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My dog was given Rimadyl and it caused her to drink

Customer Question
My dog was given...

My dog was given Rimadyl and it caused her to drink excessively and pee all over the house. She never goes in the house. I stopped giving her the medication because of that. A week later she was no longer able to drink and her bowl would fill up with her saliva. Her tongue would hang out of her mouth and she couldn’t close her mouth. She also stopped eating. I took her to the vet and they told me it was a idiopathic neurologica disease also called dropped jaw. They said it would get better in about 3 weeks. We have to put food in a syringe in order for her to eat. She isn’t eating enough. She throws up after we feed her. She just looks zoned out all the time now. I definitely don’t think she’s getting enough water. Her nose is dried out and cracking. Her tongue is no longer pink. It’s turning red and almost like it’s drying out too. She almost looks like she’s giving up. Has no desire to even walk around anymore. She just sleeps. Her eyes are blood shot and look like they almost want to roll to the back of her head. Do you think this is going to clear up and get better? Could the Rimadyl be the culprit of what has happened to my pup? She will be 7 in April. She still has so much time left.

Veterinarian's Assistant: I'll do all I can to help. This sounds like it might be serious. I'll let the Veterinarian know what's going on ASAP. Is there anything else the Veterinarian should be aware of about your dog?

She has bad arthritis in both back legs. That was the reason for the Rimadyl.

Submitted: 3 months ago.Category: Dog
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Customer reply replied 3 months ago
It says that a cat vet is working on my question. I clearly stated I have a dog
Answered in 16 hours by:
1/9/2018
Dog Specialist: Dr. Michael Salkin, Veterinarian replied 3 months ago
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 33,271
Experience: University of California at Davis graduate veterinarian with 45 years of experience
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Dog Specialist: Dr. Michael Salkin, Veterinarian replied 3 months ago

I'm sorry that your question wasn't answered in a timely manner. It does sound as a trigeminal neuropathy exists but we need to consider differential diagnoses as well. Please look at the following synopsis of this condition and then return to our conversation with additional information and concerns. An idiosyncratic (peculiar) reaction to Rimadyl is possible but adverse effects from that nonsteroidal antiiflammatory drug usually involve the gastrointestinal system - inappetence, vomiting and/or diarrhea.

Definition

An idiopathic, self-limiting inflammatory condition that involves the motor and sensory branches of the trigeminal nerve and (on occasion) the sympathetic innervation to the eye (i.e., Horner's syndrome)

Synonym: Dropped jaw

Epidemiology

Species, Age, Sex

Dogs most commonly affected; rare in cats

Genetics and Breed Predisposition

No sex or breed predilection; golden retrievers may be overrepresented.

Risk Factors

Other immune-mediated disease

Associated Disorders

Possible paraneoplastic association

Clinical Presentation

Disease Forms/Subtypes

Bilateral paralysis of the masticatory muscles that primarily affects the mandibular branch of the trigeminal nerve

History, Chief Complaint

Acute or subacute onset of an inability to close the mouth. The dog cannot prehend food, may hypersalivate, and has difficulty drinking water.

Physical Exam Findings

Bilateral paralysis of the masticatory muscles

Affected dogs are bright and alert and do not appear as though they are in pain. Most have no other detectable neurologic abnormalities.

In some cases, there is decreased facial sensation bilaterally, and Horner's syndrome may be observed.

Trismus/inability to open the mouth does not occur with trigeminal neuritis.

Etiology and Pathophysiology

Most common neurologic cause of an inability to close the mouth in the dog

Etiology is unknown, but extensive bilateral nonsuppurative inflammation, demyelination, and, in some cases, axonal degeneration of all portions of the trigeminal nerve and its ganglion, with no brainstem lesions, have been reported at necropsy.

Complete recovery is observed in 2-3 weeks (rarely, may take several months), with no drug therapy being reported as useful.

Facial sensation is usually preserved. Occasionally, Horner's syndrome may be observed, presumably because the postganglionic sympathetic axons course with the ophthalmic branch of the trigeminal nerve.

 Diagnosis

Diagnostic Overview

The diagnosis is based on characteristic clinical signs, absence of other neurologic deficits, and elimination of the possibility of orthopedic (mandibular, temporomandibular joint) disorders. Advanced diagnostic testing is generally reserved for cases showing additional or unusual neurologic deficits, when spontaneous resolution does not occur, or if rabies is possible (quarantine/euthanasia).

Differential Diagnosis

Rabies

Traumatic mandibular injury

Inflammatory or infectious central nervous system (CNS) disease

Initial Database

CBC, serum chemistry profile, urinalysis: usually within normal limits

Screening for infectious diseases such as protozoal, fungal, and viral diseases is recommended, as clinically and geographically appropriate.

Advanced or Confirmatory Testing

Unnecessary in most cases

Cerebrospinal fluid (CSF) analysis may be normal or show mild increases in protein concentration. Lymphocytic pleocytosis is rarely observed.

Electromyography may reveal increased insertional activity and other mild changes.

Computed tomography or magnetic resonance imaging of the brain: within normal limits

trigeminal nerve biopsy: not recommended

trigeminal NEURITIS: trigeminal neuritis patient exhibiting the classic dropped jaw appearance and partial Horner's syndrome.

 Treatment

Treatment Overview

Spontaneous resolution usually occurs in 2-3 weeks with no treatment.

Acute General Treatment

Maintenance of hydration and alimentation is critical.

Percutaneous gastrostomy may be helpful in severe cases.

Chronic Treatment

Signs will typically resolve spontaneously in 2-3 weeks but in some cases will take months to fully normalize.

Nutrition/Diet

Will most likely need a slurry or canned food gruel in the immediate period since the patient is unable to close the mouth but the tongue is still functional

Clinical signs should resolve in 3 weeks.

Behavior/Exercise

Encourage strengthening of the muscles by using a tennis ball to chew on.

Possible Complications

Dehydration

Weight loss

Recommended Monitoring

Hydration status

Food intake

 Prognosis & Outcome

Excellent for recovery

 Pearls & Considerations

Comments

If signs do not resolve in the 2-3-week period, other differentials should be considered.

If sensory deficits are observed, the recovery period may take longer.

Prevention

Make sure that the patient maintains adequate hydration and is eating well.

Client Education

Signs are typically self-limiting and should resolve in 2-3 weeks.

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Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 33,271
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Experience: University of California at Davis graduate veterinarian with 45 years of experience

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