Medical issues

28 June 2015

Disa hasn't been well.  I promised I'd share my experience of what's been happening in the hope that it might prevent misdiagnosis for other animals, and potentially lead to further research.

August 2014

The first time I remember noticing anything.  Disa had been curled up in bed having a snooze and decided to join me in the garden.  As she came out, I noticed she wasn't putting any weight on one of her back legs. Her toes were balled up and she was swaying. Other than that, she was perfectly happy - walking around and sniffing everything as usual. After a few minutes, she was walking normally again, so I assumed it was a dead leg.  You would, right?

A few weeks later, it happened again, under similar circumstances.  I was more intrigued than anything else.  Odd that she should have two dead legs when I wasn't aware it had happened before.

January 2015

This time we were at the end of an hour long walk around the village and I assumed she wasn't putting her paw down as she had something stuck in the pad.  But there was nothing there.  I remembered the 'dead legs' from last August, but this was weird... how could she have a dead leg after a long walk?  The next afternoon, she was lying in bed and tried to get up.  She seemed unable to put any weight on any feet and swayed around a bit.  It didn't seem to bother her, she just laid back down and after a few minutes she was fine.  Now I was starting to get worried.  But, of course, then there were no symptoms for two months.

March 2015

This is when things really kicked off.

Every week, twice a week, she would have an episode where she would be unable to stand.  She would try, stagger around, then lie down.  After 10-20 minutes she would be fine.  All the time she looked otherwise ok.  Her tail was up and, if she was outside, she would sniff in the garden and chase birds.  But then she started to toilet and vomit each time.  Her whole body started to go into spasm and she would tremble.  Afterwards, she would understandably be exhausted and take herself to bed.

After the first couple of episodes, I spoke to my local vet.  She gave the obvious diagnosis that it was something neurological, but wanted to rule out infection or liver problems.  I was pretty sure it was neither, as it had been going on so long.  But a quick blood test was a good first step.

I must admit that I was pretty upset and annoyed when the vet called and said: "Good news; her blood tests have come back clear!"  How could that be good news when it meant that it could be something very serious?

Diagnosis

The vet forwarded my videos to a specialist and referal came pretty quickly.  Under a week later I took Disa to see Laurent Garosi at Davies Veterinary Specialists.  He was very thorough in his questioning but very quickly came to the conclusion that it was paroxysmal dyskinesia - roughly translated as an 'unexplained movement disorder'.

It turns out that these symptoms have been seen in several breeds, but with different causes in each. In Cavalier King Charles Spaniels, for example, it's been linked to a single gene. But in Border Terriers, it seems to be conncted to gluten in the diet.  Of course, he had never seen a case in a Norwegian Elkhound before.  His manner was very reassuring and, for those that are interested, he explained it was likely to do with the message transmission through synapses.  He said it was very very unlikely to be caused by any problem with her brain, as she was displaying no other symptoms.  It was equally unlikely to be a gluten problem, as again there were no other symptoms.

Laurent explained that there is medication that could be used to relieve the symptoms.  However, it tends to be episodic - ie the symptoms come in waves of being bad for a few months, then better.  The problem with a new diagnosis is that there is no way of telling where in that cycle you are.  So if he gave medication, we wouldn't know if it was helping or if we were entering a downturn anyway.  So basically the best thing to do was carry on like normal, monitor and wait.

Latest

Of course, since the build up to two episodes a week and the rush to a specialist, Disa was then completely symptom free for several weeks.  In fact, she's only had a few, very brief episodes since.  So Laurent was right to advise holding off on medication.

The episodes remain brief, but seem to be occuring more frequently again now.  All I can do is wait and see.

 

 

Further reading (may need some scientific understanding)

Paroxysmal movement disorders in dogs - Veterinary Times n° 16 of 23/04/2012

Phenotypic characterisation of canine epileptoid cramping syndrome in the Border terrier - J Small Anim Pract. 2014 Feb;55(2):102-7.

A canine BCAN microdeletion associated with episodic falling syndrome - Neurobiol Dis. 2012 Jan; 45(1): 130–136.

Comments

By June (not verified) on

Thank you for sharing your experience re Disa's episodes - I have a labrador retriever diagnosed with paroxysmal dyskinesia. He's been having these episdoes for nine years now.

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