https://www.vetsurgeon.org/f/clinical-questions/29759/could-this-be-craniomandibular-osteopathy-or-srma 12 week old female Scottish terrier presented with acute onset of lethargy and pain when being touched around the head/ mouth. No known injury, though she does play rough with her littermate. On examination mild pyrexia (39.2C), fairly normal PE, possiblyen-USTelligent Community 10https://www.vetsurgeon.org/thread/229600?ContentTypeID=1Thu, 08 Apr 2021 07:53:01 GMT146601cc-3922-4be7-9974-7e1d4e45a66b:7266285d-af82-49b2-bcd0-14e730aed210Lucy Fleming<p>Thank you Andy - I&#39;ve just seen the little pup back this morning and she is much better according to her owner. Had no analgesia yesterday and no relapse of signs noted, so perhaps it was just a traumatic injury of some sort (apparently her brother can fit her entire cranium into his mouth...)&nbsp;</p> <p>We&#39;ll keep an eye out for any relapse but a good result for now.&nbsp;</p><div style="clear:both;"></div>https://www.vetsurgeon.org/thread/229546?ContentTypeID=1Mon, 05 Apr 2021 06:43:01 GMT146601cc-3922-4be7-9974-7e1d4e45a66b:e9c6220a-2898-469e-8938-59a5deadedcdAndrew Kent<p>Hi Lucy,</p> <p>Its uncommon we see immune-mediated disease at this age (and I agree your signs/exam don&#39;t sound classic) so I agree I would have other differentials higher on your list and imaging would seem a sensible starting point.</p> <p>You could run a c-reactive protein as its typically very high with active immune-mediated disease (although not sure it has specifically been studies with CMO - those cases don&#39;t tend to come via Internal Medicine so I have little experience with them, I guess they get seen by orthopaedic surgeons?).</p> <p>Andy</p><div style="clear:both;"></div>