Abstract
Objective: The objective of this retrospective review was to examine the impact that adding photobiomodulation therapy (PBMt) to rehabilitation therapy had on the pathology of degenerative myelopathy (DM) in canine patients.Background: Canine DM is a progressive, fatal neurodegenerative disease for which there exists a dearth of effective treatments, limiting clinicians to pursue symptom palliation.Methods: Clinical records of dogs referred for presumed DM to a specialty rehabilitation facility were screened for patients meeting study criteria. Qualifying patients were divided into two groups: Protocol A (PTCL-A) and Protocol B (PTCL-B) group, based on the PBMt protocol used. Data related to demographics, diagnostics, rehabilitation protocols, and progression of clinical signs were collected. Data were analyzed to determine differences in outcomes between the two treated groups and historical data expectations, as given by a previously published study.Results: The times between symptom onset and euthanasia of dogs in the PTCL-B group: 38.2 ± 14.67 months (mean ± SD), were significantly longer than those of dogs in the PTCL-A group: 11.09 ± 2.68 months. Similarly, the times between symptom onset and nonambulatory paresis (NAP) or paralysis of dogs in the PTCL-B group: 31.76 ± 12.53 months, were significantly longer than those of dogs in the PTCL-A group: 8.79 ± 1.60 months. Further, Kaplan–Meier survival analysis showed that the times from symptom onset to NAP of dogs in the PTCL-B group were significantly longer than those of dogs in the PTCL-A group (Mantel-Cox Log Rank statistic = 20.434, p < 0.05) or the historical data group (Mantel-Cox Log Rank statistic = 16.334, p < 0.05).Conclusions: The data reviewed show significantly slower disease progression—longer survival times—for patients in the PTCL-B group than those in the PTCL-A group or published historical data. Further studies are warranted.
Highlights
Canine degenerative myelopathy (DM) is a progressive adult-onset neurodegenerative disease[1] characterized by progressive generalized proprioceptive ataxia of the pelvic limbs, asymmetric upper motor neuron (UMN) paraparesis, and a lack of paraspinal hyperesthesia, which progresses to lower motor neuron (LMN) paralysis of the pelvic limbs, and, eventually, the thoracic limbs.[2]
Records were excluded unless patients had one or more of the following diagnostics performed: magnetic resonance imaging (MRI) of the spine to rule out other lesions, DNA testing for superoxide dismutase 1 (SOD1) mutation performed by Animal Molecular Genetics Laboratory (AMGL) at the University of Missouri, or postmortem histopathologic examination of the spinal cord confirming a diagnosis of DM
Underwater treadmill—water height varies between level of the greater trochanter and stifle, speed at a walk and total walking time based on individual dog: all dogs started at 5 min duration at a walking pace at *1.0–2.0 mph
Summary
Canine degenerative myelopathy (DM) is a progressive adult-onset neurodegenerative disease[1] characterized by progressive generalized proprioceptive ataxia of the pelvic limbs, asymmetric upper motor neuron (UMN) paraparesis, and a lack of paraspinal hyperesthesia, which progresses to lower motor neuron (LMN) paralysis of the pelvic limbs, and, eventually, the thoracic limbs.[2]. ALS and DM are progressive, incurable, fatal diseases; clinicians look to available and novel therapies, and clinical interventions to improve the overall quality of life and, hopefully, increase the life expectancy of affected patients. While ALS patients may be medically managed for relatively long periods of time while their disease progresses and they become severely debilitated— usually dying from respiratory failure within 3–5 years of developing symptoms, dogs with DM are usually euthanized when they become nonambulatory and/or fecal or urinary incontinent (which has been noted at various clinical stages of disease,[2,5] though usually occurs with paraplegia), both of which present challenges to at-home care by pet owners
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