Neurological Cases

My 13.5yr old lab had a potential neuro episode of some sort a week ago.  She woke me up panting, unable to stand (which happens sometimes given her arthritis and how she lays and floor surface type, etc), sitting upright but back legs trembling (pretty normal for her since her FCE three years ago-neuro said it is nerves firing), and eyes twitching (I didn’t make note of the pattern because unfortunately I didn’t know that mattered).  Within an hour and a half she was able to walk though she was a little wobbly.  Has been completely normal since and no more episodes.  She had an FCE three years ago that paralyzed all four legs and she recovered from that with only a slight limp.   She goes to a chiropractor monthly also.  My initial thought was she has a pinched nerve, or her legs are asleep etc.  My vet thinks it was a seizure and warned me at her age statistically she’s at high risk of it being brain tumor related which makes me sick even thinking it could be such but she said without an MRI we can’t be sure. She didn’t think it was vestibular since she recovered quickly and not a stroke since nothing altered post episode, she’s the same as she was prior.  I’m waiting on her T4 results.  I’ve read to not do MRI on neuro cases bc of potential risks with anesthesia.  Attaching her CMP & CBC.  Thoughts??

Dr. Steve's Advice -  I've seen vestibular episodes be fleeting. I would probably suggest you try Halscion (https://goldstandardherbs.com/products...) since it is so effective at treating vestibular disease, is frequently effective at treating seizures, and contains my favourite formula for treating brain tumors (which vets seem to want to diagnose all the time but are exceedingly rare). I would give it a try and see if it helps. The history of FCE suggests it will likely work and may help give her some strength.

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It’s MooMoo the Havanese boy again! Hope you’re well! We’d really appreciate your opinion from what you can tell based on these videos. From Jan - Oct 2022, he’d randomly have an episode like this (1st Video). Our primary vet thought they were just muscle spasms. 

Then since 11/02/2022, he’s been having a “progressive” version of the above (2nd Video) right around the same time he was dealing with a couple of tick issues. (Positive exposure to Anaplasma but negative PCR result in mid-Nov.) Another engorged tick with Lyme was found on 11/4 but we didn’t do Lyme C6 then per your advice; instead had him on Voltrex and just monitored symptoms. He’s been asymptomatic except for these random episodes. Primary vet initially thought perhaps they were lameness but now she doesn’t think so. Fast forward to last month Lyme C6 test level was 80 hence vet suggested doxycycline despite not knowing what these episodes represent. 

Characteristics besides what can be observed in the videos: no specific triggers/timing, frequency ranges from few times a month to sometimes only once every few months, resolves on its own within a few minutes as if nothing had happened and no abnormal behaviors pre/post episode. Always fully conscious during an “attack”. Pupils would become diluted and subsides upon recovery during the “intense” version. 

We saw another vet for a second opinion last week and she suggested the possibility of Idiopathic Epilepsy. She didn’t think he needs treatment for Lyme since “the dot on the Snap 4DX was very faint”, plus he’s asymptomatic. 

Physical exams as well as results of blood work & urinalysis & fecal last month were fine (except for elevated Eosinophils at 1,494). MooMoo is 7yrs old on a gently cooked diet.

After doing some online research I’m now convinced that he has
Paroxysmal Dyskinesia (PD) and not idiopathic epilepsy given the absent of autonomic signs. What do you think? If so, any supplements that may help with his condition? 

Given the timing of events; could these episodes be neurological symptom caused by Anaplasma/Lyme infections if you don’t think they are PD? (Assuming that 1st & 2nd video aren’t related? And even if he never displayed any common symptoms of the infection?) 

Thank you so much for your time Dr Steve! 

P.S. Last video is the most recent that happened last week for your reference.

Dr. Steve's Advice - when you'd asked about the quantitative test, I assumed your dog was 100% asymptomatic. Lyme can induce neurological symptoms, though, so since this was going on sporadically, then use of doxycycline as a one time treatment doesn't seem inappropriate. If it works to relieve these symptoms, fantastic. If not, then other tests should be run.

The high eosinophil reading is unusual. Voltrex usually resolves that. If it has become elevated at the same time as these choreiform movements developed, then you'd have to wonder even about a muscle parasite being involved. If you have fed raw pork at all, ask your vet to try treating for Trichinella, an intramuscular parasite from that meat in particular. Even if you haven't used raw pork, get a fecal done, in case this is some weird instance of larval migrans.

Otherwise, the diagnosis you came up with is as good as any, but it is only descriptive. There is no particular treatment specific to it. I think that if there was no parasite and if doxycycline didn't help, I'd suggest treating this as a kind of dyskinesia or psychomotor seizure. I'd recommend two things for that, both from Kan Essentials: Calm Repose, and also Liver Support Formula. The two are synergistic to resolve this kind of problem. Liver Support Formula is a muscle relaxant and helps resolve muscle inflammation. It also nourishes the Blood from a Chinese medical point of view. Blood deficiency can cause types of mild seizure where animals are conscious but bizarre things are happening. Calm Repose treats that.

You can source both of those formulas from Aleksandra Topic by following the instructions in her post at: https://www.facebook.com/groups/1158575954706282/posts/1420037418560133/

Hope that helps!

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Seems like small seizures. 

Happens when he lies down. Its not like JUST before he falls asleep, it can happen as soon as he lays his head down. 

NEVER happens when he sits, walks, stands etc. 

Feel its seizures, but if you see both videos, in one i abort the seizure by calling his name. As I read,  if a seizure, thats not possible. 

Vet says they are strokes. And he will have a huge one sometime. Tomorrow or in two yrs. Dont know. 

But, strokes would make him lose balance or make him behave diffrent, since he can have these 20 times a day. 

20 strokes a day would in my opinion leave a mark. But he has no signs of any change 

It can be a week with almost none, and a week with alot. You can see his ears twitch, his head rises and I saw the other day when he was on his side that his leg also was "affected" . I cant say for sure, but I feel his breathing also 

Any tips to what this may be?

Dr. Steve's Advice - if it's the ear twitching etc. that you're talking about, that is unlikely to be a stroke. Strokes produce pretty catastrophic loss of balance in animals. This looks more like a focal seizure, if anything. As long as seizures stay focal, they are not very consequential.

Nonetheless, there are many basic herbal formulas that could help, but I don't know what you have access to. If there is a veterinarian nearby that does acupuncture, that is a good place to start, as they may be able to improve it for you and have access to those formulas.

Hope that helps

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I have a 5 year old toy poodle that I got when she was 3.  Shortly after getting her, she started to have seizures. She would have 1 or 2 seizures within 48 hours, approximately once every 6 weeks. I had read a study on the homeopathic belladonna, and the day I gave it to my dog, she clustered 7 or 8 times and took her to emergency. After getting that under control, we tried Tian Ma Go Teng Yin.  She was doing OK on that, especially after she had her infected teeth removed.  She stopped having clusters and seizures were milder and more spaced out, going as long as 3 months.  But then they started getting frequent again (every few weeks) so we stopped Tian Ma Go Teng Yin and tried Di Tan Tang.  On Di Tan Tang, her seizures seem to be less severe but the frequency hadn't lessened. Xiao Yao San was recently added to the Di Tan Tang but had another seizure a few days after starting it. Perhaps that wasn't enough time to get into her system so we're still watching and waiting.  According to her old vet records with the previous owner, she started having seizures within hours of vaccines and flea treatments. Penny loves to eat, is quiet, low energy and loves the sun.  Diagnosis of idiopathic epilepsy and otherwise healthy except her eyes tear up and get gunky profusely but sporadically. Thank you in advance for any guidance on food, supplements, or other natural herbs that might work for her.

 Dr. Steve's Advice - if Tian Ma Gou Teng Yin (Calm Repose, Gastrodia and Uncaria) worked well for her seizures, then it confirms she is Blood or Yin deficient. Di Tan Tang is a drying formula and can actually make Blood deficiency worse. I would guess that Xiao Yao San paired with Tian Ma Gou Teng Yin makes more sense, or even Yi Guan Jian with Tian Ma Gou Teng Yin. YGJ has calming herbs for the Heart and Shen. 

The other thing I would get is homeopathic Ignatia (sold as Iamara if you're in Canada). Use 30C strength and give it a couple of times a day for a few days, then maybe just once a day for the remainder of the week. It's a curious thing, but seizures that come on after a dog has changed homes seem to respond well to it.

Let us know if that helps

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Shade, 3 yr Australian Shepherd presented with sudden Ataxia and fever after I returned home from a trip.  Traveled to a neurologist within 2 days, who called her a mystery as all vitals were good. 

He doubted Encephalitis, however I agreed to the Spinal Tap which to his surprise, came back positive.   We opted to do all the test to determine cause, all negative.  Just a side note....we had horrible winds for a solid 3 months prior to onset, not sure if something there caused this.  We live extremely rural, farmland.

Originally this was idiopathic, now DX as Mediated Autoimmune.  She has been and currently raw fed.

She is MDR1...one gene. All genetics great!

On 10Mg..Prednisone BID which is making her crazy   She weighs around 43 pounds.  Starting Atopica next week and tapering Prednisone. 

Supplemented with Adored Beast Chaga drops, Love Bug Probitics, Turmeric a few times a week. Was on Mushroom support as well for 30 days along with 2 types of antibiotics.   She responded quickly!

Any advice or other supplements would be greatly appreciated. 

Thank you so much for this page!!  She is a intact female, no other health problems ever.  This was a shocker!

Of course the million dollar question...anyway to know when this is resolved or go the full 9M?

Dr. Steve's Advice - I'm glad your dog responded quickly. For immune mediated CNS disease like meningitis and meningoencephalitis, I use a herbal formula called Augmented Bupleurum and Kudzu Clearing Formula, which you can often find on Amazon if your vet doesn't want to carry it. I've found it to work as well as immune suppressant drugs and to be curative.

I would say if you were to try it, start the herbs then after 5 to 7 days, instead of switching to Atopica, begin gradually weaning off the pred. If you get off the pred with no symptom recurrence, then that is promising, but I'd still continue the herbs for a month or so before trying to reduce their dose (if you want to - some people just keep going at a low dose). 

If you can't get off the pred, then those herbs aren't going to work for you, and you'd go with the Atopica. I've never seen that happen, though.

Note that it's been my experience this kind of thing can sometimes happen every six months, and for sure is a very common problem in August. I'd make sure to have some of the herb around next July and just start her on it prophylactically until late September. I'd do the same the following year. If it doesn't show up again in a couple of years, then you're probably free of it.

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Hi Dr. Steve, found your page after my 2 yr old, 22 lb dachshund chihuahua super-mutt rescue pup was just diagnosed with immune-mediated meningitis last week after spinal tap and bloodwork (after months of no diagnosis, couldn't figure it out as his 'episodes' I.e. of screaming In pain, neck hunched over, were sporadic and at random). His bloodwork (via neurologist) also confirmed eosinophilia (1.4K/uL), hepatocellular pattern with ALT 1142 U/L, AST 56 U/L, ALP 433 U/L. He's been on 20mg prednisone, slowly tapering to 15mg on Day 8 (in a few days). He goes back to neuro In 3 weeks for re-check. After reading a bunch of your recommendations in this forum for other dogs, I ordered the Kan Herbs Bupleurum and Kudzu clearing tabs. These should arrive any day now. I am hoping he is not on pred forever. The side effects are really horrible on him.

1/ Can the Kudzu tablets be taken with prednisone? How often should I be giving It to him? According to the chart, he is around 1.5 tablets a day?

2/ What other anti-inflamatory supplements and/or foods should I be giving him with the Tablets?

3/ He is currently on Nutrisource kibble but am looking for a better approach to make him healthy. I was looking Into Farmers Dog or JustFoodForDogs. What Is your guidance here?

Thank you so much, and am so glad I found your page.

Dr. Steve's Advice - The Bupleurum and Kudzu dose you looked up is to be given twice daily. There is room to increase it if it is helping but you weren't able to decrease the pred. A real food diet like the ones you were considering should be helpful as well at reducing the inflammation. A probiotic should be added, such as Lactobacillus or Bacteroides. The probiotic will need a fermented carb and soluble fiber source to thrive, so make sure maybe 1/6 o the food is fruit, cooked grain, beans, or vegetables of some type.Hopefully your dog is doing better! If he still has bouts of neck pain, please find a veterinary chiropractor to check the atlas bone in his neck. Fixations there can produce symptoms mistaken for meningitis.

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Dexter, my 12 year old Pomeranian chihuahua. 

His first episode of what I thought to be a stroke was on JUNE 1. It is the second video posted with his held tilted. This lasted for a little over a minute. 

I took him to the desert this weekend and fed him dinner and he threw it all up. (I’ve noticed since June 1 he has had a very hard time handling any kind of heat) 

This morning around 8 am he was acting strange unable to eat his food normally, walking into walls and can’t seem to acknowledge where my voice is coming from.  He is still having symptoms/ disorinetation and it is 6pm. The 1st video is of him today. 

I attached his recent blood work. 

I’ve gotten one other opinion but am looking for what this possibly can be and what next steps to take for treatment. 

The vets here have told me to see a neurologist and that it could be thousands and I don’t have that. Other than that I have had no suggestions or next steps for care. 

Thank you to the moon and back for your time and expertise.

Dr. Steve's Advice -  the most likely diagnosis is an acute onset of idiopathic vestibular disease, especially if it occurred before and then resolved. This is more common in the hot summer months, because it is an acute CNS inflammatory lesion, and blood flow to the brain (such that it would precipitate or aggravate inflammation) is always highest in the summer. Many affected dogs are heat intolerant because they can't quite regulate their vasculature properly, leaving them more prone.

Before going to a neurologist, I would try Halscion (https://goldstandardherbs.com/products...) by Gold Standard Herbs. Although listed as a calming formula, I've used it also to resolve vestibular disease. Animals with severe anxiety have excessive cerebral blood flow, too, as do people (such as in PTSD), leaving them more prone to inflammatory brain conditions. If my read of his situation is correct, the Halscion should resolve it in a week or so. Using a bottle or two might eliminate the risk of it happening again. For sure I would keep some around if it works, though, in case there is a recurrence next summer.

The other thing I would do is see if there is a local veterinary chirorpactor around, to make sure that Dexter's neck doesn't become fixated because of how he feels he has to hold his head to maintain his balance. Atlas fixations can produce or perpetuate the same symptoms, so hopefully you can find someone who can check that for you.

If the above doesn't help, most veterinarians should be able to do a detailed enough cranial nerve exam to consult with someone and see what the list of differentials are without you having to spend thousands. I suspect, though, that the above will work

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 My dog was recently diagnosed with Idiopathic Peripheral Vestubular Disease.  It has been 5 days now and there has been some improvement.  Is there a cure for this and if not, what will her quality of life be?   Thank you in advance Doctor Steve! 

Dr. Steve's Advice -  the condition is curable. Get a hold of some Halscion (https://goldstandardherbs.com/products...) from Gold Standard Herbs, as I've yet to see a case coming on in summer that doesn't rapidly improve on it. Next year you can use it prophylactically to prevent it, beginning say in June and going through to September. Often it stops happening when people use Halscion to treat it.

Lastly, consider a chiropractic treatment to make sure there are no vertebral fixations of the neck perpetuating the problem by secondarily irritating nerves entering and emerging from the vestibular region.

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 Hi Dr. Steve. I really enjoyed seeing you on the Inside Scoop this past weekend. So I have a home full of special needs French bulldogs.one of my current fosters came to me paralyzed. Because she’s a frenchie, we initially suspected IVDD which I have a lot of experience with. MRI and other testing however led to a diagnosis of autoimmune meningitis. She has responded amazingly to her treatments of cyclosporine, high dosages of prednisone and monthly cytosar treatments. She is walking again, albeit wobbly, and also regained the ability to potty on her own.  This is my first time dealing with any type of meningitis. 

I also am treating her with my holistic vet, who put her on a home cooked whole food diet (I normally raw feed),probiotics, digestive enzymes, along with backbone and curcuma flow by Health Essentials. 

My concern is despite the holistic support she still seems to be having a hard time with the drugs, especially the prednisone. We are slowly tapering her down to see if we can do so without prompting a relapse. She pants heavily and excessively almost constantly. She also is having a hard time putting in weight despite my feeding her three times tbe amount I’m feeding my other frenchies. 

My question is, is there anything else I should be giving her to support her little body and to detox her?  Chemo, immunosuppressants, and steroids are all such harsh drugs.

Dr. Steve's Advice -  This is one of my favourite things to treat, actually! I have never seen a case NOT be cured by a centuries-old herbal formula called Chai Ge Jie Ji Tang, that Kan Veterinary Essentials sells as Augmented Bupleurum and Kudzu Clearing Formula (https://tcvmpet.com/.../bupleurum-and-kudzu-clearing...). If it took your dog further than he is now in terms of mobility and stability, you'd be able to gradually wean him off the pred and the chemo drugs.

He may need something different afterwards to return to 100% normal, but that one formula may well do the trick and tends to be curative - as in the problem does not come back.

Hope that helps!

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 Hello Dr. Steve… I have a five year old Maltese with a history of resource guarding. I got him when he was 16 weeks old and I was his fourth placement. I had him neutered just before six months old (he was marking and I didn’t know better then) and it was days after he was neutered that he began RG and bit a family member. He continued RG with my other 2 dogs, one in particular, and she’s always remained a bit timid around him. I hired a trainer and learned to read his cues and implement some management, and as he matured his episodes were less frequent but never fully resolved. He’s an anxious boy and gets very nervous when we have company or when he’s taken out of his environment (anywhere other than outdoors). These situations put him over threshold and given the chance, he will become aggressive and attack.  Fast forward to this past September, he went in for a dental and had a few teeth removed.  In the weeks following his dental, his RG has been at an all time high. He’s very random and inconsistent and even our new trainer is perplexed as he’s not a  “textbook”. RG. We had 5 episodes in 7 days’ time so I booked him in with my vet to discuss adding something systemically to see if we can  manage his anxiety and better work with him. She started him on Calming Care probiotics and CBD oil. Five days following the start of those, he had a focal motor seizure.  He’s never had one before. I took him off both the CBD and probiotics to monitor for a couple weeks and will try again if he remains seizure free. My question is this: both times he’s had anesthetic, his anxiety and RG skyrocketed. (He never even guarded prior to his neutering and I’m told puppies don’t normally RG). In the past I’d read about the long term neurological and behavioural effects Acepromazine can have on dogs. Can you shed any light on this?  While my vet nor her associate believe the CBD oil is what triggered the seizure, both have recommended ceasing for the time being. Is it possible his aggression/RG are connected to a seizure?  I’m at a bit of a loss and feel like there’s something more going on with him. I just started him on Long Dan Xie Gan Tang to address his anxiety. He’s on a fresh food fully balanced diet with a high grade Omega 3 and hemp hearts. Any suggestions you have would be so much appreciated! 

Dr. Steve's Advice -  your pup is likely Blood deficient from a Chinese medical point of view. Unless you used the Natural Path or Kan Essentials version of Long Dan Xie Gan Tang, the formula may not help, but you can try it and see. The formula treats an Excess of the Liver, but in your dog's case, I think there is a deficiency.
When it is adequately suffused with Blood, the Liver in Chinese medicine is associated with confidence and compassion, which are both ways of going out and engaging with the world. It is balanced by the Lung, which is the organ of internalization, withdrawal, pulling back and drawing boundaries.
Blood deficient dogs have a deficiency of confidence, which can be aggravated by neutering, since in Chinese medicine, the sex hormones are a form of Essence, and Essence is needed to generate Blood. Just because your dog is neutered, though, doesn't mean we can't get his Blood levels back up, but you will have to lean on a real food diet and herbal medicines. If he is on a kibble or canned diet, you will be fighting an uphill battle.
When dogs lack Blood and confidence (or "Wood"), the Lung becomes relatively stronger. An increased tendency to pull back manifests, and other "Metal" behaviours. Because Blood deficient dogs feel so anxious, they try to control their environments and become very frightened when taken out of familiar surroundings. The sense of lack leads to resource guarding or avarice, out of fear they will never "have enough".
As for the focal motor seizure, Blood deficiency is a common cause of them. So I don't see this as related to the anesthetic or the CBD, but rather this underlying cause which has been present for many months.
Here are the steps I would take:
1. Change the diet to a real food meat-and-vegetable diet ASAP. It should eventually be curative as long as he enjoys eating it and appears to easily digest it.
2. If the Long Dan Xie Gan Tang doesn't work, and he has zero digestive issues, get a hold of Liver Support Formula from Kan Essentials. It strongly nourishes Blood and should also reduce the seizure tendency. Note that the intent of LDXGT is to weaken the Liver, not nourish it, so it could actually make him feel a little worse, unless you're using Kan or Natural Path. I guess keep an eye out for that happening.
If he does have GI issues, then try Kan Essentials' Happy Wanderer instead. If he needs anti-seizure effects but is on Happy Wanderer, get a hold of Calm Repose from the same company and use it at the same time.
You can obtain all these from Aleksandra Topic by following the instructions she provides here: https://www.facebook.com/groups/1158575954706282/posts/1420037418560133/
3. Make sure he is not hypothyroid, a common condition associated with Blood deficiency, which the above formula recommendations will help correct, but perhaps not be able to address it fully. Also make sure he has an omega 3 fatty acid supplement to help support normal mentation
4. If herbs and diet don't help, make sure his jaw is not out of alignment, secondary to the dentistry and acting as a cause of pain and anxiety. It's a common issue, and vets are not at all trained to assess for it or treat it. Try to find a veterinary chiropractor who can take a look

I'm confident you can solve this problem in your dog, but it will take some time. Training won't be immediately helpful, until you see signs he has started to settle down, at which point he will be more cognitively capable of 'learning lessons' and not just reacting or panicking

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 It may be too late..sweet 10 year old Baxster was rushed to the emergency vet last night.  It looks like it could be Vestibular Disease.  He's home, but not moving much at all.  Are there recommendations from a holistic side that we can try?  He is experiencing paralysis on one side.  I have a new bottle of Halcion that I got for my sweet girl that just passed.  We do live in Florida and, of course it is hot.  All suggestions welcome.  Thanks in advance Dr. Steve. 

Dr. Steve's Advice -  vestibular disease can be treated, and I've never seen a better cure than Halscion (https://goldstandardherbs.com/products...). I'd start it right away. It's most famously effective for vestibular disease occurring in the second half of the summer (i.e., cases with a July or August onset). I'd start with that.

Note, however, that a true paralysis on one side (which means no limb movement at all on that side of any kind) can indicate a stroke. I take it that is not what is going on, though, as your vets would not then have given you a tentative diagnosis of vestibular disease. They would have suspected something much more serious. If you are seeing a stroke, Halscion is still the best treatment, but recovery can be more protracted and you might want to get a rehab or physiotherapy team involved. I assume it's not that bad, though

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 Hello! My 2.5 year old German wirehaired pointer has been on extended release Keppra for epilepsy for 1 year. The videos I see of dogs with epilepsy show a full blown seizure (unconscious, foaming, urinating, etc). When she experiences a break through, it’s more like a muscle spasm as shown in the video from May. Her legs back up but she is fully conscious (although confused) and half the time wagging her tale. It recently happened a few weeks ago and mild “muscle spasms” lasted through the night. I thought maybe it was fertilizer in our neighborhood causing a trigger but we were at the beach with her latest episode. Perhaps it’s triggered by stress, exercise, dehydration? I have so many questions. Luckily it is a low dose of Keppra but I wish I knew what triggers it.

1. Have you see anything like this?
2. Would a neurologist visit be helpful in proving a diagnosis? 

Thank you, thank you.

Dr. Steve's Advice -  these kinds of 'deficiency' myoclonus seizures often respond well to a combination of Calm Repose, and Liver Support Formula. Both of these can be obtained from Kan Essentials. A reliable source of those, as opposed to potentially counterfeit versions on Amazon, is Aleksandra Topic. You can email her at aleks.topic1@gmail.com. Dose according to the guidelines at https://nphc.ca/using/dosage

Hope that helps!

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 Hello Dr Steve,  I have a 2 1/2 yr old jack russell mix that was recently diagnosed with SRMA. He's on 5mg (tapered down from 7.5mg) , he has been on it since mid December. At first he lost alot of weight, I increased his food (Carna4 and sardines, Dr Harveys paradigm veggie mix, fish oil, probiotics) he has since gained some weight. But now he is developing some hot spots and hair loss pockets in his coat. His behavior has gotten a little more dominant and confrontational toward our other pups.   I put Gastroelm in his second meal of the day since his poops were getting to be black and i wanted to support his digestion.   My question is, is it ok to put him on Cessorex at the same time he is on prednisone? Anything else I should add to his diet to support him?

He doesn't seem like a happy camper to me so I want to help him feel better any way i can. Please help. (here's a pic of my Elvis)

Dr. Steve's Advice -  absolutely you can use Cessorex (https://goldstandardherbs.com/products...) for your dog. It might help facilitate a full recovery from the meningitis, can reduce the aggression you're seeing, and can help resolve the skin issues, too.

Regarding diet, give some thought to subbing out the Carna4 for a real food (e.g., home cooked or raw) diet. Even air drying constitutes a form of heat treatment that increases AGE levels in the diet and thus its overall inflammatory effects

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Hi Dr. Steve! I hope you’re doing well. 

I’ve been using Halscion since September 28th for my 2-year-old husky with epilepsy, and I’m super ecstatic to say we’ve been seizure free ever since!!! He’s still on Keppra XR 750 mg, which he has been on since May. Even with Keppra, he was having grand mal seizures every 3-5 weeks, so Halscion has been nothing short of amazing for us. 

Unfortunately, he’s been limping off and on, mainly on his front right leg, though occasionally he lifts his back right leg while walking like he stepped on something sharp. The last couple times happened a day or two after a seizure, so I thought he must be sore from the seizure. The limping went away in about 2-4 days. But about 2 weeks ago, he started limping again even though he didn’t have a seizure, and this time it lasted about a week. I took him to my primary vet, who said his tendons and ligaments were all normal and that his joints had normal range of motion. He has a history of Lyme disease, for which he was treated with 30 days of doxy in May. We ran the test again to rule out Lyme, and it came back negative. He also sees a chiropractor regularly (and is due to see her next week), but she also couldn’t feel anything wrong when I mentioned the limping at the last appointment. 

Do you think his limping is related to his seizures? I also read that muscle/joint pain is a side effect of Keppra in humans, though WebMD says it’s rare. I think he’s also experiencing a runny nose and dry mouth from the Keppra as well. The neurologist said at the time of diagnosis that Keppra doesn’t have any side effects, which obviously isn’t true, whether it’s causing the limping or not. Have you seen similar cases, and is there anything you would recommend? 

As always, thank you very much in advance. Your wisdom and advice are so appreciated.

Dr. Steve's Advice - you have a very handsome dog! You're correct that Keppra is known to cause pain, muscle damage in particular. It is rare, but you should suspect it if blood tests show a high creatine kinase levels (not creatinine). That should be easy to check.

Any chance you can have someone else check his back or neck? Most forelimb lameness is from cervical fixations. Can you find a rehab therapist, perhaps? Or an animal massage therapist? An acupuncturist? They can be a bit more sensitive at finding problem areas, picking up on muscle tightness, and finding vertebral fixations. They also have more tools than your average vet for getting rid of pain.

If all else fails, you could start probing the condition, trying to diagnose it by a 'response to therapy'. For example, you could try identifying the general nature of the problem. If it responds to antispasmodic herbs like Kan Essentials' Liver Support Formula, then its a spasm issue. If it responded to Blood moving anti-inflammatory herbs or drugs (like Boswelia, NSAIDs, etc.) then it's an inflammatory issue.

Hopefully that helps somehow. If you get more information, feel free to come on back for more advice

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Hello Dr. Steve, looking for any kind of insight and input for my guy, Ares. He’s a 2 year old Cane Corso. The last 2 months he has had some leg issues that have progressed. Original vet put him on rest, rimadyl, and methocarbamol. He declined more so we ended up at the ER vet which gave me a referral to a neurologist. He was limping on left front leg and hind legs. It’s mostly his left side of his body with weakness in both hind legs. They did a full exam, MRI, csf tap, joint taps, blood work, and 4DX test. All came back negative and his blood work was near perfect as they put it. He was started on 20mg of prednisone (1 tablet every 12 hours for 5 days then 1 tablet every 24 hours for 5 days then half a tablet) until we go back on the 11th. Prilosec every 12 hours for 10 days. Pregabalin (150mg 1 capsule as needed for pain every 8-12 hours). We saw brief improvement while on twice a day, but now has declined again so they said to put him back at twice a day until we return for his checkup. He was never given a real diagnosis just said possible neurological disease and wanted to test out the steroid treatment. The first 2 days on the steroid he couldn’t walk much so we had to carry him, but day 3 he was able to get on all 4s and somewhat walk short distances. He has lost muscle mass in his hind legs and front left shoulder. He has been on Lumbrex for a few days now. They keep telling me that he is a mystery and want to try out this treatment and go from there. The MRI did show a minor pinched nerve in his neck, but he said it doesn’t explain the lameness in his hind legs. I attached the documents they emailed me about his MRI and treatment plan. Is there anything else I should try to give him or have them test him for? He is on a raw food diet and has been since being a puppy. He also gets Myos Muscle Formula in his food. 

Dr. Steve's Advice - the response to higher doses of corticosteroids implies neural inflammation, but it's not sustainable as a solution.

Your next visit should probably be with a chiropractor. The narrowing of the foramen between C6-C7 can easily explain the abnormal front gait and might immediately improve with a chiropractic treatment. The radial nerve is very affected by a nerve pinch in that location, causing difficulty in extending the paw. Your dog has learned to flip his paw forward as he extends his foreleg and then slap it down to allow weight bearing.

A chirorpactic examination should also be performed to of the sacro-iliac joints. Secondary muscle spasms due to pain from a fixation here can create a type of soft tissue sciatica called piriformis syndrome. You can see that he has difficulty fully weight bearing on that leg and extending it fully. Sciatic nerve root impingement from piriformis syndrome would have been completely missed on a normal work up, unless it was done by a skilled rehab or physiotherapist.

Given the presence of nerve root impingement, inflammation and pain, and the likely involvement of the S-I joint, I would use Voltrex as well as Lumbrex to try to get him feeling better, while you see who can check him out for vertebral fixations

Hopefully this helps

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Hello Dr. Steve,

My 15 yr. old Beagle, Grace has been experiencing reactions like in the videos attached. She seems to only be bothered outside in the sun and shadows. Because of her age I opted to not have an MRI done. Her eyes checked out fine. The vets best guess is that it is focal seizures and she is on Keppra that seems to help. Wondering if you have other thoughts on what this could be.?  Thank you so much!

Dr. Steve's Advice - That is interesting, Saving Grace! Grace most likely has stimulus-sensitive myoclonus, which are involuntary jerking motions that can be precipitated by stimuli such as motion and/or bright light.

In Chinese medicine, sensitivity to bright light is considered a feature of Blood deficiency, as is muscle twitching. A safe thing you can try to remedy both is Liver Support by Kan Veterinary Essentials (https://www.amazon.com/Kan-Herbs-Essentials.../dp/B00NDF4W1M). I can't b sure it will work, but I think it might and it should be safe to try in an older dog

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Good Afternoon Dr. Steve. My chihuahua is 10 years old and has an auto immune issue that caused encephalitis back in February. It was pretty scary. She has been on prednisone since then as well as leflunomide. She is starting to dial off the every other day prednisone to every three days for six weeks and then dial off of them completely. She will stay on the leflunomide for a bit longer to see how she does. She also is taking Clavamox for 8 more days of a 30 day course from a bacterial skin infection on her belly that she had and couldn't fight on her own. My question to you is that her eyes tend to get goopy since being on these medications. She recently finished a 3 week course of NeoPolybac Ophthalmic Ointment but now she is having issues again. Do you know of anything that I can do for her naturally to help her eyes? Also, do you know of any supplements that can help her with her auto immune disease? Thank you so very much. 

Dr. Steve's Advice - Hi there! My general approach to these cases is to use Augmented Bupleurum and Kudzu Clearing Formula, as discussed in this post: https://www.facebook.com/groups/1158575954706282/posts/1225766157987261/

The drugs you're using are powerful immune suppressants, activating an infection in the eye. Antibiotics have a hard time resolving these kinds of problems because antibiotics are really dependent on an intact immune system to do their best work.

The nice thing about the above mentioned formula is that calms down excessive systemic immune reactions such as those that caused your dog's meningo-encephalitis. At the same time, though, they boost local immunity, so your dog can still fight infection. Lastly the herbal formula seems to be curative. I've never seen a dog relapse after using it to address this issue, whereas we do see recurrences in dogs that are managed with drugs.

Hopefully this helps you out!

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I'm looking for any information on helping my dog who is in the the lower end (or outside of range) of the expected glucose range (three tests in a row over a 3 month period.) And recently below range in a fructosamine test as well.  (No abnormalities found in a recent pancreas ultrasound)

She's almost 13, 35 lbs and has suffered from poorly controlled idiopathic seizures for a few years. (We've tried numerous meds, treatments, etc. ) Her vet and I are both thinking this low range could be contributing to her seizure activity.

Is there something I can to to help boost her glucose a little to get her in a healthy range? Right now she's on a raw diet.

Dr. Steve's Advice - you might want to rule out insulinoma in your dog. An insulin:glucose ratio can be determined on a blood test, if your vet's lab offers that test.

Low glucose can prompt seizures. Chinese medicine would look at the two things - seizures and low glucose - as concomitant, and not necessarily an issue of the latter causing the former. In other words, the same treatment may remedy both problems independently.

One treatment I've used for hypoglycemia that is also used to help control seizures is Long Dan Xie Gan Tang (Gentiana Combination). Kan Essentials sells this (often on Amazon) as Subdue Liver Fire. Dose according to the table at https://nphc.ca/using/dosage

Since your dog is on raw but having issues, you might also want to try Halscion (https://goldstandardherbs.com/products...) by Gold Standard Herbs. I would also add in probiotics, fermentable carbs and soluble fiber. Dysbiosis can occur in response to raw (or rather a deficiency of certain strains), and this can result in altered mentation. You'll see testimonials regarding epilepsy on the page for Halscion.

Hopefully one of these two approaches helps you out. I suspect it will

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