Degenerative Myelopathy Cases

This is my almost 14 year old corgi Franklin. Franklin was presumptively diagnosed with DM in April 2021 and has been receiving underwater treadmill therapy and laser therapy 2x a week as well as acupuncture 1x weekly since, he also goes on an approx 1 mi walk in his cart everyday. My rehab vet has your book and uses your acupuncture recommendations for DM. Franklin has been on a fresh cooked or commercial raw diet for the last 10 years. Additionally I just ordered your DM Formula after watching your latest interview with Upward Dog Rehab. 

In addition to DM, Franklin also has degenerative disk disease, arthritis in virtually every joint, vWD, and relatively stable Insulinoma (no surgery). 

I have 2 questions in regards to his treatment. 

1) Do you think it would be safe to add Voltrex? I have 2 concerns about adding too many herbs and different herbal combos….my first concern is twice in the past few years herbs prescribed by his integrative vet has led to bleeding from mucous membranes and bruising due to his vWD, the second concern I have is many herbs reduce blood glucose and he has Insulinoma so we have to be careful…. Any thoughts on this? He’s on Galliprant and Gabapentin to manage pain but I feel like he needs more for overall inflammation. Would it be safe to use DM formula and Voltrex together? 

2) My rehab vet is trying to follow the DM laser therapy protocol using higher joules and longer duration and he wanted me to try to find out if you have any handouts I can give him showing your recommended protocol?  Also in the most recent interview it seemed like PEMF therapy was possibly contraindicated in DM? I have both an Assisi Loop and Respond PEMF Bed I have used to help manage his arthritis but now I’m worried maybe that’s not such a good idea?

Dr. Steve's Advice - go ahead and have your dog tested for DM rather than just presuming it's there. There are now inexpensive genetic tests available directly to owners. Sarah MacKeigan: Upward DOG: Rehab & Wellness probably has more info on this and her group is an excellent resource for managing DM. If the genes for the SOD-1 mutation aren't there, then you are free to target the back using Voltrex and/or Lumbrex (https://goldstandardherbs.com/products) from Gold Standard Herbs, lower intensity laser; and PEMF

That being said, the PEMF influence declines almost logarithmically, such that it might be pretty weak by the time it reaches the spinal cord

As for laser, I don't have a handout because I don't use the treatment. 30 Joules per square cm sticks in my mind as an ideal setting

Voltrex may help the osteoarthritis without aggravating the DM, but I'd see what the DM Formula accomplishes. You may see some benefits from that formula in the joints as well as with the DM. 

Don't forget gentle chiropractic and other spinal mobilization techniques. They are crucial in helping reverse symptoms.

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Hello...this is Aurora, she is 7.5 years old. When she began knuckling under her right rear paw, my heart sank. I lost a Rhodesian ridgeback female and German shepherd female to DM over the past 25 years. Right away I sent for a Gensol DNA test, bought Gold Standard DM formula, and Primal Herb Neuro Regen. I read everything you have on DM. She is fed Big Dog Natural dehydrated grain-free raw, Dr. Harvey's Paradigm and Raw Vibrance, with Gussy's Gut and ahiflower oil. All our drinking water is processed through reverse osmosis, no chemical flea and tick treatments, minimal vaccines. She has always been a ball fanatic, so has been well exercised up to now. I am going through Upward Dog website information now. What additional might you recommend? We are retired on a fixed income, so doing the best we can...

Thank you for the service and support you provide to pet parents, it is so appreciated.

Dr. Steve's Advice -   it seems like you're starting off strong with all that you're doing to manage your dog's degenerative myelopathy, including the DM Formula (https://goldstandardherbs.com/products...). I have a couple of thoughts:

- Even dehydrated foods can be problematic, with respect to their content of pro-inflammatory AGEs. Freeze dried diets are about as processed as you can get in the way of dry food, before starting to see problems. Cooked or raw is always superior to even the best freeze-dried food, since the less processed a food is, the more anti-inflammatory and antioxidant it is. Inflammation is the enemy in DM

- The Neuro Regen may well help a lot, but has actions that can potentially be an issue for your dog as well. If you're using it because a lot of other people with DM dogs have found it to work, great! If it's just something you found on your own, I would hold it in reserve

- physical therapies like chiropractic can help reduce pressure on the cord and normalize limb function. Not all paresis in a DM dog is due to DM. These dogs almost invariably have another source of spinal impairment, which is aggravating the DM tendency.

- For the same reasons, seeking out physical and rehabilitative therapy is probably a super good idea. Almost everyone wants to do laser in these dogs. Please make sure they are not using settings for disc disease, but are using settings that provide high joules/sq.cm outputs. The higher the better, it seems, given the limited research we have on the subject

- if the above is not sufficient to reverse some of the knuckling you're seeing, add in Sublime Joint Formula from Kan Essentials. A limited number of dogs on real food and DM Formula that are also receiving physical therapies have turned the corner and started improving when that formula was added. You can source it from Aleksandra Topic, following the instructions she provides here: https://www.facebook.com/groups/1158575954706282/posts/1420037418560133/

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I have a 9 yr old GSD with DM. We have been following your protocol as best I can!!!  since learning about you through Sarah MacKeigan!  Feeding Fresh, acupuncture, laser,  benefit hips and knees, hepato support, and turmeric . I have tried every form of omega FA and cannot get it into him!! He does not like his food tainted! And he is not the greatest eater at all times as it is. 

Luke is no longer able to use back legs, is fecal incontinent and off and on small amounts of urine leaking. ( most times he can hold it and shut it off when I want him to just empty!!!) lol 

My questions are: 

1. What is the palatabilty of your DM supplement like?  I fear because it is granules, I won’t be able to get him to take it.  Or do I stick with what we are doing?  Add anything? 

2. My integrative vet has adjusted the acupunture points and it had helped some with the urination.  It is usually when I can’t get him completely empty and when I lay him down he will urinate a little bit. Any tips/ tricks/ herbs to help address that? 

Thank you so much for all you are doing! And it was great watching this live session today!!!

Dr. Steve's Advice -  I'm glad you enjoyed the presentation and I admire your dedication towards your dog. He looks very handsome and is an inspiration the way he can still feel proud and engaged in the photo!

The DM Formula (https://goldstandardherbs.com/products...) by Gold Standard Herbs is superior to Benefit Hips and Knees, so I think there is something to be gained by trying it. It has flavouring added to it to make it much more palatable than regular Minor Bupleurum. There is a new version of the formula coming out in January that is even more powerful, to the extent we are seeing some dogs even improve, rather than just slow in their decline.

Perhaps those two will help with the bladder. You can try to give Saw Palmetto each day to help dilate the urethra a bit and make it easier to fully express his bladder. If you use the Natural Path glycerine version then you can give lots as there will be no palatability issues

Hopefully these ideas help

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Hi Dr. Steve, 

No emergency here, just a question regarding being proactive. I saw your answer to one of the posts that you don't treat anything unless there is a problem. Still, is there any supplement that you absolutely recommend for a dog to be on the safe side? I give my GSD vitamin c, lion's mane(he is 6 years old and soon to be a senior dog and I've read lots about this mushroom that it protects nerves and even can delay DM in dogs) and probiotics daily. Am I being over worried pet owner?)) 

Thank you in advance for your reply

Dr. Steve's Advice -  mushroom extracts and vitamins are very forgiving, able to be used in virtually any animal without creating issues, so your approach seems fine to me. I'm just cheap and lazy, so I don't take action unless I have to, and then target my interventions so I can learn what works for the next case. That's not necessarily the optimal path for everyone. You do you, Nina! One thing we know about health, the more complex the diet, the more stable the dog (or human). Nutritive supplements along with a fresh food diet are key components of creating complexity in the body.

Regarding DM, fresh food diets, exercise, and proactive physiotherapy is probably highly advisable. Get a home DM test kit to find out if that is something you need to worry about. There are many now. All are inexpensive and don't need a vet's involvement. You'll have your answer in a couple of weeks

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  Hi! This is Leo. He’s a rescue. I adopted him in September 2017. The shelter was told then he was 6 years old. So that would put him at 12 this year.

Symptoms:
-leg tremors: (my main concern & what we haven’t found an answer for.) - they started small & very difficult to catch. They’ve progressed to all 4 paws, shoulders / legs.
-heavy panting & breathing with minimal to moderate activity.
-dragging his back paws when walking (not all of the time but it is very noticeable)
-odd back paw placement (see photo).
-lumps / bumps near his spine. (Doctor needle biopsied 1 & the results were fat).
-back end weakness.
-poor balancing skills.
-he is very easy to knock over (not intentionally, he is very different on his feet than my other dogs).
-difficulty standing up from laying down.

Veterinarians: He has been to 8 veterinarians where I live, in Oklahoma. He has his 9th veterinarian appointment coming up in August with an Internal Medicine Specialist. 

Tests: We have ruled out Addisons disease with a ACTH stem test. His last full panel bloodwork was at the end of May - all results were normal. Last set of X-rays of his spine & hips, November 2022. 

Treatment: He has had underwater treadmill sessions, laser therapy, acupuncture, chiropractic adjustments, urinalysis, bloodwork, radiographs, swimming, back end awareness, strengthening exercises & more.

Question: **Has anyone experienced anything similar? He’s my first (senior) dog I’ve had on my own and I have no idea if it’s related to age either but I am assuming if it was something so simple I would have found numerous stories of the same thing, I haven’t & I’ve been researching for 6 years. 

—after doing tons of research, I believe he might have degenerative myelopathy along with something neurological— 

Diagnosis: He has spondylosis & was diagnosed in April 2020. He also has arthritis & slight hip dysplasia. Multiple neurologists have stated that the spondylosis wouldn’t cause the leg tremors. 

Video examples of tremors:
• https://youtu.be/UyvwGsijoxY
• https://youtube.com/shorts/ZmLCfbFSEGA
• https://youtu.be/Dg4sTIVgU0I

Thank you in advance for the comments and help! I’ve tried so many things & I simply cannot afford thousands for a neurologist + there is not one in Oklahoma. He does have referrals to out of state neurologists, we just simply don’t have the finances.

Dr. Steve's Advice -  My sense, given (your) Leo's age, the videos, and the odd position of his left hind foot is that his tremors are due to deficiency of Qi or Yang and Blood. In modern medicine, muscles are more likely to tremor when they are not adequately perfused. It's a spin on muscle spasms, except they are releasing.

Given the above and the presence of spondylosis, my first suggestion would be Lumbrex (https://goldstandardherbs.com/products...) from Gold Standard Herbs. It greatly helps improve circulation to the periphery and spine, to combat limb weakness, especially involving the hind legs, but also the forelegs.

As to whether this could be DM, you can conduct a home test for very low cost using saliva from your dog. Just send it in (like you would for Ancestry or 23&Me) and they will get back to you in a couple of weeks to advise whether your dog has any genes coding for DM. I suspect, though, that this is not what is going on.

I would try the Lumbrex, and also try the chiropractor again, in case the results are better with the herbs on board. If you see partial benefits, we can build on the Lumbrex by adding in other herbs to address specific lingering symptoms.

Hopefully you give this a try. I think Leo should be able to get a lot better.

P.S. the let hind foot is hyperextended because Leo is too weak in the hind end to adequately contract his flexor muscles, allowing that side to sag downwards. With normal flexor tone, he should be able to draw himself higher on that hind leg, causing the toes to rotate back downwards toward the ground

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 Good morning Dr. Steve, thank you for taking the time to read my post!
I have an 11.5 year old neutered male Corgi.  He's approximately 6 months into showing signs of DM, with nonpainful left hind weakness, and leg drag.  He's been x-rayed, ultrasound, and MRI.  All unremarkable regarding spinal injury.  He has been raw fed his entire life, core vaccines as a pup and titered thereafter.  We live in the deep South, mosquito capitol of the country, so heartworm meds are required.  I give plain Interceptor, every 45 days, which I've stopped after finding the mass.  He's currently on DM Formula.

My question relates to the photo below.  This mass was found in the process of doing DM x-rays.  He is 100% asymptomatic, all labs are perfect.  We've been to three different Vets for testing and opinion, but no one can put a name on this mass besides, "weird", "strange" and "rare".  According to the Vets, it's "seems" to be attached to the end of a liver lobe, has fibrin in it, and they are calling it a hematoma.  
I've asked questions till I'm blue in the face, but no definitive answers.  I understand they are as perplexed as me, but would like your opinion on what this may be.  Of course, the only definitive course of action is to do exploratory surgery.  Since he's asymptomatic, and already on a DM journey, we've opted to let him live out the rest of his life happy and untouched by a scalpel, until the mass becomes involved in his daily life.
Any and all suggestions you could provide regarding WHAT this is, can anything holistic be done to slow down its growth, and any opinion on may have caused it.  I'd like to add, I started Amber Naturals HWF last September 2022 when the worst of the mosquito season was over.  This is concerning since the mass erupted some time between then and now.  It was not on his annual x-rays prior in July of 2022.  I have read that HWF can cause liver issues.  Do you have any experience with that?
Again, MANY thanks for being there for us!

Dr. Steve's Advice -  

A mass that is spherical like that is very commonly a cyst. Has an abdominal ultrasound been performed to determine its nature? For sure if it was a hemangiosarcoma, your dog would have been deceased by now. Are liver enzymes elevated? If not particularly, then it is more likely to be a cyst. During the ultrasound, the opportunity may arise (if it is a cyst) to aspirate it for some fluid. Cytological analysis of the fluid would tell you perhaps more certainly where the cyst is emanating from and if it needs to be removed.

Regarding the degenerative myelopathy, did you confirm its likelihood with a DM test? What are your experiences with DM Formula (https://goldstandardherbs.com/products...). Has it stabilized your dog at all?

As for whether HWF could have caused this, I don't have any experience with the product. My suspicion, though, is that this is coincidental. I don't see anything in the ingredient list that makes me suspicious it could be behind this.

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Hi Dr. Steve,

My baby girl, my heart, my whole world needs your advice and we would be forever grateful for any help we can get.

This is my dog Whitey - rescued from a shelter 7 years ago and she was a neglect case. She will be 13 years old on June 1st. She is epileptic, has a "leaky heart", focal and epileptic seizures, 2 torn acc's and is not a candidate for surgery. She also has spondylosis which we caught with knee x-rays. She has laser therapy 2x/week. Electro-acupuncture, massage once a week and she has had one chiorpractor adjustment. She also gets a massage from me, walk (at least 2 hrs) and leg exercises daily.

She takes mushrooms, a joint suppliment (Extend), fish oil (4400mg EPA/DHA), Galliprant (50mg), VetriScience Immuno DMG (4 chews)and Levetiracetam (600mg 2x/day) daily.

Whitey is having back end mobility issues - trouble standing, falling a lot, legs twisting up, feet bending backwards etc. Assuming (vets and I) from pinched nerves in her spine. She doesn't seem to have any pain.

Whites holistic vet recommended your DM suppliment in which we purchased; however, your help line referred me here saying there was a better option. So here I am - hoping, praying, asking for anything I can do to make my girl more mobile.

Dr. Steve's Advice - get a DM test done on your dog. If they are positive for the genes that cause degenerative myelopathy, then you're on the right formula, but otherwise I would approach this case by using Lumbrex (https://goldstandardherbs.com/products...) and Voltrex from Gold Standard Herbs at the same time.

DM Formula is designed specifically for the DM dog. Given your dog's age at the onset of all this ataxia and proprioceptive deficits, I suspect your dog does not have DM. Do a home test to make sure, though. Don't guess. There are many, they only take a short time to get the results back and they are not expensive. Use Google to find one.

DM Formula is focused on preventing nerve death, not spinal nerve impingement. Lumbrex and to some extent Voltrex are needed for those. Voltrex will help the compromise stemming from the unresolved cruciate tears and secondary osteoarthritis. If you use Lumbrex in a DM dog, there is the possibility they could worsen, so you need to get that test done to know for sure. If it's negative, make the move immediately to Lumbrex and Voltrex.

You're investing a lot of money into appointments, and you're lucky to have those skilled professionals at hand. Help make sure that money is as well spent as possible by feeding a fresh food diet. All your dogs problems boil down to crappy circulation (assuming Whitey is DM negative) and the number one cause of crappy circulation in dogs is kibble, followed closely by daily use of NSAIDs. I recognize the convenience of kibble and the perceived need for the NSAIDs to relieve pain, but you need to know they are getting in Whitey's way. If the above steps start to rally your dog, then you will hopefully have the confidence to fully take the plunge with all my advice, and change the diet as well. At that point, you will be able to reduce NSAID use to every once in a while, and your dog will start to heal.

Here's hoping that's how it all goes down. And that your dog...doesn't!

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 Hi Dr Steve My 8 yr old German shepherd has degenerative myopathy recently diagnosed. She is currently raw fed and on no medications. She is on digestive enzymes for EPI and we are managing well. What can I do to help support her through this time. We have been to my vet and we just started rehab with laser therapy and the water treadmill. He also showed me how to massage her hind muscles and do traction on her spine. She is still walking on her own but dragging her left foot some and a little unsteady in her rear. She still makes it up and down steps and does her best to run around the yard. She’s always been high energy. I do know there’s no cure but hoping I can slow down the process some and keep her as happy and healthy as I can. Thank you.

Dr. Steve's Advice -  hopefully you've read all the other posts on DM in this group and learned about Sarah MacKeigan: Upward DOG: Rehab & Wellness, which caters particularly to supporting owners support their dogs with DM.

I'm glad you're doing physiotherapy. The required settings can be tricky to figure out on lasers etc. used for DM dogs. If your dog comes home and does better, not worse, then those settings seem appropriate.

A real food diet is always advisable, and lastly, consider DM Formula (https://goldstandardherbs.com/products/DM-Formula-p487935035) from Gold Standard Herbs. For dogs who are still early in the disease process like yours, there is an excellent chance you could reverse some of those deficits you're seeing now. If you try it, let us know how things go!

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