Stages of Degenerative Myelopathy in Dogs - The Progression of the Disease

If you're here, you probably have a dog that has (or is suspected to have) degenerative myelopathy. This disease progresses slowly but the progression is faster towards the later stages. There is no currently no cure for DM and no proven way to halt its progression. Here's a look at the stages or progression of degenerative myelopathy. Knowing what to expect can help to figure out how to best help your dog as well as prepare you for what's to come.

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.

Early Stage

In the early stages of DM, the symptoms can be easily overlooked particularly if your dog is already a senior. You might put it down to general "old dog" stuff like arthritis, or losing muscle mass as he gets older. Here are a few things that can present themselves during the early stages of degenerative myelopathy:

  • A slight scraping sound of the dog's nails against the ground. It's often infrequent and intermittent, so easy to overlook.

  • Uneven wearing on the nails of the hind paws. Many of us probably wouldn't even notice (or pay a lot of attention) when clipping their nails.

  • A hint of clumsiness - a little stagger here, a slight trip there. We might just think the dog mis-stepped.

  • Slight weakness - dogs may seem to be straining a little harder to climb the stairs, for example.

Mid Stage

Symptoms become more pronounced as the disease progresses. This is the stage where more involved care is required. Another page in this section offers some suggestions on how to help a dog with degenerative myelopathy.

  • The scraping sounds of the dog's nails against the ground will become more frequent until it starts happening regularly.

  • Weakness. The loss of muscle mass in the dog's hindquarters, particularly the thighs, becomes very noticeable. Dogs struggle to climb stairs or get back up into a standing position. When standing, their hindquarters may start to "sag" because they don't have the strength to maintain the position for long. Eventually the weakness will progress to the point where they need assistance walking.

  • A loss of coordination is noticeable. The dog's hind end seems "wobbly" when he walks. He loses his balance sometimes but can recover in the early-mid stages. In the later mid-stage he may not always be able to recover his balance on his own. Dogs with long tails may trip over their own tails.

  • Poor balance. Gently push against the dog's side while he's standing and he'll lose his balance.

  • The dog's hind legs will cross. He loses the sensation of where he's actually placing his paws, so his paw placement can be faulty when he stands (he isn't likely to notice). It can also happen when he walks which can cause him to trip or stumble over his own legs.

  • Knuckling. Dogs will start to stand or walk on the top of the paw, rather than on the pads. If you deliberately pick up the foot and turn it top-side-down, they may right the foot after a delay, and eventually not at all as the disease progresses.

  • The dog's tail will hang limp. He'll wag less, if at all. In talking with other people who loved dogs with DM, this symptom was often one of the hardest to deal with emotionally. It was for me as well - my dog used to wag happily in his silly enthusiasm to go for a walk (sometimes even 'helicopter-wagging'). He stopped wagging completely as the degenerative myelopathy progressed.

  • Urinary or fecal incontinence, or both.

I know this can seem disheartening and overwhelming. There is no question that DM is a difficult disease for both the dog and the people who love him. I just ask that you try to keep in mind that dogs with DM are typically still happy and very engaged with their families. Here are ways to help a dog with degenerative myelopathy.

Late Stage

Many people make the decision to euthanize during the late-mid stage, or the early-late stage of degenerative myelopathy. Late-stage symptoms include:

  • Jerkiness of movement. The dog's tail, legs, and hind end will move in an uncontrolled, spastic way. Sometimes the hind legs will kick out for no apparent reason. The tail may raise and lower randomly as if the dog needs to defecate.

  • Extreme weakness, loss of coordination and balance. Dogs need help to walk and care must be taken so that they don't fall and injure themselves. They are weak to the point where they cannot squat to defecate or urinate (they will fall if not supported). They aren't able to get up from a down position without help, and cannot stand for long without support.

  • Eventual paralysis of the hind end.

  • Weakness in the front end, including shoulders and legs.

  • In the very late stages, the dog will become so weak he is unable to support himself in any way. Respiratory issues will occur along with organ failure. Dogs are usually euthanized before it gets to the point.

Here's a video that shows the a dog going through the stages of degenerative myelopathy. This isn't my dog, but mine went through something very similar. Please note that some people may find this video upsetting.

It's often stated that dogs reach the late stage of degenerative myelopathy within a year from when the clinical signs first appear. This wasn't true in our case. My dog, adopted at 15, already had the initial symptoms of degenerative myelopathy when adopted. Progression of his symptoms accelerated much more rapidly during the final six months of his life, however three and a half years after we adopted him, he was still mobile. I do truly believe that keeping him active helped. He went to physical therapy as well as continued his twice-daily walks in order to maintain his strength as much as possible. Here are some other ways to help a dog with degenerative myelopathy.

More information on degenerative myelopathy in dogs: