DEGENERATIVE MYELOPATHY

The story of Asjabi...










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29 april 2007


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This is the story of Asjabi. A wolf-greyish German Shepherd, male, and a cross-breeding of a German Shepherd bitch and presumable a Czech or Saarloos Wolfdog. Asjabi is diagnosed with Degenerative Myelopathy (DM).

On this page I try to keep track of the process that Asjabi and his masters (my wife and I) are going through and the efforts we undertake to slow down the deterioration by DM as much as possible. Unfortunately, Asjabi lost the unfair fight with DM on 7 June 2013. He will hold a special place in our heart forever.

Table of contents

1)
2)
3)
4)
5)
6)
7)
8)
9)
10)
11)
12)
13)
14)
15)
16)
17)
18)
19)
20)
21)

What is DM?
The beginning
Teared off cruciate ligament
The first signs
A little bit of hope
MRI
Result bloodtest
Meeting with orthopaedic surgeon
Hydrotherapy
Adjustments and aids
Spiral stairscase
Shoes
Biko Physio Brace
Wheelchair
Incontinence
Mental aspect
Asjabi becomes famous!
Asjabi looses the fight against DM
Chronological recapitulation
Links
History of the page

1) What is DM?
During our first search on the internet we read a lot of questions amongst other dog owners about DM. Especially the question "What is DM?" is asked a lot online. The text below (marked as Italic) is copied from Wikipedia on 19 April 2012.

Canine degenerative myelopathy (also known as chronic degenerative radiculomyelopathy) is a progressive disease of the spinal cord in older dogs. The disease has an insidious onset typically between 7 and 14 years of age. It begins with a loss of coordination (ataxia) in the hind limbs. As of July 15, 2008 the mutated gene responsible for DM has been found present in 43 breeds including German Shepherds, Boxers, Chesapeake Bay Retrievers, Rhodesian Ridgebacks, and both breeds of Welsh Corgis.1, 2 The disease is chronic and progressive, and resulting in paralysis.

The myelin is an insulating sheath around neurons in the spinal cord. One proposed cause of degenerative myelopathy is that the immune system attacks this sheath, breaking it down. This results in a loss of communication between nerves in lower body of the animal and the brain.

Testing
The Orthopedic Foundation For Animals has a DNA test that can be purchased to see if their dog carries the mutated genes for DM. The test is for any dog but is only recommended for certain breeds. The test consists of a cheek swab (using something similar to a Q-tip to swab the inside of the cheek to submit for testing).

The test checks for the mutated gene that will tell if your dog may be affected by degenerative myelopathy, if it is a carrier, or if it is unaffected.

The results are:

Clear

This means your dog does not have the mutated strain and it will not develop degenerative myelopathy. (clear)

Carrier

This means your dog is a carrier of the gene but will not develop degenerative myelopathy.

Affected

This means that your dog is affected with degenerative myelopathy and may develop degenerative myelopathy (affected). Not all dogs with A/A results will develop DM.

Genetics
Breeding risks for degenerative myelopathy can be calculated using the Punnett Square:

1.

If both parents are clear (N/N) then all of the puppies will be clear

2.

If one parent is a carrier (N/A) and one is clear (N/N) then roughly 50% of the puppies will be clear and 50% will be carriers

3.

If both parents are carriers (N/A) then roughly 25% will be clear (N/N), 50% will be carriers (N/A), and 25% will be affected (A/A)

4.

If one parent is clear (N/N) and one parent is affected (A/A) then all puppies will be carriers (N/A)

5.

If one parent is a carrier (N/A) and one is affected (A/A) then roughly 50% of the puppies will be carriers (N/A) and 50% will be affected (A/A)

6.

If both parents are affected (A/A) then all puppies will be affected (A/A)

Symptoms
Degenerative myelopathy initially affects the back legs and causes muscle weakness and loss, and lack of coordination. These cause a staggering affect that may appear to be arthritis. The dog may drag one or both rear paws when it walks. This dragging can cause the nails of one foot to be worn down. The condition may lead to extensive paralysis of the back legs. As the disease progresses, the animal may display symptoms such as incontinence and has considerable difficulties with both balance and walking.1, 3 If allowed to progress, the animal will show front limb involvement and extensive muscle atrophy. Eventually cranial nerve or respiratory muscle involvement necessitates euthanasia.2

Progression of the disease is generally slow but highly variable. The animal could be crippled within a few months, or may survive up to three years or more.1

Causes
The etiology of this disease is unknown. Recent research has shown that a mutation in the SOD1 gene is a risk factor for developing degnerative myelopathy in several breeds.2 Mutations in SOD1 are also associated with familial amyotrophic lateral sclerosis (Lou Gehrig's disease) in people.4

Known causes of spinal cord dysfunction should be excluded before accepting the diagnosis of degenerative myelopathy; disc disease (protrusions) or spinal cord tumors can cause compression of the spinal cord with similar signs to degenerative myelopathy.5

Treatment
Degenerative myelopathy is a non-reversible, progressive disease that cannot be cured. There are no treatments that have been clearly shown to stop or slow progression of DM.1

Exercise
Exercise has been recommended to maintain the dog's ability to walk.1 Physiotherapy may prolong the length of time that the dog remains mobile and increase survival time.6 Canine hydrotherapy (swimming) may be more useful than walking.7 Use of a belly sling/leash allows the handler the ability to support the dog's hind legs while exercising or going up and down stairs. A cart may enable the dog to remain active and maintain its quality of life once weakness or paralysis of the hind legs sets in.

Sources

1.

Kahn, Cynthia M.; Line, Scott, eds. (2005-02-08). "Degenerative Diseases". The Merck Veterinary Manual (9 ed.). Merck. ISBN 0911910506

2.

Awano T et al.
Genome-wide association analysis reveals a SOD1 mutation in canine degenerative myelopathy that resembles amyotrophic lateral sclerosis
Proc Natl Acad Sci USA. 2009 Feb 2

3.

Hovanessian, Natasha (2001-03-27)
Degenerative Myelopathy
Listing of Inherited Disorders in Animals. University of Sydney. Retrieved 2008-07-25

4.

Awano, T.; Johnson, G. S.; Wade, C. M.; Katz, M. L.; Johnson, G. C.; Taylor, J. F.; Perloski, M.; Biagi, T. et al (2009).
Genome-wide association analysis reveals a SOD1 mutation in canine degenerative myelopathy that resembles amyotrophic lateral sclerosis
Proceedings of the National Academy of Sciences 106 (8): 2794–2799. Bibcode 2009PNAS..106.2794A. doi:10.1073/pnas.0812297106. PMC 2634802. PMID 19188595.

5.

M. D. Lorenz and J. N. Kornegay.
Handbook of Veterinary Neurology, Philadelphia
W.B. Saunders Company, 2004, pp 147-9

6.

Kathmann I, I; Cizinauskas S, Doherr MG, Steffen F, Jaggy A. (July–August 2006)
Daily controlled physiotherapy increases survival time in dogs with suspected degenerative myelopathy
J Vet Intern Med 20 (4): 927–932. doi:10.1892/0891-6640(2006)20[927:DCPIST]2.0.CO;2. PMID 16955818

7.

Clemmons, R.M. (2002-08-27).
Degenerative Myelopathy German Shepherd Dogs
University of Florida, retrieved 2008-07-25

8.

Degenerative Myelopathy
Canine Inherited Disorders Database. University of Prince Edward Island. 2001-10-30.
Retrieved 2008-07-25

9.

Mitchell, Tamira (2001-03-27)
Myelopathy
Listing of Inherited Disorders in Animals. University of Sydney, retrieved 2008-07-25

External links

1.

Degenerative Myelopathy Symptoms, Diagnosis and Treatment Video
Retrieved 2011-06-18

2.

Degenerative myelopathy in Canis familiaris
Online Mendelian Inheritance in Animals (OMIA)
Retrieved 2008-07-25

3.

Degenerative Myelopathy Support Group
Retrieved 2008-07-25

4.

Degenerative Myelopathy
Canine Genetic Diseases Network. University of Missouri College of Veterinary Medicine
Retrieved 2007-07-02

At the bottom of this page I've added some links to interesting websites we've found recently.

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2) The beginning
We buy Asjabi as a pup from the 'Poor Animal' foundation in Prinsenbeek (The Netherlands). Asjabi, his mum and three other pups were found in France and taken to an asylum. Soon after that, the family of five are taken to Prinsenbeek where we buy Asjabi as the last remaining pup on 24 January 2005. We know from people working for the foundation that Asjabi's mother is going to Sneek to meet her new owners.

We want to give the new family member a foreign name but because we only hear one day ahead that Asjabi is available for us, we haven't come up with one yet. An employee of the foundation suggests the name 'Aghis-Habi' (Asjabi), which means 'Great Warroir' in Berber language. We think that this name is so unique that we decide to give the pup this name, although we have to admit that we use the phonetic spelling as the 'official' spelling of his name. Because of the fact that no one is really sure how old Asjabi really is, we estimate his age to be 6.5 week, which leads to 10 December 2004 as day of birth in his passport.

Asjabi is raised by my wife who can't work until September 2005 due to medical treatments. Asjabi is an enterprising puppy. Within four days he is able to climb our open spiral staircase all the way to the top. The next day I am (amongst other proud dads) at Prenatal to buy a stair gate.

Towards our Belgian Shepherd Djiep (pronounce 'Jeep'; a seven year old bitch and a very stable dog) Asjabi develops as the leader of the pack. Other dogs often get a big mouth, but there are also several dogs that Asjabi is really fond of. Maybe it is a coincidence but all those dogs are Retrievers or Labradors. Most liked by Asjabi are two Golden Retriever bitches ('the girls' as we call them) that are roughly the same age as Asjabi.


Djiep and Asjabi, February 2005


Djiep and Asjabi, winter 2008 - 2009

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3) Teared off cruciate ligament
During the summer of 2010 Asjabi tears off his cruciate ligament in his right knee. Our vet advices us to make an appointment at the Wagenrenk veterinary clinic in Wageningen where Asjabi is operated by Drs. Govers. The cruciate ligament is fixed using the so-called 'classic method'.

In the winter of 2010 - 2011, Asjabi is able to walk again really well. We notice however that his right hind-leg draws a much longer 'track' through the snow than his other legs. We always meant that this was a consequence of the operation at Asjabi's cruciate ligament, which led to a slightly different 'length' or 'tension' in the new cruciate ligament compared to the old one. Because this effect didn't seem to bother Asjabi, we didn't ask our vet to check it out.

In the spring of 2011, our Belgian Shepherd Djiep is diagnosed with bone cancer. Djiep already had trouble with walking long distances so we made a short walk with both dogs, after which we brought Djiep home to make a really long walk with Asjabi. To save Djiep from further suffering, we have to put her down on 3 June 2011. Asjabi seems to deal the best with the loss.

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4) The first signs
In the early summer of 2011 we notice that when walking, Asjabi doesn’t move his right hind-leg straight forward, but that it swings slightly outwards. At that moment, we think that this is a consequence of the operation a year ago. When we look back we believe that this is the first sign of DM. Late March 2012 I record the video below that clearly shows the swinging of the right hind-leg:


March 2012: Asjabi's right hind-leg clearly swings out

Because Asjabi sometimes limps, we ask our vet to take photos of his right knee, because we fear another problem with his cruciate ligament. The photo however shows no problems in his knee. The vet continues his investigation by doing the little 'tric' to verify DM. He bends the foot backwards, so that the upperside of the toes is on the tabel. Asjabi immediately corrects his left foot, but his right foot takes a bit longer. The vet mentions 'dying nerves', but we cannot foresee what this means.

We look on the internet for more information and the first story (Dutch only) we read is about the German Shepherd Tanja who suffered from DM as well. A heart rending story. What will await Asjabi and us?

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5) A little bit of hope
Because it is possible that the dying nerves are caused by the surgery of the cruciate ligament (a damaged or pinned nerve), our vet advises us to go to the Wagenrenk again where Asjabi has been operated at his cruciate ligament in 2010. Op 22 December 2011 we have an appointment with Dr. Mandigers. Due to personal circumstances, Dr. Mandigers is not available, but we are helped by Dr. Bergknut. He performs several exercises with Asjabi and he suspects a hernia in the lower part of his back that pinns the nerves. An MRI-scan will give the ultimate proof but if it is indeed a hernia, then surgery can be a good solution to free the pinned nerve and stop the nerves from dying. Asjabi is prescribed Rymadil 100 mg against the pain caused by the hernia. Because we think that the effect of the Rymadil is not sufficient we discuss this with out vet who prescribes Previcox 227 mg from early January 2012.

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6) MRI
On 10 January 2012 we go to the Veterinary Medicine Faculty of the Utrecht University for an MRI. We are welcomed by Dr. Bergknut. Dr. Mandigers, who is present as well says (even without a really thorough look) that he doesn't share the opinion of Dr. Bergknut about a hernia being the main cause of the problem. A sample of blood is being retracted for a DM test and next Asjabi is anaesthetized for the MRI.

When the results of the MRI are being discussed with Dr. Bergknut, he tells us that there are indeed signs of a hernia, but that the hernia can't be fully responsible for Asjabi's situation. The MRI clearly shows that (the muscles of) the right hind-leg are a lot smaller than (the muscles of) the left hind-leg. Dr. Bergknut advices us to make an appointment with an orthopaedic surgeon of the faculty, Dr. Meij.

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7) Result blood test
On 25 January 2012 we receive the result of the lab. According to the appendix that comes with the result, the test results in one of three of the following results:

Clear

This means your dog does not have the mutated strain and it will not develop degenerative myelopathy. (clear)

Carrier

This means your dog is a carrier of the gene but will not develop degenerative myelopathy.

Affected

This means that your dog is affected with degenerative myelopathy and may develop degenerative myelopathy (affected). Not all dogs with A/A results will develop DM.

The result is the worst possible: Asjabi is tested as affected with DM.

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8) Meeting with orthopaedic surgeon
On 27 January 2012 we have a long meeting with Dr. Meij. He advices us not to operate the hernia that Asjabi has. Painkillers are sufficient enough to fight the pain and an operation and the rehabilitation basically will result in a weaker dog. In this stage of DM, Asjabi needs to walk. His muscles need to be stimulated constantly, so enough exercise as long as we don't go too far. Asjabi is allowed to run as well, but we are not allowed to provoke this by throwing sticks and balls. We also need to avoid Asjabi from 'bunnyhupping'. This may overload his (still) healthy left leg. Because we spoiled Asjabi more after Djiep died, he now weighs 48 kg. Dr. Meij advises us to let Asjabi loose some weight, because this may help him during the process.
 
Dr. Meij tells us that DM can't be cured but that the process can be slowed down by the proper therapy and exercise. Dr. Meij knows quite well what we're going through. He also had a wolf-greyish German Shepherd that has been diagnosed with DM at the age of 7. His dog died at the age of 10, but had to use a wheelchair during it's final stage.

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9) Hydrotherapy
On 1 February 2012 we start with hydrotherapy in Mierlo at 'Dier en Dokter' (Animal and Doctor). After an intake with the vet, it is decided that next to the hydrotherapy, Asjabi will get a monthly injection of a drug called 'Anabolin' that strengthens his muscles. Next, Asjabi has to walk on the submerged conveyor belt for 20 minutes. Asjabi is a bit scary at the start, but little chunks of Frolic are enough to distract him. In the second half of March 2012, Asjabi has three sessions of each 40 - 45 minutes. Late March we have to limit the length of the session to 25 - 30 minutes.

After talking with the vet at 'Dier en Dokter' we decide to quit the hydrotherapy late June 2012. Asjabi's 'bad' right leg gets 'tangled' with his left leg, which leads to an insufficient training of his right leg. We do continue the monthly injections with Anabolin, but from now on these are being given by our 'own' vet. Since our last visit to 'Utrecht' we paid attention on the amount of food and snacks and it paid off: At the end of the hydrotherapy sessions Asjabi weighs 42.5 kg. So he lost 5.5 kg since late January 2012 and it suits him well!


Asjabi during a hydrotherapy session

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10) Adjustments and aids
Because the DM causes less control on his right hind-leg, we are forced to make several adjustments to our house. Apart from that, we also bought several aids.

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11) Spiral staircase
Asjabi has climbed the stairs in our house on a regular base (he sleeps on or next to our bed) and the DM and the hernia don't stop him from doing so. Dr. Meij tell us that climbing the staircase once a day isn't a problem. But next to climbing the stairs, there is also the staircase itself. It is a spiral staircase with painted steps. The DM in combination with these steps gives Asjabi far less control in climbing and descending the staircase and on some occasions we find him trapped halfway the staircase, because one of his hind legs has slid over the back end of a step. We place the stair gate at the lower end of the staircase and with carpet, MDF and a lot of tie-wraps we convert the open spiral staircase into a dog friendly closed staircase.


Dog friendly spiral staircase

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12) Shoes
On 25 February 2012 one of Asjabi's nails of his right hind-leg is worn down so badly that it starts to bleed. We clean the nail with water and soon the bleeding stops. We decide to buy Asjabi some shoes to protect his nails from further damage. The first type we buy is a sort of slipper from 'Europet Bernina'. Simple, but is seems to do the job. Asjabi has no problems in wearing the shoe and he doesn't make a single attempt to take the shoe off. He only has to wear his shoes when we take him for a walk and he can even run a bit in these early stages of DM. Asjabi will be wearing these shoes until he looses his walking reflex in his hind legs early April 2013. At that moment we use the little belts that came with the wheel chair (see below).


Europet Bernina dog shoes

Through a local petshop we are able to buy a pair of Neopaw Summer dog shoes that he had for sale. The size is right and they look very cool! These shoes are better then the slippers, but it is a lot more work to put them on.


Neopaw Summer dog shoes

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13) Biko Physio Brace
The vet in Mierlo shows us an article about the 'Biko Physio Brace'. The Biko Physio Brace is also known as 'Biko Hundeexpander'. We ask Dr. Bergknut if he knows about this aid. He tells us that he doesn’t know this typical aid and that there are many aids for dogs that suffer from DM. Some of them work fine, some of them don't. It is simple a matter of trying this specific aid.


March 2012: Asjabi becomes more and more unstable

The videos on the Biko website that show the difference between a dog walking with or without the Biko physio brace convince us and we order one. The first experiences are really good! Asjabi can make tight turns, he is much more stable and his right leg swings a lot less.


Video from the Biko website that shows
the effect of the Biko Physio Brace


Asjabi with the Biko Physio Brace

For interested dog owners: It seems as if the price for private persons is set by the manufacturer. The price of the Biko Physio Brace is € 144.- (price level: 2012) as well in Austria as in the Netherlands. The Biko Physio Brace comes with 2 sets of 2 elastics, 2 sets of 3 belts in different lenghts to adjust the Brace and 2 belts to connect the elastics to the foot of the dog. A similar harness like Asjabi wears on the photo above is necessary when using the Biko Physio Brace, but it needs to be purchased separately.

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14) Wheelchair
By early Juni 2012, Asjabi's condition is so worse, that the Biko Physio Brace gives him insufficient support and we decide to gather information on a wheelchair. During our search we discover a report (Dutch only) about experiences of people with a dog in a wheelchair.

We contact hondenrolstoel.nl (wheelchair-dogs.com) and we ask for help on a forum where someone advises us to look on the internet for a second hand wheelchair. We are lucky! A second hand wheelchair (bought in early 2012 from wheelchair-dogs.com) for a large dog is available nearby. We contact wheelchair-dogs.com and give them the measurements of Asjabi. They let us know that this wheelchair should be large enough for Asjabi. We contact the seller and make an appointment to let Asjabi test the wheelchair.

After we put Asjabi in the wheelchair he wonders for a minute or so and then he goes for a walk through the garden. We decide to buy the wheelchair. The following two weeks we use to let Asjabi get used to the wheelchair by take him for one walk a day in the wheelchair. Asjabi isn't all that happy in the beginning and we need to encourage him to follow us, but later those two weeks he seems to get used better to the wheelchair.

The last week of June 2012 we take Asjabi with us on a vacation to the Dutch isle Vlieland. By know, Asjabi totally accepts his wheelchair. For the first time in months, Asjabi is able to make really long walks and each day we are on the beach or in the village. Almost all reactions of other people are positive and Asjabi is really happy when we get him the harness that comes with the wheelchair.


June 2012: Asjabi without Biko Physio Brace and wheelchair


June 2012: Asjabi in his wheelchair on Vlieland


June 2012: Asjabi in his wheelchair on Vlieland


June 2012: Asjabi with his wheelchair on Vlieland


June 2012: Asjabi with his wheelchair on Vlieland

In the mean time it is early November 2012. Asjabi still likes to go walking with his wheelchair. Even more: when we put him in his wheelchair and we aren't quick enough to open the gate, Asjabi summons us to hurry up, so he can start his walk. The muscles in the lower part of his back and his rear legs seem to shrink by the day and Asjabi's body begins to look like an upside down pear. Strong and with a lot of muscles at the front, skinny at his hips and rear legs. The wheelchair came with little belts to tie his rear legs up to prevent the nails from wearing down, but because Asjabi still has a 'walking reflex' in his rear legs, we haven't used these little belts yet.


November 2012: Asjabi with his wheelchair on Vlieland for the 2nd time


December 2012: This is the way Asjabi moves around without his wheelchair


December 2012: Despite the fact that Asjabi can't walk
without any aids, he still has a walking reflex in his hind-leg.

When we walk through freshly fallen snow in December 2012, we notice that a lot of snow sticks to the wheels of the wheelchair. With heaps of snow at his wheels, Asjabi drags his wheelchair with him (luckily he is quite strong) and eventually the snow falls from the wheels, but it makes us want to find a solution for this problem. A photo on the Facebook page of Wheelchair-dogs.nl, a couple of second hand skis on the internet and four 50 mm pipe clamps do the trick:


Januari 2013: Asjabi on skis


Example of the used pipe clamp. The handle at
the top can be detached because it is of no use


The wheels of the wheelchair are easily cramped in the pipe clamps


Januari 2013: Asjabi on skis in the snow

Asajbi looses his walking reflex in his hind legs early April 2013. From that moment on we use the little belts to avoid his feet from dragging over the ground. This way, Asjabi encounters less resistance when he uses his wheelchair. A disadvantage is that he is less stable while using his wheelchair. When for example he is chewing on a stick, his wheelchair can roll back, causing Asjabi to fall flat on his chest. In the beginning, Asjabi can get on his feet again by himself, but late April 2013 we have to help him up by lifting the front end of the wheelchair and the harness.

Early May 2013, Asjabi is unable to get up the stairs with our help (he sits in out hands whith his hind legs while he used to walk with his front legs up the stairs). We decide to let him sleep downstairs from now on. On the other hand, he is still able to make one hour walks in his wheelchair.

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15) Incontinence
The next stage in the DM process is that - next to the ongoing signs of paralysis - the dog becomes incontinent. In November 2012 we notice that Asjabi defecates a couple of times inside our home. This always happens when we want to take him for a walk. At those moments he is so happy and wild that he looses the control over his sphincter. At this moment we don't mind, but it is a sign of the ongoing progress of DM...

About late December 2012 we notice that Asjabi looses small amounts (droplets) of urine. Next to that, he sometimes pees inside our home when he is very excited (for instance when another dog is inside). We suspect that this is a further step in developing incontinence. We make an appointment with the vet and we do some research on the internet. We find four different kind of drugs: Propalin, Enurace, Incurin and IncontinentieStop (IncontinenceStop).

During the appointment, the vet notices that Asjabi's bladder is quite full, despite the fact that he urinated just a couple of minutes earlier. He suspects that Asjabi's ureter is being pinched off while he is in his wheel chair, so he is unable to empty his bladder well enough. This could be a reason for Asjabi's urine loss. The vet shows us how to help Asjabi to empty his bladder by applying proper pressure to his bladder ('expressing the bladder'). Please take notice: Ask your vet to demonstrate this technique for you! Also: By applying enough pressure, you can even open the sphincter of the bladder, but we only had to use this technique when Asjabi urinated by its own. Late April 2013 we discover a trick to help Asjabi to urinate. With quick handmovements we caress Asjabi on both sides of his abdomen until we feel that his belly starts to swell and he looses a few droples of urine. At that moment we apply proper pressure to his bladder to let Asjabi urinate. As for the drugs: The vet advises Propalin, because he has seen the best results with it, better than with Enurace or Incurin. IncontinenceStop isn't a drug but a food supplement.

At the same time we also buy a Karlie 'Gentleman Wrap'. This some kind of wide belt that can be used for dogs that for instance suffer from a mild form of incontinence. Asjabi wears this belt at night, together with a Tena lady 'sanitary napkin'. Just as with his shoes, Asjabi accepts the belt without any problems. The belt with the sanitary napkin does the job and together with our aid when he needs to urinate, Asjabi hardly looses any urine anymore. At this moment we don't use the Propalin but we just keep expressing the bladder.


Karlie 'Gentleman Wrap'

During the same appointment with the vet, Asjabi is being weighed for the first time since the end of the hydrotherapy. Especially because of the reduction of his muscles in his hind-legs, Asjabi now weighs 37 kg. Due to his fur, the weight loss is hardly noticeable, but when we caress Asjabi we feel his bones sticking out.

Late January 2013 we realise that the 'Karlie Gentleman Wrap' isnt the proper solution for Asjabi's incontinence. The Wrap shifts too easy and we switch to the Snuggease daiper for dogs. We buy two Snuggease daipers (Twinpack). A twinpack Snuggease is reasonably priced and it enables us to rinse the Snuggease on a daily bases and properly wash them once a week. For the time being we use the Snuggease without the Tena lady 'sanitary napkin'. We also made the hole in the Snuggease for the dogs tail a bit bigger to allow Asjabi to defecate outside the Snuggease.

When the weather becomes a bit warmer in April 2013, we realise that the Snuggease might be too warm for Asjabi. We buy the 'Karlie Gentleman Wrap' in a larger size (XL) and put the lining of an ordinary daiper in it. The surface to collect fluid is larger (Asjabi is a large dog) and the chance that his penis isn't covered by a piece of the daiper is a lot less compared to the sanitary napkin we used before.


SnuggEase daiper for dogs

Despite all the aids we use, we sometimes have to clean up little bits of urine or turds (luckily they are firm). No matter how good you clean these spots, it is almost unevitable that these spots begin to smell. To avoid nasty smells, we use 'Beau Beau Geurweg' ('Beau Beau get-rid-of-smells'). This substance contains micro-organisms that 'eat' the last remains of dirt, thus avoiding foul smells. Beau Beau Get-rid-of-smells is available at pet stores.


Beau Beau Get-rid-of-smells

Late January 2013 we start with the SnuggEase and the Propalin together, but because the Propalin causes Asjabi's faeces to get thinner (luckily it isn't diarrhea) we quit using the Propalin a week later. For the time being we continue to help him empty his bladder and at night Asjabi wears his SnuggEase (and the Karlie Gentleman Wrap since April 2013). Early March 2013 the incontinence gets worse and Asjabi looses often and more urine, so we need to clean up little puddles of urine more often. Because Propalin causes thinner faeces, we try IncontinenceStop. We read a lot of good stories about it on their website and on 12 March 2013 we start with IncontinenceStop. After about two weeks it is hard to say if IncontinenceStop really works, but accoring to their instructions, IncontinenceStop should become effective after a month. A couple of weeks later we have the idea that IncontinentieStop is partially effective. Asjabi seems to loose less urine, but IncontinentieStop can't prevent Asjabi to pee inside the house.

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16) Mental aspect
Although DM on itself is a painless disease, the dog can suffer from pain that in a way is caused by DM. Asjabi is a very vivid dog and the DM can cause him to fall down and hurt himself. When we see him looking at us in an unhappy way, we help him on his feet again and we massage him. Next to that, his nails wear down and this can cause pain as well.

But apart from that: Asjabi should be aware of the fact that his hind legs don't do what his brain 'thinks'. You can explain DM or a similar disease like ALS to a human being, but you can't explain this to a dog. We simply don't know is Asjabi is 'unhappy' at this moment and if he is, what to do about it. We notice however that Asjabi barks a lot more when someone is at our front door (luckily we have old aged neighbours). After Djieps dead, Asjabi already barked more, but this behaviour is now even more prominent. We're not sure, but we think that this comes because Asjabi is 'unsure' about what is happing to him.

The lady that takes Asjabi for a walk during the day told us already in late September 2012 about a reading of one of her dogs. I was quite sceptic about a reading, but my wife really wanted it and because it wouldn't hurt Asjabi, we send Karlijn of 1goedgevoel.nl (a good feeling) a photo of Asjabi and some questions. We wanted to know if Asjabi was still a happy dog. About three weeks later, Karlijn phoned us with the 'results' of the reading. She told us things that she couldn't have known by herself or that she could have read on this page.

Asjabi told her that he was proud that he wore the collar of Djiep (he had ruined his own - brand new - collar and I'd given him the collar of Djiep), that he thinks that Banzai is often too pushy (Banzai can be really pushy sometimes), that he always sleeps on the bed with an old woman (about the time of the reading, our (step)daughter lived with us for a couple of months) and that he went on holiday with a boat and a blue car (the taxibus on Vlieland had a blue interior). The most important thing however was that despite of his handicap, Asjabi still feels happy and that he has no pain, but that he feels a bit groggy sometimes (this could be a side effect of the Previcox).

In April 2013 we sense a slighty different mood with Asjabi. He still likes to go walking in his wheelchair, but when we are at home it seems as if Asjabi starts to realise that his body abandons him.

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17) Asjabi becomes famous!
Early October 2012 we receive a phonecall by wheelchair-dogs.com. They tell us that they gave our telephone number to the editorial staff of the Dutch glossy LINDA who are working on an article about handicapped dogs. Within a week, Asjabi and his wheelchair are on a stage at a photostudio in Amsterdam. Asjabi behaves exemplary and the photographer takes a few beautiful pictures of him. After a video interview and a walk in the Amsterdam Vondelpark we go home. That evening we are being interviewed by phone by one of the people of the editorial staff.

A backstage video about the article is published on YouTube on 20 November 2012. Asjabi and his masters appear for a mere eight seconds in this video (at 0:09, 0:17 and 0:38 - 0:44), but Asjabi is so proud!


Backstage video LINDA

The 100th edition of LINDA is published on 21 November 2012 and yes: He is in it! The article (in Dutch) can be downloaded here.

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18) Asjabi looses the fight against DM
Around May 2013, Asjabi is - when not in his wheelchair - only able to roll from one side to the other (only when his hind legs don't get entagled). Further more he only can turn his body 180° when he has enough hold on furniture or carpets in our house. However, he isn't able to get around the house by himself, so we always need to help him with this. On several occasions we notice him grumbling when he wants something, but isn't able to. He also chokes many times when he eats and drinks because he has to do this while lying down and in general it seems as if Asjabi slowly becomes frustrated because of the deterioration by the DM.

We also notice that when Asjabi is in his wheelchair, his body is slowly abandoning him. The sheeps at the children's farm in the nearby park are still interesting, but sometimes even a stroll is too fast for him, especially when it is warmer. Asjabi's head still wants to, but his body isn't capable to. On several occasions he falls down with his wheelchair because his front legs don't have sufficient strength to correct the wheelchair when it rolls backwards.

We consult our vet and after thinking everything over, my wife and I decide on 5 June 2013 that Asjabi is entitled to have a worthy end of his life. Although we love him with all our heart, we think that we will act selfish if we want to keep him with us for much longer.

On 7 June 2013 the vet comes at our house to put Asjabi down in the presence of my wife and me. We are shattered and he will hold a special place in our heart forever.

We take him to a crematorium in Boxtel and in the near future we will scatter his ashes - together with Djiep's - at the river Dommel in Eindhoven where we walked a lot and where Djiep and Asjabi used to swim in the summer.

We will never forget him.

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19) Chronological recapitulation

10 December 2004

Asjabi is born (presumably on this day) in France.

24 January 2005

We pick up Asjabi at the ‘Poor Animal’ foundation in Prinsenbeek.

25 August 2010

Our vet makes an X-ray of Asjabi’s right knee because he limps several times and spares his right hind-leg. The vet however doesn't sees any impediments.

3 September 2010

Because Asjabi's condition gets worse, our vet directs us to the Wagenrenk veterinary clinic in Wageningen, where we have an appointment with Dr. Govers. Zij detects a teared off cruciate ligament.

10 September 2010

Asjabi is operated at the Wagenrenk veterinary clinic in Wageningen by Dr. Govers. His cruciate ligament is fixed with the so-called 'classic method’.

3 June 2011

We have to put down our Belgium Shepherd Djiep down due to bone cancer. We also notice that Asjabi's right hind-leg swings out a tiny bit. In March 2012 we record a video of it.
Video 1

30 September 2011

Our vet makes another set of X-rays because Asjabi seems to have a problem with his right knee again. He sends the X-rays to the Wagenrenk veterinary clinic in Wageningen. The X-rays don't show any abnormalities.
Our vet also does a little test by bending Asjabi’s hind-legs back. Asjabi corrects his left hind-leg immediately, his right hind-leg follows after a couple of seconds. Our vet mentions 'a dying nerve-system’ and on the internet we find information about Degenerative Myelopathy and the story (Dutch only) about the German Shepherd Tanja.

7 December 2011

Because Asjabi's complaints also can be caused by a hernia, more X-rays are made from Asjabi's hips and lower back. These X-rays are send to the Wagenrenk veterinary clinic in Wageningen to be checked.

22 December 2011

We have an appointment at the Wagenrenk veterinary clinic in Wageningen where Dr. Bergknut sees Asjabi. He suspects that Asjabi's complaints are caused by a hernia that might be operable. Asjabi is prescribed Rimadyl 100 mg because of the pain that is caused by the hernia.
Next to that, an appointment is made at the Faculty of Veterinaryology in Utrecht for an MRI to find the nature and location of the hernia.

2 January 2012

Because we suspect that the Rimadyl 100 mg works insufficiently, our vet prescribes Previcox 227 mg.

10 January 2012

An MRI is made at the Faculty of Veterinaryology in Utrecht. Next to that, a blood sample is drawn to test Asjabi on DM. This test is conducted at the Dr. Van Haeringen laboratorium.

25 January 2012

We receive the result of the blood test at the Dr. Van Haeringen laboratorium by mail. Asjabi is tested as being affected by DM.

27 January 2012

We have an appointment with Dr. Meij at the Faculty of Veterinaryology in Utrecht. He tells us that DM can't be cured, but that the process can be slowed down by hydrotherapy for instance. He also advises us to let Asjabi loose some weight, because he weighs 48 kg.

1 February 2012

We start with two sessios of hydrotherapy a week at ‘Dier en Dokter’ (Animal and Doctor) in Mierlo. The vet at ‘Dier en Dokter’ suggests to give Asjabi a four-weekly injection with Anabolin to strenghten his muscles.

25 February 2012

Asjabi’s nails are worn down that m,uch that they start to bleed. To protect his nails we decide to buy dog shoes.

19 March 2012

After three weeks with two sessions of hydrotherapy a week we switch to three sessions of hydrotherpy a week.

3 April 2012

Due to the fact that Asjabi stands and walks less stable (video 2), the vet at ‘Dier en Dokter’ shows us the Biko Physio Brace (‘Biko Hundeexpander’). We ask Dr. Bergknut if he knows about this aid, but he doesn't. A video (video 3) on the website of Biko convinces us and we buy the Biko Physio Brace. Asjabi stands a lot more stable and he can even run a bit. He still needs to wear his shoes.

4 June 2012

The DM has deteriorated Asjabi’s nerve system so much that the Biko Physio Brace is of hardly any use (video 4) and we start to look for a wheelchair. On the internet we find a second hand wheelchair that - according to the supplier - should fit Asjabi.

9 June 2012

Together with Asjabi we go to see the wheelchair. We put him in the wheelchair and after a minute he starts to wander through the garden. We decide to buy the wheelchair and the next two weeks we slowly let Asjabi get used to his wheelchair.

20 June 2012

After talking to the vet in Mierlo we decide to quit with the hydrotherapy because Asjabi's bad (right) hind-leg gets tangled behind his good (left) hind-leg. From now on, the four-weekly injections of Anabolin are being given by our 'own' vet. Asjabi weighs 42.5 kg.

22 June 2012

Together with Asjabi we go on a one week vacation to the ilse of Vlieland. Thanks to the wheelchair, the vacation is a success! Asjabi can walk for several miles and the wheelchair proves to be a success.
Video 5
Video 6
Video 7

9 Oktober 2012

Asjabi co-operates at a photoshoot for the 100th edition of the glossy ‘LINDA’. After a video-interview in the studio and an interview by phone at our place, we wait how Asjabi will show up in ‘LINDA’.

23 Oktober 2012

Because Asjabi licks his penis frequently, we ask the vet to test his urine. We fear an infection, but no abnormalities show up.

17 November 2012

We leave for another short vacation to the ilse of Vlieland and Asjabi comes with us. Asjabi can be seen frequently on the beach, in the woods or in the village.
Video 8

20 November 2012

A backstage video of the photoshoot appears on the website of the ‘LINDA’.
Video 9

21 November 2012

The 100th edition of ‘LINDA’ appears with the article about Asjabi.

8 December 2012

Despite the fact that Asjabi has used the wheelchair for the last six months, his legs still have a walking reflex.
Video 10
Despite being in a wheelchair for six months, he still enjoys to carry large sticks.
Video 11
When not in his wheelchair, Asjabi only uses his front-legs
Video 12

9 January 2013

The vet prescribes 'Propalin' because Asjabi looses tiny bits of urine. ‘Propalin’ fights the symptoms of incontinence. We also buy a ‘Karlie Gentleman Wrap’ for Asjabi to wear at night, together with a Tena lady 'sanitary napkin'. For the time being we only use the ‘Karlie Gentleman Wrap’ with the 'sanitary napkin'. Next to that we express Asjabi's bladder during his walks in the wheelchair. Asjabi now weighs 37 kg.

11 January 2013

Due to the snow, we attach skis on Asjabi's wheelchair. In fresh and deep snow, the skis prove to be usefull.
Video 13

18 Februari 2013

 

Due to the disappointing effect of the ‘Karlie Gentleman Wrap’ we switch to the SnuggEase daipers for dogs.

12 March 2013

 

Because Asjabi's incontinence gets worse and the Propalin makes his faeces rather soft, we switch to IncontinenceStop because of the positive stories about it on the manufacturers website.

1 April 2013

 

Asjabi no longer has a walking reflex in his hind legs and because of that we use the little belts to keep his feet from the ground.

5 May 2013

 

Even with our help, Asjabi has hardly any strength left to get up the stairs, so he sleeps downstairs from now on. A one hour walk in his wheelchair however is hardly a problem.

7 June 2013

 

Asjabi's condition has deteriorated rapidly the last couple of weeks and after consulting our vet we have made the decision to put him down. He will hold a special place in our heart forever.

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20) Links
Manufacturer Biko Physio Brace
Information on the Biko Physio Brace
Dutch representative for the Biko Physio Brace
Supportgroup Degenerative Myelopathy
Exercises for dogs with DM
Reading of your dog (Dutch only)
Wheelchair for your dog
German Shepherd kennel "von Haus Demuth"
Foundation "Healthy German Shepherd" (Dutch only)
University of Missouri DM page
DM survey and database of Dr. Clemmons (University of Florida)
Domaine du Chien, Bed & Breakfast for you and your dog

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21) History of this page

29 January 2012

Page embedded in the structure of the website;

22 April 2012

First publication;

24 April 2012

Added a few links, a text about wheelchairs and a text about the mental aspect;

29 May 2012

Photolinks adjusted;

7 July 2012

Text and photos about the wheelchair added;

10 August 2012

Text about hydrotherapy added;

4 November 2012

Texta about mental aspect and links adjusted, photoshoot Dutch glossy LINDA! added;

18 November 2012

Text about incontinence added;

20 November 2012

Link to the video of LINDA! added;

21 November 2012

Announcement about the article in LINDA! added;

13 December 2012

YouTube videos and link to article in LINDA added;

18 January 2013

Text about incontinence added, weight of Asjabi and a link to a report on dogs in a wheelchair added;

20 January 2013

Text about skis on the wheelchair added;

27 January 2013

Chapters and a chronological recapitulation added;

18 February 2013

 

Text about incontinence adjusted;

23 March 2013

 

Text about incontinence adjusted;

29 April 2013

 

Text about incontinence adjusted and several minor additions to the text;

5 May 2013

 

New links added and several minor additions to the text;

18 May 2013

 

Text about incontinence adjusted and several minor additions to the text;

9 June 2013

 

Text about the passing away of Asjabi added to the site;

4 July 2013

 

New links added and several minor additions to the text;

2 March 2014

 

Several minor additions made to the text.

10 August 2014

 

Several minor additions made to the text.

6 July 2015

 

Several minor additions made to the text.

1 June 2020   New videolinks added.

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Last update: 1 June 2020