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Old 09-09-2012, 01:17 PM   #1 (permalink)
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Dexter Has Masticatory Muscle Myositis

Poor Dexter has not had an easy time in the health department.

Back in August of last year, we took Dexter in for a general checkup a few days after bringing him home and the vet found that he had worms. A lot of worms. Roundworms, Hookworms and Whipworms. We were given a three day course of Panacur for treatment. A couple of days later, I went to get Dexter out of his crate after a nap and he was completely covered in drool. He came out of his crate drooling and walking sideways. Since things like this never happen during “normal business hours,” off we went to the emergency vet. They did blood work and X-rays and his gastrointestinal tract was a complete mess. On one angle, the vet thought it looked like a possible obstruction, but every other angle looked like no obstruction. He was also severely dehydrated. They kept him over night, did fluids and re x-rayed him around 5am. The overnight vet called around 5:30am and let me know that he was doing better, but still hadn't pooped. They had done the next round of x-rays and said they are 99% sure that what appeared to be an obstruction is just a massive amount of dead worms and poop. They eventually gave him an enema to get him to go, and said a ton of worms came out in his poop. We were given another three day course of Panacur. He did well with that treatment and when he was finally free of worms, we were able to enroll him in classes. He was a very skinny guy for a while, but we were also able to finally get some weight on him and have him looking like a healthy pup again.

Fast forward now to this last week – we were at the vet on both Thursday and Friday. On Thursday, he was kind of lethargic, wasn't drinking and was drooling more than normal. Went to the vet, and we thought it was another allergic reaction to a bee sting (he had similar symptoms just over a month ago, so it seemed that’s what was going on). They did sub-q fluids and suggested I give him Benadryl every 8 hours for 5-7 days, but to call them if things change, get worse, etc.

On Friday, he was still pretty low energy (I assumed that was the Benadryl) and wasn't drinking (which I assumed was the sub-q fluids). When giving him the afternoon Benadryl dose, he spit out the treat and would only eat the peanut butter and the pills. My husband and I started talking and thinking about all the little things we'd noticed about Dex over the last week. Individually, none seemed *that* odd, but all put together, we knew something wasn't right with him. We started offering all of his favorite toys to him – baseballs, Jolly Ball, bully sticks, and he would kind of nose them and start pacing, or pick them up very delicately, move them across the room, and then start pacing. We then inspected him again and his eyes were still super red and his lower eyelids were raised up quite a bit. I tried to open his mouth and he wouldn't let me. I usually inspect his mouth every week or so, and he's never had a problem with me opening it or feeling around in his mouth. I tried again, and he got up and ran away from me and was very hesitant to come back to me. Our regular vet had closed (of course!), so off we went to the emergency vet. After examining Dexter, her initial thought was Masticatory Muscle Myositis (MMM). She consulted with their dental/oral specialist and we decided to go ahead and have the blood work done for the 2M antibody test. It takes 5-7 business days to get results from that test, so we likely won't know anything until this Friday at the earliest.

I’ve read every post I could find on DT pertaining to MMM and can only hope we are doing what’s right for Dexter. He’s currently taking immune system suppressive doses of Prednisone and is also on pain medicine. He’s drinking a ton, peeing a ton and acting like he’s never been fed a decent meal in his entire life. His activity seems to have improved a bit over the last couple of days. He’s now able to chew his food and carry baseballs in his mouth. He picked up his Jolly Ball for the first time last night and I actually started crying. He initiated play with Roxy this morning, so that was really nice to see as well. He still can’t yawn and when I try to open his mouth, he’s pretty resistant to it.

Please send prayers and positive thoughts our way. I can’t remember who on DT, but someone said this is one of those things were the treatment is as bad as the disease. I’m trying so hard to stay positive for Dexter, but I keep breaking down in tears when I think too much about it.

I would also appreciate any advice on dealing with a dog on such high levels of prednisone for extended periods of time. We’re watching him very closely to try to avoid accidents in the house, so far so good. Tuesday, we all go back to work. The good news is that my mom comes over mid-day to play with the dogs and get them outside, so he will only have to go 4-5 hours max without a potty break. I just know that’s a LONG time when you’re on prednisone

We love Dexter more than anything and wouldn’t trade him for anything, but holy crap, after dealing with Roxy (our little “Medical Mystery”) Dex was supposed to be our healthy dog.

Now, to reward you for reading this small novel, here are a few pics of the handsome guy:

Mat training is more fun with a friend


Good grief - I am handsome!


Was the flash really necessary?? I was SLEEPING!!!


I loves to sleep upside down!


And from the vet on Friday night.
Mom - can we please go home? I do not feel well
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Old 09-09-2012, 01:22 PM   #2 (permalink)
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So sorry to hear Dexter's not feeling well. We send dober-hugs for a speedy recovery. He's very handsome!

I think I remember reading (a while ago) that Lolonurse once had a dobe with MMM.
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Old 09-09-2012, 01:25 PM   #3 (permalink)
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Poor fellow. I do hope he gets to feeling better--soon. Hang in there!
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Old 09-09-2012, 01:29 PM   #4 (permalink)
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Amy, he is just beautiful. Hugs to your poor boy, hope he feels better soon!
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Old 09-09-2012, 01:36 PM   #5 (permalink)
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Sending best thoughts and wishes to your handsome guy. I know zero about MMM, unfortunately, so can't be any help there. I've not even heard of it until right now. Dog illness is so stressful...

I had to use steroids on a husky mix girlie of mine because her airborne allergies were so bad. Initially we just used it during flare-ups, and actually acupuncture helped a lot with her allergies, so that we didn't have to give it to her as often (something you may want to consider for your guy? Again I know nothing about MMM). As she aged she got a really bad nasal infection and after that we could never fully wean her off of the steroid. We got her tapered down to a very low dose though, and though I was always worried about the long-term side effects of the drug, honestly, as soon as I tried to get her fully off of it, she would be miserable with her allergies. In my mind, keeping her comfortable in the present was worth the trade off it may have had on her longevity, though ultimately we'll never know if it did affect her life span, affected her internally, etc.

She only had one urine accident and that was during a time when she was on a higher dose. We never gave her that much again.
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Old 09-09-2012, 05:29 PM   #6 (permalink)
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Quote:
Originally Posted by sam&macksmom View Post
So sorry to hear Dexter's not feeling well. We send dober-hugs for a speedy recovery. He's very handsome!

I think I remember reading (a while ago) that Lolonurse once had a dobe with MMM.
Thank you! You are definitely right about Lolonurse. I'm planning on sending her a PM for thoughts/advice

Quote:
Originally Posted by bean View Post
Sending best thoughts and wishes to your handsome guy. I know zero about MMM, unfortunately, so can't be any help there. I've not even heard of it until right now. Dog illness is so stressful...

I had to use steroids on a husky mix girlie of mine because her airborne allergies were so bad. Initially we just used it during flare-ups, and actually acupuncture helped a lot with her allergies, so that we didn't have to give it to her as often (something you may want to consider for your guy? Again I know nothing about MMM). As she aged she got a really bad nasal infection and after that we could never fully wean her off of the steroid. We got her tapered down to a very low dose though, and though I was always worried about the long-term side effects of the drug, honestly, as soon as I tried to get her fully off of it, she would be miserable with her allergies. In my mind, keeping her comfortable in the present was worth the trade off it may have had on her longevity, though ultimately we'll never know if it did affect her life span, affected her internally, etc.

She only had one urine accident and that was during a time when she was on a higher dose. We never gave her that much again.
I know what you mean - I hadn't heard of MMM until Friday either. I googled "my dog won't open his mouth," and found a lot of things that sounded just awful. I was really hoping the vet would find something much simpler and less serious.

Thank you for sharing your experience with your girl and steroids. It's my (very) basic understanding that if it really is MMM, and after Dexter has full range of motion and full use of his mouth muscles again, that we'll be able to keep reducing the amount of steroids. It seems that some dogs can be weaned off completely, and some need to be on a low does forever.

It's SO weird looking at his face, I swear sometimes it's changing before my eyes. My mom came over earlier to see him to see what to expect when she's here this week. Proof that I'm not going crazy is that he looked completely different from when she got here to when she left. I keep reading about bulging eyes, but to me, his eyes are the opposite and very sunken in.

Ugh. I don't usually like to wish time away - but the blood work results can't come soon enough.
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Old 09-09-2012, 08:29 PM   #7 (permalink)
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Sending good vibes for Dexter . I hope he feels better soon.
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Old 09-09-2012, 09:05 PM   #8 (permalink)
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Oh no, sending good thoughts to you and your boy. I know a few Vizslas who have had MMM. I'll see if I can find the informative blog one of them had.

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Old 09-09-2012, 09:20 PM   #9 (permalink)
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I hope he starts feeling better. Poor guy
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Old 09-09-2012, 09:53 PM   #10 (permalink)
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Zil had really bad muscle wastage around his head when he was really sick, and unfortunately never regained it.
The masticular muscles help to support the eyeball, so when they waste, the eyes do become shrunken and drop inwards. You just have to keep an eye on them that foreign particles don't become trapped in them...dust, dirt etc and enforce a strict rule of no heads out the window when driving. (or wear doggles). You will probably notice an increase in eye boogers as his body tries to flush out any irritants...just check regularly to make sure the tears free flow and no ducts get blocked or eyelashes trapped. Daily cleaning is beneficial (a damp boiled and cooled sponge works well and is soothing.)
Unfortunately, prednisolone can augment the wastage, and high doses can also cause hair thinning/loss and a 'typical' table top appearance to the muscles on the back.
Sorry the poor boy is going through the wars...hopefully he will make a full recovery when the pred dose can be reduced.
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Old 09-09-2012, 11:40 PM   #11 (permalink)
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Old 09-10-2012, 05:48 AM   #12 (permalink)
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Quote:
Originally Posted by Australdi View Post
Zil had really bad muscle wastage around his head when he was really sick, and unfortunately never regained it.
The masticular muscles help to support the eyeball, so when they waste, the eyes do become shrunken and drop inwards. You just have to keep an eye on them that foreign particles don't become trapped in them...dust, dirt etc and enforce a strict rule of no heads out the window when driving. (or wear doggles). You will probably notice an increase in eye boogers as his body tries to flush out any irritants...just check regularly to make sure the tears free flow and no ducts get blocked or eyelashes trapped. Daily cleaning is beneficial (a damp boiled and cooled sponge works well and is soothing.)
Unfortunately, prednisolone can augment the wastage, and high doses can also cause hair thinning/loss and a 'typical' table top appearance to the muscles on the back.
Sorry the poor boy is going through the wars...hopefully he will make a full recovery when the pred dose can be reduced.
Thank you so much for sharing your experience. What you said about the eyes makes so much sense. He's had massive eye boogers the last few days. He's also developed a new habit of rubbing his face on my legs after he eats.

The vet mentioned the potential for hair loss and that he could develop a "pot belly" appearance, but did mention the back - so thank you for the heads up on that. It's weird and sad watching him change so much so fast, but it's a tad easier when you know to expect it.
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Old 09-10-2012, 06:16 AM   #13 (permalink)
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Sending lots of good thoughts and prayers for Dexter.
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Old 09-10-2012, 08:33 AM   #14 (permalink)
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Originally Posted by Adara View Post
Oh no, sending good thoughts to you and your boy. I know a few Vizslas who have had MMM. I'll see if I can find the informative blog one of them had.

This site has 3-4 links
More Reading

another one
A Hungarian Vizsla Health Problem
Thank you so much for the links!!
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Old 09-10-2012, 10:09 AM   #15 (permalink)
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I'm sorry to read about what you guys are going through. It sounds so awful and very upsetting.

I'll be thinking of you guys. Please keep us posted on what you find out.

Also, I love that first pic of them together. So sweet. Such a good picture.
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Old 09-10-2012, 03:41 PM   #16 (permalink)
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Wow, so sorry to hear of what you and Dexter are going thru. Hope his outcome is good and maybe not MMM. Be sure to let us know what the test results are.

He is such a beautiful boy. I really hate to hear he is not doing well.
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Old 09-11-2012, 06:58 AM   #17 (permalink)
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I'm sorry to read about what you guys are going through. It sounds so awful and very upsetting.

I'll be thinking of you guys. Please keep us posted on what you find out.

Also, I love that first pic of them together. So sweet. Such a good picture.
Thank you so much brw It's so very upsetting. I keep thinking Dexter is older than he is, but he's just so young and it seems like he's gone through too much for such a young guy. He's a hefty guy, and towers over the girls, so it's easy for me to forget that he's only 18 months old.

The funny thing about that picture. The dobes were driving me bonkers, so I immediately thought "mat training." Since Roxy has had more training, I thought she'd have more patience and actually listen to me (ha!). I told her to wait, threw down Dexter's mat, gave him his command, and before I could throw Roxy's mat down, they both were scrambling for space on Dexter's mat. Even more surprising is that they were like statues while I went to get my phone to take pictures.

Quote:
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Wow, so sorry to hear of what you and Dexter are going thru. Hope his outcome is good and maybe not MMM. Be sure to let us know what the test results are.

He is such a beautiful boy. I really hate to hear he is not doing well.
Thank you Linda! I will definitely post updates as soon as I know anything. I can't believe it's only Tuesday - I'm SO ready for those test results!
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Old 09-12-2012, 03:01 PM   #18 (permalink)
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Lots of prayers for Dexter and you guys.
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Old 09-14-2012, 02:32 PM   #19 (permalink)
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Waiting to hear the news...
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Old 09-15-2012, 11:51 AM   #20 (permalink)
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Small update on Dexter:

We don't have the results back yet on the 2M Antibody test, hopefully those will come early next week.

We did get the results back on the Creatine Kinase test. Normal levels are under 200 and Dexter's are at 325. The vet said that indicates muscle inflammation that may or may not be indicative of MMM - so we still need the results of the 2M Antibody test.

Physically speaking, some of the good: he's panting normally again (as in, full open mouth pant). He does chew some of his food, but he's still doing some gulping, so we sit with him while he eats to keep a close eye on things. He's playing with his Orbee baseballs again.

Physically speaking, some of the not so good: he won't let me open his mouth. He'll let me stick a finger in his mouth and around his gums, but as soon as two hands go on his face, he gets very uncomfortable and squirmy. I'm not forcing that issue, just praising him like he's the worlds smartest dog the instant I get two hands on his face and he doesn't freak out.

He's peeing like I've never seen before. I went out earlier to clean up the yard and play with the dogs. He peed six times. Six times. Our yard is not *that* big. Only one seemed like a marking pee, the others were all long enough by themselves to each be full bladder emptying pees. After we came back in, he was walking through the kitchen and started dribbling pee. I sent him out, and he had two more loooooooong pees. He has also started squatting his back legs very low to the ground when he goes. My mom timed once this week, a full two minutes. How he hasn't had full accidents in the house is beyond me.

His head looks very bizarre to me. I took a ton of pictures earlier, of his head and of his awkward pee stance and photobucket is not cooperating with me and throws an error every time I try to upload. I'll try again later, I've currently lost my patience for it right now

Thank you everyone for the prayers and positive thoughts - please keep them coming - we definitely still need them.
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Old 09-20-2012, 10:29 AM   #21 (permalink)
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Update on Dexter:

Results came back from the 2M Antibody test and the results confirmed the MMM diagnosis. Our vet feels like he'll make a full recovery since we caught it quickly and he regained full range of motion so quickly. We'll be decreasing the prednisone soon and hoping that symptoms do not return. Hopefully we'll be able to keep weaning down the prednisone. He's handling it well, but he's definitely not himself, and I want my playful little guy back.
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Old 09-20-2012, 08:32 PM   #22 (permalink)
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sending good vibes and well wishes full the full recovery!
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Old 09-21-2012, 12:31 AM   #23 (permalink)
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My sister human was on prednisone for over a year had the moon face and all the dumb doctor she was going too was not watching close enough my sister is now a diabetic from the prednisone. More Hugs and Rays to your boy.
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Old 09-21-2012, 11:53 AM   #24 (permalink)
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Quote:
Originally Posted by moona View Post
Update on Dexter:

Results came back from the 2M Antibody test and the results confirmed the MMM diagnosis. Our vet feels like he'll make a full recovery since we caught it quickly and he regained full range of motion so quickly. We'll be decreasing the prednisone soon and hoping that symptoms do not return. Hopefully we'll be able to keep weaning down the prednisone. He's handling it well, but he's definitely not himself, and I want my playful little guy back.
I've been thinking of you guys.

I'm sorry to hear the MMM diagnosis is now confirmed, but at least you do have an answer.

I'm going thru tx of a mystery autoimmune thing with one of mine, currently. After unnameable $$$ diagnostic$, still no answer, so we are just treating, keeping comfortable, and praying, ya know?

Still, woulda been nice if your answer had been something less sucky, huh?

He is such a handsome boy, you know I have such a soft spot for the red boys.

Give 'im an ear rub for me, will ya?

Hugs to you.
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Old 09-22-2012, 02:14 PM   #25 (permalink)
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I'm really sorry to hear you got that diagnosis...but glad to hear your veterinarian is optimistic about Dexter's recovery. I have high hopes for Dexter.

Please do keep us informed about his recovery.
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