collapse after vomiting

Re: collapse after vomiting

ilanit — Wed, 24 Apr 2013 13:02:59 GMT

He was sleeping, then started salivating, got off the bed, then vomited, urinated and defecated. After that collapsed and was 'like a dead weight'. No clonic/tonic activity, but not rigid/stiff.

So maybe an atypical fit? Although floppy more like syncope!In any case, we are not doing any tests for now. She will do her best to make a video so maybe I can post it in a year's time!

Re: collapse after vomiting

ilanit — Tue, 23 Apr 2013 18:17:39 GMT

Thanks all.

I'll talk to them in the morning

Re: collapse after vomiting

Bob Russell — Tue, 23 Apr 2013 17:39:44 GMT

Filming is brilliant! It gives the owner something to plan for and prepare for the next event. They have something to do during the event (other than panic)! It can be sent to your local, friendly neurologist for an opinion. If the owners are like me they can prepare by learning in advance how to video on their phone!

Reassure, the dog has not come to any harm from these events so reassure the owner that there is no panic to get answers. Let them know that a specialist can view the footage if necessary!

This will (ethically) get them off your back for the time being without blindly testing the pet. Once you have seen the video you may well be in a better position to decide the way forward.

These things are worrying for owners so a clear plan keeps them on your side.

Re: collapse after vomiting

Mark Hedberg — Tue, 23 Apr 2013 16:36:53 GMT

You and my wife would get along FAMOUSLY. (the walking hundreds of miles bit, not the sicking up bit.)

Re: collapse after vomiting

Gillian Mostyn — Tue, 23 Apr 2013 16:20:31 GMT

[quote user="ilanit"]Although I wasn't there to check the heart rate at time of incident, the owner specifically mentioned the heart rate was very fast [/quote]

But that would be immediately after the collapse - you don't know what it was doing immediately before the collapse.

I am probably saying all this because I did something similar last weekend. I did a 50 mile walk in 16 1/2 hours (yes - I'm mad), finished, got in car (passenger), nodded off, woke up feeling incredibly nauseous (never felt like that in my life), went to be sick, and then passed out!!! Frightened the life out of Ian but I was AOK when I came round.

Bodies do strange things sometimes!!!

Re: collapse after vomiting

ilanit — Tue, 23 Apr 2013 16:14:55 GMT

[quote user="Gillian Mostyn"]

Afterall, it may simply be a reaction to the vomitting - blood pressure changes in brain or vagal something or other.... (as you can tell, my neurology is great! )

[/quote]

Thought about that. But than there would have been sinus bradycardia. Although I wasn't there to check the heart rate at time of incident, the owner specifically mentioned the heart rate was very fast

Re: collapse after vomiting

Gillian Mostyn — Tue, 23 Apr 2013 16:14:40 GMT

[quote user="ilanit"]And the owner was very keen to know. [/quote]

I guess the dog is insured then.

Re: collapse after vomiting

ilanit — Tue, 23 Apr 2013 16:13:15 GMT

[quote user="Gillian Mostyn"]If the dog is 100% well apart from once yearly collapsing episodes, is there any reason to investigate at all?[/quote]

I guess mostly curiosity! And the owner was very keen to know.

Re: collapse after vomiting

ilanit — Tue, 23 Apr 2013 16:11:22 GMT

Thanks!

No salivating or urinating, just vomiting and defecation. Was normal after, although seemed a bit 'shell-shocked'. Forgot to ask about muscle tone. Will phone them in the morning to get a bit more details. You are right that my history taking was not complete

Re: collapse after vomiting

Gillian Mostyn — Tue, 23 Apr 2013 16:06:05 GMT

[quote user="ilanit"]

It collapsed after vomiting this weekend. Owner was with him when he started vomiting and defecating everywhere. Then he collapsed and remained unresponsive for 15 minutes (according to owner, so probably shorter, but she said she was in the car when he came round so it seems longer than typical syncope). She also noticed his heart was racing. No clonic/tonic activity.

Arriving at the clinic he seemed to have recovered. Heart: tachycardic (but he is always quite stressed at the clinic). No other abnormalities.

[/quote]

[quote user="ilanit"]He had 2 previous episodes similar to this, 1 and 3 years ago. In between dog has been fine[/quote]

If the dog is 100% well apart from once yearly collapsing episodes, is there any reason to investigate at all?

I would be using the 'wait and see' approach, and only investigate if there was any increase in frequency or severity. Afterall, it may simply be a reaction to the vomitting - blood pressure changes in brain or vagal something or other.... (as you can tell, my neurology is great! )

Re: collapse after vomiting

Mark Lowrie — Tue, 23 Apr 2013 14:34:13 GMT

I’m afraid the signs described by the owner are a bit too vague to be too specific. You can start an investigation but this is likely to be fairly broad until we can ascertain exactly what the patient was doing during the episode(s). Given there have been 3 episodes in total over 3 years I don’t think there is a need to rush into anything right now and the basic blood work you have done rules out imminent concerns.

My first bit of advice is for them to film any future episode as this would be the most useful thing and is relatively cheap!! Other questions you can ask that would be useful:

Did he return completely to normal after the episode? May help work out if there were post-ictal signs indicative of a seizure e.g. was he wobbly on his legs, bumping into things etc.
Was he stiff (increased tone – more likely seizure) or floppy (decreased tone – more likely syncopal/cataplexy) during the episode?
Did he salivate or urinate during the episode (autonomic signs indicative of a seizure)?

As mentioned above, if the dog is normal in-between and has had similar episodes over the years then I wouldn’t rush into tests without more information.

Re: collapse after vomiting

ilanit — Tue, 23 Apr 2013 14:12:40 GMT

Bile acid stimulation test?