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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 28956
Experience:  University of California at Davis graduate veterinarian with 45 years of experience
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My German Shepherd had to have a MRI done. When she came

Customer Question

My German Shepherd had to have a MRI done. When she came home she had a bad sore throat and was coughing really bad. Then she started gagging after she ate. I was so worried one night I took her to the ER. I was sent home and told maybe allergies. ER was at the same hospital she had the MRI. A few days past and her bark changed, she got pneumonia and then was told she had Mega E. Why did all of this happen? She was in the hospital for three weeks and was to the point she could not eat without feeding tube. She was not at all like this before the MRI. The MRI was done because she started some back eg weakness. I was told she had some mild disc disease and she needed rest so it could get better. SHe was the picture of health until the MRI and she came home like a different dog. Why?
Submitted: 2 years ago.
Category: Dog
Expert:  Dr. Michael Salkin replied 2 years ago.

I'm sorry that your question wasn't answered in a timely manner. While I'm necessarily constrained by not being able to examine Lakota, acquired myasthenia gravis would be my working diagnosis for such a patient. Myasthenia gravis describes a skeletal muscle weakness due to a decrease of acetylcholine receptors at neuromuscular junctions. It's fairly common and German shepherds are overrepresented as a breed. Limb weakness as you described with regurgitation/dysphagia (difficulty swallowing), and aspiration pneumonia due to megaesophagus are pathognomonic (particularly indicative) of myasthenia gravis in dogs. This disorder is caused by circulating autoantibodies against the acetylcholine receptor. Factors that initiate the immune response are incompletely understood. I can't know if Lakota was already suffering from myasthenia prior to her MRI or the the procedure triggered an acute , fulminating form of myasthesia.

Please respond with further questions or concerns if you wish.

Customer: replied 2 years ago.
She was in the hospital for 3 weeks and tested for MG, heavy metal, thyroid, addisons you name it. I feel what happened to her happens during anesthesia for gee MRI. She came home form having the MRU with the sire throat, coughing and it progressed form three.
Customer: replied 2 years ago.
Sorry for typos. I am typing on phone.All took place and progressed after MRI was done. She came home from hospital this way Also another after MRI one of her pupils would not construct
Expert:  Dr. Michael Salkin replied 2 years ago.
Thank you for the additional information. I can't think of a mechanism for MRI to cause such symptoms unless she suffered an idiosyncratic (peculiar) reaction to one or more of the drugs she was administered as a preanesthetic or anesthetic. Was she presumptively treated for MG although testing was negative?
Customer: replied 2 years ago.
Reflux during causing esophagitis.? Her bark also changed. Laryngeal spasm?the esophagitis progressed to Mega E
Her throat was so sore right when she came home. She was having trouble swallliwubg
Customer: replied 2 years ago.
she was treated for MG even tho test were negative
Customer: replied 2 years ago.
Poor positioning, forcing teachable tube, poor monitoring or reaction to something.
I am not wanting to take legal action against anyone if this is a thought. I just have no other answer . I need closure and I know she was fine other than what I described. This was why MRI was done. I went the hospital the same time she did. If only I had been able to be more on top of things.
Expert:  Dr. Michael Salkin replied 2 years ago.
Thank you again. Yes, gastroesophageal reflux was likely but not something we see progressing to megaesophagus. I would pose that megaesophagus caused the reflux, instead. While laryngeal paralysis can certainly cause a change in vocalization, so can the irritation from reflux. I also need to consider that her endotracheal tube might have been overinflated causing inflammation at the site of the distended air-filled cuff - a common cause of post-anesthesia coughing and discomfort.
Customer: replied 2 years ago.
She was so very uncomfortable when she dame home. It was several days before her bark changed. She had never had any issues of this nature until after the MRI. Esophagitis / esophageal stricture.
Like I said, I was not myself and I ask them if they could please scope her. I cannot remember what they said but said they could not
Customer: replied 2 years ago.
Is large all paralysis same as spasm? I have a dog that had tied for paralysis. So I am very familiar with that
Expert:  Dr. Michael Salkin replied 2 years ago.
I regret that I've offered up all I have. If you feel that it would be of benefit, please consider a pet loss support group to which you can be referred by her vet.
No, laryngeal spasm is peracute (sudden). Laryngeal paralysis is a slowly progressive neuromuscular disorder now thought to be just one symptom of geriatric onset laryngeal paralysis polyneuropathy (GOLPP).
Customer: replied 2 years ago.
I wish she would have been scoped soon and if a structure was noted it could have possibly been repaired. It here is much more to this, but from the info I have given you it is prob the best answer you can give.
It is just beyond me why it was not considered she may have a structure when it all started and they did not want to scope her.
No Lakota did not have alar Par. My dog Ella does and was quite a shock Lakotas bark changed just as Ellas had and no lar oar for Lakota
Expert:  Dr. Michael Salkin replied 2 years ago.
I understand.
Customer: replied 2 years ago.
Oh and I have accepted she is gone just not the answers as to why. I am retired from a veterinary profession so I do have some knowledge of things but no way am I a dr.
I appreciate your time
Expert:  Dr. Michael Salkin replied 2 years ago.
Ah! You're quite welcome.