We’re excited to bring you the latest updates from our team. In this issue, we introduce our newest specialists, Dr Raquel and Dr Iago. You’ll also find details about our upcoming CE night, featuring sessions on Anaesthesia in Brachycephalic patients and the diagnosis and management of Hypothyroidism. Plus, read about Lucy, one of our patients, and her remarkable journey with Guillain-Barré Syndrome.
When sudden flaccid paralysis
Lucy is a very well and athletic 9yo female Border collie who, at the beginning of August, went from being completely normal to, 36 hours later, being unable to stand and finally completely paralysed, able only to raise her head a few centimetres from the ground with loss of all limb reflexes and movement. Lucy remained bright & alert & could eat, if propped up, without regurgitating food. She was not salivating profusely & did not have a dilated oesophagus on chest Xray, making tick paralysis unlikely. Other potential causes of sudden onset flaccid paralysis included polymyopathy, myaesthenia gravis, botulism, tetrodatoxin (puffer fish) intoxication, snake envenomation and polyradiculoneuritis (Guillain-Barre syndrome). Most of these causes could be ruled out with history, clinical examination & laboratory tests and a final diagnosis of Guillain-Barre syndrome was made.
Guillain-Barre syndrome (polyradiculoneuritis) is an auto-immune disease triggered when the patient’s immune system produces antibodies against certain gastrointestinal infections, vaccines or even blood transfusions, which then inadvertently attack nerve tissue supplying motor function to the body (dorsal nerve roots), sparing the head. Diagnosis can be confirmed with spinal MRI, which reveals swollen dorsal spinal nerve roots as they branch off from the spinal cord. Recovery can be spontaneous but, slow and requires a lot of patience & dedicated nursing.
Lucy needed a urinary catheter to be placed in order to prevent her soiling her coat while in hospital and needed a lot of physiotherapy & nursing care to get her to a point where, although still unable to walk, she could be taken home & looked after by her dedicated owner. Finally, after 6 weeks, Lucy regained the ability to walk with assistance & by early August, 2 months after initial presentation, was close to 100% returned to normal.
We never did determine the cause of Lucy’s Guillain-Barre syndrome although, vaccination seemed unlikely as there was no recent history of this. Most cases seen in dogs are caused by certain gastrointestinal infections such as Campylobacter & Yersinia, with a history of diarrhoea 1-3 weeks prior to onset of paralysis. Ingestion of raw chicken has been implicated in some of these cases.
