A sudden onset head tremor in a 1.5 year old lurcher

Re: A sudden onset head tremor in a 1.5 year old lurcher

mariette asselbergs — Thu, 10 May 2012 22:04:06 GMT

Thanks for your comments Mark.

Update now is:

Bloods and Xrays (neck and head) nothing abnormal. We didn't dare to do a spinal tap......

Medication changed to baytril and corticosteroids (preds) and temperature has gone down, tremors have disappeared and dog is eating again.

There must have been some infection somewhere but nothing showed up in the bloods so maybe viral?

Re Pyometra she is spayed.

Mariette

Re: A sudden onset head tremor in a 1.5 year old lurcher

Mark Lowrie — Tue, 08 May 2012 13:22:38 GMT

I’ve finally been able to get to a computer that allows me to see the link for the video. I know it’s late but the video seems to show a head tremor that is very intermittent and not associated with movement. Therefore I think cerebellar disease is unlikely. It also looks quite different to idiopathic head tremors as the episodes last a few seconds at most.

Therefore given the pyrexia and suspected pain (when eating??) I would investigate this first as this is the more concerning feature of the presentation.

We have seen some dogs that have a strange kind of twitching/shaking of an ear or the head that have a septic focus. The two cases that come to mind are dogs that had a pyometra and facial twitching which resolved following treatment of the pyo. God knows what the aetiology of the tremors was in these cases…

Do you have an update on the case Mariette?

Re: A sudden onset head tremor in a 1.5 year old lurcher

Lucy K — Tue, 01 May 2012 07:15:04 GMT

How about a cervical abscess? It would explain the pyrexia and pain on swallowing, maybe the pain of holding the head up is causing a tremor? Please let me know if this is way off and why!

Re: A sudden onset head tremor in a 1.5 year old lurcher

mariette asselbergs — Tue, 01 May 2012 06:24:17 GMT

Thanks all of you for suggestions and help! Yes i was also thinking CSF, possibly while sedated for xrays. Was also thinking of toxoplasmosis since she eats everything she finds.

Re pancreatitis: no abdominal pain on palpation, no vomiting, and clearly is hungry but seems to be prevented from eating by a pain or fright. Does not make a difference between hard or soft food, but not while drinking.I haven't seen her reaction, so far I have gone by what the owner has told me, but since she will be in today, we may be able to observe her more closely. (Although not me, I'll be TB testing in pouring rain......).

Mariette

Re: A sudden onset head tremor in a 1.5 year old lurcher

Utlendigur — Mon, 30 Apr 2012 21:10:07 GMT

CSF tap?

The head tremor does look a bit like a case we had several years ago - young curly coated retriever - that was diagnosed at referral as cerebellar degeneration (I think) - but that didn't have pyrexia as far as I know (doesn't have concurrent pancreatitis too does it? - just trying to think laterally since that would also give a praying posture, pyrexia and reduced appetite). I'll try to look up the case on Weds

Re: A sudden onset head tremor in a 1.5 year old lurcher

Mark Lowrie — Mon, 30 Apr 2012 20:12:26 GMT

Unfortunately I'm away and only on iPhone so can't paste web page. The high temp and praying posture ( suggestive of pain) v suggestive of meningitis (as Kate said) but not sure how head tremors fit with this diagnosis.

Re: A sudden onset head tremor in a 1.5 year old lurcher

mariette asselbergs — Mon, 30 Apr 2012 19:03:03 GMT

Update today (D4 since onset).

Dog is not any better, eating only little bits and winces/ frightens after swallowing. Little head tremors after chewing. Losing some weight now. And what is most worrying: temperature up to 40.8 this afternoon. She also showed a "praying "stand which I consider a sign of abdominal pain, but the owner says that she has always done that. Looking at her I would never guess that she has this high a temperature.

We have sent in blood for a complete urgent profile and she is booked for x rays tomorrow.

If there is no obvious sign of a raging infection I hope to get her on steroids under abx cover.

Mariette

Re: A sudden onset head tremor in a 1.5 year old lurcher

mariette asselbergs — Mon, 30 Apr 2012 18:55:13 GMT

Mark, if you post the link in your browser you get it on you tube. Unfortunately it is horizontal, I didn't manage to turn it 90 degrees, but maybe you can turn the screen of your laptop....?

Hope it works

Mariette

Re: A sudden onset head tremor in a 1.5 year old lurcher

Mark Lowrie — Mon, 30 Apr 2012 17:33:06 GMT

I can't get the video to work. There are lots of things that may be happening here but I'd want to see the tremors before commenting...

Re: A sudden onset head tremor in a 1.5 year old lurcher

Kate Richardson — Mon, 30 Apr 2012 11:37:24 GMT

I think bloods would be good, looking for a cause of the pyrexia especially prior to using pred- last thing you want to use if there are signs of a raging infection, so make sure you get a blood smear looked at to check for any toxic loking neutrophils. Having said that, steroid responsive meningitis springs to mind- right age, right breed, but have to rule out other causes of pyrexia

Re: A sudden onset head tremor in a 1.5 year old lurcher

Thomas Johnson — Mon, 30 Apr 2012 09:03:43 GMT

I'm not sure whether it quite fits the signs you're seeing but have you considered masticatory myositis?

Re: A sudden onset head tremor in a 1.5 year old lurcher

mariette asselbergs — Mon, 30 Apr 2012 06:44:36 GMT

Thanks Evelyn, I think blood and x rays are the next step.

But I would be surprised if the tooth was the problem since it is of normal colour, totally painless and there is no sign of inflammation or swelling or tenderness in the gums or jaw bone. Also she does not show any problem or painfulness chewing, she is just slow.

With re to the tympanic bullae there is no head tilt or problem with equilibrium at all, totally clean ears and no history or ear problems ever.

Since the dog is not insured we do not want to increase cost if we can avoid so.

Mariette

Re: A sudden onset head tremor in a 1.5 year old lurcher

Evelyn Barbour-Hill — Sun, 29 Apr 2012 17:42:40 GMT

With all respect, you don't know what the broken tooth is doing until you've Xray-ed it. Nor the tympanic bullae.

Re: A sudden onset head tremor in a 1.5 year old lurcher

mariette asselbergs — Sun, 29 Apr 2012 16:58:13 GMT

Update today: (3 days since tremor first seen) Dog shows less tremor, but is very lethargic compared to normal energetic self. Owner observed that while eating carefully she suddenly stepped back as in pain or fright and winced. Her food bowl is in a stand, so she does not eat with her head very low, although still lower than horizontal.I have carefully looked over all neck movements, every single (nice healthy) tooth, opened mouth widely , no pain, throat nothing abnormal, sinuses all hollow and not painful on percussion, ears totally clean. Surprisingly the temperature had gone up to 40.3. But since I cannot find any indication of an infectious process anywhere so far, and since she is on abx anyway and still wanting to eat (she looked expectantly and full of hope to my hand in my pocket) I put her on twice daily paracetamol until tomorrow. If still the same, or still feverish we'll go for bloods. We don't consider x ray of skull (yet) unless neurological symptoms progress.

If it was Africa I would put rabies in my diff diagnosis (unexplained fright at food, unexplained head tremors) but in three days it has not progressed in a rabies way. But it could have eaten a dying bat ......

I was also considering a neurological sequella from distemper, but there is no history of any illness in the weeks/months before.

Will keep you informed!

Mariette

Re: A sudden onset head tremor in a 1.5 year old lurcher

Evelyn Barbour-Hill — Sun, 29 Apr 2012 13:10:12 GMT

The tooth is probably nothing to do with it, but you do need to check it. You need radiographs. I expect you'll be doing radiographs anyway, to look at the ears and other bits?

Re: A sudden onset head tremor in a 1.5 year old lurcher

James Laidlaw — Sun, 29 Apr 2012 09:28:00 GMT

Exposed pulp of fractured tooth could be an entry point too? Or tooth root abcess/osteomyelitis? I'm only thinking I the tooth, it's early and my brain isn't fully functioning yet!

Re: A sudden onset head tremor in a 1.5 year old lurcher

Nicola Lawlor — Sun, 29 Apr 2012 09:21:00 GMT

I am no expert for sure, but can you rule in/out tetanus here? Cases are rare but I have seen two, one of which was in a lurcher. I have no idea if they are more predisposed than other breeds though??