Once a DM dog starts spending more time lying down, pressure sores become one of the most serious — and most preventable — complications you’ll face.

Quick answer: Pressure sores (also called decubitus ulcers or bedsores) form when sustained pressure cuts off blood flow to the skin over bony prominences like hips, elbows, and hocks. DM dogs in the middle and later stages are at high risk because they can't shift their own weight. Prevention focuses on high-density foam bedding, repositioning every 2–4 hours, keeping skin clean and dry, and doing a daily skin check. Caught early — as redness or hair loss — pressure sores can often be managed at home. Open, infected, or deep wounds require prompt veterinary care.

Why DM Dogs Are So Vulnerable to Pressure Sores

Dogs with degenerative myelopathy (DM) — a progressive neurological disease that gradually paralyzes the hind limbs and, in later stages, the forelimbs — lose the ability to reposition themselves as the disease advances. Healthy dogs shift their weight constantly, even in sleep. A dog who can’t do that has sustained pressure bearing down on the same patches of skin for hours at a time. Without adequate blood flow, that tissue starts to break down.

The problem tends to sneak up on caregivers. The coat hides early damage, dogs with reduced sensation may not show obvious discomfort, and by the time a sore is visibly open, it’s already a significant wound. Understanding the risk ahead of time — and building prevention into your daily routine — is genuinely the most important thing you can do.

⚠ī¸ ⚠ī¸ Higher Risk as DM Progresses
  • Risk increases significantly once a dog stops bearing weight on hind legs
  • Dogs with reduced sensation may not react to pain from a developing sore
  • Incontinence dramatically accelerates skin breakdown — moisture and bacteria are a dangerous combination
  • Thin or older dogs have less tissue cushioning over bony points

Where to Check: The High-Risk Spots

The most common pressure sore locations in DM dogs are directly over bones that press against hard surfaces. Do a slow, deliberate check of all of these every single day — preferably during grooming or a cuddle session so your dog associates it with something pleasant.

  • Hips (iliac crest): The pointy top of each hip bone. One of the most common sites in dogs who lie on their sides.
  • Hocks (rear ankles): Often dragged during the knuckling phase, which causes friction sores as well as pressure sores.
  • Elbows: As hind end weakness progresses, dogs shift more weight forward — the elbows take a beating.
  • Sternum (breastbone): A common site in dogs who lie on their chests (sphinx position) for long periods.
  • Sides of the knees: Any bony knee prominence in contact with a hard surface is at risk.

Run your fingers gently over each area. You’re looking for heat, firmness, hair thinning, redness, or any break in the skin.

How Do I Know If a Sore Is Forming?

Early pressure sores appear as redness, warmth, or patchy hair loss over a bony prominence — often before the skin breaks open. The skin may look slightly shiny or feel firmer than the surrounding area. At this stage, you have the best chance of reversing the damage with better padding and more frequent repositioning.

The 4 Stages (In Plain Language)

Knowing how to describe what you’re seeing helps enormously when you call your vet.

  • Stage 1: Intact skin, redness or discoloration that doesn’t fade when you press and release. No open wound yet.
  • Stage 2: Shallow open wound or blister. The outer and middle layers of skin are damaged.
  • Stage 3: Full-thickness wound — you can see the tissue beneath the skin. Needs veterinary care.
  • Stage 4: Deep wound reaching muscle, bone, or tendon. Urgent veterinary care required.

If you’re ever in doubt about what you’re looking at, call your vet. A photo sent through a patient portal often gets a faster answer than you’d expect.

🚨 🚨 Go to the Vet For These Signs
  • Any sore that breaks open or has visible raw tissue
  • Wounds that smell bad or have yellow/green discharge
  • Sores that are not improving after 48 hours of home care
  • Fever, lethargy, or loss of appetite alongside a skin wound (signs of infection spreading)
  • Any wound you can’t see the full depth of

Prevention: What Actually Works Day to Day

Most of the pressure sore prevention advice you’ll find is practical and low-cost — it just requires consistency.

Bedding

High-density memory foam is widely recommended by rehab therapists because it distributes weight more evenly than fiberfill or standard pet beds. Egg-crate foam toppers are a more affordable option. Whatever you choose, it needs to stay clean and dry — moisture is a major accelerant of skin breakdown. Waterproof covers help, but check underneath them regularly, because they can trap heat and condensation.

From what I’ve seen shared in the DM caregiver community, one of the most common regrets is sticking with a cheap, thin bed too long. The upgrade is worth it before the sores start.

Repositioning

Most rehab therapists recommend repositioning dogs who can’t shift their own weight every two to four hours during the day. For overnight, at least one position change is generally suggested for dogs in later DM stages. Keep a small folded towel or foam wedge nearby — you can use it to prop your dog slightly on one side rather than flat, which helps relieve hip pressure.

A good sling or support harness makes repositioning physically easier on both of you, especially as your dog gets heavier in your arms.

Skin and Coat Care

Keep the skin over bony prominences clean and dry. If your dog is incontinent, change soiled bedding promptly and clean the skin thoroughly after every accident. Moisture — especially from urine — combined with pressure is an extremely fast route to a Stage 2 wound.

Lightly trimming long fur over high-risk areas makes it easier to see what’s happening at skin level. You don’t need to shave — just enough that you can see redness before it hides under a thick coat.

✅ ✅ Daily Prevention Checklist
  • Full-body skin check every morning — press and release any red areas to check if color fades
  • Clean and dry all skin contact points after incontinence episodes
  • Reposition every 2–4 hours if dog cannot shift weight independently
  • Inspect bedding for dampness or soiling — replace if wet
  • Check hocks and elbows after any mobility sessions for friction redness

Protective Gear for Active DM Dogs

For dogs still in carts or doing assisted walking, hock and elbow protectors (sometimes called donut wraps or booties) can reduce friction sores significantly. From what many caregivers report, even a simple knit sleeve over the hock makes a real difference during the knuckling phase.

ℹī¸ 💡 Padding the Cart Too
  • Check where your dog’s harness or cart hardware contacts the skin — these create their own pressure points
  • Thin foam pipe insulation cut to length can pad metal bars inexpensively
  • After every cart session, check the contact zones for redness before it becomes a sore

Home Treatment for Stage 1 Sores

If you catch a sore at Stage 1 — redness only, skin intact — home management is often appropriate while you monitor closely.

  • Remove the pressure source immediately: improve bedding, increase repositioning frequency
  • Keep the area clean and dry
  • Don’t rub or massage the reddened skin — this can cause further damage
  • Check twice daily and document with photos so you can see if it’s improving or worsening
  • If it hasn’t improved within 48 hours, or if the skin breaks open at all, call your vet

For minor abrasions from friction (common at the hocks), your vet may recommend a topical antibiotic ointment and a protective wrap while the area heals. Never wrap tightly — circulation matters.

Caregiving for a DM dog in the later stages is genuinely hard, and I won’t pretend that adding one more thing to your daily checklist is easy. But I want you to know — from everything I’ve seen shared by caregivers who’ve been through this — that catching pressure sores early is one of the most meaningful things you can do. A two-minute skin check in the morning can save your dog from weeks of wound management and real pain. You’re already showing up every single day for your dog. This is just one more small way that love translates into action.

This guide is based on real experience and should be used alongside professional veterinary care. Always consult your veterinarian before starting any new treatment or making changes to your dog’s care plan.

Frequently Asked Questions

How do I know if my DM dog has a pressure sore forming?

Early pressure sores appear as a small area of redness, warmth, or hair loss over a bony prominence — most often the hip, elbow, or ankle. The skin may look slightly shiny or feel firm. Catching it at this stage is much easier than treating a wound that has broken open.

How often should I reposition my DM dog?

Most rehab therapists recommend repositioning every two to four hours during the day and at least once overnight if your dog cannot shift position on their own. The goal is to relieve pressure on any single bony point before tissue damage starts.

Can I treat a pressure sore at home?

Very mild redness without broken skin can often be managed at home with better padding, repositioning, and keeping the area clean and dry. Any sore that breaks open, looks infected, or doesn’t improve within 24–48 hours needs veterinary attention — these can go deep fast.

What bedding is best for preventing pressure sores in DM dogs?

High-density memory foam is generally considered the best option because it distributes weight more evenly than fiberfill or traditional pet beds. Egg-crate foam toppers are a more affordable alternative. Whatever you use, keep it clean and dry — moisture dramatically speeds up skin breakdown.