Table III.

Clinical grading scale of disease progression in DM affected dogs.

Clinical Grade	Clinical Signs*
1	Paraparesis and General Proprioceptive Ataxia
	• Progressive general proprioceptive ataxia
	• Asymmetric and spastic paraparesis
	• Postural reaction deficits in pelvic limb
	• Intact spinal reflexes (patellar reflex may be decreased)
2	Nonambulatory Paraparesis to Paraplegia
	• Mild to moderate loss of muscle mass in pelvic limbs
	• Reduced to absent spinal reflexes in pelvic limbs
	• +/- urinary and fecal incontinence
3	Paraplegia to Thoracic Limb Weakness
	• Signs of thoracic limb weakness
	• Flaccid paraplegia
	• Absence of spinal reflexes in pelvic limbs
	• Severe loss of muscle mass in pelvic limbs
	• Urinary and fecal incontinence
4	Tetraplegia and Brain Stem Signs
	• Flaccid tetraplegia
	• Difficulty with swallowing and tongue movements
	• Absence of spinal reflexes in all limbs
	• Reduced to absent cutaneous trunci reflex
	• Generalized and severe loss of muscle mass
	• Urinary and fecal incontinence

^*The presumptive diagnosis of DM for dogs was based on the presence and progression of these signs. Early stages include grades 1-2, and late stages include grades 3-4. (Adapted from (Coates and Wininger 2010); Shelton et al 2012)