Medical Mystery: What caused dog to have trouble closing his jaw, drinking water?
I became concerned that he might have something lodged in his upper throat near his larynx or esophagus. His owner couldn't recall what sharp objects, such as razor blades, might have been in the trash can.
Bode Argentieri, a 12-year-old Cavachon (that's a cross between a Cavalier King Charles Spaniel and a Bichon Frise), is a house call patient of mine. His owner called me concerned about his strange behavior.
Bode could not close his mouth, making eating a challenge. She sent me a video, which showed Bode lapping incessantly at his water bowl, seemingly unable to swallow any of the water. Bode's actions were similar to how a human might act after having burned his mouth on hot pizza. He showed interest in food, but simply sniffed and then walked away. This behavior had been going on all day, and no burn had been witnessed.
By the time I arrived at Bode's home, the plot had thickened.
Several bloody Q-tips were found — evidently left behind after a bathroom trash can raid. Bode's owner confirmed that the blood hadn't come from her, so I deduced that Bode had retrieved the Q-tips, and was bleeding from his mouth.
I became concerned that he might have something lodged in his upper throat near his larynx or esophagus. His owner couldn't recall whether any sharp objects, such as razor blades, might have been in the trash can.
We discussed radiographs and determined that endoscopy with a light sedative, might answer our concerns. An endoscope is a camera device that can be inserted into the throat and grab any lodged items.
Bode was taken to Veterinary Specialty and Emergency Center nearby to have the endoscopy performed.
Solution:
It turns out that the bloody Q-tips were just a red herring, distracting us from what was really going on.
Bode had trigeminal neuritis, which the neurologist on staff confirmed.
Idiopathic trigeminal neuritis is the technical diagnosis. Idiopathic is a term we use when we cannot determine the exact cause of, or pathological reason for, a disease. Sometimes there is an underlying immune-related cause but not always.
The syndrome is also referred to as "dropped jaw." The trigeminal nerve, or cranial nerve No. 5, has three branches. Most dogs, like Bode, show symptoms related to the nerve branch leading to the lower jaw. They may drool a lot, be unable to close their mouths, or struggle getting food over the back of the tongue. Sometimes the muscles near their jaw atrophy, or thin out.
Another branch of the nerve leads to the upper part of the jaw while the third may go as far up as the eye and ear. If affected, these branches can lead to a loss of sensation or numbness.
The good news is that trigeminal neuritis is not painful and resolves on its own, often in three or four weeks. Sometimes steroids are prescribed to speed up the healing process, but they have not been proven to reduce recovery time.
For dogs afflicted with this syndrome, it is helpful to make their food into a slurry, so that they can lap up small amounts at a time. Rarely, dogs require feeding tubes until they are fully recovered.
Fortunately, Bode did not take steroids, and was 80 percent back to normal a month later. By six weeks, he was fully himself again.
Dawn Filos is a veterinarian and owner of Bucks Mercer Mobile Vet, a house-call mobile practice in Bucks County and Mercer County. She blogs at askthepetvet.com, and can be contacted at Info@askthepetvet.com.