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I have a 13 year old shih tzu, 14 in December. He has now…

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I have a 13...

I have a 13 year old shih tzu, 14 in December. He has now begun to have problems with his breathing it would seem along with a sort of gaging cough as though trying to clear something out of his throat but there is nothing there. Today he seemed to fall over on the garden and began screaming as though in pain, he was shaking and seemed as though he had passed away but seems to be much better now. He is a little unsteady on his feet and is now very slow when he walks

Veterinarian's Assistant: I'm sorry to hear that. The noise must be worrying. I'll connect you to the Veterinarian. What is the dog's name?

Rolie

Veterinarian's Assistant: Is there anything else important you think the Veterinarian should know about Rolie?

Not really, these are the only issues that we’ve had with him really apart from some milkyness on his eyes

Submitted: 8 months ago.Category: Dog Veterinary
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Answered in 4 hours by:
10/1/2017
Dog Veterinarian: Dr. Kara, Veterinarian replied 8 months ago
Dr. Kara
Dr. Kara, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 18,576
Experience: Over 20 years of experience as a veterinarian.
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Hello, I'm Dr. Kara. I have over 20 years of experience as a veterinarian and I'd like to help. Please give me a moment to review your concerns.

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Dog Veterinarian: Dr. Kara, Veterinarian replied 8 months ago

I am sorry to hear about Rolie's gagging cough, and changes in breathing pattern. I understand today he had an episode of collapse, screaming, twitching and then sudden quiet such that you were concerned he may have passed away.

When a dog seems to lose control like Rolie did we worry about 2 things.

1) A seizure which is a loss of conscious muscle control with rhythmic muscle contractions occurring. These dogs may lose urine or stool continence, vocalize, they are unaware of their surroundings and their muscles tend to be very tense during the episode.They seem fine afterwards though puzzled about what happened and can be a little tired. This is a link to a video of a dog having a seizure: http://www.youtube.com/watch?v=VSL1_yeKo5o&feature=fvwrel

2) the second possibility is a fainting episode (syncope) which can be caused an irregular heart rhythm (either very fast or very slow) such that oxygen doesn't get to the brain and they pass out. These dogs seem to stiffen and then slide to the ground like a wet noodle and have more relaxed muscles. They may vocalize because they feel woozy due to low brain oxygen levels, but then they lose consciousness and relax. When that happens the oxygen demand is less, the heart can reset itself and they "wake up" and seem relatively normal. Some of these dogs lose urine and stool continence and some do not. They may have minor muscle twitches due to low oxygen levels, but they are not as stiff or rhythmic as true seizures. This is a link to a video of a dog having a quick syncopal episodes. They are usually longer then this dog's: http://www.youtube.com/watch?v=mkj4jREIec8&feature=fvwrel

The irregular heart rhythm that leads to syncope can be hard to pick up on a regular exam as they may be triggered by exercise or excitement or even sleep (extreme relaxation). And if they aren't stressed at their exam their heart rate may be slow and normal (these are dogs with tachycardia or fast rate arrhythmias) or if they are stressed then their heart rate may increase to an normal level (these are dogs with bradycardia or very slow heart rates).

Both of these "episodes" can be triggered by excitement. Since Rolie has a history of a gagging cough, often seen with heart disease, then a syncopal episode is more likely than a seizure.

Seizures in older dogs usually signify that there is a medical problem. Younger dogs (6 months to 6 years) are more likely to be diagnosed with idiopathic epilepsy or seizures of unknown origin but in older dogs seizures are usually related to metabolic organ disease such that waste products build up and affect brain function or a primary brain problem (inflammation or tumors).

Unfortunately other than keeping Rolie quiet there isn't much you can do at home. He needs a physical examination, bloodwork, chest radiographs, an EKG (electrical tracing of his heart function) and possibly further testing to diagnose his condition.

If this is heart disease we need to properly diagnose his arrhythmia to know how to treat him medically and if this is indeed a seizure then looking for and treating underlying metabolic organ disease is needed or medication to help decrease seizure frequency and severity if this is related to primary brain disease.

If he has another episode and you could videotape him (many cell phones have the capability to do this) that would be tremendously helpful for your veterinarian as well.

As long as he doesn't have another episode today I highly recommend that he see his regular veterinarian as soon as possible.

Please let me know if you have any further questions.

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Dog Veterinarian: Dr. Kara, Veterinarian replied 8 months ago
Hi,
I'm just following up on our conversation about your pet. How is everything going?
Dr. Kara
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Dog Veterinarian: Dr. Kara, Veterinarian replied 8 months ago

Hello, I wanted to make sure that you didn't have any further questions for me, and I'd like to know how things turned out for your pup. If you could give me an update that would be great, thank you, ***** *****

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