Two Hearts - Our Battle with Degenerative Myelopathy
I start this article, with a short note, to tell all how very much I
love my German Shepherd Dog, Jack Flash. It is one of the greatest love
stories of all times. It began, when I went to view a litter of pups, 12½
years ago, picked out a female, and this little guy just refused to leave
my side. When the breeder went inside to fill out the forms for the purchase
of the female I had picked, he came over to me and hooked his little paw
over my arm. He looked at me with a "hey, it's me, don't you know
this was meant to be" look on his face, and promptly rolled over and
"grinned". His shenanigans continued, and he ended up in my lap,
defying me to resist those oblique little eyes that seemed to hold the
promise of undying love. The little paw remained hooked over my arm, and
when the breeder returned, she smiled, and promptly returned to her house
to fill in the papers for the little bundle of love, who was to be named
Jack Flash.
Jack Flash completely stole my heart. He was a delight, right from the
start. He was a lover boy, and always wished to please. He had his "puppy
moments", as all 
dogs
do, but being extremely intelligent, would not repeat behavior for which
he was reprimanded. He became my shadow, and was always by my side. When
I showered in the morning, his little nose was always pressed against the
glass. He loved going in the car, accompanying me on my errands, and had
kisses for everyone who approached him. On sunny days, I always noticed
his shadow, melding with mine, if I glanced at the sidewalk. Although puppyhood
passed, in what seems to be the blink of an eye, his love for everyone
he encountered, remained. He was, and truly is, a gentle soul. The only
time Jack Flash ever exhibited aggressive behavior, was when my life was
threatened, and in doing so, averted a potential car-jacking. True to the
loyalty and devotion for which his breed is known, he saved my life….
It was last winter, in February of 1997, when 11½ year old Jack
Flash, began to have difficulty getting up. I "chalked it up"
to old age, and looking at that beloved graying muzzle, I tried to convince
myself that this was a result of long periods of inactivity. His hips were
not the greatest, and due to the cold weather, he was not able to be outdoors,
exercising and swimming, as was the usual summer routine. He always played
indoors, however, and often jumped into the air to catch his ball, one
of his favorite pastimes. (He loved his ball playing, 2nd only to ringing
the neck of his "fuzzy man" toy) However, once he lay down after
a play period, he would again struggle to get up. Each time I saw him struggling
to do what had always come easy, my heart spiraled down to my toes. This
dog and I are inseparable. We are the "Theme from Endless Love".
We are two hearts that beat as one. I kept hoping and praying that warmer
weather would arrive early, and Jack Flash would once again, return to
his agile self.
Believing it was merely the "winter cold" and damp weather,
I brought Jack to my veterinarians, Dr. Brian Marder and Dr. Jon May, for
a check-up, hoping for reassurance. Both checked Jack carefully, and informed
me that although Jack's hips were not the best, and there was a possibility
that Jack could be experiencing difficulty getting up due to arthritis,
it could also be caused by a disease known as Degenerative Myelopathy.
Brian is an unusual vet. He is loved by all who have brought their dogs
to him, for he retains the sensitivity that one would expect a vet to lose
after years of practice. When asked about a cure for this disease, I could
tell from the look on his face, that the prognosis was poor. He performed
some reflex tests upon Jacks rear paws. He turned Jack's paw backward,
so instead of Jack standing on the pad of his paw, he would, instead, stand
on his toe. Immediately, Jack replaced his paw in the proper position.
I breathed a sigh of relief, and excitedly told Brian how happy I was that
now Jack Flash could keep his promise to me to "live forever".
Brian still looked grim, and explained that although Jack did most definitely
"right" his paw, Degenerative Myelopathy was still a possibility.
He explained that DM was a progressive disease, and Jack could be in the
earlier stage of the disease. Jon, an excellent diagnostician, agreed with
Brian's assessment of the situation. I didn't want to hear that, nor did
I wish to consider that to be a possibility. There was no cure… There was
also the other possibility that Jack might have injured his back, jumping
into the air to get his ball. Over the course of the winter, Jack Flash
began to steadily decline. Not only did he have difficulty getting up,
but he seemed to be rapidly developing other problems as well. He began
to stumble, and lose his balance easily. (This was a dog that could have
"walked a tightrope") I began to observe him standing with his
rear legs crossed beneath his body, or both rear legs together underneath
his body. Jack loved to be scratched, and loved having his hindquarters
stroked. He would often plant himself next to me, hindquarters against
my hands, waiting for his favorite massage. Suddenly, these joyous moments
became anxiety provoking for both of us, as Jack would topple over when
the massage commenced. Other strange things were also beginning to happen.
Jack has a magnificent long and plushy tail. His tail, always carried so
beautifully, suddenly began to interfere with his ability to walk. Instead
of being carried regally behind him, somehow, his tail was wrapping around
the inside of his rear legs, where it was managing to trip him as he walked.
Jack Flash did not appear to be ill, nor did he appear to be in any
pain! He was as mentally alert as ever, and continued to be playful, seeming
to take his new disabilities in stride. His attitude was cheerful, and
his love for the world and everything in it, was still intact.
Although things seemed bleak, every time I was convinced that there
was a possibility that Jack Flash might have DM, the symptoms he was exhibiting
would seemingly disappear. I was sure things would be all right. I kept
checking Jack's rear paws, to make sure he was standing on the pad, not
the toe. I felt re-assured each time I looked down and saw him standing
with his paws in the proper position.
Spring finally arrived, along with warmer weather, but again, Jack began
to have difficulty getting up and down once again. In addition to the symptoms
he had been exhibiting off and on throughout the winter, he now seemed
to have difficulty even walking across the street! His rear legs were no
longer clearing the ground when he walked, and I could hear the nails of
his rear paws scraping the ground as he walked. Suddenly, he could no longer
get up onto my bed (his favorite place to sleep). The stairs, which he
always took two and three at a time, now became a nightmare for him, and
sometimes, if he forgot about his disability (in his haste to be FIRST),
he would tumble down.
Once again, I brought Jack Flash to Brian and Jon, our veterinarians.
Both were now convinced that there was a good likelihood that Jack Flash
had Degenerative Myelopathy. Heartbroken, I called a neurologist to make
an appointment for Jack.
In May of 1997, I brought my beloved Jack Flash to the neurologist.
He was examined carefully by the neurologist, and his history was taken.
The neurologist, Brian, and Jon all agreed the cause of Jack's difficulties
was in all probability, Degenerative Myelopathy. I asked what could be
done to determine if this, in fact, was the cause of Jack's problems. The
neurologist informed me that there was no specific test for Degenerative
Myelopathy. A DM diagnosis is made by ruling out other diseases that might
cause the symptoms Jack Flash was exhibiting.
The tests to rule out other causes of Jack's difficulties were very
serious tests for a 12 year old dog. Myelograms carry the risk of both
anesthesia and an allergic reaction to the contrast agent. There is usually
a longer recovery time in older dogs, in a test like this, and some dogs
do not tolerate this test well. MRI scans also involve anesthesia, a concern
for an older animal, and CSF taps, involve sticking a needle into the spinal
column to get spinal fluid to test. Paralysis is a possible outcome of
some of these tests. I asked what could be done for Degenerative Myelopathy,
if the tests confirmed the worst suspicions. I was told, there was nothing
to be done about DM, other than to try to make my dog as comfortable as
possible. I was told that as Jack's symptoms had been getting worse rapidly,
he would be entering the final stages of Degenerative Myelopathy. When
I asked how much time I had left with my beloved friend, I was informed
that dogs usually only live about 3 months at this stage of DM, but he
would in all probability, become paralyzed before that time arrived.
The ride home from the neurologist, was a trip from hell. I felt as
if the sun had been yanked from the universe, the oxygen supply depleted,
and as if the whole world had imploded onto my person. The thought of subjecting
Jack, at his age, to these tests, if the outcome was that there was "nothing
to be done" seemed foolish, at best. The risk just seemed to be too
high.
Later that night, as if things were not bad enough, Jack became ill.
Brian had just left for vacation. I never had a dog that had bloated, and
I was completely unfamiliar with this experience. I did not realize that
Jack had Bloat, and did not know the seriousness associated with this condition.
How Jack survived that night, I will never know. I think he managed to
live through sheer willpower and determination. Jon May was in the office
the following morning when I brought Jack in for treatment. Jon took one
look at Jack, felt Jack's spleen, and informed me that if Jack's life were
to be saved, he would need immediate emergency surgery! There was nothing
for me to do but to go home, and he would call when the surgery was completed.
A few hours later, I received a telephone call from Brian, who had immediately
come home from his vacation, upon hearing of Jack's illness. Jack was out
of surgery, and doing well. Obviously, Jack needed to be hospitalized for
a few days. Brian and Jon assured me they would have Jack up on his feet,
as soon as possible, and explained to me that inactivity only caused DM
to progress faster! I was devastated.
It seemed to me that someone, somewhere on this earth must be doing
some kind of research on Degenerative Myelopathy. It just didn't make any
sense that a disease like this would be ignored or overlooked by scientists.
A new computer sat on my desktop at home. I didn't have the vaguest idea
how to use it, having found everything about it to be nothing but confusing.
However, that computer was my link to a world where, perhaps, I could find
information that could possibly save the life of Jack Flash. In my heart
of hearts, deep down in my soul, I believed that if I looked hard enough,
I could find the information I needed so desperately!
People can be wonderful. I managed to sign on to the Internet, but didn't
have the vaguest idea how to go about getting information. My husband had
an AOL membership, so I started visiting chat rooms, in the hopes of finding
how I could go about getting the information for which I was searching.
The AOL "help" technicians, people I met in the AOL chat rooms,
and the people I met on the AOL German Shepherd Bulletin Board all went
out of their way to help me. They instructed me on how to post messages
on newsgroup bulletin boards, in the hopes that some one would be able
to provide any information regarding research on Degenerative Myelopathy.
I don't think I slept the entire time Jack Flash was in the hospital.
I went to visit him daily. His positive attitude helped him to make a dramatic
recovery from his surgery. I spent most of my time, while he was in the
hospital, searching for DM information. The night before I went to pick
him up and bring him home, I received information, in an email from a kind
hearted stranger, about a Dr. Roger Clemmons at the University of Florida,
who was, indeed, doing research on Degenerative Myelopathy.
I immediately emailed a letter to Dr. Clemmons, and sent it to the web
address that was given to me. I hoped and prayed that he would respond,
as every day that went by, was one less day with my beloved Jack Flash.
I was racing the clock. Although, as stated, I hoped Dr. Clemmons would
respond, I never did actually think that I would hear from him.
The following day, I brought Jack Flash home. Once he was settled in,
I ran upstairs, to look at my computer, to see if possibly my prayers had
been answered. (I put a gate at the foot of the stairs, to prevent my loyal
friend from following me.) I turned on the computer, and there, less than
12 hours after my original email was sent to Dr Clemmons, was a response.
Suddenly, I was poked by Jack's nose. Somehow, stitches and all, he had
managed to dislodge the gate, and sneak up the stairs, to be by my side.
Dr Clemmons
emailed me a complete set of instructions, regarding treatment to slow
the progression of DM. He even gave me the name of a lab who could make
the necessary prescriptions at a price which I could not beat, anywhere.
I had informed him that I was reluctant to put Jack through any of the
"rule out" tests, and to anesthetize Jack as he had just undergone
surgery. Dr Clemmons suggested I send a video of Jack to him, including
pictures of Jack walking, standing, and his daily activities. I also included
footage of Brian showing Jack's hindquarter reflexes. Jack, at this point,
was no longer immediately "righting" his toes, when turned back.
His reflexes were slower than they were when last checked.
I sent the video to Dr. Clemmons, who agreed with the diagnosis of Brian,
Jon and the neurologist. All concluding that Jack, in fact, did have Degenerative
Myelopathy. I started Jack Flash on Dr. Clemmons' program.
Dr. Clemmons' program for slowing the progression of Degenerative Myelopathy
relies on the following: Aminocaproic Acid, N-Acetylcysteine, large doses
of anti-oxidant vitamins B, C, E, Selenium, Beta Carotene, and other vitamins
and supplements such as Gammalinolenic Acids, Gingko, Ginseng, Omega 3
Fatty Acids, Bromelain, Curcumin, Tofu, Ginger, raw garlic, and Co-Enzyme
Q. Exercise is also considered crucial to slowing the progression of DM.
As soon as Jack's stitches were healed, and Brian and Jon said he was well
enough, I began to swim Jack religiously, every other day, in our backyard
pool.
Within 3 weeks, Jack Flash began exhibiting a remarkable response to
Dr. Clemmons program. He began to walk without dragging his legs. He could
walk further than he had been able to before beginning the program. I found
that I was, once again, able to massage Jack, without him falling over,
or losing his balance. He continued to improve, and after a while, he was
able to get on and off my bed again, and was able to go up and down the
circular stairway in my home, without the tumbles that used to plague him.
After a point, Jack Flash seemed to stabilize.
There are good times and bad times when dealing with DM. Typically,
it is a disease in which symptoms wax and wane. However, it is now February
of 1998, 10 months after Jack Flash was diagnosed with Degenerative Myelopathy,
and my companion is still by my side. He is still leading a quality life.
He is NOT paralyzed, and he has outlived the short life expectancy given
to us last May.
Dr. Clemmons and I continue to communicate regularly. I have started
a Degenerative Myelopathy Support Group, for people whose dogs have been
diagnosed with DM. I want all to know, there IS a treatment for Degenerative
Myelopathy, and there IS something to be done about this disease! There
might not be a cure, but there is a way to slow the progression of this
disease, which will allow you and your dog to have more quality time together.
Dr Clemmons has set up a Neuro Chat Room, accessible through his website,
for the members of the Degenerative Myelopathy Support Group. We usually
meet once a week, on Wednesday Evenings, and most of the time, Dr. Clemmons
spends 2 hours or more with us, answering our questions, and helping us
improve the lives of our stricken dogs. In addition, he has set up a Degenerative
Myelopathy Message Board, where we can post questions, which he answers
between our meetings. He is a most wonderful person, with a heart of gold.
He truly cares for animals and the people who love them.
All too often, veterinarians do not recognize the early symptoms of
Degenerative Myelopathy (I was one of the lucky ones), and all too often,
DM is mistaken for other problems, such as hip dysplasia. I have written
a letter to the AVMA, asking that one of their future conferences be devoted
to DM. Too many veterinarians actually believe nothing can be done about
DM, and too many veterinary neurologists are too quick to "write off"
DM dogs.
I have written this article in the hopes that I have been able to educate
people about Degenerative Myelopathy. I want people to know that there
IS a program to help dogs who have been diagnosed with this disease, and
that this program DOES work, in 80% of the cases. PLEASE - DO NOT GIVE
UP ON YOUR DM DOG!! Dr. Clemmons continues to do research on this disease,
and Jack Flash continues to go up and down the staircase, get in and out
of the car, get on and off my bed, and still walks by my side. My steps
have slowed a little, to accommodate those of Jack Flash, but, happily,
he remains by my side. We are still two hearts, two hearts, two hearts
that beat as one…
Final note: Jack Flash's veterinary acupuncturist, Dr. Dick Fredericks,
recognizing the importance of exercise in relation to the health and well
being of DM dogs, has recently constructed a facility that houses an indoor
heated swimming pool for dogs. This is located near my home, and will provide
a way for Jack to continue to get a non-impact workout in the cooler months.
I have to admit, I may have nagged Dick into this, but Jack had him at
"hello"…
Hop
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