Integrative Medical Approach to Treatment:
The treatment of DM involves four basic approaches:
1) exercise
2) dietary supplementation
3) medication
4) other supportive measures
Rationale:
Degenerative Myelopathy is an autoimmune disease whereby the patient's own immune
system attacks their central nervous system. This immune attack leads to loss of myelin (insulation
around nerve fibers) and axons (nerve fibers). While it begins and is most severe within the
thoracolumbar (middle back) spinal cord, DM also affects other areas of the central nervous system
including the brain stem and sub-cortical white matter. The cause of this autoimmune disease is not
known, but there are probably genetic, environmental and toxic factors which eventually lead to its
development. Conventional medicine has little to offer patients with DM. On the other hand, use of
exercise, certain vitamins and selected drugs have delayed or prevented progression of DM in many
afflicted dogs. While these treatment modalities have been directed at suppression of the clinical
signs, little has been done to prevent the development of this autoimmune disease.
The purpose of this paper is to provide a rationale for treatment of German Shepherd dogs
afflicted with DM with dietary alternatives and certain dietary supplements, hoping to prevent or
correct the immune dysfunction which leads to the development of DM. Most of the suggestions
presented here have been extrapolated from the human disease most similar to DM in dogs, Multiple
Sclerosis, or its animal model, experimental allergic encephalitis. Additional information about the integrative treatment of MS can be found on Dr. Weil's web page (http://www.drweil.com). Dr. Weil
teaches integrative medicine at the University of Arizona's Medical School.
Exercise:
The importance of regular aerobic exercise in the prevention of chronic degenerative diseases
should not be overlooked. Many studies in human beings have demonstrated improved muscle
performance, memory and cerebral blood flow in patients who undertake aerobic exercise. Many
of the goals of treatment in DM are obtainable through regular exercise. Two forms of exercise seem
the most useful: walking and swimming. Both have their merits and they may not be exclusive. A
number of owners have reported that swimming assists dogs beyond the exercise of mere walking.
Swimming generally increases muscle tone and allows movement without stress on joints. Walking,
on the other hand, helps build strength, since gravity is involved. In older patients, particularly those
with arthritis, gradually building the exercise program is important. In addition, allowing a day of
rest between heavy workouts can help the patient recover faster from the exercise. A good general
reference of exercise physiology and exercise programs is a book by Jeff Galloway: Galloway's
Book on Running, Shelter Publications, Inc., Bolinas, CA, 1984.
Exercise is extremely important in maintaining the well being of affected dogs, maximizing
muscle tone and maintaining good circulation and conditioning. This is best achieved by an
increasing schedule of alternative day exercise. Running loose on the owner's property is not
adequate; regular periods of programmed continuous exercise are the most important. It is equally
important that the patient with DM be allowed to rest on the day when exercise is not programmed.
This will allow strained muscles and tendons to heal and increase the build up of muscle strength.
The dogs do not have to be confined, only that they are not encouraged to do strenuous exercise on
the "off" day. I recommend starting with 5-10 minutes of walking or swimming every other day for
2 weeks. Then, increase the length of exercise time to a goal of 30 minutes twice a week and a long
walk of 1 hour once a week. If your dog already exceeds this limits, that is fine. However, remember
to provide a day of easier exercise between vigorous workouts. This is particularly important as the
patient gets older. If the patient exhibits muscle or joint stiffness on the day following vigorous
exercise, try ginger, garlic, mustard and feverfew to reduce inflammation. Alternately, carprofen
(Rimadyl 2 mg/kg twice a day) or acetaminophen (5 mg/kg up to 3 times a day) may help make the
patient more comfortable. Many DM patients have remained functional because of exercise alone.
We use to think that hospitalization was harmful to patients. We now know it is the lack of exercise
which is harmful. Make sure your pet gets their exercise if they are hospitalized or kenneled for any period of time.
Supplementation:
Dietary Considerations:
Dietary and dietary supplement management of DM has not received great attention. We,
and others, have long sense recommended certain dietary additives do in part to deficient levels of
certain vitamins in dogs afflicted with DM, yet dietary supplementation has not resulted in more
than mild reduction in the rate of progression of the clinical signs. On the other hand, diet may have a powerful influence on the development of chronic degenerative diseases and new information
suggests that dietary regulation might play a more significant role in the progression and
development of diseases like MS. Elimination of toxins from pre-processed food may assist in
preventing a number of immune-related disorders.
The current treatment of DM is designed to
suppress the immune disease, but does nothing to correct the immune alterations which led to the
disease state. Diet might help in correcting this defect and allow the immune system in DM dogs to
stabilize.
The principles of dietary therapy are outlined here, including a "home-made" diet. For
those who cannot "cook" for their dog, the basic diet should be supplemented with the additional
ingredients list below. It is best to choose a dog food which is close in protein content and is as
"natural" as possible. Wild dogs were not meat eaters. They ate bodies, including intestinal contents
(often laden with plants and plant materials). Dogs have evolved so that eating animal fats and
protein do not cause them to suffer the same problems as human beings when eating these sources
of saturated fats. Even so, dogs probably suffer from the same causes of dietary and environmental
intoxication which affects human beings.
The basic diet and its components have been checked for balance. In addition to the basic
components, we are adding vitamins, minerals and natural herb supplements for which no specific
requirement is known or at levels which are to provide a specific pharmacologic effect. Again, we
recommend those compounds which scientific evidence supports their efficacy. Used according to
the following formula, the diet and compounds should not do any harm and have the potential to do
good. By cooking for your dog, you can select healthy products which do not have preservatives and
additives which might be harmful. In addition, you have the option to use organically grown foods.
If the dietary approach is successful, DM patients may not need to use other medications to prevent
further deterioration. It is also possible that this diet might prevent the development of DM in dogs
who are presently healthy. These hypotheses will be evident in the future, if they remain true.
Basic diet: (based upon 1 serving size for 30-50 pounds body weight)
2 oz Boneless Pork Center Loin Chop (boiled, baked or fried in olive oil)
4 oz Tofu (soybean curd)
8 oz Long Grain Brown Rice (3 oz cooked in 6 oz water)
2 tsp Extra Virgin Olive Oil
¼ cup Molasses or Honey
2 Whole Carrots (boiled and then cut up)
1 cup Spinach (cooked)
4 Tbs Green Bell Pepper (chopped and steamed)
4 Broccoli Spears (boiled and then cut up)
This diet (1 serving for 30-50 pounds body weight) provides approximately 1160-1460
calories per serving. You can substitute poultry meats, beef and lamb for the pork chop.
This will
alter the composition slightly, mainly by added additional fat. The weight of meat is based upon
boneless weight. Most of the items can be prepared in a microwave. Based upon your dogs body
weight, you will need to make more or less. For example, if your dog weighs 80 pounds, multiply
all the ingredients by 1.5 (can be as high as 2.5 times, though), keeping their relative proportions.
This is a starting point. You can also make this portion of the diet in advance, aliquot it into appropriate quantities and freeze it for later use. Just before feeding time, remove the diet from the
freezer and thaw in hot (or boiling) water or microwave to defrost. To complete the diet, add (amount per serving) before serving:
1 tsp Dry Ground Ginger
2 Raw Garlic Cloves (crushed)
½ tsp Dry Mustard
1 tsp Bone Meal
Using the above diet, approximately 1 serving equals 1 can of commercial dog food. The exact
requirements for your dog can be approximated by substituting the diet on that basis. You should
weigh your dog each week, if losing weight, increase the amount of the diet given. If gaining weight,
cut back on the amount given. Eventually, the correct amount will be clear. The reason why the
amount has such a broad range in that ideas about the daily caloric requirements vary. Since many
German Shepherds have sensitive stomachs, it may be wise to phase in the new diet by mixing it
with their existing food until they have adapted. Start by mixing the diet with their existing food in
equal amounts. After 1 week increase the diet to 75% of their food. After another week, switch
completely over to the diet. This diet is balanced and high in most of the vitamins and minerals
which your dog will need. Any shortcomings will be corrected with the supplements given below
as part of the treatment.
Note: The general purpose of the diet is to provide excellent quality of ingredients with
protein coming from Soybean curd (tofu). Tofu contains many valuable flavonoids and other
ingredients which promote health. If you decide to use a commercial food, you may want to use a
Soybean Concentrate which contains these ingredients, but lacks the extra protein. Alternatively,
you can add tofu to the diet (5-6 oz/day) and add honey or molasses to it (¼ cup) to make it taste
better. Reduce the commercial diet by 25-33% and monitor your dogs weight, reducing or increasing
the commercial diet accordingly. The addition of raw garlic is to provide garlic's anti-inflammatory
action and (since it is raw) to provide an antibiotic action. Raw garlic is anti-bacterial and
anti-fungal. This action is lost when garlic is cooked or dried. Dry ginger is also a good
anti-inflammatory. Together with garlic, dry ginger can replace the need for aspirin-like (NSAID)
drugs. Fresh ginger or pickled ginger are also good anti-emetic compounds, calming the stomach.
Mustard provides ingredients which support improved digestion and bowel function. So, raw garlic,
dry ginger (occasionally using fresh or pickled ginger) and dry mustard should be added to the food,
even if it is commercial. These will not unbalance the commercial food, providing important drug
properties without the side-effects of "non-natural" drugs. Using the vegetables, the diet also
provides many nutrient and vitamins which are not found in commercial dog food. If commercial
dog food is given, giving extra Soy Concentrate, Soy Lecithin and Beta-Carotene to the diet will
improve the commercial food. They are not needed, if you feed the above diet. The diet provides a
balanced, moderate protein and fat diet which is high in many essential nutrients. The only
commercial food which fulfills many of the goals is Nature's Recipe Canine Vegetarian Diet,
available from many specialty pet supply stores.
Supplements (dietary):
Vitamins:
B-Complex: B vitamins are water soluble and any excess amount will be eliminated through the
urine. They may help in neural regeneration and are something which should be given to dogs. No
dog should die while having cheap urine. In DM, there is altered absorption of some B vitamins and
supplementation can correct this. If your dog is healthy, then give high potency B-complex
(containing approximately 50 mg of most of the B components). If your dog has DM, give stress
formula B-complex containing 100 mg of most of the B components.
Yeast: Nutritional yeast, in powder or flake form, is a good source of the B-complex vitamins, trace
minerals, and some protein. It is not expensive. A heaping tablespoon of yeast will color your dog's
urine yellow (owing to its content of riboflavin). You may sprinkle it on the diet, as an alternative
to giving your dog a B-complex pill. However, it may be more difficult to be sure you are giving the
right dose. Try 1-2 T with eat meal.
Antioxidants:
Vitamin E: Vitamin E is an important nutrient which has been shown to have a number of
physiologic and pharmacologic effects. It is a potent antioxidant and reduces fat oxidation and
increases the production of HDL cholesterol. At higher doses it also reduces cyclooxygenase and
lipooxygenases activities, decreasing production of prostaglandins and leukotreines. As such, it is
a potent anti-inflammatory drug. It will reduce platelet function and prolong the bleeding time
slightly in healthy individuals. There is no known side-effects to vitamin E at levels less than
4000-6000 IU per day (except in cats, where levels >400 IU/day might create hepatolipidosis). This
drug slows the progression of DM and corrects for low serum and tissue levels. In DM, there does
appear to be a deficient absorption and tissue-binding protein which accounts for the low serum and
tissue concentrations of vitamin E. I recommend that vitamin E be given to all German Shepherd
dogs. For GSD under 2 years of age, give 400 IU of vitamin E daily. For GSD over 2 years of age,
give 800 IU of vitamin E daily. If your dog develops DM, then the dose of vitamin E should be
increased to 2000 IU daily.
Vitamin C: Vitamin C works with vitamin E and helps regenerate vitamin E, potentiating its
antioxidant effect. Vitamin C supplementation does no harm, since the excess is excreted through
the kidney. While dogs produce vitamin C in their bodies (unlike human beings, pigs and guinea
pigs who must have it in their diet), under stress or disease, they may need vitamin C in excess of
their manufacturing capacity. In excessive dose, vitamin C can cause flatulence and diarrhea. This
intestinal tolerance level varies among dogs, but is generally around 3000 mg per day in an adult
GSD. I recommend this be given to all GSD. For GSD under 2 years of age, give 250 mg vitamin
C twice a day. For GSD over 2 years of age, give 500 mg of vitamin C twice a day. If your dog
develops DM, then increase the vitamin C to 1000 mg twice a day unless this level causes diarrhea.
Selenium: Selenium is an important mineral which has antioxidant properties similar to vitamin
E. Vitamin E can replace the requirement for selenium in the body, but selenium cannot substitute
for vitamin E. In addition, selenium does not cross the blood-brain barrier like vitamin E. On the other hand, selenium may help allow vitamin E to be more effective. Many plant sources are low
in selenium and supplementation may be important. Selenium can create toxicity if given at too high
a level; therefore, never give more that 200 :g of selenium per day in large dogs nor more than 100
:g per day to small dogs. Below these levels, selenium should be safe. I recommend giving
selenium to GSD. For GSD under 2 years of age, give 100 :g of selenium daily. For GSD over 2
years of age, give 200 :g of selenium daily.
Membrane stabilizers:
Omega-3 fatty acids: Omega-3 fatty acids like EPA (eicosapentaenoic acid) and DHA
(docosahexaenoic acid) are the constituents of fish oils that act as anti-inflammatory agents and may
be worth trying if your dog has an autoimmune disorder or arthritis. Many versions of these
substances are on the shelves of health-food stores, from salmon oil to capsules of concentrated
EPA. However, eating some cooked salmon or sardines may have benefits over capsular forms of
the fish oils. Alternatively, you can give ground flax seeds, flax oil, or hemp oil as a dietary
supplement; rather than fish oils. These materials will reduce platelet function for a brief period in
dogs, but it seems that dogs compensate for this within about 8 weeks. Omega-3 fatty acids replace
the 2-series fatty acids over time. As such, cellular stimulation produces 3-series prostaglandins and
thromboxanes. The latter does not cause inflammation and reduce blood flow like the 2-series
thromboxanes. I recommend all dogs receive a 1000 mg of fish oil capsule, 1 T ground flax seeds
or eat 2 sardines every day.
Gammalinolenic acid: Borage oil, evening primrose oil or black currant oil, are natural sources
of gammalinolenic acid, a fatty acid which is hard to get in the diet. GLA is an effective
anti-inflammatory agent with none of the side effects of anti-inflammatory drugs. It also promotes
healthy growth of skin, hair, and nails. It may be good for skin conditions, arthritis, and autoimmune
disorders. It takes six to eight weeks to see changes after adding GLA to the diet. I recommend all
dogs receive 500 mg of GLA twice a day, either as borage oil, evening primrose oil or as black
currant oil.
Soybean Lecithin: Lecithin is a fat-like substance found in the cells of the body. It may combat
atherosclerosis, improve memory, and fight Alzheimer's disease in human beings. However, there
is no scientific evidence to support these claims. On the other hand, lecithin is harmless. It is not
necessary as a supplement unless your dog has DM and you elect not to use the diet proposed above.
(There is plenty of soybean lecithin in the tofu.) If you decide to use commercial dog food, add 1-2
tsp of soybean lecithin granules to the food at each feeding.
Coenzyme Q: Coenzyme Q also called Co-Q-10, is a natural substance that assists in oxidative
metabolism. It may improve the utilization of oxygen at the cellular level, and patients with heart,
muscle and nerve problems may find it worth trying in doses of 30-100 milligrams a day. Some
human beings report that it increases their aerobic endurance. Coenzyme Q is harmless, but not
cheap. It is probably not worth supplementing your dog with Coenzyme Q, if it is healthy. However,
since DM patients suffer from nervous system problems, muscle wasting and need aerobic
endurance, I recommend giving DM patients 100 mg Coenzyme Q daily.
Tonic herbs (natural remedies):
Ginkgo leaves: One tonic I recommend is an herbal preparation made from the leaves of the ginkgo
tree (Ginkgo bilboa). Recently extracts of ginkgo leaves have attracted much attention from
researchers because of their ability to increase blood flow to the brain. You can buy capsules of
these extracts in most health-food stores, although different brands vary considerably in their content
of active ingredients (ginkgocides). Ginkgo is nontoxic. For DM dogs, give 1 capsule twice a day.
Ginseng: (males only) Two species of ginseng are available: Oriental ginseng (Panax ginseng) and
American ginseng (Panax quinquefolium). Both are full of compounds (ginsenosides) that work on
the pituitary-adrenal axis, increasing resistance to stress and affecting metabolism, skin and muscle
tone, and hormonal balance. Oriental ginseng is more of a stimulant and can raise blood pressure
in some people, so I recommend using only the American species for dogs. Ginseng probably has
little to offer young dogs, but may provide an increase in vitality to an older one. I recommend using
1 capsule of American ginseng once or twice a day in male dogs over 6 years of age. (Obviously,
this includes male GSD who have DM!)
Dong quai: (females only) Dong quai is a Chinese herbal remedy made from the root of Angelica
sinensis, a large plant in the carrot family. It is often called "female ginseng," because it is a general
tonic for women and the female reproductive system in much the same way that ginseng acts as a
tonic for men and the male reproductive system. Dong quai is available in the form of encapsulated
extracts. It is a good general remedy for female dogs who lack energy. I recommend using 1 capsule
of dong quai once or twice a day for female dogs over 5 years of the age.
Green tea: Green tea is a good general tonic and has some cholesterol lowering effects. It also
contains theophylline which can help boost energy. It is available as a capsular extract or you can
make green tea and add it to the diet. I recommend 1 capsule (or cup) twice a day for DM dogs.
Grape seed extract: A great deal of recent evidence supports the value of grape seed extract in
reducing free radicals and decreasing the chances of developing chronic diseases. It is best to use
standardized extracts. Alternatively, your dog can drink 1 cup of "purple" grape juice or eat 5-6 red
grapes (peel and seeds included) a day. The dose of the extract is 1 capsule (50 mg) daily for DM
dogs.
Siberian Ginseng: Siberian ginseng is derived from the root of a large, spiny shrub
(Eleutherococcus senticosus) found in Siberia and northern China. It is a relative of true ginseng,
but has entirely different properties. Siberian ginseng has "adaptogenic" properties and reduces
physiologic responses to stress. Scientific investigations suggest it increases physical performance
and endurance and improves immune function. For dogs with DM, given 1 capsule twice a day.
Bromelain/Curcumin: Bromelain is an extract of pineapple stems which has the property of
decreasing circulating immune-complexes. As such, there is no Western medicine which is its equal.
Since many of the complications and the direct initiation of the immune damage may be caused by
the elevated immune-complexes in DM, bromelain may be an important key in helping to control the progression of DM. Curcumin (the yellow pigment of turmeric plants) is a potent
anti-inflammatory agent. Bromelain and curcumin have a synergistic effect whereby they assist the
absorption of each other from the gastrointestinal tract, increasing their potency. As such, they
should be given together. Many health food stores carry combinations of bromelain and curcumin.
For dogs with DM, give 400-500 mg of bromelain with 500-400 mg of curcumin twice a day.
(Curcumin is found in low concentrations in the spices turmeric and yellow mustard. As such, it is
possible to replace the "capsule" form by adding 1-2 Tbs of turmeric and 1-2 tsp of dry yellow
mustard to the diet.)
Feverfew: Feverfew is a natural NSAID compound without the side-effects of prescription drugs.
It can be used in dogs with pain or arthritis to help reduce inflammation and discomfort. I do not
recommend it for routine use; but, if your dog has pain from arthritis, give 1 capsule every 8-12
hours as needed. You can use this for 5 days out of the week, safely.
Note: WestLab Pharmacy has developed a palatable vitamin/mineral/herb product (Antiox-Q) which
contains bovine cartilage, coenzyme Q, vitamin E, GLA, omega fatty acids, selenium, ginkgo,
bromelain, curcumin, olive oil and B complex. This product contains the correct dosage of these
compounds and only needs the addition of vitamin C, the ginsengs, green tea and grape seed to be
complete. They may be contacted at 1-(800)-4WESTLA [1-(352)-373-8111, locally].
Medication:
Over the last 2 decades, we have found 2 medications which appear to prevent progression
or result in clinical remission of DM in many (up to 80%) of the patients. These medications are
aminocaproic acid (EACA) and n-acetylcysteine (NAC).
We recommend giving EACA as a
solution, using the generic product. This product, while designed for injection, can be mixed with
chicken broth to provide a palatable solution for oral usage. We mix 2 parts of aminocaproic acid
solution (250 mg/ml) with 1 part chicken broth and give 3 ml of this mixture orally every 8 hours.
In our experience, this mixture has been equally, if not more, effective to the tablet form of EACA.
Besides, the solution is much less expensive than the tablets. The generic form of EACA solution
can be obtained from American Regent, 1-(800) 645-1706 (outside of NY). The generic drug from
American Regent may be obtained through prescription with the help from a local pharmacy. An
alternative source for EACA is to have a compounding pharmacy make the solution from chemical
grade EACA. One such pharmacy is WestLab Pharmacy in Gainesville, FL. They can be reached
at 1-(800) 4WESTLA [1-(352) 373-8111, locally] and can mail the medication and bill the client
directly. The only side effects that have been attributed to EACA have been occasional
gastrointestinal irritation. This presents a problem only in a few patients, usually who have
pre-existing GI problems that the medication might exaggerate. A local pharmacist can help in
determining whether any additional drugs might be contra-indicated or lead to possible
drug-interactions with the recommended therapy. The only known interaction is with estrogen
compounds; but, only in high doses.
Acetylcysteine is a potent anti-oxidant which has powerful neuroprotective effects. We give
75 mg/kg divided in 3 doses a day for 2 weeks. Then, we give the 3 doses every other day. The
N-acetylcysteine comes as a 20% solution and must be diluted with chicken broth (or other
- 53 -
compatible substitute) to 5%. Otherwise, it will cause stomach upset. This new treatment is
expensive unless purchased through compounding pharmacies. Again, WestLab Pharmacy has this
product and can send it to clients upon veterinary prescription. Using N-acetylcysteine at the above
dosing does not appear to have side-effects. It can produce vomiting and may increase the bleeding
time. The GI upset is likely due to the sodium content of the pharmaceutical product, which requires
high concentration of base to buffer to pH 7.4. By reducing the pH during preparation, WestLab's
product does not have as many side-effects. Giving fresh ginger 30 minutes before and giving the
NAC with food (or on a full stomach) often reduces this effect.
The combination of aminocaproic acid, N-acetylcysteine, dietary supplements and exercise
is the best treatment we have been able to discover to date. It corrects those aspects of the immune
dysfunction which we can treat, based upon our belief that DM is an immune-mediated
inflammatory disease. We always hope that all patients will respond to our treatment protocol.
Unfortunately, it does not work in all cases; however, this combined treatment has been up to 80%
effective in patients diagnosed at the University of Florida. The chances of successful treatment are
improved if the therapy is begun early in the course of DM rather than later. A response to the drugs
should be evident within the first 7-10 days. There is no other medications that we have found to
provide any real benefits in the long term treatment of DM. Further information about other
treatments may be found in Current Therapy X, pages 830-833 and in Vet. Clin. Nor. Am.
22:965-971, 1992.
Other Supportive Measures:
Heartworm medication:
Since the monthly heartworm medications (Heartgard, Heartgard plus and Interceptor)
increase immune responsiveness, we do not recommend using these products. Instead, we
recommend plain diethylcarbamazine (DEC or Filaribits) which must be given daily. I do not
recommend Filaribits plus (some dogs experience liver problems using it). If your dog is currently
taking a monthly heartworm preventative, you must give one last dose and start the daily medication
the next day. This is because the medications work at different points in the heartworm "life-cycle".
Revolution, which is a new topical heartworm preventative, does not alter the immune response like
the other monthly products. As such, Revolution should be safe to use in DM to control internal (and
external) parasites.
Flea prevention:
Many of the old and new flea product can cause problems when certain neurologic
conditions are present. As such, we recommend using boron, pyrethrums and Precor as the main
control methods. Of the new medications, Frontline Spray and Revolution may be safe to use.
Acupuncture:
The traditional Chinese art of insertion of needles into various specific points of the body
(with injection of small amounts of fluid or electrical stimulation) has been shown to provide
analgesia and relief from acute and chronic pain. This has the advantage of having none of the
side-effects of analgesic drugs. In addition, acupuncture can do no harm. In DM, acupuncture alone
slows the condition, but does not stop the progress. One the other hand, DM patients who have
concurrent arthritis may benefit from acupuncture therapy.
Dietary Cartilage:
In many cases of degenerative joint disease with arthritis, recent studies have suggested that
glycosaminoglycans and chondroitin sulfate may help reduce pain and inflammation from
osteoarthritis, assisting in the healing process. While these products are available through
health-food stores or a pharmaceutical medication through your veterinarian, you can give these to
your dog directly by giving cooked cartilage. Sources of dietary cartilage would included cooked
and "de-bone" chicken wings or using cooked spare ribs as the meat source in the diet. Why pay for
cartilage products if it can be gotten for free in the dietary source. Some people taught the benefits
of shark cartilage, but there are no scientific studies to support these claims. (It is also ecologically
unsound to kill sharks to harvest their cartilage.) On the other hand, increase dietary cartilage can
do no harm, particularly in the face of arthritis. In DM patients with arthritis, I recommend 1-2
grams of dietary cartilage with each meal. Another alternative is bovine gelatin (Knox gelatin or
Knox Nutrajoint) which can be added to the food (1-2 packages per feeding). In some dogs, using
glucosamine/chondroitin sulfate complex will be beneficial in controlling joint pain and stimulating
healing; however, dietary cartilage has these compounds along with other important ingredients.
Forms of glucosamine/chondroitin sulfate complex are available at health food store. (These are
cheaper than products available from your veterinarian and may work as well) I recommend around
1200 mg of glucosamine and 1500 mg of chondroitin sulfate daily, if other forms of cartilage are not
available.
Stress Reduction:
DM progresses at different rates and "stress" plays a role in its advancement. Minimizing
stressful situations is important where possible. While anesthesia does not appear to cause problems
with DM; in the past, even minor invasive surgical procedures can result in a marked increase in
clinical signs of DM. Unfortunately, the worsening caused by surgical stress can be irreversible. Due
to the advent of N-acetylcysteine therapy and being more attentive to the continued exercise of
hospitalized DM patients, we now have been successful in performing many surgical procedures in
these dogs. These have included cervical and thoracolumbar disc surgery and total hip replacement.
Before aggressive surgeries are considered, it is best to determine that the patient's neurologic status
is stable. Post-operative physical therapy remains crucial in getting patients on their feet quickly.
Note: If your dog already has DM, you should consider treatment with the above natural products
and more traditional aminocaproic acid and acetylcysteine medications. Use the aminocaproic acid
and acetylcysteine for the first 2 months of therapy and then see if they can be withdrawn (without
signs of deterioration). If so, then continue with the natural approach from that point on.
Fuente: UNIVERSIDAD DE FLORIDA (USA) |
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