Friday, August 24, 2012

Degenerative Myelopathy (DM): Top 10 Management Suggestions (Part II)



Last time I introduced Degenerative Myelopathy (DM) and the associated challenges. The following is a list of my top 10 suggestions for management of DM:

1.Specialty Regional Veterinary hospitals can be considered  to provide  inpatient care, diagnostic tests and rehabilitation services to initially “maximize” the dog’s condition and formulate a home treatment plan, order equipment, etc.
 
2. If inpatient care is too expensive or not available, many veterinary facilities now offer rehabilitation services as an outpatient. 

There are also independent canine rehab practitioners/Physical Therapists, who offer care in their offices or in your home.

Rehab should include an evaluation, intervention using range of motion, stretching, massage, gentle strengthening using resisted bands, physiorolls, rocker boards, sensory input techniques, sling-assisted walking, etc. Some physical modalities such as electrical stimulation may be used.

Aquatic therapy is also very helpful and important in maintaining mobility via canine swimming pool programs or underwater treadmills.  

Water buoyancy can benefit walking, standing and swimming should be done in short bouts.

Underwater treadmill at Jasmine's rehabilitation center, Woodcock Veterinary Services
3. Your vet can help you learn about bowel and bladder management,  manual bladder expression,  keeping a schedule, cleaning your dog,  checking for soiling or urine “scalding”.  

Sometimes shaving the region is used to prevent infections.

4. Consider using a padded and possibly elevated dog bed for comfort and ease of on/off.  

Help your dog with frequent turning to avoid pressure sores.

5. Bring the dog outdoors and keep them moving but avoid over exertion, heat and limit their exposure to sun.

6. Slings and harnesses assist the dog transferring from lying to sitting, to standing, during walking, and while turning.

Help’EmUp Harness

7. Identify and avoid barriers in the home such as stairs or uneven floors and reduce slippery surfaces by adding carpet runners or non-skid mats.

8. Routinely check the dog’s skin for scrapes or sores, infections, abnormal wear of nails, pads. 

Booties are available for foot protection when the hind limbs drag and also offer anti-slip control.  Consult your vet, PT and groomer for suggestions.

9. Ask the vet or other pet expert about proper nutrition, protein consumption, hydration, and weight management. 

Help with the dog’s ability to use food and water bowls by positioning close, on a non-skid pad and at proper height.

10. Wheeled carts can be helpful for your dog’s mobility.  

Standard rear-wheeled carts are fine if the fore limbs are strong.  If the rear legs show “knuckling”, the feet and hocks need to be supported by a sling or stirrup in the back of the cart.  In many other cases, especially where the trunk and fore limbs become weakened, a “counter balanced” cart is more effective, starting with neutral and progressing to full counter balancing (this refers to a forward shift in the axel position).

The Standard Rear Wheel Cart
Some companies offer a variable axle, which can be adjusted by the dog owner.  Engineering, quality and workmanship are so important when choosing a company to make the cart and I highly recommend Eddie’s Wheels, in Massachusetts, USA.

***
Susan E. Davis (Sue) is a licensed Physical Therapist with over 30 years of practice in the human field, who transitioned into the animal world after taking courses at the UT Canine Rehabilitation program.  She is located in Red Bank, New Jersey.

She has been providing PT services to dogs and other animals through her entity Joycare Onsite, LLC in pet’s homes and in vet clinics since 2008.

She also provides pro bono services each week to a shelter and sanctuary for neglected and abused animals.  Sue is the proud “dog mommy” to Penelope, a miniature Dachshund with “attitude”.  For more information see her website www.joycareonsite.com , or follow on Twitter @animalPTsue.

Further reading: 

Resources:
Doggie Essentials/Quality Sanitary Products
Scout's House/Non-Slip Pet Socks
Eddie's Wheels
Help'Em Up Harness

Articles by Susan E. Davis:
Functional Strengthening Exercises: the What, Why and How
One Thing Leads To Another: Why The Second ACL Often Goes Too
Compensation: An Attempt To Restore Harmony
Paring Down to the Canine Core
Canine Massage: Every Dog ‘Kneads’ It”
Photon Power: Can Laser Therapy Help Your Dog?  
Physical Therapy in the Veterinary World  
Reiki: Is it real? 
Dog Lessons: Cooper  
The Essentials Of Canine Injury Prevention: 7 Tips For Keeping Your Dog Safer 

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