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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 28560
Experience:  University of California at Davis graduate veterinarian with 45 years of experience
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My male dog is a just under two years old. He has had 5 or

Customer Question

My male dog is a just under two years old. He has had 5 or six episodes over the past 5 months where he looks like he is trying to bring something up. When he does, what comes up is a white to clear mucous-like fluid. Once he brings this up, he will stagger or lose balance and collapse on his side. This lasts for just a few seconds and he then is back up acting like nothing happened. My concern is that the last three episodes have all occurred since Thanksgiving. This is a dog that enjoys active play and fetch. Climbs hills easily on walks with us, has good energy and is very alert and interactive throughout the day. He is up to date on all vaccines and is current with his heart worm preventive meds.
Submitted: 1 year ago.
Category: Dog Veterinary
Expert:  Dr. Michael Salkin replied 1 year ago.

The proximity of his regurgitation and then ataxia and collapse is strongly suggestive of complex partial seizures (also called pyschomotor seizures) which are defined as focal or asymmetric sensory or motor activity affecting any part of the body and which may be associated with autonomic signs such as salivation or regurgitation/vomiting and a change in mentation/behavioral abnormalities are seen. At 2 years of age, these seizures may presage idiopathic (unknown cause) epilepsy in our dogs.

Less commonly, such behavior suggests myasthenia gravis - a neuromuscular disease which can take many forms - one of which is generalized limb weakness characterized by stiffness, tremor, and a short-strided gait that may progress to inability to walk and collapse plus regurgitation due to esophageal dysfunction (a megaesophagus/ballooning out of the normally rigid esophagus). The weakness is often precipitated by 1-2 minutes of exercise and improves with rest. You haven't reported that Grayson's behavior follows such exercise, however.

Grayson's symptoms can be a challenge to clarify. His vet will need to perform a thorough physical exam paying particular attention to Grayson's heart rate and rhythm (arrhythmia/irregular heart rate can cause syncopal (fainting) episodes); X-rays (+/- barium swallow) may be suggested in order to evaluate his esophagus and if the esophagus looks abnormal, an acetylcholine antibody receptor test for myasthenia gravis would be indicated.

Please respond with further questions or concerns if you wish.

Customer: replied 1 year ago.
Thank you for your response. As I stated briefly except for those few brief episodes, Grayson is a perfectly healthy dog. He loves active play with no restrictions in his endurance or movements. He is beautifully athletic in his play and fast in running and his walking gait is brisk and normal
Customer: replied 1 year ago.
Could it be the food we are giving him
Expert:  Dr. Michael Salkin replied 1 year ago.

Thank you. All of the differential diagnoses I listed were done so in light of his otherwise being normal. All can cause peracute (sudden) but very short-lasting symptoms. No, there's no reason to incriminate his diet. Please continue our conversation if you wish.

Customer: replied 1 year ago.
Thanks again for your response. I just wanted to update you on the case with Grayson above. A trip to his vet, blood work and exam revealed that his problem was likely due to an empty stomach and type of reflux. We keep his hard food in his bowl all day and he goes and eats when he wants. Apparently, he was holding back on eating an adequate amount of his hard food in favor of what modest chance of table food he might get. His episodes always occurred early in the day when his stomach had potential to be the most empty. The treatment was to begin using a variety of soft food options with the hard. We were to give him smaller meals three times a day and re-evaluate over time. I am happy to report since we have been doing this, there has not been a single episode. As far a his brief collapse following his clear vomit, our vet stated she has seen that with her own dog and is a vagal stimulus that some will have. She was more concerned with the reason for the clear food-less vomit than the subsequent collapse. All blood work came back normal and as a precaution she rechecked his stool for parasites that had been done 2 months earlier. We continue to monitor Grayson, but with this new diet and regular feeding none of the symptoms have repeated. Thought this insight could provide another possible option for you in the future if you are again presented with this set of circumstances online.
Expert:  Dr. Michael Salkin replied 1 year ago.

Thank you for the good update. I appreciate your taking the time to let me know. I never argue with success.