My dog has myasthenia gravis. How do I manage his care & symptoms?

Thank you for using Petco Pet Education Center, formerly Petcoach! Myasthenia gravis is an immune attack against the receptors to acetylcholine on cells. Medications that are used to treat this disease are used to increase the relative amount of acetylcholine that remains at the nerve-cell interface and others are used to try and decrease the immune attack against the receptors on the cell. Mestinon decreases the destruction of acetylcholine and therefore increases its activity of the acetylcholine. This usually helps with muscle weakness. Prednisone and azathioprine are immune suppressant drugs. Myasthenia gravis may occur as a primary (idiopathic) disorder or maybe secondary to other diseases such as cancers. If another cause is discovered (such as cancer) then then you need to treat the primary condition to try and resolve the myasthenia gravis. Unfortunately, many pets with myasthenia gravis can still have signs of esophageal dysfunction. Megaesophagus (dilation and weakness to the esophagus) commonly occurs and sometimes may not resolve even with otherwise effective treatment. This leaves many pets with myasthenia gravis at risk for developing aspiration pneumonia due to chronic regurgitation. A veterinary neurologist is often helpful to have involved in these cases.

Hello and thank you for reaching out to Petco Pet Education Center, formerly Petcoach. I'm sorry to hear that Rooney has been diagnosed with megaesophagus. This means that the esophagus is abnormally enlarged/dilated, and does not move food down toward the stomach appropriately. This can make dogs more prone to regurgitating their food or water, meaning the food or water falls from their mouth after eating/drinking. Dogs with megaesophagus are more likely to develop aspiration pneumonia, which can be life-threatening. The type of food is not as important as how you feed Rooney. It will be important to feed Rooney in an upright position, and offer him meatballs of wet dog food one at a time. There are specific dog feeding chairs, called Bailey chairs, that you can purchase online, that help dogs with megaesophagus eat upright. I hope this is helpful!

Wow, this is quite a complicated case, so the answer will not be straightforward and is very involved. I'm assuming that you are trying to present an impressive report, but I'd recommend scaling this back, because the more complications you add, the more you will be accountable for. There are a few fundamental things that I'd like to point out about your report that are already erroneous and may result in reduced points. First, you need to understand the difference between symptoms and signs. Symptoms are what the patient is feeling and telling you. Examples of this are the patient feels tired, pain or dizzy. Since animals cannot talk, we can only base these things on observations (aka signs). This means that you can never truly refer to anything as a symptom in animals. They are all signs. Megaesophagus is a sign. You should also be aware of the difference between ammonia and pneumonia. Ammonia is a nitrogen-containing molecule and is often used as a cleaning product. Pneumonia is a condition where the lungs are diseased/inflamed. If you have not been taught these concepts, then I doubt your instructor expects you to know what medications to give for this condition. To make it easier, but still impressive, I would say that the pup has a persistent right aortic arch (PRAA) and that you need to place a stomach tube while he awaits surgery for the PRAA. Keep the SOAP simple to the level of education you are at. There is no way your instructor could expect you to know how to diagnose and treat these conditions. This is graduate veterinary level of work. I know I still haven't answered you question, so I'll give you a few treatments below for pneumonia secondary to megaesophagus, which would be secondary to Mysthenia gravis. If he had this along with anemia and a stomach tube, then there would be no take-home meds, because this dog would need to be hospitalized. IV enrofloxacin and metronidazole for the pneumonia Oral (through the stomach tube) pyridostigmine for the Megaesophagus. Blood transfusion depending on the severity of anemia When dog recovers from pneumonia, it should go on oral prednisone for the Myesthenia Gravis. I hope that helps and the project turns out well.

Hello, I am so sorry Brandi has been struggling. Based on the information you provided, I suspect Brandi has megaesophagus which occurs secondary to neoplasia, myasthenia gravis, hypothyroidism or its idiopathic. Independent of the underlying cause, a permanently dilated esophagus carries a poor prognosis and often leads to pneumonia. Some medications such as metoclopramide, cerenia and sildenafil may be helpful. Additionally, you should research a Bailey’s chair which forces the pet to eat in an upright position to prevent choking. I hope this information helps.

Hello. I am sorry for the IVDD diagnosis. Was a surgical option presented to you? Many dogs go through surgery very well & have outstanding results. Bella should be placed on restricted activity. This usually means complete cage rest, only being allowed out to relieve herself. There is no need to give melatonin nor change her food. I would avoid bathing unless she is soiling herself ( urinating or defecating )in which case you might want to put a doggie diaper on her. The surface of the crate should be flat & non-slip & should be well padded to prevent sores. If the carprofen & neurotin is not keeping her comfortable, you may be able to increase the dose of neurotin, or she may need a stronger pain reliever like fentanyl. Lack of appetite can be from the pain, so increasing/changing pain meds may help. You can also speak with your vet about using an appetite stimulant like mirtazapine or Entyce to improve her appetite. I hope Bella is feeling better soon. Thanks for using Petco Pet Education Center, formerly Petcoach.

Hi there and thank you for using Petco Pet Education Center, formerly Petcoach! Degenerative myelopathy is a progressive neurologic condition that is more common in the German Shepherd Dog, but affects other breeds as well. I am assuming your vet suspects this condition because of hindlimb weakness/wobbliness. Because many things can cause similar symptoms, especially if pain is a component of the process, getting more of a definitive diagnosis can be helpful. There is a DNA genetic test for degenerative myelopathy that can help aide in diagnosis. You could talk to your vet about this if this would be helpful for you to know. Mainly because this can be a sad disease to help the pet through, especially in later stages. Most of the treatment is centered around supportive care, assistance walking, booties on feet, physical therapy. The person who would have the most up to date information on the treatments of this disease would be a veterinary neurologist. You could also talk to your regular vet about a referral if you feel that this would be helpful for you as well. The treatment you describe above likely comes from a specific veterinary neurologist that suggested some medications may be beneficial but this has not likely been backed up by reasearch yet unfortunately. I hope this helps and thank you for using Petco Pet Education Center, formerly Petcoach!

Hello, sorry to hear about Vito. These signs could indicate early onset of arthritis in his hips or back. Other areas such as pain in his knees can also be exacerbated by cold weather. I would recommend having Vito evaluated by your veterinarian if he continues to be weak in his hind so that they can further treat his arthritis. In the interim, try walking him during the warmer parts of the day. His intermittent vomiting may be a separate issue not associated with his weak hind end. This should also be evaluated if he is doing it daily, or if he vomits more than 3-4 times in one day. Hope this helps and best of luck.