Collapsing dog

Re: Collapsing dog

Kay Varley — Thu, 15 Nov 2012 10:59:51 GMT

So sorry for not replying sooner. Thank you for taking the time to give me such useful information. I am on maternity leave so not checking up on my clients as regularly as I could do. The owner said the dog grazes on dry food during the day so doesnt know when he ate prior to the bloods. He's not had any more episodes so she doesnt want to investigate further but at least we know what to do if it happens again. I think I exaggerated the head stand part- its more of a knuckling on the front legs and landing on his nose type thing. I've asked her again for the video so I'll try and put it on but I think there's probably more exciting dog headstand videos on You Tube! Thanks again

Re: Collapsing dog

Rajat — Mon, 29 Oct 2012 17:33:41 GMT

Thanks Mark !

Re: Collapsing dog

Mark Lowrie — Mon, 29 Oct 2012 16:52:02 GMT

This sounds like one of those very difficult cases and I think I would agree with something Bob posted on another thread about videos of strange episodes – one person’s description can very often differ to another’s and so it can be very difficult to interpret a fit from a faint. Therefore I would second the opportunity to see this video as the description sounds very unusual and therefore this could be something quite weird.

A syncopal episode would usually involve a loss of tone – i.e. floppiness. If this dog isn’t floppy then this is less likely. The same goes for narcolepsy/cataplexy. I would agree with the advice you got from another neurologist, as partial seizures can often present with mild to no post-ictal signs.

However, hypoglycaemia can be something that can go a bit under the radar and I wouldn’t completely rule it out. The cases I have seen with this may be found to have a normal glucose if the dog has been fed in the last 12 hours, whereas a blood sample following a 12 hours fast should be low. If the bloods on this dog were done following a 12 hour fast then I think it is ok to rule-out but if not it would be very easy and very cheap to repeat. I tend to do 3 blood samples 2 hours apart over a 6 hour period to completely rule-out hypoglycaemia. Whereas if the first sample is <3 mmol/L then no need to do this.

I think though the next step would be the video if you can try and download it. Head-stands are very unusual!

Re: Collapsing dog

Rajat — Mon, 29 Oct 2012 16:29:47 GMT

I'd be surprised if a dog has seizure with no post ictal signs - you said he was fine after the episode, but 100% fine? Not dazed or a bit slow or any of the usual post ictal stuff?

Insulinomas don't always present with low BG if I remember correctly. If they have money to investigate it I'd do that before treating- as the dog doesn't appear to be currently 'suffering seriously' i.e. not in dire need of treatment. But that's one way of looking at it, and not the only way. Maybe Mark L can comment on these signs.

On another note I'd love to see the headstand video!

PS I really really doubt a dog with neck pain would do a headtsand

Re: Collapsing dog

Kay Varley — Mon, 29 Oct 2012 12:13:17 GMT

I've spoken to the neurologist who said its most likely a seizure. If it was an insulinoma then he would expect the BG on the routine bloods to be low and also the dog's recovery would be slower, plus he wouldnt have been symptom free for the 12m in between. The other differential would be a cervical disc causing the knuckling if he twisted his neck suddenly but its less likely with no pain signs. We'll probably try phenobarbs. Thanks for your help everyone!

Re: Collapsing dog

Moira Hamilton — Sun, 28 Oct 2012 18:55:14 GMT

Meant to write Good Luck at the end not repeating good idea!!!!

Re: Collapsing dog

Moira Hamilton — Sun, 28 Oct 2012 18:52:51 GMT

I had a similar case in a cat, however it seemed to resolve on it's own, have also had an insulinoma case, and though he definitely collapsed he didn't do anything as dramatic as a head stand! Though in his case the glucose was very low on the routine screen. Could be one of these odd seizures like fly catching syndrome? But think as stated above and by yourself I think a holter ECG would be a great idea, good idea!!!

Re: Collapsing dog

Kay Varley — Sun, 28 Oct 2012 18:23:51 GMT

Thanks for your help everyone. I'll definitely go down the insulinoma route next. If I was good on a computer I would attach the video just because its quite interesting watching a dog doing a headstand. I'll let you know what happens.

Re: Collapsing dog

ilanit — Sat, 27 Oct 2012 05:07:50 GMT

Just a wild thought: mild case of cataplexy?

I second checking for insulinoma might be a good idea

Re: Collapsing dog

Utlendigur — Fri, 26 Oct 2012 22:05:07 GMT

Insulinoma? The last one I saw (I seem to attract them) was doing similar things, and they can show signs only intermittently and not always associated with exercise. Might be worth a glucose:insulin ratio if not cardiac.

Re: Collapsing dog

Rajat — Fri, 26 Oct 2012 20:55:28 GMT

Hmm bit of a mystery then! I agree with you a Holter would be a sensible next step. A resting ECG may show up some abnormalities too but unless he obliges by collapsing while you have the leads on it won't really help

Let us know how it pans out please..:)

Cheers

Rajat.

Re: Collapsing dog

Kay Varley — Fri, 26 Oct 2012 20:44:52 GMT

Thanks Rajat. His heart sounded fine, heart rate normal, electrolytes normal. I've asked the owner to look at the gums and check the heart rate if he has another episode. At least it keeps them busy! Holter monitoring sounds like a good plan. Its the kind of case where you get the impression all the tests will be normal....

Re: Collapsing dog

Rajat — Fri, 26 Oct 2012 20:06:34 GMT

Hi Kay

I would suggest that sudden collapse with quick return to normality is quite suggestive of a syncopal episode...

What does cardiac auscultation reveal? Electrolytes?

I would be suspicious for a cardiac cause - any chance of running an ECG on him?