Dr. R.M. Clemmons and the fight against Degenerative Myelopathy of German Shepherd Dogs.

Degenerative Myelopathy of German Shepherd Dogs (DM of GSDs) was first described as a neurologic disease in 1973. Since that time until the first years of this decade, relatively little has been said and most shepherd owners find out about it only after a diagnosis has been presented.

The intent of this article is to fulfill two purposes: First, an attempt will be made to describe, in understandable layman’s terms, DM of GSDs, what therapies have been helpful in delaying the progress of the disease in patients, and some of the latest discoveries in the fight against DM. The research of Dr. R. M. Clemmons is relied upon heavily for this article and is quoted extensively.

The second purpose of this article is to provide sources for shepherd owners to access in an effort to become more informed.

A simplified description:  DM of GSDs is caused by an autoimmune disease that attacks the nervous system of the shepherd. It leads to increasing neural tissue damage that culminates in the paralysis and death of the shepherd.

This description over-simplifies the disease and does nothing to help the reader grasp the mind-numbing horror of how it consumes a shepherd. In his paper “Degenerative Myelopathy of German Shepherd Dogs,” Dr. R.M. Clemmons, took two pages to define and describe this disease. Even though he is undoubtedly correct in his definition and description, the lay reader is left with the awareness that they have been told something very significant and scary, but they are not exactly sure what. Once the reader works through all of the scientific jargon and reaches the section entitled “The Integrative Medical Approach to Treatment of Degenerative Myelopathy” they will find a clear and concise description outlining a course of therapy that brings together traditional and non-traditional approaches to veterinary medicine that have been successful in delaying the progress of the disease in many patients.

In his report Dr. Clemmons indicates that DM can be treated through a combination of four basic approaches: 1) exercise, 2) dietary supplementation, 3) medication, 4) other supportive measures.

Exercise:
Research in humans as well as canines indicates that aerobic exercise is relevant to the wellbeing of the patient by improving muscle performance, and cerebral blood flow. Dr. Clemmons explains that:

“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 to recover faster from the exercise.”

Dr. Clemmons goes on to explain that a gradual introduction to an exercise program is very important and alternating days of work and rest provides optimum results. He outlines an exercise program that has proven successful and provides advice as to what nutritional supplements can best assist the exercise program.

Supplementation: dietary considerations.

Dietary considerations for GSDs suffering from DM closely resemble those of humans suffering from diseases like Multiple Sclerosis (MS). Dr. Clemmons states:

“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.”

At this point in the report Dr. Clemmons provides a basic diet with specific caloric and portion to weight related descriptions and instructions. Also provided is specific and detailed information about vitamins and minerals, amino acids, enzymes and herbs that have proven beneficial when used to supplement the basic diet.

Medication:

Dr. Clemmons makes the following important statement about medications in this report:

“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 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.”

Contact information for suppliers of these medications is provided in the report. (Also listed at the end of this article.)

In regards to acetyleysteine Dr. Clemmons states:

“Acetyleysteine 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 compatible substitute) to 5%. Otherwise, it will cause stomach upset. This new treatment is expensive unless purchased through compounding pharmacies.”

Other supportive measures:

The following note of caution is provided by Dr. Clemmons regarding heartworm medication.

“Since the monthly heartworm medications 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.”

Further explained is that some of the newer internal and external parasite prevention measures do not affect the immune system.

One final precautionary note is delivered by Dr. Clemmons:

“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.”

The research performed by Dr. Clemmons and the University of Florida provides hope for many shepherd owners. His work continued beyond the above mentioned report and in 2004 he was able to identify the DNA marker for DM of GSDs. DNA testing is now available at an affordable price.

The latest in DM testing is the new DM DNA sampling test. Blood should be collected in a CBC (purple top, EDTA) vial, from a peripheral vein, placed in the refrigerator until shipping, and shipped, overnight mail, to Dr. Clemmons at the following address:
 

Dr. Clemmons’ Lab
% VMC Clinical Pathology Laboratory
2015 SW 16th Avenue
Gainesville, FL 32610
(352) 392-4700 Ex 4400

With the CBC vial, you must follow the directions for mailing on Dr Clemmons DM Flash Test site: neuro.vetmed.ufl.edu/dm_flash_test_web and enclose payment for processing the DNA sample.

For more information on DM of GSD and current therapies:

• This report in its entirity can be found at:  http://neuro.vetmed.ufl.edu/neuro/DM_Web/DMofGS.htm
• For additional information about the integrative treatment of Multiple Sclerosis and its relevance to the treatment of DM of GSDs go to:  http://www.drweil.com.
•  This website is owned and maintained by Mrs. Marjorie Zimmerman who lost her beloved GSD "Jack Flash" to DM of GSDs.  It provides contact information  for support groups, a geneological website maintained to track DM of GSD occurrences and resources to help deal with a diagnosis of DM of GSDs.  www.mzif.com/main.htm
• This is a compounding pharmacy referenced in Dr. Clemmons article.  They are experienced in providing the medications and supplements used to treat DM of GSDs.  They can be reached at Westlab Pharmacy, Gainesville, Florida 1-800-493-7852.