Pug Myelopathy - expert advice and info
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Thread: Pug Myelopathy - expert advice and info

  1. #1
    Kathleen Smiler is offline Village Puppy
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    HI- I very rarely look at this site but I would like to update your information on Pug Myelopathy
    This very complex spinal disease is very widespread and quite unique in purebred pugs and there is very little published in the literature.
    After my pug was diagnosed in 2005 I have worked with the condition, a complex of different presentations (lesions) but we believe all the same disease. The latest information appears on the links below.
    Thus you need a veterinarian that convinces you they are very familiar with pug spinal disease and not treating your dog as other breeds are treated. Pugs rarely have Degenerative Myelopathy (DM).
    Physical therapy and early introduction of a therapeutic cart engineered for pugs with Pug Myelopathy appears to be the best medical management. This will counteract the atrophy occurring in the rear limbs and will keep them able to walk longer.
    Surgery is very controversial and if recommended, take your MRI to another neurologist and get a second opinion.
    It is critical that your pug be able to completely empty the urinary bladder. You need to learn to monitor the volume and character of their urine so you will know when to begin expressing the bladder, which is an essential part of long term nursing care at home.
    If your pug is leaking urine (Is your ataxic pug still urinating normally?) there is a serious problem of possibly a bladder infection, stones, crystals,etc.
    Medication is palliative, but may make them more comfortable. The rear end is normally painless, but arthritis and muscle strain occurs in the front end as they age, in particular if they are using a cart that is not well suited for long term use.
    We highly recommend, after diagnosis by a neurologist, that you seek an evaluation and physical therapy program from a veterinarian credentialed in rehabilitation. They will help you determine if and what rear limb exercise therapy cart is appropriate.
    All forms of physical and integrative medicine may help and/or extend your pug's mobility but there is no magic treatment. Chiropractic adjustment may be very dangerous and should not be done on a purebred pug's back without the OK by the dog's neurologist due to the instability caused by hypoplastic and aplastic articular processes of the thoracic vertebrae. Over 90% of purebred pugs have these underdeveloped spinal bones but we believe only 10-20% develop the neurological deficit that first appears as ataxia and can slowly progress to paralysis.

    Please ask to join Facebook Wheelie Pugs if you are caring for an affected pug. There are 3 questions you must answer or your request to join will be declined).

    I am attending the 2019 Milwaukee Pug Fest and will have a display of information and presentations at 2:15 both days.
    Milwaukee Pugfest

    I saw a 2012 post last from a Lola (?) describing Pug Myelopathy and I would like to find it again ! appreciate any help
    Kathy

    Kathleen L. Smiler, DVM, DACLAM
    PO Box 429
    Lakeville, MI 48366
    248-953-3182 FAX 248-751-5900
    [email protected]
    Pug Rear Leg Ataxia Paralysis
    https://www.facebook.com/Pug-Dog-Hea...8123938233440/
    Pug Myelopathy Project at MSU on AVMA Clinical Study Database: https://ebusiness.avma.org/aahsd/stu...l.aspx?sid=312
    Wonderful Support Group https://www.facebook.com/groups/wheeliepugs/
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  2. #2
    Kathleen Smiler is offline Village Puppy
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    Hi, I replied first to your former post. Any integrative therapy such a laser is nice, but there is no silver bullet for this disease. A consult with a rehab veterinarian that can convince you when making the appointment has considerable experience with pugs is important. They offer multiple modalities, so have an evaluation, see if she is fit, not overweight, not too old or frail, and has a good program to manage arthritis in her front end. Then get a selection and fitting for her cart, Eddies Wheels are really the best. https://eddieswheels.com/n/137/Pug-M...-Cart-Can-Help It is better to develop a series of therapies that you can afford, then be unable to afford the program initially proposed. We do have a must read document in the FILES on Wheelie Pugs with good examples to understand physical therapy at home.
    She needs to exercise but in a good physical therapy program you do daily at home. Working in the cart and with PT she should strengthen her legs but not overdo. Some medications may be helpful but many veterinarians are Rx them without a clear reason for each drug. Steroids (prednisone) are used by some neurologists to "see" if they can addressed the possible inflammation of the spinal cord, but the trial should be short, the doses low enough to avoid adverse side effects (excessive panting and anxiety that can exacerbate Brachycephalic Airway Syndrome (BOAS). Thus arthritis meds - glucosamine, omega 3, a mild NSAID, and sometimes Adequan injections are usually helpful. Gabapentin is being used, but the efficacy or value is questionable. Many owners don't like the side effects and I personally think gabapentin may suppress the spinal pelvic reflexes and in some dogs hamper their ability to develop a spinal walk that can keep them up and mobile for a longer time.

    Hope that helps, each dog needs an individualized nursing care program, and you can work out providing the essentials with help from management techniques on Wheelie Pugs.Most affected pugs live their entire normal lifetime with good care despite their disability.
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  3. #3
    Kathleen Smiler is offline Village Puppy
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    DefaultPug Myelopathy Research Update

    Regarding Pug Myelopathy Research, we are finally making strides forward.

    The pathogenesis study at Michigan State University recruited 42 purebred pugs affected by Pug Myelopathy which was an excellent enrollment success.

    The dogs received a neurological exam, a CT scan, an MRI, follow up data collection and many were returned to MSU for a post mortem at the end of their natural life. Dr. Jon Patterson, the Principle Investigator, has spent countless hours carefully examining the deceased for lesions present that were originally detected in the initial imaging studies. Dr. Patterson is now compiling the data. Delays occurred when all the faculty radiologists left for better jobs and the CVM neurologists changed frequently. However, we were able to collaborate with other institutions to review the data and are anticipating analysis to be completed soon. This paper from Dr. Patterson will be considered one of the most comprehensive on the pathology of purebred pug spinal disease.


    Genetics
    In January of 2018, Kari Ekenstedt, DVM, PhD, a geneticist at Purdue University proposed collaborating with the Michigan State Myelopathy Project data to initiate a study of the genetic basis for Pug Myelopathy, and other spinal diseases found in purebred Pugs, with the ultimate goal to develop a genetic test or risk model (depending on mode of inheritance) that can be used to both predict cases that would develop, and to guide breeding decisions to hopefully decrease prevalence of the condition(s). Genetic approaches will aim to consider individual phenotypes (SAD, arachnoid fibrosis, hemivertebrae, etc.), with the assumption that one or more genes are involved. Accurate phenotypes are vital in genetic studies, which is why the partnership with Dr. Patterson and MSU, as well as radiologists, is essential. Cases will be recorded as having (or not) all of the following: hypoplastic or aplastic vertebral articulations, hemivertebrae, intervertebral disc disease, spinal arachnoid diverticula, spinal cord atrophy, and arachnoid fibrosis based on necropsies at MSU, and any abnormalities visible via survey radiographs from multiple locations (MSU, Purdue, others). DNA samples will be collected from dogs enrolled in the ongoing MSU study, and many new dogs will also be enrolled.

    The following grant has been awarded to Dr. Kari Ekenstedt at Purdue as the first of a two part effort to study purebred pug spinal disease.

    AKC Canine Health Foundation Grant #02589: Genetic Basis of Canine Spinal Abnormalities
    Principal Investigator: Kari Ekenstedt, DVM, PhD; Purdue University
    Total Grant Amount: $112,993; Grant Period: 4/1/2019 - 3/31/2021
    This study will identify potential genes and risk alleles to better understand the genetic basis of canine spinal abnormalities using comparisons between affected and unaffected dogs. The identification of these genes and risk alleles will advance knowledge with an ultimate goal to develop genetic tests and/or a genetic risk model to help predict healthy spines for good health in breeds with tightly curled tails such as Pugs, French Bulldogs, English Bulldogs, Boston Terriers and Basenjis.

    We will be recruiting blood DNA samples from pugs to be sent to Purdue for the study. Please contact me for the appropriate forms. [email protected] Also include any pedigree or known lineage information and photos of your dog from the side, and a head shot. This will help categorize the phenotype or appearance of the dog.

    Another effort is underway with rehabilitation veterinarians to initiate a clinical study to understand the benefits of long term physical therapy and early introduction of a therapeutic exercise cart for the rear limbs. The cart is like having a walker or treadmill to counteract atrophy and help develop a "spinal walk" to prolong mobility in pugs with thoracic spinal compression lesions. Anecdotal information from owners using physical therapy before their dogs are seriously compromised have been very encouraging and more veterinarians credentialed in rehabilitation are providing services to support these pugs long term. Some neurologists still advise to not initiate a cart until the dog can't walk at all. We feel this advice needs to be updated to reflect the multiple success stories with therapeutic exercise. However any cart must be selected after evaluation of the pug's age, health, fitness, weight, and arthritic problems in the neck and shoulders. The dog must be fitted correctly with a well engineered cart and be conditioned to use it safely. We discourage any PVC, DIY, home made carts as the may actually injure the dog and hasten loss of mobility. If there are financial constraints it is much better to seek a charity that provides carefully selected carts for affected pugs than to try to acquire the cheapest inappropriate substitute.

    pugrearataxiaparalysis.com

    Owners are being educated on long term care by resources such as Wheelie Pugs on Facebook.

    We are hopeful to identify and fund additional veterinary scientists who are interested in investigating improved surgical management procedures. Surgical management is very controversial and the long term prognosis, in purebred pugs, is poor. We are also hopeful to study the bio mechanics of the pug spine that may influence the high incidence of Pug Myelopathy in the current purebred. There are multiple recent publications comparing the thoracic vertebral malformations in brachycephalic breeds. The clinical diseases are quite different between breeds and as we understand the pathology of disease in each separate breed, hopefully we can seek solutions that will benefit all.
    Nina_W likes this.

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  5. #4
    Wonka & Nilla's Avatar
    Wonka & Nilla is offline Village Dancing Jitterpug
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    I've copied a few of Dr. Smiler's posts onto this one thread to keep all this terific information together on one Sticky.

    Thank you, Kathy, for sharing!!
    Village Moderator


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    Wonka the Dancing Pug, CGC, W-FD, W-TFD
    and introducing... Miss Jelly Bean "Beanie" Licorice Pug
    Forever in our hearts:
    Miss Nilla Sassafras Pug August 17, 2002 to April 19, 2018

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