Grey had suspected tremorgenic mycotoxicosis

The beginning of the year was truly hellish. Out of all Grey's previous health related ups and down, apart from when he was 8 weeks old, I never felt we were close to losing him. But  I did feel it the first week in January and it nearly broke my heart. To cut to the happy ending of this story, he's fine now.

Grey started to have acute muscle spasms along his hind legs and entire torso on Thursday January 3rd at the end of what was a lovely walk in the countryside. He was shaking and having what I can only describe as convulsions. He remained on his feet throughout. After what turned out to be over 24 hours of intensive care at 3 vets, he was discharged on the evening of Saturday January 5th and diagnosed with suspected tremorgenic mycotoxicosis. In layman's terms these are toxins in the form of a mould that cause severe tremors and spasms by their effect on the central nervous system.

Here's a friendly easy to read basic guide to tremorgenic mycotoxicosis 

"Ingesting even a small amount of mold can cause small muscle tremors and ataxia (which will cause your pet to look like he/she is drunk or having trouble walking) for a period of hours or days. A large amount of mold exposure can cause severe tremors, seizures and even death."

Grey must have had a substantial exposure. Here's a video of the very beginning of the attack. I started filming him within a minute of the first spasm.



The new year had started started out with Polka having learnt to open all the kitchen drawers and cupboards barr one. I had stupidly put off moving all the baking stuff until my day off after New Year and I thought she couldn't open that particular type of cupboard door. That was quite stupid of me, because Polka is a very fast learner, and has set herself the task of learning all the doors! We came home from the cinema on New Year's Eve to find the floor strewn with empty packets of currants, sultanas, popcorn, Atora Suet.

We knew Polka would have eaten her weight in contraband but Grey looked less like he'd partaken of the booty. Off we went to the emergency out of hours vets in Canterbury to see in the New Year with the hounds being made to sick up what they'd eaten. Currants, sultanas and grapes etc are potentially lethal. Vets don't know why. it might be down to something they're sprayed with. Whatever it is, if it's going to be harmful, it might only take a couple. You can't really mess about if they've eaten this type of food.

Both dogs were given Apomorphine to induce vomiting. Polka had eaten literally the hugest amount you could imagine and more. The nurses came out to wonder at how could such a petite dog pack away such an amount of currants and raw popcorn. Grey had eaten less, but still it was currants and an entire packet of suet with parts of the cardboard box. They both recovered well and the next day we had a lovely long walk with our friend on New Year's Day on Tuesday. Wednesday we went on a long walk with Grey's brother Gunner and his owner.

Then came Thursday January 3rd. I went out with them both at lunchtime to our usual walking area; a network of fields covering a massive area below Minnis Bay and Reculver. The sun was shining, bright blue sky, fields were green. Both dogs had a lovely relaxed walk. Polka was almost clean as a whistle as we were homeward bound. Just as we were headed to within 500 metres to the car, we bumped into a fellow dog walker and his pack of english pointers and a spaniel. Grey unsurprisingly got a little over excited and started playing in an OTT fashion with Polka. He does when he doesn't really know what he should do. So Polka ended up covered in mud. We said our goodbyes, everyone calmed down and we three headed off back to the car.

As Polka and Grey were trotting in front of me down the long concrete road through the fields, I started paying particular attention to how differently their hind legs worked as they moved side by side. I didn't think there was anything wrong at this point other than fascination. Then Grey suddenly stopped and went on point to the left. His hind legs started to tremble. This in itself wasn't what got me worried. His hind legs often tremble through tension if he's pointing something he's caught a scent of. But this was a different to a point he was slightly crouched up and I could see he was confused or worried. He then walked across the path and into the field to the right. It was instantly clear something was wrong with how he was walking, his gait wide, his back legs now shaking more violently and tremors started up his torso. He was clearly worried and not fully in control.  I immediately started filming him for 1 minute the video is here.

After the video I managed to get him into the car, so that took me 2 minutes. By the time I was phoning home and the vets, literally a minute after, he was having violent spasms in the crate in the back causing him to hit his head repeatedly as he fell off balance.

It took me 40 minutes to drive to our vets through rush hour traffic. By the time I arrived he was in a dreadful state with very rapid repeating spasms and unable to walk. Our vets met us and came out to carry him into the surgery. I assumed it was some kind of seizure, perhaps epilepsy like his brother Gunner has. Our vets tried to stabilise the spasms over the next few hours in the hope that we'd be able to take him home and we'd have to then figure out a plan of action moving forward.

But the spasms didn't stop. He was given diazepam and later phenobarbital. By the time our vets were going to close for the evening, he'd been there for 3 and a half hours and he was still having spasms. We took the decision to transfer him to the out of hours emergency vets in Canterbury where he'd been on New Year's Eve. I found it very hard to leave him. Grey also suffers from stress at vets and being confined, especially in a strange place. At this point they were treating him for a possible intoxication of some sort, but thinking that the cause would turn out to be neurological. It was in no way related to the New Year's Eve episode as too much time had elapsed between and Grey hadn't presented with any symptoms in between. The spasms also had been very rapid in their onset.

Grey continued to spasm until late in the evening when he was more deeply sedated. We visited him at midnight and he was very deeply under with his tongue out. But he was still having muscular spasms.  At 8am the next day we transferred him from the out of hours vets to our own and from there he was referred to the Royal Veterinary College to their Queen Mother Hospital intensive care unit.

The journey there was horrendous. Grey was very stressed in the crate, attempting to pace and circle. He was repeatedly falling onto his face onto the walls of the crate and dragging his muzzle and side of his head along the wire. There was no other safe way of transporting him on the motorway than the crate. He was crying, howling and whining the entire journey of an hour and 45 minutes. There was nothing we could do to consol him. We just had to get there. He was clearly also suffering because of the drugs he'd had and by then he'd been having muscle spasms for 18 hours. He was exhausted.

The RVC is amazing. Everything you would wish a hospital for humans would be. They took him into the ICU and took a detailed history from us. The RVC told us that managing prolonged seizures or spasms of this nature was quite tricky. The use of Diazepam to control the spasms could have the side effect of also causing more unrest in some cases, which in turn could raise the temperature. Prolonged temperature rise could lead to organ failure. If the spasms were not brought under control, they said they may have to put him under to a deeper level like a G.A. for up to 48 hours where he would then need assistance for breathing and management of fluids. This would bring the risk of pnumonia. The further complications are managing dogs like Grey who present in an already stressed state. Panting, pacing, agitated. Again it was being treated first and foremost as a possible toxin related incident and secondly as a neurological issue.

We left the RVC with heavy hearts. I started the fear the worst. It suddenly hit home that this could turn out to be really serious because of the length of time that it had gone on. And then thinking about all the possible outcomes. As we drove near home, past the fields where he'd been taken ill, it was exactly 24 hours since the whole episode started.

Later Friday evening we finally got a call that turned it all around. The RVC vet who was looking after Grey called to say how he was sat in with Grey and how the tremors had more or less stopped. That they had tried to sedate him when he was admitted and that hadn't really worked, so they had moved all of the cats to another department! I had to smile at this. I was already feeling better about his stay at RVC because a friend had told me how the ICU there is laid out: Central desk with the cages arranged all around, so all the animals can be viewed. Importantly for me, I knew that when Grey was starting to feel better he would love being able to see everyone and that would reduce his stress.

The RVC said that they suspected that Grey had had a tremogenic mycotoxicosis. Basically, a tremor/spasm causing mould or fungal intoxication that he could have picked up from the environment that we walk in. In urban dogs this might be a mouldy cheese sandwich under a park bench or dogs getting into and ingesting material from the compost bin. They said it could have been some mouldy apples or something in leaves on our walk. It's probably more common than is picked up because when it starts it could be a number of things.

The wet weather we had for the entire autumn is possibly the cause. Everything was rotten and stagnent. Who knows what it was that he ate.

Reading up on the condition it seems specialist care is paramount. There are dangers of over heating, dangers of pnumonia, you shouldn't really induce vomiting.

Here he was the day after he came home. Looking beaten up like Rocky. Sore nose and eyes. But home:

  I feel incredibly lucky to have him back. I had a glimpse of what it would be like to lose him. I don't want to go there.  It took him about 3 days to start walking normally again. He's really well. Apart from one little lump on his skin on his hip that seems to have grown over the last few weeks that we'll have to get checked out. But we really hope we've had all our bad news in one go for a while. 

Please, no more scares.

http://cp.vetlearn.com/Media/PublicationsArticle/Bough-ToxBrief-SeptVT06.pdf

Extract from the book, Small Animal Emergency and Critical Care Medicine, by Elizabeth Rozanski, John Rush