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Dr. Ann Karing
Dr. Ann Karing, Canine Veterinarian & Advocate
Category: Dog
Satisfied Customers: 351
Experience:  Doctorate of Veterinary Medicine, Magna Cum Laude, American Veterinary Medical Association
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My dog is 10 years old. He recently had his spleen

Customer Question

Hello,
My dog is 10 years old. He recently had his spleen removed 5 months ago. About 3 months ago I decided to play ball with my dog. I threw the ball once and he retrieved the ball with no problem. The second time I threw the ball he began to run about 15 feet and all of a sudden he began to slow down as if he was losing his footing. He then fell to the floor on his chest and his body began to shake for 5 seconds. His eyes were completely opened and head held up and extended. His body stopped shaking and he looked around as if he was confused; grabbed his ball and walked towards the door of the house. He had another attack that was similar one month later. My mother had woken him up to go outside and relieve himself. He made it outside, but as soon as he got inside he had another attack right on his pillow. This time he fell on his side and he was completely stiff for about 5 seconds, eyes open and neck extended. He then rolled over on his belly and did one shake. He looked around as if nothing kinda happened. I decided to take him to a cardiologist that ran a bunch of tests, X-rays,blood work, and ultrasounds and nothing came back. The doctor decided to place an electronic heart recorder on him for one month, we are currently on week 2. The heart monitor will only record an attack if we press a button on the recorder while he is having the attack. That day that we brought him to the cardiologist he had 2 attacks, I think my dog has travel anxiety. One was while I was checking him in and the other was while we were leaving. We did happen to catch the 2nd attack that happened while we were leaving on the recorder and his heart was at 240bpm. The doctor then decided it looked like his heart was racing fast. She decided to prescribe him Atenolol. I gave him ¼ of 25mg for 3 days and he had another attack on the fourth day. This attack seemed to be alittle more intense. This attack lasted about 20 seconds and after he got up he looked completely confused and scared. That attack was recorded as well. The doctor called me and said that with that attack his heart completely stopped. She told me to discontinue the medication, which I did, the medicine may have caused that attack she said. He has yet to have another attack and it has been alittle over a week now. Now the doctor feels it may be sick sinus syndrome, which will involve a pacemaker. The doctor at this point is waiting for another attack to hopefully make a final decision and help my dog. I am hoping that someone out there has encountered a similar situation and can provide some helpful information.
Submitted: 1 year ago.
Category: Dog
Expert:  Dr. Ann Karing replied 1 year ago.
Hi there,
I'm sorry your dog is having this problem. It sounds as though there has been a very thorough evaluation of his condition. However, I do have a few questions to better assist you.
Was your dog's spleen removed and found to be cancerous?
If so, what type of cancer?
Also, have you shown the cardiologist a video of one of the episodes? Could this be seizure activity?
If the events are seizures that would explain why there has been nothing revealing on the event monitor so far. Please let me know the answers to the above questions and I will advise you further based on your responses.
Thanks so much, Customer
Customer: replied 1 year ago.
Hello,
My dogs spleen was removed and found to be non cancerous. As far as a video, I have yet to catch one on video. Doctors have told me it does not sound like seizure activity. My dog does not pee himself while having the attack and the attack will only last 5 seconds. Also, he gets up right away and knows who I am after the attack. My boyfriend happened to witness a dog having an attack almost identical to my dogs and he asked the owner what was wrong with their dog. The owner said his dog suffers from exercise induced stress syndrome. My dog is still wearing the vest and no abnormal heart beat at this time.
Expert:  Dr. Ann Karing replied 1 year ago.
Hello again,
Thank you for the additional information. When you say induced stress syndrome, I think your are referring to EIC (i.e. exercise induced collapse). Your dog's situation doesn't sound like EIC because there is not consistently intense exercise just prior to the events (just went out to the bathroom once). Also, most dogs with EIC start having the episodes at a younger age as well (i.e. 2 - 7 yrs of age). You can read more about EIC and DNA testing for the disease at this website:
http://www.cvm.umn.edu/vdl/services-and-fees/canine-neuromuscular/canine-exercise-induced-collapse-eic/
You are doing the exact right thing by ruling out cardiac causes first. Hopefully the event monitor will reveal the cause of the problem. Make sure they have taken a blood pressure on your dog (high or low blood pressure could cause these events). If a heart problem/3rd degree heart block is ruled out, then other considerations (i.e. assuming all lab work is normal) are seizure activity, myasthenia gravis and narcolepsy. You can read more about myasthenia gravis here:
http://www.veterinarypartner.com/Content.plx?P=A&S=0&C=0&A=1544
This site has some information about narcolepsy:
http://www.petmd.com/dog/conditions/neurological/c_multi_narcolepsy_cataplexy
There are many causes of seizures so that I do not have a website reference for that subject that is helpful.
I hope that the information I provided has been helpful. Please remember to select REPLY TO EXPERT if you have more questions or would like additional information. It is my goal to provide you with the most complete information possible prior to you leaving a feedback rating. If you received all the information you needed, then kindly submit a rating.
Sincerely, Customer
Customer: replied 1 year ago.
Hello,
I did forget to mention that my dog does have slightly elevated ALT levels, which was the only thing that came back after his blood work. My dog has had X-rays and blood work done from numerous of doctors and besides the ALT level everything else is normal. The doctors that I have seen tell me it is nothing to worry about. Also, the cardiologist has told me that the irregular heart beat is coming from the top of his heart rather than the bottom. She did preform an ultrasound on his heart and found nothing. A couple things I have noticed about my dog after his spleen was removed are: he continues to lick his bedding a lot and nose (which he has never done before), he sleeps more throughout the day, and his back legs seem to be more stiff than ever before ( sometimes he will actually walk with a limp). Also, my dog does seem to snore more than ever before, I can actually hear him in the other room. His breathing is also a little more heavy if you ask me. Are there tests that can be performed that can rule out EIC,myasthenia gravis and narcolepsy? And if so what kinda test are they?
Expert:  Dr. Ann Karing replied 1 year ago.
"Slight" ALT elevation is not a great concern but that value needs to be monitor to see if it increases at which point further diagnostics would be indicated.
There is a genetic test for EIC that is submitted to University of Minnesota College of Veterinary Medicine:
http://www.cvm.umn.edu/vdl/services-and-fees/canine-neuromuscular/canine-exercise-induced-collapse-eic/index.htm
The gold standard test for myasthenia gravis is the acetylcholine autoantibody serum test which is run only at the University of California: http://vetneuromuscular.ucsd.edu/forms/Lab%20forms%20for%202015/Serviceweb15RevisedComplete.pdf
Diagnosis of narcolepsy/cataplexy is more complicated. The episodes must be induced by some excitement and then one or more of the following methods may be used to assess the dog:
Food challenge: Place 10 pieces of a highly tasty food (that the dog loves to eat) in a row, 12-24 inches apart. Record the time that it takes the patient to eat all the pieces, along with the number, type, and duration of any episodes that occur. Normal dogs eat all the food in 2 minutes to eat the food and have several episodes. If episodes occur, then proceed to one of the below tests to help confirm the diagnosis.
Yohimbine challenge: After clinical signs have been induced, inject yohimbine IV and observe the animal. The severity of signs should be reduced by 90% within 20-30 minutes of the injection. Duration of effect is about 4 hours.
Physostigmine challenge: This drug may be used to induce clinical signs. Inject physostigmine salicylate and wait 9-15 minutes and observe response to a stimulus (e.g. food trial test). Increased severity of signs in response to a stimulus is an indication of narcolepsy/cataplexy. Signs may last as long as 15-45 minutes, so this test must be done with caution.
Atropine challenge: This drug should result in a marked reduction in the number of episodes, if narcolepsy/cataplexy is present. Begin with a food challenge to try to induce the attacks. Once signs are induced, inject atropine IV and repeat the food challenge.
Thanks, Customer
Customer: replied 1 year ago.
Hello,
At this time I have decided to take my dog to a neurologist and a different cardiologist hopefully someone can help. I thank you for much for your help.
Expert:  Dr. Ann Karing replied 1 year ago.
You're welcome. I hope the issue will get sorted out and be nothing very serious.
Sincerely, Customer