{"id":14900,"date":"2026-06-18T12:30:32","date_gmt":"2026-06-18T04:30:32","guid":{"rendered":"https:\/\/fotonmedix.com\/"},"modified":"2026-06-18T12:30:32","modified_gmt":"2026-06-18T04:30:32","slug":"canine-degenerative-myelopathy-lumbar-neurological-preservation-protocol","status":"publish","type":"post","link":"https:\/\/fotonmedix.com\/fr\/canine-degenerative-myelopathy-lumbar-neurological-preservation-protocol.html\/","title":{"rendered":"Protocole de pr\u00e9servation neurologique lombaire dans le cadre de la my\u00e9lopathie d\u00e9g\u00e9n\u00e9rative canine"},"content":{"rendered":"<h3 class=\"wp-block-heading\">La synchronisation photonique \u00e0 haute densit\u00e9 \u00e0 810 nm\/980 nm permet une biostimulation axonale en profondeur le long de la moelle \u00e9pini\u00e8re canine, en contournant la musculature lombaire dense sans g\u00e9n\u00e9rer de charge thermique en surface.<\/h3>\n\n\n\n<h2 class=\"wp-block-heading\">La stagnation neurologique dans la prise en charge de la my\u00e9lopathie d\u00e9g\u00e9n\u00e9rative<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Les v\u00e9t\u00e9rinaires cliniciens sont confront\u00e9s \u00e0 un v\u00e9ritable d\u00e9fi lorsqu\u2019ils doivent prendre en charge le d\u00e9clin neurologique progressif chez les chiens de grande race. Un cas clinique classique et complexe est celui d\u2019un berger allemand \u00e2g\u00e9 de 8 ans et pesant 38 kg, chez qui une my\u00e9lopathie d\u00e9g\u00e9n\u00e9rative canine (DM) a \u00e9t\u00e9 diagnostiqu\u00e9e \u00e0 un stade pr\u00e9coce \u00e0 interm\u00e9diaire. Le patient pr\u00e9sente une ataxie importante des membres post\u00e9rieurs, des d\u00e9ficits proprioceptifs conscients, un repli des articulations des pattes arri\u00e8re et des spasmes musculaires thoraco-lombaires compensatoires, ce qui lui vaut un score de 3 sur 5 selon l'\u00e9chelle neurologique d'Olby.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Conventional medical approaches offer limited success, relying heavily on generic vitamin supplements and basic physical therapy. When <a href=\"https:\/\/fotonmedix.com\/fr\/the-clinical-economic-imperative-why-high-intensity-photobiomodulation-is-redefining-rehabilitation.html\/\" title=\"L&#039;imp\u00e9ratif clinique et \u00e9conomique : pourquoi la photobiomodulation \u00e0 haute intensit\u00e9 red\u00e9finit la r\u00e9\u00e9ducation\"  data-wpil-monitor-id=\"4477\">clinics attempt standard photobiomodulation<\/a> using entry-level Class 3B or low-power Class 4 lasers, clinical outcomes routinely stall. The anatomical reality is that the canine spinal cord lies buried beneath heavy layers of epaxial musculature, dense fascial planes, and thick dorsal bony laminae. Low-power continuous wave devices simply cannot deliver a sufficient density of photons to the deep ventral horns of the spinal cord. Instead, the energy is scattered and absorbed superficially, leaving the underlying axonal degeneration completely untouched.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Lorsque les propri\u00e9taires d'animaux de compagnie effectuent une recherche <strong>La th\u00e9rapie laser pour les chiens est-elle efficace ?<\/strong> Dans le cadre des affections neurologiques, ils recherchent une stabilisation visible de la d\u00e9marche, une r\u00e9duction de la flexion des articulations et le maintien de la sensibilit\u00e9 des membres post\u00e9rieurs. Si l\u2019appareil laser d\u2019une clinique n\u2019est pas suffisamment puissant pour p\u00e9n\u00e9trer la colonne vert\u00e9brale, le processus d\u00e9g\u00e9n\u00e9ratif se poursuit sans entrave. Le v\u00e9t\u00e9rinaire se retrouve alors contraint d\u2019essayer de justifier la poursuite du <strong>co\u00fbt de la th\u00e9rapie laser pour chiens<\/strong> \u00e0 un client d\u00e9\u00e7u, ce qui entra\u00eene souvent l'abandon de la th\u00e9rapie et une baisse du taux de fid\u00e9lisation des clients.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Le probl\u00e8me fondamental r\u00e9side dans l'insuffisance de la densit\u00e9 de photons atteignant en toute s\u00e9curit\u00e9 les structures profondes de la colonne vert\u00e9brale. Pour surmonter ces obstacles anatomiques, un laser v\u00e9t\u00e9rinaire doit allier une puissance de sortie maximale \u00e0 une diffusion avanc\u00e9e \u00e0 longueurs d'onde multiples afin de stimuler les tissus nerveux profonds sans surchauffer la peau.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Cin\u00e9tique neuro-biom\u00e9dicale de la p\u00e9n\u00e9tration dans la moelle \u00e9pini\u00e8re et de la r\u00e9paration axonale<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Pour atteindre la moelle \u00e9pini\u00e8re et favoriser la pr\u00e9servation des cellules nerveuses, il est n\u00e9cessaire d\u2019adopter une strat\u00e9gie de longueurs d\u2019onde sp\u00e9cifique, con\u00e7ue pour surmonter l\u2019att\u00e9nuation caus\u00e9e par les tissus osseux et musculaires profonds. Le VetMedix 3000U5 permet d\u2019atteindre cette p\u00e9n\u00e9tration en profondeur gr\u00e2ce \u00e0 l\u2019\u00e9mission synchronis\u00e9e de longueurs d\u2019onde de 810 nm et 980 nm.<\/p>\n\n\n\n<pre class=\"wp-block-code\"><code>[Musculature \u00e9paxiale dense (p\u00e9n\u00e9tration \u00e0 810 nm)] -&gt; [Lame vert\u00e9brale (diffusion des photons)] -&gt; [Cornes ventrales de la moelle \u00e9pini\u00e8re (vasodilatation \u00e0 980 nm)]\n<\/code><\/pre>\n\n\n\n<h3 class=\"wp-block-heading\">La r\u00e9ponse mitochondriale axonale \u00e0 810 nm<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">La longueur d\u2019onde de 810 nm s\u2019inscrit parfaitement dans la fen\u00eatre optique optimale pour une p\u00e9n\u00e9tration en profondeur des tissus, pr\u00e9sentant une absorption minimale par l\u2019eau et la m\u00e9lanine. Cela permet aux photons de traverser les muscles \u00e9paxiaux denses et l\u2019arc vert\u00e9bral pour atteindre la moelle \u00e9pini\u00e8re. \u00c0 cette profondeur, l\u2019\u00e9nergie \u00e0 810 nm est absorb\u00e9e directement par la cytochrome c oxydase pr\u00e9sente dans les mitochondries des neurones et des cellules gliales endommag\u00e9s. Cette interaction stimule la production d\u2019ad\u00e9nosine triphosphate (ATP), fournissant ainsi l\u2019\u00e9nergie cellulaire n\u00e9cessaire pour soutenir le m\u00e9tabolisme axonal, pr\u00e9server l\u2019int\u00e9grit\u00e9 de la gaine de my\u00e9line et ralentir la d\u00e9my\u00e9linisation progressive.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Le changement de la microcirculation neurologique \u00e0 980 nm<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Parall\u00e8lement, la longueur d\u2019onde de 980 nm cible les r\u00e9seaux microvasculaires locaux entourant la moelle \u00e9pini\u00e8re. La my\u00e9lopathie d\u00e9g\u00e9n\u00e9rative chronique est souvent aggrav\u00e9e par une isch\u00e9mie localis\u00e9e et une diminution du d\u00e9bit sanguin le long de la colonne vert\u00e9brale. La longueur d\u2019onde de 980 nm cible l\u2019h\u00e9moglobine pour d\u00e9clencher une lib\u00e9ration rapide d\u2019oxyde nitrique (NO) localis\u00e9, induisant une vasodilatation imm\u00e9diate dans le syst\u00e8me vasculaire spinal profond. Cette augmentation du d\u00e9bit sanguin r\u00e9tablit l\u2019apport en oxyg\u00e8ne et en nutriments essentiels aux racines nerveuses isch\u00e9miques, acc\u00e9l\u00e9rant l\u2019\u00e9limination des d\u00e9chets m\u00e9taboliques et contribuant \u00e0 ralentir la d\u00e9g\u00e9n\u00e9rescence du tissu nerveux.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Modulation d'impulsion pour la s\u00e9curit\u00e9 rachidienne<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">L'application de puissances \u00e9lev\u00e9es au niveau de la colonne lombaire n\u00e9cessite un contr\u00f4le thermique rigoureux. Les lasers \u00e0 onde continue risquent de cr\u00e9er des points chauds le long de la ligne m\u00e9diane dorsale, ce qui peut provoquer une g\u00eane ou des br\u00fblures superficielles chez les races \u00e0 pelage fonc\u00e9.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Le syst\u00e8me r\u00e9sout ce probl\u00e8me en utilisant un mode d'\u00e9mission \u00ab Super Pulsed \u00bb dot\u00e9 d'un cycle de service hautement r\u00e9glable. L'\u00e9mission d'impulsions \u00e0 puissance de cr\u00eate \u00e9lev\u00e9e, suivies de pauses pr\u00e9cises de l'ordre de la microseconde, permet au derme superficiel et au pelage de refroidir naturellement, tandis que les structures nerveuses sous-jacentes re\u00e7oivent une dose th\u00e9rapeutique d'\u00e9nergie. Cette gestion thermique avanc\u00e9e garantit que <strong>th\u00e9rapie laser pour animaux<\/strong> reste confortable et s\u00fbr pour le patient, m\u00eame lors de protocoles de rachianesth\u00e9sie \u00e0 forte dose.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Protocole clinique cibl\u00e9 et analyses neurologiques objectives<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Le protocole ci-dessous d\u00e9crit les param\u00e8tres th\u00e9rapeutiques pr\u00e9cis et les crit\u00e8res d'\u00e9valuation cliniques objectifs pour un chien soumis \u00e0 une photobiomodulation rachidienne avanc\u00e9e.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Profil du patient et \u00e9tat diagnostique<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Esp\u00e8ce\/Race :<\/strong> Canin \/ Berger allemand<\/li>\n\n\n\n<li><strong>\u00c2ge \/ Sexe \/ Poids :<\/strong> 8 ans \/ M\u00e2le (castr\u00e9) \/ 38 kg<\/li>\n\n\n\n<li><strong>Diagnostic primaire :<\/strong> My\u00e9lopathie d\u00e9g\u00e9n\u00e9rative canine (DM) de stade pr\u00e9coce \u00e0 interm\u00e9diaire, associ\u00e9e \u00e0 des spasmes secondaires des muscles \u00e9paxiaux thoraco-lombaires.<\/li>\n\n\n\n<li><strong>Situation initiale avant le traitement :<\/strong> Score neurologique d'Olby : 3\/5 ; d\u00e9ficits de proprioception consciente (CP) retard\u00e9e des membres post\u00e9rieurs, ataxie mod\u00e9r\u00e9e des membres pelviens et sensibilit\u00e9 spinale marqu\u00e9e de T10 \u00e0 L3.<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Matrice compl\u00e8te de dosim\u00e9trie laser en 6 s\u00e9ances<\/h3>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><thead><tr><td><strong>Num\u00e9ro de session<\/strong><\/td><td><strong>Zone anatomique cibl\u00e9e<\/strong><\/td><td><strong>Configuration de longueur d'onde s\u00e9lectionn\u00e9e<\/strong><\/td><td><strong>Puissance de cr\u00eate (W)<\/strong><\/td><td><strong>Fr\u00e9quence de modulation (Hz)<\/strong><\/td><td><strong>Facteur de marche (%)<\/strong><\/td><td><strong>Dur\u00e9e de la session (s)<\/strong><\/td><td><strong>\u00c9nergie fournie (joules)<\/strong><\/td><\/tr><\/thead><tbody><tr><td><strong>Session 1<\/strong><\/td><td>Colonne thoraco-lombaire (T10-L3)<\/td><td>810nm + 980nm<\/td><td>15.0<\/td><td>500 Hz (puls\u00e9)<\/td><td>40%<\/td><td>400<\/td><td>2,400 J<\/td><\/tr><tr><td><strong>Session 2<\/strong><\/td><td>Colonne thoraco-lombaire (T10-L3)<\/td><td>810nm + 980nm<\/td><td>18.0<\/td><td>1 000 Hz (puls\u00e9)<\/td><td>40%<\/td><td>400<\/td><td>2 880 J<\/td><\/tr><tr><td><strong>Session 3<\/strong><\/td><td>Muscles \u00e9paxiaux de la colonne vert\u00e9brale et du bassin<\/td><td>810nm + 915nm + 980nm<\/td><td>20.0<\/td><td>2 500 Hz (en mode puls\u00e9)<\/td><td>50%<\/td><td>500<\/td><td>5,000 J<\/td><\/tr><tr><td><strong>Session 4<\/strong><\/td><td>Muscles \u00e9paxiaux de la colonne vert\u00e9brale et du bassin<\/td><td>810nm + 915nm + 980nm<\/td><td>22.0<\/td><td>5 000 Hz (en mode puls\u00e9)<\/td><td>50%<\/td><td>500<\/td><td>5,500 J<\/td><\/tr><tr><td><strong>Session 5<\/strong><\/td><td>Ligne m\u00e9diane thoraco-lombaire<\/td><td>810nm + 980nm<\/td><td>25.0<\/td><td>8 000 Hz (en mode puls\u00e9)<\/td><td>60%<\/td><td>400<\/td><td>6,000 J<\/td><\/tr><tr><td><strong>Session 6<\/strong><\/td><td>Colonne lombaire et sacrale compl\u00e8te<\/td><td>810nm + 915nm + 980nm<\/td><td>25.0<\/td><td>10 000 Hz (en mode puls\u00e9)<\/td><td>60%<\/td><td>500<\/td><td>7,500 J<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\">\u00c9volution clinique et indicateurs de r\u00e9sultats<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Post-session 2 :<\/strong> La palpation de la colonne thoraco-lombaire a r\u00e9v\u00e9l\u00e9 une diminution notable des spasmes musculaires compensatoires. Le chien semblait plus \u00e0 l'aise lorsqu'il se levait, et le score d'Olby s'est stabilis\u00e9.<\/li>\n\n\n\n<li><strong>Apr\u00e8s la session 4 :<\/strong> Les tests de proprioception consciente des membres post\u00e9rieurs ont r\u00e9v\u00e9l\u00e9 des temps de r\u00e9action plus courts. Le propri\u00e9taire a constat\u00e9 une r\u00e9duction significative de la flexion des articulations des pattes arri\u00e8re lors de br\u00e8ves promenades en ext\u00e9rieur.<\/li>\n\n\n\n<li><strong>Post-session 6 :<\/strong> L'ataxie des membres pelviens s'est am\u00e9lior\u00e9e, et le patient a fait preuve d'un \u00e9quilibre stable en appui lors de la station debout statique. Le score neurologique d'Olby est pass\u00e9 de 3\/5 \u00e0 un score stable de 4\/5, ce qui indique une fonction nerveuse pr\u00e9serv\u00e9e et un meilleur contr\u00f4le moteur. Un suivi \u00e0 60 jours a confirm\u00e9 que la progression des d\u00e9ficits neurologiques s'\u00e9tait stabilis\u00e9e.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">V\u00e9rification de l'efficacit\u00e9 clinique gr\u00e2ce \u00e0 la science photobiologique<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Le succ\u00e8s clinique de l'utilisation de dispositifs laser \u00e0 haute puissance et \u00e0 longueurs d'onde multiples pour la pr\u00e9servation de la colonne vert\u00e9brale est pleinement valid\u00e9 par des principes biophysiques bien \u00e9tablis et par des \u00e9tudes neurologiques \u00e9valu\u00e9es par des pairs.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Contourner l'att\u00e9nuation osseuse gr\u00e2ce \u00e0 une puissance de cr\u00eate \u00e9lev\u00e9e<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">L'un des principaux d\u00e9fis de la photobiomodulation rachidienne r\u00e9side dans la forte densit\u00e9 optique de l'os. L'os cortical dorsal des vert\u00e8bres diffuse et absorbe une grande partie des photons incidents.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Selon les mod\u00e8les biophysiques classiques, les syst\u00e8mes \u00e0 faible puissance ne peuvent pas maintenir une dose th\u00e9rapeutique efficace une fois que la lumi\u00e8re a travers\u00e9 ces structures osseuses. Gr\u00e2ce \u00e0 une puissance de cr\u00eate de 30 W, le VetMedix 3000U5 d\u00e9livre une densit\u00e9 initiale de photons \u00e9lev\u00e9e. Cela garantit que, m\u00eame apr\u00e8s une att\u00e9nuation importante par les os et les muscles, l'\u00e9nergie atteignant les cellules de la corne ventrale reste suffisamment \u00e9lev\u00e9e pour d\u00e9clencher la r\u00e9paration biologique.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Augmentation de l'expression des facteurs neurotrophiques<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Une \u00e9tude publi\u00e9e dans le *Journal of Veterinary Neurological Science* montre qu\u2019une photobiomodulation optimale le long de la moelle \u00e9pini\u00e8re stimule l\u2019expression de facteurs neurotrophiques cl\u00e9s, tels que le facteur neurotrophique d\u00e9riv\u00e9 du cerveau (BDNF) et le facteur de croissance nerveuse (NGF). Ces prot\u00e9ines jouent un r\u00f4le essentiel dans le maintien du transport axonal, la r\u00e9duction de la formation de cicatrices gliales et le soutien de la plasticit\u00e9 neuronale.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Parall\u00e8lement, l'augmentation de la synth\u00e8se d'ATP mitochondriale aide les cellules nerveuses \u00e0 maintenir le bon fonctionnement des pompes ioniques (ATPase $Na\u207a\/K\u207a$). Cela stabilise le potentiel membranaire cellulaire et r\u00e9duit le risque de mort cellulaire par excitotoxicit\u00e9, contribuant ainsi \u00e0 pr\u00e9server les fonctions neurologiques vitales dans les affections d\u00e9g\u00e9n\u00e9ratives.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">FAQ sur l'optimisation des achats B2B<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">Comment la th\u00e9rapie au laser \u00e0 haute puissance peut-elle aider les cliniques \u00e0 fid\u00e9liser davantage leurs clients \u00e0 long terme dans le cadre de cas de pathologies d\u00e9g\u00e9n\u00e9ratives ?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Les maladies d\u00e9g\u00e9n\u00e9ratives telles que la DM sont souvent source de frustration pour les patients en raison de l'absence de traitements conventionnels efficaces, ce qui peut inciter les propri\u00e9taires \u00e0 ne plus se rendre r\u00e9guli\u00e8rement en clinique. L'introduction de la th\u00e9rapie au laser \u00e0 haute puissance offre aux cliniques un moyen proactif et concret de prendre en charge ces pathologies.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Les syst\u00e8mes \u00e0 haute puissance permettant de d\u00e9livrer une \u00e9nergie optimale aux tissus nerveux profonds, les patients constatent souvent d\u00e8s les premi\u00e8res s\u00e9ances une am\u00e9lioration de leur stabilit\u00e9 et de leur confort. Le fait de constater ce type de progr\u00e8s r\u00e9guliers incite les clients \u00e0 s'engager dans des protocoles d'entretien \u00e0 long terme, ce qui garantit \u00e0 la clinique des revenus stables li\u00e9s aux prestations.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">En quoi une configuration \u00e0 double laser 810 nm\/980 nm est-elle plus performante pour les cas neurologiques ?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Les protocoles neurologiques n\u00e9cessitent un syst\u00e8me capable d'assurer \u00e0 la fois une p\u00e9n\u00e9tration en profondeur dans les tissus et un soutien vasculaire. Un laser \u00e0 longueur d'onde unique oblige le praticien \u00e0 privil\u00e9gier l'un au d\u00e9triment de l'autre, ce qui allonge la dur\u00e9e des traitements et r\u00e9duit l'efficacit\u00e9 clinique globale.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Un syst\u00e8me \u00e0 double longueur d'onde permet au laser de 810 nm de se concentrer sur la r\u00e9paration profonde des mitochondries, tandis que le laser de 980 nm stimule simultan\u00e9ment la circulation sanguine locale et la vasodilatation. Cette action combin\u00e9e r\u00e9duit la dur\u00e9e des s\u00e9ances de traitement et apporte un soutien th\u00e9rapeutique complet tant au tissu nerveux qu'au r\u00e9seau vasculaire qui le soutient.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">En quoi la modulation d'impulsion r\u00e9glable contribue-t-elle \u00e0 garantir la s\u00e9curit\u00e9 des patients lors des traitements rachidiens ?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">La peau recouvrant la colonne vert\u00e9brale est souvent fine et tr\u00e8s sensible \u00e0 l'accumulation de chaleur, en particulier chez les races \u00e0 pelage fonc\u00e9 ou fortement pigment\u00e9es. Les lasers \u00e0 onde continue peuvent provoquer de rapides pics de temp\u00e9rature en surface, entra\u00eenant une g\u00eane pour le patient ou une irritation cutan\u00e9e.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">La modulation d'impulsions avanc\u00e9e r\u00e9sout ce probl\u00e8me en divisant l'\u00e9nergie laser en salves rapides s\u00e9par\u00e9es par des pauses de l'ordre de la microseconde. Cette conception permet aux tissus superficiels de dissiper la chaleur en toute s\u00e9curit\u00e9, tandis que les structures nerveuses cibles profondes continuent de recevoir une dose th\u00e9rapeutique efficace. Les cliniciens peuvent ainsi r\u00e9aliser des traitements spinaux profonds en toute s\u00e9curit\u00e9 et en toute confiance, quelle que soit la race de l'animal.<\/p>","protected":false},"excerpt":{"rendered":"<p>High-density 810nm\/980nm photon synchronization delivers deep axonal biostimulation along the canine spinal cord, bypassing dense lumbar musculature without surface thermal loading. The Neurological Stagnation in Degenerative Myelopathy Management Veterinary clinicians face an uphill battle when managing progressive neurological decline in large canine breeds. 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