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My dog has been diagnosed with trigeminal neuritis (drop…

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Hi my dog has been...
Hi my dog has been diagnosed with trigeminal neuritis (drop jaw), and when originally diagnosed our vet said it was idiopathic since the muscular degeneration appeared equal on both sides of his head.
Everything you read online says it should resolve itself after about a month, but its been six months by now. Outside of the dropped jaw, he acts totally normal - running, playing, catching balls, eating, drinking, so thank goodness we don’t have to administer any supportive care.
Sometimes his mouth is closed and we get excited, other times he is totally relaxed and we see his lower jaw droop very low and it really freaks us out.
Can you help? What should we do? Take him in for an MRI? It’s been months and we’re at a loss.
Submitted: 22 days ago.Category: Dog Veterinary
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Answered in 18 hours by:
4/1/2018
Dog Veterinarian: Dr. Joey, Board Certified replied 22 days ago
Dr. Joey
Dr. Joey, Board Certified
Category: Dog Veterinary
Satisfied Customers: 4,943
Experience: 15 yrs in practice, specialist canine/feline medicine
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Hello I am Dr. Joey. Thanks for asking your question and trusting me to help you and your pet today. I am a licensed veterinarian with over 18 years of experience. Tough question and I do apologize no expert has jumped in to provide you with an answer.

This does sound suspicious to be trigeminal neuritis. Some cases do take 6-8 weeks to improve, but at 6 months I don't think you can expect much improvement beyond what is going on. If this was a tumor, then we would expect it to progress, but if it was a benign, slow growing tumor then it might not progress rapidly.

Other possible causes of a dropped jaw to consider, which I do hope was discussed might include trauma, Neospora caninum, Rickettsial vasculitis and Hypothyroid neuropathy. I assume he already had full screening for all tick-borne diseases and screening of his thyroid as these are easy issues to diagnose and treat. Trauma will be tougher to diagnose.

MRI can be highly useful to diagnose this. MRI imaging can show diffuse enlargement of the affected nerves with hyperintensity. Tumors would be easy to see as would trauma. It is one way to definitively diagnose the problem. I'd lean in the direction of having this test done, even though it is expensive. At least we may be closer to having a diagnosis and know how to treat this.

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Customer reply replied 21 days ago
Hello Dr Joey - could you spell out the symptoms of the Neospora and Ricketsial possibilities you listed?
Dog Veterinarian: Dr. Joey, Board Certified replied 19 days ago

Sorry for the delay in a reply. I have been quite busy at work.

Signs of Neospora in general causes a variety of neurological signs: trouble swallowing, trismus (lock jaw), tongue paralysis, muscle loss, hypermetria (high stepping especially in the front limbs) and head tremors (when cerebellum is infected), and Horner's syndrome. Older dogs have more central nervous system signs: seizures, behavioral changes, blindness, and tremors.

Rickettsial disease refers to all tick-borne diseases which can be many as they can often affect the neurological system, especially lyme disease (Borrelia), but generally we run a panel to screen for all the tick-borne diseases when worried which can be done off of blood or spinal fluid.

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Dog Veterinarian: Dr. Joey, Board Certified replied 16 days ago
Hi Vlad,

I'm just following up on our conversation about Finnigan. How is everything going?

Dr. Joey
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Dr. Joey
Dr. Joey
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Satisfied Customers: 4,943
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