Ask The Vet

Degenerative Myelopathy, SOD 1 Test

My dog was recently diagnosed with Degenerative Myelopathy. She is a German Shepherd/ Rott mix that is appox. 12 years old. I do not know much about the disease and was wondering if you could tell me about it and if there is anything Holistically that I can do for her.

~ Denett

Dr Sara ChapmanDear Denett,

I am sorry to hear that your girl is unwell. The diagnosis of Degenerative Myelopathy (DM) is very upsetting. DM is an immune-related chronic and progressive degeneration of the spinal cord. Affected dogs show gradually worsening incoordination and weakness in their hind limbs. Unfortunately, the test for the SOD 1 mutation, which is used by many vets as a means to definitively diagnose DM, is not a very accurate test.

I have heard and read different opinions about the value of DM testing in predicting disease and eliminating carriers of disease. I have seen patients with DM without any abnormal copies of the SOD 1 gene, and elderly ‘At Risk’ patients (with two copies of the abnormal gene) with no disease whose owners were panicking every time their dog dragged a toe. No test is going to be 100% accurate, but there really doesn’t seem to be very good correlation at all between the At Risk / Clear state and disease.

The acknowledged veterinary expert on Degenerative Myelopathy of German Shepherds is Dr. R. M. Clemmons at the University of Florida. He has been studying DM in Shepherds for years: DM Study His website is a gold mine of information about this disease. One apparent omission on the site is any mention of the genetic testing for the SOD 1 mutation.

I attended Dr. Clemmons’s Degenerative Myelopathy lecture at the American Holistic Veterinary Medical conference in Kansas City last month, where he discussed diagnosis and treatment of DM. I asked him what role DM testing for the SOD 1 mutation should have in diagnosis of the disease and in breeding programmes. He said that the current SOD 1 DM test is not useful for definitively diagnosing disease or for eliminating breeders. It is not predictive of the development of disease. The SOD 1 seems to be near the locus for the DM gene, which is why it is associated with it in some cases.

Clemmons then went on to say that this focus on a test which is not predictive is drawing attention away from actually finding the locus (or loci) truly responsible for causing DM. He would like to see more work toward improved diagnostics. He also noted that similar disease presentations are being labelled DM, and many have not been shown to have the same pathogenesis (cause and development of disease) as the disease in German Shepherd Dogs. They may not have the same genetic pattern of inheritance at all.

It is possible, Denett, that your girl does indeed have DM, but I would not use a positive SOD 1 test as confirmation of the diagnosis. In confirmed cases of DM Dr. Clemmons has had dramatic success with the protocol that is outlined on his website, involving exercise, diet, supplements, and two medications, as well as supportive treatments.

I am concerned that your dog may have another spinal cord disease which looks somewhat like DM and that, in the presence of a positive SOD 1 test, your vet may have diagnosed DM. Many older dogs develop mild proprioceptive deficits, which means that they don’t always know where their hind feet are, and they may drag their toes at times. This is not the same as DM; it is usually much less serious. Dogs can also develop disc problems which can mimic DM. Disc diseases are treated differently from DM. I urge you to work with a vet who is willing to pursue a more definitive diagnosis, if that is what you want. It is hard to give advice about therapeutic options when we are not certain of the problem.

I will say that I have had good success treating dogs with both proprioceptive problems and disc disease. I have used constitutional homeopathic prescribing and acupuncture. You might consider looking for a vet in your area who offers these services, if it turns out the the DM was diagnosed on the basis of the flawed SOD 1 genetic test.

S.F. Chapman DVM, MRCVS, VetMFHom

DHEA, Soy Milk, Incontinence

Can you please explain “two of my favorite incontinence cover-ups include the supplement DHEA and 1/2 cup soy milk as needed”. I can’t find any info on DHEA in dogs. Thank you.

~ Lois

That would be helpful as I have a VERY allopathic mother with a very incontinent dog, she’s currently using meds that aren’t really working. She would not go for homeopathy but an herbal treatment that may work would be most welcome Personally, I would rather treat the dog with homeopathy and address the source, not the symptoms, but she’s very closed minded…

~ Diane

Dr Jeff FeinmanHi Lois and Diane,

So sorry to be unclear about my use of DHEA and soy milk. What I meant is that these supplements can naturally and effectively palliate incontinence while the body heals during homeopathic treatment. When indicated, I may use one or both of these along with medicines chosen for the totality (the “gestalt”) of the individual. Before covering up any symptom though, it is important to have your vet rule out incontinence due to metabolic and lower urinary tract diseases (like bacterial and stone induced).

I find that soy milk can be very useful in helping to manage incontinent patients. The natural phytoestrogens in soy aid with normal function of the urethra to help prevent urine leakage. Add ¼-½ cup of unsweetened soy milk to each meal. Try this first before adding in DHEA to help manage mild incontinence.

When needed I may also add a DHEA product designed for people. I am not aware of any specifically for pets. The products I use are derived from wild yams and provides building blocks for various hormones. In people, it has been used to increase energy, metabolism, during menopause, etc. I’ve seen a similar improvement in well-being in many dogs that I have used DHEA. The doses I use vary from just one 5mg capsule per day all the way to 25mg twice a day. It is best to use this supplement, especially at higher doses, under veterinary supervision.

Good luck!
Dr. Jeff

Lyme Vaccine

I am considering no longer letting my Shar Pei get the Lyme vaccine even though we are in a Lyme hot spot. I have read the efficacy is limited. I am thinking the risk outweighs the potential benefit. He is on flea and tick preventative and not roaming in the woods.

~ Cathy

Jennifer RamelmeierDear Cathy,

You are correct in your feeling that the risks outweigh the benefits of a Lyme vaccination. The Lyme vaccine at best gives limited and short term protection. In addition, there is also evidence to show that vaccination depresses the immune system and leaves the dog susceptible to other infections. Which brings me to the point that the tick can carry a multitude of other bugs along with the Lyme such as Babesios, Erhlichosis, Anaplamasmosis, Rocky mountain spotted fever and others.

So rather then try to vaccinate for all of these bugs it is better to keep the ticks off the pets in the first place. I am big on environmental control. Use a product like PCO by cedercide.comon the lawn/woods
every 6 weeks and then use a product like redicare (keys soap) or best yet (cedercide) directly on the dog. Do not use the veterinary topicals like frontline or advantage as they are toxic and mildly carcinogenic to the dog and your family.

Yours in health,
Jennifer Ramelmeier DVM, CVH

Brain Tumor

My 13-year old beloved Shiba Inu was given a near certain diagnosis of a brain tumor yesterday. Because of her age and the uncertainty of recovery, my husband and I have decided not to go forward with conventional cancer treatments and just keep her as happy and comfortable as we can until her quality of life is such that we feel euthanasia is the only option. At the moment, she is still very happy and playful and we want to keep her that way as long as possible.

After that diagnosis, we immediately came home and started searching the internet for anything natural that could possibly help in some way and maybe buy us some extra time with her. I came across Ruta 6c as a homeopathic treatment for killing cancer cells. If it can’t make things any worse, I am absolutely open to giving it a shot but I am confused about what the difference is between Ruta 6c, 30c and 200c and can’t seem to find anywhere what a proper dosage for a dog is. Any help or advice on this subject would be so greatly appreciated. This is our baby and we want her to be happy and healthy as long as possible.

Thank you in advance.

~ Mallory

Dr Jeff FeinmanHi Mallory-

I’m so sorry to hear about your pup’s possible brain tumor. It is good news and a very good sign however that her vitality is still high. Her happiness and quality of life are most important whatever treatment you chose. High vitality indicates that she may still be able to respond to treatment.

You didn’t mention her signs or symptoms, but if she has just started having seizures, and all metabolic dis-eases have been ruled out, I agree that a brain tumor is most likely. I understand that you have chosen to forego chemo and radiation treatments if indicated.

However, you might want to consider further diagnostic imaging (CT scan or MRI). Further workup and definitive diagnosis may help guide your palliative care decisions. Some canine brain tumors are slow growing and are surgically resectable depending on their location. After removal, you may still get some quality time with her. This article will give you many more details about conventional brain tumor diagnosis and treatment: Unfortunately, it does not discuss the holistic therapy options.

This is an unpublished letter to the editor of JAVMA (the main vet journal) where I discuss this problem further:

No matter how you decide to treat her however, I’d advise holistic and homeopathic adjunctive therapy. Very important is to upgrade her diet. Fresh food will both provide much needed nutrients as well as help her piece of mind and mental state. Try to minimize her carbohydrates. Immune modulating and brain supporting supplements like omega-3 fatty acids (fish oils), DMG, Rx Vitamins Onco Support, medicinal mushrooms, etc. may also be useful. Further phytonutrient and antioxidant support is provided by using 1-/4-½ cup per meal of a 1:1 fresh/frozen blueberry and steamed kale mix. Most of my patients that have cancer are also treated homeopathically. In addition to the Ruta that you mentioned, there are many other homeopathic medicines that can help. Belladonnna is one that has been documented to reduce seizures in dogs.

Regarding your question about the best way to use Ruta and other homeopathic medicines, you should realize that posology needs to be individualized. Last week’s discussion and the linked article will give you much more info: Posology includes potency, dose and timing of administration of these medicines. Many, many factors need to be considered. I’d strongly advise working with a well-trained veterinary homeopath. S/he can both discuss all of your treatment options as well as help guide your pup towards both optimal holistic and homeopathic treatments.

These steps should help you can get more quality time with your beloved companion.

Dr. Jeff

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