UPDATE: Spoke to the vet again today as the diazepam is making no difference and Gus' head shakes seems to be getting worse. My vet feels we should try phenobarbital (which I have at home because Pippin is on it for epilepsy) for 4 or 5 days as he feels Gus may be having focal seizures and I've to talk to him again on Friday.(or sooner if I need to)
I have checked out focal seizures online and some of them do look like what Gus is doing...would this be caused by SM?
Clare's info says there is not a known connection but notes there could be as they are seen alongside SM.
I'd get him onto gabapentin and cimetidine even more urgently than or rather than pheno if your vet feels there is any chance of SM -- from what you describe I'd say most neurologists would feel there surely is a significant chance he has SM. You may find the gabapentin and cimetidine help to manage this. Gabapentin is actually used for seizures (original use) and also helps neuropathic pain. Your vet can use C Rusbridge's treatment algorithm. Prob will want to start at 100mg 2x or 3x and see how he does, and 50mg cimetidine 2x but can go to 3x.
Had a look at a video of focal seizures and they are nothing like Oliver's head nodding, which I'm fairly sure is pain- and SM-related. He sits still and literally nods his head from level to down and back again quite quickly, licking his lips. He doesn't do it every day, and next time he does it I must note whether it happens when he's due his next lot of medication. Is this the sort of head nodding Dr Rusbridge was talking about, Karlin? Or more like the video of the schnauzer, who was staring upwards, scratching and very restless? Really, SM symptoms are like a bottomless pit - you keep on pulling up more and more of them!
Kate, Oliver and Aled
Hi Kate- Oliver's head nodding sounds like what Gus does....I looked at lots of focal seizures online and a few looked liked what Gus does but not the Schnauzer. Gus does scratch too at times and while head nodding he seems to falter on his legs, he had a particularly bad episode on Sat where he seemed to be nodding his head while the rest of his body twitched but it only lasted a few seconds. He head nods everyday and it's gotten to be a few times a day in the last couple of weeks. Sometimes as much as three in an hour but they don't last long.
Karlin - I will speak to my vet again tomorrow, thanks.
Hi all -- Clare was talking about a range of this behaviour from mild nodding with eyes part closed as if falling asleep -- can be up and down or side to side, which Jaspar does and he also nods head up and down while licking at his lips, in a kind of 1-2-3-pause rhythm. Or it can be be quite active jerky head nodding and legs can be weak and the dog might part fall over or completely fall over. In the worst cases, a dog's legs might go out from under them and they fall. They know it is something that is in the breed, and they don't know what causes it; called a 'myoclonus'. She also has said a mildish head nod/jerk is common in cavaliers as they age for some reason. This is what Jaspar has and what I had asked about a while back. I know other people with cavaliers with this issue, in some cases at the extreme end.
As Jaspar doesn't have SM and has this behaviour -- and had it at a time when he had been MRId clear -- I would guess they are right in guessing it is not directly related to SM. Maybe it is to CM or head conformation? -- just as so many have PSOM show up on MRI. Hopefully there will be some research on this in the future.
Clare did tell me that generally the behaviour is not anything to worry about unless it is causing collapse or is otherwise bothering the dog or is severe. She did say that sometimes steroids have helped more severe cases so that might be something to think about if it is really extreme. But I'd still want to try some SM meds if there's a strong feeling Gus has shown symptoms over his lifetime -- and your vet is willing to trial some SM meds. He could probably contact Clare to ask about the head jerking or you could talk to the neurologist at UCD?
I googled this and what came up but several old threads from Cavaliertalk :).
So we have had quite a few cavaliers reporting with various levels of this kind of twitching/nodding/tripping behaviour, with the most noticeable behaviour almost always in older dogs. For example see:
Yes, Oliver's head nodding is probably related to his CM rather than his SM, which is why he has a lot of headaches from his dilated ventricles - or rather had, as his new drug is controlling them pretty well. He is also, of course, nearly 12, so I'm having to recognise symptoms of age as well as symptoms of CM/SM (not to mention spondylosis as well!). It's the first time in thirty years I've managed to have a Cavalier this old, so I'm on a learning curve. (Isn't it terrible to say that - a breed this size should normally be living well into their teens. MVD and thoughtless breeders have a lot to answer for. Oliver has a good heart (Grade 2, not bad for his age), so we just have to get him through all the other things!)
Kate, Oliver and Aled
PS Aled is just beginning to show symptoms of his CM/SM and he is twitching - little muscle spasms like hiccups or a quick shiver. He's only 5.
Sorry you haven't been able to figure this out yet and that so far medication hasn't helped. Karlin made a point about several threads about this happening with older dogs. It makes sense. During his last year, Sydney had focal seizures, not severe, but his legs would shake and it almost looked as if he was nodding off to sleep while standing or sitting up. Our vet said it's common in older dogs.
I hope you can get help to control this and his other SM symptoms.
Further update.....Spoke to my vet again on Tuesday and he said he would still like to continue with the Phenoleptil until the weekend. Gus is doing well on it:) No nodding and no sitting around looking 'sad' he is more active than he has been in a while and seems to be in better form, more his old self. Also when he sleeps he seems more settled.
My vet feels, as we do, that this is a good result so, we've been advised to leave him on the 12.5 twice a day and monitor how he is doing. Vet says he was probably having focal seizures but may have had pain too, as he does not hang his head as low as he had started to these past few weeks. He thinks that he may still have SM. We will of course look at other meds should he deteriorate at all.
Thanks again for all the advice.
Just an update...Gus started head nodding after a while on the pheno....another chat with the vet and we both decided that at the moment he doesn't seem to be in any pain just stops to nod his head sometimes and then continues on as if nothing happened, so we ceased all meds (apart from supplements) and he is in great form and even started playing with the other dogs for a while a few days ago. But now has gone back to being a relaxed elderly gentleman, except when there is food around
Vet agrees we will not really know if anything else like sm is going on apart from his disc degeneration without mri and we're not putting him through that so at the moment we
are happy to leave him with the odd nod that doesn't now seem to phase him....
any thoughts on this, hope I'm doing the right thing....