Degenerative Myelopathy in Dogs
What Is Degenerative Myelopathy in Dogs?
Receiving a degenerative myelopathy (DM) diagnosis for a dog is one of the most difficult, devastating moments a pet owner can face. To date, physical therapy is the only intervention that can slow its progression while prolonging quality of life1.
Also known as chronic degenerative radiculomyelopathy (CDRM), it is estimated to be found in 0.19% of all dogs2 and more common in certain breeds, such as German Shepherds, Corgis, and Boxers.
The DM disease process involves a gradual loss of protective myelin sheath around the spinal cord nerve fibers, slowing the conduction of nerve signals. This causes the disruption of movement, co-ordination, and eventually bladder and bowel function.
It typically begins at the thoracolumbar region (mid-back) of the spine which controls the hind legs.
Recognizing Degenerative Myelopathy in Dogs
In the early stages of degenerative myelopathy, the signs can be very subtle and may be easy to overlook or mistake for normal aging. Owners may notice small changes such as occasional scuffing of the nails, mild weakness or wobbliness in the hind limbs, difficulty getting up, or a change in coordination. These changes can initially come and go or only become noticeable on certain surfaces or when the dog is tired. As the disease progresses, these subtle signs typically become more consistent and pronounced. An early diagnosis can prolong your dog’s life if appropriate interventions are taken.
1Pancotto, TE. Rehabilitation Therapy for the Degenerative Myelopathy Patient. Vet Clin North Am Small Anim Pract. 2023 Jul;53(4):845-856.
2Coates, JR. Wininger FA. Canine Degenerative Myelopathy. Vet Clin North Am Small Anim Pract. 2010 Sep;40(5):929-50
Causes of Degenerative Myelopathy in Dogs
DM is a genetic disease with an autosomal recessive inheritance pattern. While a clear cause of degenerative myelopathy in dogs is yet to be established, it is strongly linked to a mutation in the superoxide dismutase 1 (SOD1) gene3 which is also implicated in human ALS.
Affected dogs must carry two copies of the mutated SOD1 gene to have DM. Dogs with one mutated SOD1 gene are carriers who won’t develop the condition themselves but can pass it to their offspring.
Although affected dogs must inherit a copy of the SOD1 mutation from both of their parents, the disease does not always manifest in dogs carrying both mutated genes. In fact, it’s estimated that there is just a 60% risk that they will4. Currently, it’s not known why only a subset of dogs who are genetically predisposed for DM will show symptoms.
- Dog is 8+ years of age
- Has poor immune system function
- Experiencing oxidative stress
3Awano T, Johnson GS, Wade CM, et al. Genome-wide association analysis reveals a SOD1 mutation in canine degenerative myelopathy that resembles amyotrophic lateral sclerosis. Proc Nat Acad Sci USA 2009;106:2794-2799.
4Zeng, R. Coates, JR. Johnson, GC. et al. Breed Distribution of SOD1 Alleles Previously Associated with Canine Degenerative Myelopathy. J Vet Intern Med. 2014, 28, 515–521.
Types of Dogs More Prone to Degenerative Myelopathy
Certain Breeds Are Genetically Predisposed, Including:
While the SOD1 mutation has been identified in 120+ breeds and can technically affect any breed carrying the mutation, degenerative myelopathy in dogs has only been confirmed in specific breeds.
The SOD1 mutation is most prevalent in certain populations of dogs, mostly the mid- to large-sized breeds, as well some smaller dogs, such as:
Genetic testing
Genetic testing through the Orthopaedic Foundation for Animals (OFA) [insert link: https://ofa.org/] can identify a dog’s SOD1 mutation status. This an important tool for breeders and to support a DM diagnosis in at-risk breeds.
Mixed breeds
Mixed-breed dogs can also develop DM if they carry two copies of the mutated gene from both parents, even if they are from different breeds.
Symptoms of Degenerative Myelopathy in Dogs
DM can mimic other conditions in its early stages, and the signs can often be subtle. Early DM symptoms can easily be mistaken for arthritis, hip dysplasia, or even something as benign as normal aging. Most owners will observe that their dog is not in pain and understandably assume that their dog is simply “slowing down with age.”
Stage 1 — Early (months 1–6)
- Mild, often asymmetric hind limb ataxia including wobbling and swaying.
- Knuckling, where the dog’s hind paw turns under and scuffs the ground.
- Uneven nail wear on the hind feet (a subtle but important early sign).
- Shortened stride on one or both hind limbs.
- Mild weakness, difficulty with stairs or jumping.
- Loss of tail tone.
Stage 2 — Intermediate (months 6–12+)
- Progressive bilateral hind limb weakness.
- Crossing of the hind legs with side-to-side swaying.
- Difficulty rising from lying down.
- Early incontinence (urinary or fecal).
- Front limbs begin compensating for reduced hind limb function.
Stage 3 — Late (Paraplegic stage)
- Loss of ability to walk unassisted.
- Complete urinary and fecal incontinence.
- As degeneration progresses up the spinal cord and into the brainstem, other motor functions are affected, beginning with front limb involvement, then swallowing and eventually respiration.
- Fatality occurs when DM reaches the diaphragm.
The impact of physical therapy
In our clinic, we often see dogs at the Stage 1 to Stage 2 transition. The families who come in at Stage 1, before the dog loses significant strength, consistently have more options and more time. Early intervention matters.
Early Signs and Progression Timeline
Affected dogs may lose ambulation, or their ability to walk, anywhere from 6 months to 2 years after becoming symptomatic for DM. Progression varies with each dog and while physical therapy does not stop the disease process, it is effective at delaying it. Symptoms of degenerative myelopathy in dogs are grouped into the following stages of severity to acknowledge the progressive nature of the disease:
Stage 1 — Early (months 1–6)
- Mild, often asymmetric hind limb ataxia including wobbling and swaying.
- Knuckling, where the dog’s hind paw turns under and scuffs the ground.
- Uneven nail wear on the hind feet (a subtle but important early sign).
- Shortened stride on one or both hind limbs.
- Mild weakness, difficulty with stairs or jumping.
- Loss of tail tone.
Stage 2 — Intermediate (months 6–12+)
- Progressive bilateral hind limb weakness.
- Crossing of the hind legs with side-to-side swaying.
- Difficulty rising from lying down.
- Early incontinence (urinary or fecal).
- Front limbs begin compensating for reduced hind limb function.
Stage 3 — Late (Paraplegic stage)
- Loss of ability to walk unassisted.
- Complete urinary and fecal incontinence.
- As degeneration progresses up the spinal cord and into the brainstem, other motor functions are affected, beginning with front limb involvement, then swallowing and eventually respiration.
- Fatality occurs when DM reaches the diaphragm.
The impact of physical therapy
In our clinic, we often see dogs at the Stage 1 to Stage 2 transition. The families who come in at Stage 1, before the dog loses significant strength, consistently have more options and more time. Early intervention matters.
How Is Degenerative Myelopathy Diagnosed?
At this stage, there is no definitive ante-mortem (in-life) test for DM. A definitive diagnosis of degenerative myelopathy in dogs can only be confirmed by examining spinal cord tissue after death.
Diagnosis can be a complex process and requires a veterinary neurologist to exclude other conditions by conducting the following battery of tests to make a presumptive diagnosis:
- Neurological examination
- Blood work and urinalysis
- Radiography (X-rays)
- Advanced imaging (MRI/CT with myelography): this is essential to rule out compressive spinal cord disease such as IVDD or a spinal tumor. These conditions look similar to early DM during a physical examination.
- Cerebrospinal fluid (CSF) analysis
When combined with other positive signs, SOD1 genetic testing increases the likelihood of DM if two copies of the mutated gene are present.
Treatment of Degenerative Myelopathy in Dogs
Unfortunately, there is currently no cure and no treatment for degenerative myelopathy in dogs that stops or reverses the neurological degeneration. However, there are ways to manage the disease to prolong the lifespan of affected dogs, while optimizing their quality of life as much as possible. Effective strategies for degenerative myelopathy care for dogs include:
Pain management
NSAIDs or other pain management options may be prescribed by a veterinarian for compensatory muscle overuse and joint stress.
Assistive devices
Rear-end support harnesses (e.g., Help ‘Em Up Harness), drag bags for protecting dragging paws, and mobility carts (wheelchairs) are useful for dogs that have lost ambulation. These devices can significantly improve their quality of life, particularly in Stage 2–3 disease.
Environmental modifications
Owners can install ramps instead of stairs, non-slip flooring, raise food and water bowls and choose comfortable orthopedic bedding that is easy to rise from.
Physical therapy and rehabilitation
Evidence-based physical therapy has the most direct impact on how long a dog with DM remains mobile.
Research has shown that dogs with DM who underwent an intensive physical therapy program survived an average 4 times longer than dogs who did not undergo any physical therapy at all. Even a moderate physical therapy program was still more than twice as effective5.
5Kathmann I, Cizinauskas S, Doherr MG. et al. Daily controlled physical therapy increases survival time in dogs with suspected degenerative myelopathy. J Vet Int Med. July 2006;20(4):927–932.
The Role of Physical Therapy in Degenerative Myelopathy Management
How does physical therapy help in canine DM?
- Muscle strengthening maintains the dog’s ability to compensate for neurological deficits longer, delaying the loss of ambulation.
- Active movement stimulates the nervous system, which may help slow the functional deterioration of remaining nerve pathways.
- Prevents pain and secondary musculoskeletal injuries, including compensatory strain in shoulders, neck, and forelimbs.
- Supports proprioception (body awareness) as long as possible.
Evidence-Based PT Modalities and Exercises
At Canine PT and Me, we work alongside veterinary neurologists and primary care vets to develop individualized rehabilitation programs which offer comprehensive degenerative myelopathy support.
Our goal is to give your dog the most functional, comfortable time possible and provide you with the right tools to support them at home between sessions. Our tailored physical therapy programs include a combination of the following interventions:
Active therapeutic exercises
- Sit-to-stand repetitions: to build quadriceps and gluteal strength and maintain functional transition ability.
- Weight shifting: your physical therapist gently sways the dog from side-to-side while standing to challenge balance reactions and strengthen stabilizing muscles.
- Cavaletti poles and balance boards: these proprioception and coordination exercises challenge the nervous system to recruit and strengthen remaining pathways.
- Short, controlled leash walks (5–10 minutes, 5x/day, per the Kathmann protocol): are key to maintaining cardiovascular fitness and muscle activation.
Manual therapy and massage
Therapeutic massage 3 times daily reduces compensatory muscle tension in the front limbs, shoulders, and back. It also maintains tissue health by supporting blood circulation.
Photobiomodulation (Laser Therapy)
Laser therapy combined with rehabilitation is thought to delay DM progression. Laser therapy works by reducing inflammation in the body, which can help with areas of pain from compensating as well as loosening up tight muscles.
Home exercise program
Owner participation multiple times daily is essential in a home exercise program in degenerative myelopathy care for dogs.
The physical therapist’s role includes teaching owners how to safely facilitate exercises and use assistive devices correctly, as well as identifying signs of progression or secondary injury.
Managing Life With Degenerative Myelopathy
At some point, most families will face a quality-of-life decision for their beloved dog with DM. We encourage owners to discuss this sensitive topic openly with their veterinarian, who is the best person to turn to for DM support.
While it can obviously feel distressing, it is ultimately just responsible, caring ownership of a dog with a progressive disease.
Physical therapy plays a key role in improving the quality of life throughout the entire DM disease process for a dog. Most dogs will live for 1-3 years with DM, and physical therapy can prolong this time frame significantly.
Monitoring quality of life
Here are some factors to consider when it comes to ensuring a dog is still living comfortably, rather than simply just surviving DM:
- Are they still able to rise independently?
- Are they still eating, engaging, and showing interest in surroundings?
- Is incontinence being managed without causing skin problems?
- Are they developing pressure sores from lying down?
- Are they still finding enjoyment in daily activities?
Written & reviewed by Kelsey Jonas, PT, DPT, CCRT
8 years experience in canine physical therapy
Last reviewed: May 2026
The information on this page is intended as a general guide only and does not constitute veterinary advice. Always consult a registered veterinarian for diagnosis and treatment of your dog’s condition
Prevention of Degenerative Myelopathy in Dogs
DM cannot be prevented in a dog that is already alive and carries the mutation. However, there are steps which can be taken to reduce the prevalence of the disease in the dog population.
- For breeders:
- SOD1 genetic testing through OFA (ofa.org) or the University of Missouri Animal Molecular Genetics Lab
- Responsible breeding programs using genetic testing
- For owners of at-risk or affected dogs, we recommend:
- Regular veterinary monitoring from age 7–8 in predisposed breeds.
- Early genetic testing
- Maintaining healthy body weight
- Beginning physical therapy at the earliest signs of Stage 1
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FAQs About Degenerative Myelopathy in Dogs
How Long Can a Dog Live With DM?
Most dogs live between 1-3 years following diagnosis, with physical therapy shown to prolong their life span and improve the quality of life. Many dogs lose ambulation within 6 months to 2 years of diagnosis.
What Are the Benefits of Exercise for Dogs With Degenerative Myelopathy?
Structured therapeutic exercise is the cornerstone of degenerative myelopathy care for dogs and is separate to uncontrolled activity. The benefits include maintaining muscle strength and mass, stimulating remaining neurological pathways, preventing secondary musculoskeletal injuries from compensation, and preserving the dog’s ability to perform functional transitions such as rising, walking and repositioning.
Is Degenerative Myelopathy Painful for Dogs?
DM itself is not a painful condition because the symptoms of degenerative myelopathy in dogs does not cause pain in the way that arthritis, disc disease, or joint injury does. However, as the disease progresses, dogs develop compensatory patterns, including overusing muscles which cause secondary discomfort and tension.
What's the Difference Between DM and IVDD?
Both conditions cause hind limb weakness and mobility loss, which is why they are frequently confused early in the disease course. However, there are some key differences:
- IVDD (Intervertebral Disc Disease) is caused by compression of the spinal cord by herniated disc material. It is typically more acute in onset, often painful, and may be surgically treatable.
- Degenerative myelopathy in dogs is a progressive neurological degeneration with gradual onset, no pain from the neurological process itself, and no surgical intervention available.
Differentiating these two conditions requires advanced imaging (MRI or CT) to rule out compression. See our guide to IVDD in Dogs [link] for more information.
Can Genetic Testing Tell Me If My Dog Will Develop DM?
Genetic testing for the SOD1 mutation can identify whether your dog carries the degenerative myelopathy gene. However, it’s important to be aware that even if the results show a high-risk genetic predisposition for developing the disease, it doesn’t mean that your dog will develop the condition at all.
Should My Dog Use a Wheelchair or Cart?
Mobility carts, also called dog wheelchairs or rear-end carts, are appropriate for dogs that have lost ambulatory function in the hind limbs but retain strength in their forelimbs.
A certified canine rehabilitation therapist can help assess whether a cart is appropriate for degenerative myelopathy support, recommend sizing and style, and provide training.
“Very happy to have Kelsey help our 15 y.o pug be more comfortable in his old age. We’ve learned a lot more about his back condition, and what we can do to improve his mobility. He loves it when she visits for his PT sessions!”
–Anna W., Napoleon’s mom
–Lisette H., Sunny’s mom
“We called many PT in the area and none of them had any appointments. I called Kelsey and she made room for us in her busy schedule due to the severity of our puppy’s condition and timing after her surgery. It was amazing! My recommendation would be to see Kelsey right away to get your puppy on the road to recovery!”
–Robert B., Beep’s dad
