THE PREVENTABLE TRAGEDY OF DM (DEGENERATIVE MYELOPATHY)
On October 14, 2013, at 10 a.m., Kevin and I walked into the University of Missouri Veterinary Teaching Hospital with Bundas. This was one of the hardest trips in my life, a decision that had taken a long time and a river of tears. We wanted Bundas to have as long a life possible as long as he was happy. Finally it became obvious it was time to let go.
On September 4, 2002, my partner, Robbie Benoit, and I had a litter of six puppies born to CH Agyu-Golyo Ambassador (Oscar) and CH Brae's Tears of Angels (Gemma). Oscar was sired by a Hungarian dog, Nyerges Folyo Csardas, out of CH Irie's Accords and Accolades, bred by Wynne Vaught. Gemma was born on our farm, Braefiddich Farm, sired by TRR Mishuga, bred by Jan Elser, out of Eleanora Amranai, bred by Turtlerock Ranch.
Robbie and I always considered ourselves to be responsible breeders, having few litters, worrying about placing the puppies in good homes, taking the best care we could of puppies and parents. Money was never the reason for a litter. Never at any point would we have bred puppies destined to suffer this disease. Had we known of this disease, we would have suffered nightmares worrying about our "children". Had I known of the development of testing in 2009, all adults would have been tested.
DM (Degenerative Myelopathy), is a recessive inherited disease caused by a mutated gene. As it is recessive, it requires a mutated gene from each parent to produce the condition. A dog may be NORMAL (2 normal genes), CARRIER (1 mutated, 1 normal) and AT RISK/EFFECTED (2 mutated). This is most likely a very old mutation as it is found in 125 breeds, toy to giant, as well as mixed breeds of all types, appearing before breeds began to be separated. DM is very like the most common inherited version of ALS (Lou Gehrig's) in humans.
Initial presentation and progression of DM is heartbreaking. At first, the dog may start dragging a foot or show weakness in a hind leg. As it progresses, the weakness gets worse and now both hind legs are effected. As the dog walks and stands, it may be on the top of his foot(feet), producing sores. Standing for any amount of time becomes difficult. The hind legs may spread far apart for added stability, or he may involuntarily cross them.
At some point, the bowels will lose control and eventually the bladder as well. All this time, the weakness gets worse and worse. Muscles continue to degenerate and the weakness spreads to the front end as well. He may get pressure sores from lying down nearly all the time. Priapism (erection that will not go away) may be a problem. At first, using a little oil and manipulation will get the penis back in the sheath. At some point, the erection may get so severe and long lasting that blood drips from the end of the penis.
Standing and walking continues to become more difficult. He begins to fall down more and more, especially when trying to turn or back up. Random movements may start in the leg(s) making control of his movements difficult. The weaker hind leg may end up stretched out behind and "stuck", not allowing him to step forward. Touching him on the flanks or back may cause involuntary movement as well. To travel short distances he may use only his front legs and pull himself along. He may lie on the floor and vocalize seemingly out of frustration. Getting up may be nearly impossible now and you may need to pick up his hindquarters frequently.
At some point you know he will not be able to get up. He will not be able to stand and you know you have waited too late to let him go easy.
The absolute hardest thing about DM is the dog's mind is perfectly fine. You look in his eyes and see your dog. He is still the same loving devoted partner and you can do nothing to help him. Animals always trust us to "fix" everything. We feed and care for them. Keep them safe and healthy. When they are sick or hurt, we take care of that as well. This is one of the few things we cannot fix for them. It is out of our hands. And your heart breaks again and again and again.
This is not just a list of symptoms out of a clinical book. This is Bundas' story, all of it except the final chapter. We did not wait until he couldn't get up at all. We did not wait too late.
He started exhibiting symptoms a year ago with hind leg weakness and then loss of bowel control. Over the past year, Bundas had lost nearly twenty pounds and he never had any extra weight. The middle of July, Bundas had the extreme erection with bleeding which precipitated the visit to the vet, Dr. Carlson. At this point we were blaming his problems on age even though I had older Koms with no problems. We opted for palliative care, dexamethasone followed by prednisone. The priapism subsided, however, the other problems continued to increase.
By the end of July, Bundas was completely incontinent in both bowel and bladder. After posting about him on Facebook, a friend emailed me saying she thought Bundas had DM. She also included a link to a website. After reading the University of Missouri website, I knew what his problem was. I was shocked and dismayed as I had known nothing of this disease. I contacted the researchers at the University and sent in a blood sample. On September 5, 2013, test results confirmed the diagnosis. Weakness progressed but he was happy and loved. October brought the realization his time with us was over.
Some breeds are greatly effected with as many as 70% of dogs possessing one or two mutated genes. Others, fortunately, have a much lower percentage of effected dogs. Although very few Komondors have been tested, it appears Koms are not one of the lucky breeds. As of 9-9-13, only 63 Koms have been tested. Of these, 35 are NORMAL, 26 are CARRIERS and 2 have been AT RISK/EFFECTED. Obviously one of those two is our Bundas. I do not know who the other was, however, I wish they would have to courage to speak up. This gives our breed a 44% of dogs that are CARRIERS or AT RISK.
The research group had no specimens from Komondors. We made the decision to drive Bundas to Columbia for euthanization and necropsy with hope he might make a contribution to the research.
Why have so few Komondor breeders/owners made use of the test for DM? Why are so few talking about this disease, how we need to deal with it and the best way to breed it out? We stress ethical breeders must OFA hips, why not DM testing? Why do we tell prospective clients all about elbows, CERF, ect. and we do not disclose the DM status of our breeding animals?
DM is a fatal disease unless the dog dies of another cause first. Yet it is one that can be easily controlled. Unlike hips which are effected by many genes, DM is the result of a single mutation.
Please pass this on to everyone you know that loves or breeds dogs, of any breed, not just Komondors. Test all breeding animals and use the information wisely. Educate prospective puppy buyers about the disease and stress the importance of knowing the DM status of the parents. This is a disease that can be beaten if the effort is made. Now is the time to face up to the problem.
Prospective puppy buyers, don't work with breeders who deny this disease and refuse to speak of it. Ask to see the testing results of the parents, particularly if you are looking for a breeding prospect. Be smart and educated.
Visit www.caninegeneticdiseases.net for more information. The University of Missouri Veterinary Teaching Hospital is the major research center for DM. They are wonderful people and willing to be a resource.
Pictures and videos of Bundas are included here to help drive home the actual face of DM.
Included is an letter written by one of the researchers on the DM project at the University of Missouri Veterinary School. Liz Hansen wrote the article in 2010. It has been updated on September 27, 2013, to reflect the additional Komondors tested and is used with her permission. CLICK HERE
We would welcome any information or anecdotal stories regarding DM or dogs you may suspect were effected.
Many thanks to the Neurology Department of the University of Missouri Veterinary Teaching Hospital, Dr. Joan Coates, Dr. Patrick Daniel, Liz Hansen and Stephanie Gilliam for all their kindness and information. Special thanks to Dr. Daniel and Stephanie for their caring attention to Bundas.
Braefiddich's dear Komondor, Bundas, was featured in an article on DM (degenerative myelopathy) by Susan Seltzer, Animal Welfare Writer and owner of the website, Lessons From A Paralyzed Dog. Whether you are well versed on this disease, or not, please read this article and pass it along.
One Woman's Crusade To Stop Degenerative Myelopathy