Degenerative myelopathy - Page 1

Hello, I'm new to this site.  I found it while looking for info on Degenerative myelopathy. Took our German shepherd Stuart to the vet last Monday because he was dragging his back paws and crossing his legs and walking a bit unstable.  After being examined by his normal doctor she diagnosed Stuart with DM, but since she's only seen a few cases of it she had the neurologist take a look at him as well.  He initially thought it was DM as well, until he asked me how long Stuart has been like this?  We've only noticed his dragging of the paws for the last month or so, so he said that DM doesn't occur that quickly and suggested it could be a tumor or disk problem and told me an MRI is the only way to tell what's going on.  After leaving the veterinary hospital I started going over the last few months with Stuart and realized that what we thought was him being clumsy when getting up from a sitting or laying down position was probably the beginnings of DM because Stuart is a large shepherd who originally weighed 115 pounds. In January he weighed 106 and now as of last Monday he is down to 98 pounds, which I believe is muscle loss because he eats like a pig.  Therefore after going over everything with Stuart I was thinking by all his symptoms that he does have DM, so I called my vet to ask her a few questions but she suggested I call the neurologist we saw since he that was his specialty.  I did what she suggested, called and left two messages for the neurologist, never returned my call, then called a third time spoke with front desk person who called me back and told me to make an appointment with neurologist since he only saw Stuart for a few minutes.  My husband and I went to see him with Stuart on Friday of the same week because I wanted to tell him that after I'd thought about everything Stuart symptoms have been showing longer than I thought. We were told he was going to reexamine Stuart but he never touched him, he just watched him as we sat in the room and he just talked to us.  I had questions about vitamins for Stuart, accupuncture and other things that I read about to help slow down the progression, but he shot all of them down and insisted the only thing to do is an MRI which costs $3600 and is not covered by our insurance.  I almost feel is just about making the money.  Any suggestions for our Stuart? We are thinking about doing the MRI even though we can't afford it, but what if it is something we can fix, or are we just wasting our money? Wondering if we should go to another hospital for a second opinion. Any help would be great, sick to my stomach over this!   :(

An MRI can diagnose other things, treatable things, that could cause the symptoms. Remember, there is NO WAY to diagnose DM on a living dog.Only necropsy is a firm diagnosis. It's a diagnosis of elimination, ie, eliminating everything else that could cause those symptoms, and there are many. X-ray, CT scans, MRI...all are useful in diagnosing OTHER ailments that can mimic DM, but DM is only diagnosed via necropsy. If it were my dog, I'd do everything to find a diagnosis, a real diagnosis of a potentially treatable illness, prior to assuming the dog has DM and there's nothing that can be done. Are there dogs with DM in his pedigree? Do you have his pedigree? 

 

I have done a few MRIs and never have I paid $3600...that is very very high. Ask other hospitals what they charge for MRI. It may well be $1500-2k, but not $3600. That's insane. 

Jenni, the cost of the MRI varies according to area. When I was going to have one done for Hexe, I was quoted 'up to $3000', though that also included a set of chest and abdominal radiographs as well. 

To the OP, how old is Stuart, and in what general area are you located? Generally speaking, diagnosing DM is basically a matter of ruling out all other possible causes for the clinical signs being observed.  What you describe in your dog are also signalments for a condition known as cauda equina syndrome, which is a compression of a bundle of nerves that pass through the dog's pelvis, most often associated with an anatomical anomaly of the spine known as 'transitional vertebrae'; cauda equine syndrome can be corrected surgically, and most dogs the undergo the surgery recover uneventfully and enjoy their normal lifespan doing normal dog activities.  Likewise, compression elsewhere of the spinal cord, due to one or more ruptured discs, can also present in a similar manner as you've outlined with Stuart.

The age of the dog is of significance because DM is not commonly seen in dogs under 5 years of age, although it CAN occur--usually, however, clinical signs of DM aren't in evidence until the dog is 7 years of age and up, with many of the affected dogs not showing any symptoms until they are 10 years of age or more.

Where you're located is of importance solely because others might be able to refer you to facilities where you could have an MRI done at a lower cost, or to a neurologist who is more open-minded regarding treatment options or other diagnostic considerations.

 

I llive in Chicago. I pay $1000+ for a spay, $250 for a rabies shot with intact fees and tags. I pay $2500 for a c-section, $1200 if a pup spends one night at the vet on fluids only, $4000 for a false alarm obstruction surgery, and they want $1000 for a dental. If I've been wrong all these years and really our cost of living and vet expenses is low, I apologize.    But.... I have yet to find an area much higher all around than Chicago, save a few major cities in California. So, I can't believe that in Chicago if an MRI isn't $3600, that they can't do any better anywhere else if they make a few phone calls. I have a really hard time with that. 

Jenni, those prices are outrageous! You should move to MN!  I pay $250 for a spay, $25 for rabies, $200 for a dental, etc.

Jenni, I don't think you're living in the cut-rate MRI capital of the Midwest, but I do think the pricing varies depending on how many MRIs are being done within a geographic area, and how many specialists there are available to do them. In MI, there's only one neurosurgeon, and at the time I was going to have the procedure done on Hexe [which was...at least 7 years ago by my count] he also had the only facility with MRI capability as well--so the rate being charged was what the market would bear, I suppose...and I still had to travel 3.5 hrs one-way to access the facility.  I imagine I could have found someplace less expensive for the scan if I cast my net out-of-state, but in that case, I'd have to add on the travel costs and additional time off of work, and very quickly I'd be up in the same price range as I started.  That's why I ask the OP where they are located, generally, so hopefully someone can refer them to a place that does enough MRIs to not need to charge $3600.

OTOH, my vets up here in the northern part of the state are extraordinarily reasonable; for that matter, I just paid for pre-anesthetic bloodwork, including a HW test, and spaying of a 3 yr old female Pittie mix whose owner had initially decided she had to rehome her due to conflict between the bitch and a neutered male Pittie mix of the same age that had recently arisen. I pleaded with the woman to AT LEAST let me pay for the bitch to be spayed before she tried placing her, and she finally agreed; the cost for everything, including HW preventative, was $299.00.  My Max's bloat and torsion emergency call and surgery, on a Saturday night, ran me just a tad over $1000.00. Go downstate further, however, and prices will increase accordingly when you get around the areas of Ann Arbor, Grand Rapids, and so forth.

Combining threads.

 

by Stuartbentley on 09 June 2015 - 02:06

Posts: 4
Joined: Mon Jun 08, 2015 03:15 pm

Hexe....thank you for your response...we are located in New Jersey and Stuart is 7 1/2. I called one other major veterinary hospital in the area and they told me cost would start at $2000 but that does not include any fluids, x-Rays, etc that might be needed. We are going to use our veterinary hospital for the MRI, they are going to take Stuart to a human facility because the images are apparently better, unfortunately this requires overnight hospital stay because they take him to the facility in the early morning hours before people arrive. 😳. We have to do it, I couldn't bear it if it's something that can be treated...for him, his fur brother and us! I've never heard of what you explained but going to look it up to read about it. Thank you for the help any info I can get is helpful.  I will post updates on my Stuart little as they come. 🙏🙏

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by Stuartbentley on 09 June 2015 - 02:06

Posts: 4
Joined: Mon Jun 08, 2015 03:15 pm

Hexe.... I looked up cauda equina syndrome, and Stuart does not appear to be in any pain....he walks with shuffling back paws but runs like a kook...when the neurologist first saw him and felt him Stuart exhibited no sign of pain and his appetite is great...it's just so confusing and it just really sucks!! 😔😔

Stuartbentley, it sounds like you've got a good plan established now--glad to hear your regular vet is going to be able to access the MRI at the local human facility, that usually is quite a bit less costly! 

While I know it's far less likely to be something along the lines of cauda equina, I'm still going to hold out hope that the MRI shows something that can be corrected, as opposed to showing nothing...

Thank you!! It's not any less at human facility thinks it's more because it requires him to stay over night at hospital but at this point I just need to see if Stuart can be helped! Keeping my fingers crossed will keep updated! Thank you everyone! 🙏🙏

I also lost a dog to DM a couple of years ago. I would suggest a couple of things that might help. There are studies out now showing that a Class IV therapy laser can assist with the pain, inflammation and swelling. The latest study was done with a Rehab facility in Connecticut and over 50 dogs. the results are consistent. It has to be a Class IV, there are other classes out there and they do not have the strength to penetrate deep enough into the tissues. All the studies are with a Class IV  both for the DM study and a nerve regeneration study that was done in Bethesda Maryland for the military. So I would go with the best since you have a very narrow window.  I had my dog lasered a couple of times a week and he got an extra 6 months of quality life before he totally failed.  Which for DM is awesome.  If you are looking for a place that has one you can go to www.companiontherapylaser.com  go to the Pet Owner's section and Practice Finder, then put in your zip and you will get vets near you. Only a vet can have this product. Also if you want to see some videos of successes with other treatments if you go to their YouTube channel you will see some cases that are incredible. This is what gave us extra time together.

Keep your dog's weight down, for every extra pound of weight it puts an extra 5 pounds of stress on the joints. So its important that they stay as active as possible without overduing it. The more you can keep the muscle memory going the longer the dog can have.

 

I wish you the best of luck, ask questions of your vet, and look into a Rehab facility with someone certified  and having an Underwater Treadmill and a Class IV laser. They will help.