Signalment

• Age: 3 years
• Sex: female spayed
• Breed: Mixed Breed
• Species: dog

Disease Notes

• Certainty: tentative
• Comments: Maggie is an approx 3-4 year old FS MBD from Puerto Rico with an unknown history. She initially presented for, and continues to suffer from, severe episodes of seizure-like episodes of uncontrolled movements. These episodes begin with her pawing at her face, chewing at her feet and then progress into full body spasms (with patient recumbent). Unlike a seizure, however, she can be talked out of the episodes and they stop completely when the foster mom (a veterinarian) picks her up.
  
  Maggie has seen a neurologist (who subsequently consulted with seven others including DeLaJunta) and had a normal MRI of spine and brain, normal nerve and muscle biopsies and normal EMG. She has also seen a dermatologist. She has no response to Pheno, Keppra, Prednisone, Methocarbamol, Gabapentin, Diazepam, Alprazolam, Mexiletine, Apoquel, Benadryl, and even Cerenia. A gluten-free diet was recommended based on a paper on Phenotypic characterization of canine epileptoid cramping syndrome in Border Terriers. Her only response to therapy has been to Baclofen (a drug that treats skeletal muscle spasms) combined with Gabapentin.
  
  Alarmingly, she has many episodes per day (during a one hour consult, she had six although her meds were due, so they do increase in frequency). She is worse in rainy weather and in the late afternoon before feeding time (when meds are still on board). There are no other known triggers.
  
  I will upload videos as these episodes are difficult to describe and unlike anything i have ever seen (or learned about). There are several different components to this:
  - she will walk with a stiff-legged gait (sometimes dragging it) three times a day
  - violent scratching happens once or twice a day
  - seizure-like episodes with vocalizing as if in pain. This is accompanied by a market voice change. Her breathing is also affected... rather spastic as if her diaphragm muscle is involved.
  
  Other comments about her:
  -she seems to see peacefully at night, not an active dreamer but will occasionally be found in an almost "rigor mortis" stance... this is better with the Baclofen.
  - her body is (understandably) very hot after an episode
  - being carried in a Baby Bjorn keeps the episodes from happening. Not a thunder shirt, however.
  - there are no known GI sensitivities and her skin and nails appear healthy
  - her personality is very friendly with people and with dogs at home. She was a bit timid at the vet hospital
  
  Tongue/Pulse: tongue- pink, pulses- wiry
  
  Thoughts on basic patterns?
  
  My thoughts on this are that we are dealing with a severe Liver Wind situation (pawing at face) combined with a Shao Yang Stage disorder? But it also occurred to me that this could be similar to the Jue Yin excess Dr. Marsden describes in his seizure lectures. Any help with basic patterning and herb selection would be much appreciated. We are her last stop!
• Final Status:

Treatment and Outcome