind paws, often opening up sores on the tops of their paws. My dog was no exception. At first it was just a slight wearing away of the fur on the top of his paws. The fur appeared thinner but there were no wounds. Then, as the disease progressed, the fur would wear away completely ... until finally, sores started to appear.
I did a lot of reading on DM and it seems that there's a disagreement about whether or not dogs would wear booties or socks to protect their paws. On the one hand, dogs with DM already struggle with feeling where their paws are, and putting another layer of material over the paw will make it worse. And yet what do you do if your dog keeps injuring himself? I chose to put my dog in socks because I figured it was better than having open wounds all the time (which must hurt) and risking infection. Booties or socks will also prevent dogs from wearing their nails down to the quick.
Booties vs. Socks
We went through so many types of boots and socks in an effort to find out what would work best for my dog. He was about 45 lbs in weight and before degenerative myelopathy really started to take hold, he was very strong - despite his advanced age, he would run like the wind and could do steep hills without an issue.
Yet as the disease progressed, we found that the heavy-duty dog booties were too awkward and cumbersome for him and would seem to throw him off-balance. He would trip over them and seemed to have a harder time picking up his feet. We're talking about the trek-through-the-mountains, run-across-a-field-of-pointy-rocks, forge-a-river type of boots. The ones we tried were the Ruffwear boots - extremely well-made and would have protected his paws very well - if he'd been able to walk in them! They might work for a larger, stronger dog.
We then tried human baby socks. For our dog, we used the 'newborn' size. These, surprisingly, worked pretty well for him. He had good grip (we got the type with the 'grippy dots' for extra traction), they were soft and comfortable, and they didn't make his stumbling worse. The downside was that they ripped really easily as he dragged his paws. Even doubled-up, they didn't last more than 2-3 walks - and we walked twice a day! Depending on how much and how far your dog walks, where you walk (concrete or soft dirt or grass) and how much he's dragging his paws, baby socks may be a good solution. We held them up with velcro (cut into strips, and wrapped firmly but not too tightly above the wide part of his paws).
But the very best solution we found was also one of the cheapest: Pawz dog boots. First, the downsides: they're ugly and basically look like balloons. We also found the 'paw' part of the boot to be too wide. And finally, they're a bit hard to put on and it definitely takes practice. Be sure not to get the dog's dew claw caught! Once we got the hang of it, they took just a few seconds to put on. The good parts are that they stayed up, they're super-durable (the first boot finally ripped after a month of use), they're waterproof, and most importantly, our dog had good grip in them. He didn't even seem to notice he was wearing them and was happily exploring as usual on his walks.
So in summary, some things to look for in boots are:
- Good grip / traction;
- Lightweight enough that your dog can walk without tripping or falling off-balance, or making the stumbling and dragging worse;
- Easy to put on - especially if they're going to be put on / taken off multiple times a day;
- Waterproof, if possible - so that any open sores don't get dirty water in them;
For comfort, I didn't want to leave my dog's boots on all day. They only got put on when we were going for walks. A soft, comfortable (but grippy) pair of socks for indoors - leaving the harder or less-breathable options for outdoor walks - might be a good compromise. Please do take the boots or socks off overnight to allow your dog's paws and skin to breathe while he sleeps.
I put down lots of rubber-backed mats all over the house on the parts of the slippery floors that my dog used the most. Our home has lots of carpet, though, and putting down mats may not be practical for those with lots of hard floors. On one of bigger spaces I used just a basic non-slip rug netting or backing. They are admittedly super-ugly but they work pretty well. You can buy them online but they can sometimes be found much cheaper at dollar stores.
Dogs who can still do stairs will benefit from carpeted steps for traction. If you have hard flooring on your staircases, one option is to put down carpeted stair treads which are reasonably affordable and easy to apply.
Assistive Harnesses and Slings
The degenerative myelopathy progressed to the point where my dog became very wobbly when he walked. The muscles in his hind end also gradually wasted away. When he walked, his hind end looked 'drunk' plus he would drag his hind paws or walk on the tops of them. He was no longer strong enough or coordinated enough to get up or down stairs, or hills, on his own. But he still wanted to - he loved to walk! This never changed.
I looked into getting him an assistive harness mainly to help him up / down stairs and hills, and to provide support when he was going to the bathroom (he couldn't always 'maintain the position' long enough to finish peeing or pooping, without help). The harness I eventually settled on was the Help 'Em Up Harness. This harness has both a front and back piece, with lifting handles on both pieces. The back harness would have been great to help stabilize my dog while he was going to the bathroom.
Unfortunately, it didn't work out as planned. The harness is extremely well-made and high-quality. Had my dog accepted it, it would have been a tremendous help. He, however, being stubborn and independent, wanted nothing to do at all with the back part of the harness. I suspect that it made him feel even more out-of-control to have this thing wrapped around him back there. He accepted the front half with no issues at all. I kept the harness anyways, because even the front half was useful in stabilizing him when he stumbled, just by grabbing the handle on top. We did try the front & back parts together in the beginning (while trying to get him used to it) - it was so much easier to lift him in / out of the car, and we had superior control when we were helping him up or down the stairs and hills. But - like I said - he hated the back half of the harness so much that we just left it off.
Note that you can't use the back part by itself; it needs to be attached to the front half for stability, otherwise it could just fall off and cause your dog to fall, too.
Hind-Lift and Other Harnesses
It's useful to have another, simpler harness as well for quick potty-breaks, that's quick to put on. There are many varieties of support harnesses (read the reviews, they are very helpful). We received one from our canine physical therapist which worked well, but I don't know what brand it is. It's essentially just a "sling" with a handle on top to help stabilize the dog. If you have a male dog, be careful that the sling or harness doesn't impede his ability to pee (and doesn't get in the way / get soaked when he does).
Doggie Wheelchairs and Mobility Cartsdog wheelchair or mobility cart. Lots of different types and styles are available.
Although we didn't try a wheelchair or cart with this dog, we did try one with one of our previous dogs who had a different medical condition, back when we lived in another location. Many dogs take readily to carts. Ours did not.
Pictured above: Walkin' Wheels Dog Wheelchair
If your dog is light enough (and your back is strong enough!), you could just lift him into or out of the car, or up or down the stairs instead of using a ramp. I found that even with a relatively light 45-lb dog, after the 47th time carrying him up or down the stairs in a single day, I was getting tired (we have a lot of stairs in the house).
Stairs became too much for our dog after a while, especially as he stubbornly refused to use the rear half of his assistive harness. We devised a couple of ramps. We built one on for the back steps (only 3 steps, so pretty easy), with sides that came up about 18 inches. The reasoning for the sides was to prevent him from falling off (lack of coordination is one of the traits of degenerative myelopathy), yet they were low enough that we could reach over and stabilize or help him if needed.
- Wide walking surface - many ramps are just 12 inches wide, which we found way too scary for our dog. 16" is better, and if you can find it, 18" or even 20" for a larger dog will help them feel safer.
- Good traction - no slippery surfaces! Grippy carpet (some carpet can be too slide-y) or a textured surface really helps. You can also add non-slip grip tape. I probably wouldn't add traction slats because dogs with DM have a hard enough time picking up their feet as is.
- No bounce - some ramps are too bouncy, especially when big dogs climb them. This can scare them and endanger them as well - dogs with degenerative myelopathy are already uncoordinated, so bouncing them around doesn't help! Ramps should be solid with minimal movement when they walk on them.
- Low-grade - ramps need to be long enough that they form a gentle grade rather than a steep climb.
- Portability - telescoping dog ramps are good in that they take up less space when not in use. Folding dog ramps are the same.
I later discovered the Pet Loader, which I think could have been helpful. These are steps rather than a ramp, but the difference is that they can be adjusted so that there's a milder incline. It's also pretty sturdy so there's less of a chance that timid dogs would balk. I would still use a harness on my dog to help him up, just for safety's sake.
Sometimes we would take our dog out in the car. DM dogs are so unstable and the slightest thing could knock them down, so keeping them safe with the movement of the car is important. We had our dog travel in a crate which would prevent him from falling. We lined it with a memory foam mat for comfort. We actually found that it was better to have a thinner mat inside the crate then a big, soft one. The softer or plusher the crate lining, the harder a time he had getting up.
Another option is to use a dog seat belt. Make sure your dog is wearing an appropriate harness (never attach seat belts to collars).
Exercise is so important for dogs with degenerative myelopathy. It helps to keep their muscles strong for as long as possible. Hills will gradually become too difficult for the dog, as well long distances. Level walking surfaces are best to help prevent falls. Walks should be shorter and more frequent if you can manage it. We did two "main" walks per day, of about 30 minutes each. Aside from those walks we also took several tiny mini-walks of 5-10 minutes each.
Swimming is another good form of exercise. Put a life jacket on the dog - preferably one with a handle - and walk alongside him. If he doesn't want to swim (or swimming is too much for him), then just walk with him in the water. Sessions should be short to prevent overexertion.
We first looked into acupuncture. The veterinary acupuncturist told us that she believed our dog had DM (which was consistent with what the other vets had said), and if it were true, then acupuncture wouldn't help. Sure enough, it made no difference but we felt it wouldn't hurt to try.
Next, we were referred to a canine physical therapist. She assessed my dog and took him through a variety of exercises on-site to show us how we could do them ourselves at home. She also gave us a schedule of how many repetitions of each exercise to do, and how often they should be done. The goal was to maintain as much of my dog's muscle mass and flexibility as we could while also reminding him to pick his paws up higher.
I would say that the physical therapy was helpful. We did the exercises for 15-20 minutes a day, until the time came that it was too dangerous to continue (he eventually became much too wobbly on his feet). Lots of write-ups say that most dogs become parapalegic within a year of the first clinical signs appearing. My dog was 15 when I adopted him and the signs were already there ... and 3.5 years later, he was still mobile.
Currently there is no cure for degenerative myelopathy. As a last-ditch effort to buy some more time for my dog - who, despite everything, continued to be his usual cheerful self - my vet prescribed a steroid. This did help his mobility for a while but it also came with side effects. In his case, it was mostly an increase in thirst and a corresponding increase in urination. I was able to handle this because I work from home. It might not be practical for everyone. Side effects can be much more serious too. If it's something you want to consider, talk to your vet about what you can expect.
If everyone in the family pitches in and helps care for a dog with DM it can greatly reduce the amount of work involved. It also helps to give the primary caregiver a break. I've spoken with several people who had dogs with degenerative myelopathy and most said that their dogs were still bright and happy. On the flip side, the human family who loves the dog finds it very difficult to watch them deteriorate. Remember that the dog doesn't have control over the disease. Offer them good supportive and nursing care to still enjoy life to its fullest ... something that dogs are very good at!
Dogs with DM aren't always able to change positions, at least not easily. Turn your dog every couple of hours if he hasn't moved himself. Better yet, take him on a little walk-about if possible. My dog would nap blissfully for a while ... when he woke up, I'd make it game to boost him to his feet and we would go on a mini-walk - literally only 5-10 minutes long. It got him up on his feet for a little exercise plus gave him a chance to sniff stuff and go to the bathroom if he wanted to.
Bladder and Bowel Elimination
Fecal and urinary incontinence isn't uncommon in dogs with DM. My dog had fecal incontinence to some degree; he sometimes 'dropped one' while he was sleeping or just as he stood up after waking... but he also knew when he had to go when we were outside. He never developed urinary incontinence.
That said, he wasn't able to 'hold the position' long enough to completely void his bladder if we weren't assisting him. Our vet told us that DM dogs were at higher risk for a bladder infection because of this. Ask your vet to show you how to manually express your dog's bladder. You may need to do periodic testing of your dog's urine sample to make sure he doesn't have an infection.
If your dog will accept a mobility or assistive harness, I strongly recommend using one - if only to save your back and the embarassment!
It's important to treat wounds promptly to head off infection. Check your dog for open wounds, particularly on the tops of his paws and on pressure points like elbows and hips. Also check the nails; dogs with DM often scrape their nails against the ground and can wear them away down to the quick - a very painful condition. Keep sores clean and don't bandage unless recommended by your vet. Your vet can recommend or provide you with an antibiotic to help speed healing.
Keep your dog's skin clean, too, to prevent urine and fecal scalding. He may inadvertantly soil himself either because he's incontinent or can't get up in time to get outside. I dampened basic cotton wash cloths with water. They're soft on the skin, absorbent, easy-to-clean, and you can get a big pack of them for cheap.
If you need to wash your dog frequently, a dry dog shampoo can work in a pinch until you can give him a proper bath. Dogs who are really furry may need to have certain areas shaved to make them easier to keep clean.
I would promptly and cheerfully strip soiled bedding and replace it right away without making a fuss about it. Then I'd spend a couple of minutes giving my dog some love, or we'd go on a mini-walkabout. I think it helped to be matter-of-fact about the soiling and not making a big deal about it; my dog never seemed distressed or embarassed, and was always happy to get some attention or a little exercise.
Putting down lots of easily-washable blankets, towels, or dropcloths can help with cleaning too, especially if your dog has become either urine or fecal incontinent. I found that the large canvas drop cloth - like the type painters use - were invaluable. They're durable and washable. You can even get the type where one side is waterproof, great for if your dog is urine incontinent. I kept several of them on hand. I lined the floors with them wherever my dog's favourite spots were. When one needed to be cleaned, I just swapped out it with a fresh one.
If that doesn't appeal to you, there are also dog incontinence pads (also called puppy pads). They hold quite a lot of liquid and are disposable... or you could buy a bunch of reusable pads and swap them whenever needed.
Food and Water
Water bowls should be kept close to the dog for easy access. This might mean you need several bowls throughout the house, in each of his favourite places. Elevating them may help and make sure they are resting on a non-slip surface so that they don't get knocked over.
(The canvas drop cloths I mentioned earlier actually came in handy in a capacity I hadn't anticipated; my dog sometimes clumsily turned around after drinking and would jar the water dish, slopping water everywhere. The drop cloths caught all of it!)
At feeding time, you might need to put the bowl on the floor (or use an elevated feeder) in front of your dog. Standing may be too difficult for him so he might decide to eat while lying down.
Mental and Physical Stimulation
Degenerative myelopathy doesn't make it easy for dogs to continue walks like they previously did. My dog, who loved running along forest trails and up and down the hills, gradually got to the point where I had to drive him to flatter, easier trails for his twice-daily walks that he continued to insist on.
The decreased exercise and the continued loss of muscle mass due to the disease generally leads to weight gain. The weight gain makes it harder for them to walk, which leads to even less exercise ... which leads to weight gain. It's a vicious circle.
The canine physical therapist said it was important to keep my dog moving in order to keep his muscles strong. As the same time, it was important not to overdo it. She suggested that water exercise was a good option (in addition to our regular walks), but unfortunately there wasn't an underwater treadmill anywhere in the area. Short sessions in the lake were recommended. My dog wore his life jacket for these sessions and we would stroll down the lake for 10 minutes while I held the handle on his life jacket. He loved it and become very playful afterwards.
A DM dog won't be able to exercise the same way he used to. He may miss the usual exploring and sniffing he previously did. You can still keep him mentally stimulated, though, which will keep life interesting for him.
To keep my dog engaged mentally, I played food games with him, since he absolutely loved to eat. I'd put on his socks and we'd head outside with a handful of tiny treats. One by one, I'd show him the treat and then toss it somewhere into the lawn. He'd use his extraordinary sense of smell to sniff it out. It was a simple game but he looked forward to it every day. If it was too cold or too slippery outside we'd play the same game inside - only hiding treats in a variety of boxes, or folds in the blanket, or underneath various items that were close to him. He'd root around, snort, flip things over, and completely delight in the game.
There are so many things that can be done to help a dog with degenerative myelopathy. While it's not a curable disease, good nursing care and committed owners can help their dogs continue to enjoy their lives.
More information on degenerative myelopathy in dogs:
You are an amazing person. If only people had the love for one another that true dog people have for their dogs, this world would be such a better place. Thank you for the article. Fecal incontinence is my dogs main problem, tho mobility is slowly going. This disease is horrible but there is a new treatment being used successfully. I am calling Tufts tomorrow to try to get my dog on it. It won't cure it but will slow progression. It's an acid, starts with an a. If you type DM dog acid treatment into Google you'll find it. It's very promising. God bless all of you and your dogs