WHAT IS PUG MYELOPATHY? by Kathleen Smiler, DVM Pug Myelopathy is a recently recognized spinal condition Printer friendly PDF version
It is important to have your primary care veterinarian arrange a referral for your Pug for an examination by a board certified veterinary neurologist or surgeon when symptoms of ataxia first appear.
Pug Myelopathy is a recently recognized spinal condition believed unique in Pugs. It is called by several terms, and it is most often referred to as “Pug Myelopathy”. Pug Myelopathy is considered the most frequent cause of rear limb in-coordination (ataxia) and progress to paralysis of the rear limbs over a period of one to four years. Originally referred to as “Weak Rear”, this has become a widespread problem in Pugs. The rear legs appear to be weak, but the cause is a neurological deficit that develops in the spine. Affected dogs may initially drag their feet, stagger, have trouble jumping and can be fecal and urinary incontinent. It usually affects just the rear limbs, unlike a very different disease, Degenerative Myelopathy (DM), which can have similar initial signs, but progresses tragically to complete paralysis and death. In Pug Myelopathy, we are learning there is usually a complex of spinal abnormalities that involve both the vertebral bones, and can also involve compression of the spinal cord. The compression can be caused by one (or multiple lesions) that include one or multiple sites of chronic Hansen type II intervertebral disc disease (IVDD); spinal arachnoid diverticulum (SAD); spinal cord atrophy; and fibrosis of the arachnoid layer of the meninges. Unraveling the relationships between these conditions is one goal of the research at Michigan State University
Other names that refer to Pug myelopathy include “Pug constrictive myelopathy (CM)”, “facet hypoplasia”, “subarachnoid diverticulum (SAD)” and others. Although little is published about this condition, Pug Myelopathy may be the most common cause of mid-back spinal cord problems in Pugs.
Another good description of the disease is provided by Southeast Veterinary Neurology, Wong M, (2017). Case History of Surgical Treatment for Pug Myelopathy. [video] Available at: https://www.sevneurology.com/patients/wellington/ [Accessed 10 Jul. 2017].
Many veterinarians are not yet knowledgeable about this condition, as published information is not yet widely available. Pugs with rear limb ataxia may have had a previous diagnosis that was incomplete in light of this evolving information. Since so little is known, there is no consensus among neurologists about the best way to treat it. Surgery may be appropriate for individual cases, but it must be considered as soon as possible, after symptoms first occur, and may only delay progression of paralysis.
The most important palliative treatment appears to be consistent physical therapy using rehabilitation exercises to preserve muscle strength and enhance development of a spinal walk. A wheeled cart, carefully fitted by a knowledgeable professional, may improve their ability to walk. Other forms of integrative medicine can enhance their ability and desire to stay mobile. Pugs affected with Pug Myelopathy are usually pain free and can lead excellent long lives with good nursing care. All senior Pugs require periodic wellness exams to detect and alleviate other problems of aging using medication and/or supplements. It is critical the Pug is carefully monitored for its ability to completely empty the urinary bladder several times a day. Several other well documented conditions in Pugs also cause symptoms of ataxia, including hemivertebrae (usually young dogs); acute sudden onset Intervertebral Disc Disease (IVDD) or “slipped disc” – (usually painful); spinal cord tumors; and spinal arthritis in elder dogs. It is important to have your primary care veterinarian arrange a referral for your Pug for an examination by a board certified veterinary neurologist or surgeon when symptoms of ataxia first appear.
