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Masticatory Myositis - URGENT!
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Masticatory Myositis - URGENT!

My dog has masticatory myositis...long story short, his blood test was negative for 2m antibodies and I refuse to have him sedated for a muscle biopsy.  The neurologist won't treat him without the biopsy.  My regular vet will, but is not sure how to treat him - because he's diabetic, he should not take steroids.  He's posted in the vet forums and gotten no response yet.  

The first time this disease showed itself was late in 2006.  His muscles atrophied in his head and jaw, eyes were sunken, jaw locked shut, dropped from 120 lbs to 85lbs, though he was eating, and couldn't stand up on his own.  3 different vets and a canine oral surgeon were unable to diagnose him.  I've been searching for an anwer ever since.  After 2 months of this, his jaw suddenly unlocked one sunday morning.  he was standing up by himself again, and had started to regain muscle tone.  Shortly after he was diagnosed with bronchitis.  He's been fine ever since, weighing about 100 lbs, until recently.

About a month ago, I noticed his ears were hanging far back again and his eyes were sunken.  He has now lost all muscle in his head and jaw, and again looks like a skull with fur.  We saw the neurologist on Nov 4, then waited 2 weeks for blood test results to be negative.  meanwhile, he was weighed at about 92 lbs a week ago, and as of 2 days ago his rib cage is now showing.  He is eating normally.  He swims once a week at the dog hydrotherapy pool, which i'm convinced is why his back legs have not yet been affected.  His jaw is popping constantly, but has not locked shut yet.  

My vet doesn't know how to treat masticatory myositis in a diabetic dog without damaging his liver.  He and I agreed I should consult a hollistic vet.  Unfortunately, she can't see us until Nov 23.  I am desperate!  What can I give him to help fix his achy lack of muscles?  I know he sounds like a decrepit old thing, the way I describe him, but I promise you, he's not!  Any herbal supplements I can give him to help him?  
Type of Animal
:  
Dog
Age of Animal
:  
12 years 8 months
Sex of Animal
:  
Male
Breed of Animal
:  
Rottweiler
Last date your pet was examined by a vet?
:  
November 04, 2009
City
:  
Skokie
State/Province
:  
Illinois
Blood Test Results
:  
2M Antibody Report <1:100  negative
ALK PHOSPHATASE  326   HIGH
ALT (SGPT)   64
AST (SGOT)    26
CK                 37
GGT               4
AMYLASE       706
LIPASE           170
ALBUMIN          2.6
TOTAL PROTEIN        6.0
GLOBULIN                  3.4
TOTAL BILIRUBIN        0.2
BUN                             25
CREATININE                 0.9
CHOLESTEROL           333       HIGH
GLUCOSE                  239       HIGH  **DIABETIC, FASTED FOR BLOOD TEST, NO INSULIN**
CALCIUM                     9.9
PHOSPHORUS             5.3
TCO2 (BICARBONATE)            17
CHLORIDE                              112
            continued
X-Ray Results
:  

POTASSIUM                            5.0
SODIUM                                  144
A/G RATIO                               0.8
B/C RATIO                              27.8
TRIGLYCERIDE                        63
NA/K RATIO                            29
HEMOLYSIS INDEX                N
LIPEMIA INDEX                      N
ANION GAP                           20
BASOPHIL                            0
AUTO PLATELET                   468
REMARKS: WBC AND RBC NORMAL, NO PARASITES SEEN
ABSOLUTE NEUTROPHIL SFG        4864
ABSOLUTE LYMPHOCYTE              1520
ABSOLUTE MONOCYTE                     75   LOW
ABSOLUTE EOSINOPHIL                  1064  ***WAS 2921 IN 02/09, 462 IN 04/06***
ABSOLUTE BASOPHIL                        0
               continued
Other pertinent test results
:  

T4                                           1.8
WBC                                       7.6
RBC                                        6.29
HGB                                       15.1
HCT                                        44.5
MCV                                       71
MCH                                       24
MCHC                                     33.9
NEUTROPHIL SEG                  64
LYMPHOCYTES                      20
MONOCYTES                           1          LOW
EOSINOPHIL                           14          HIGH

Diabetic on vetsulin, 25 units, 2x daily
Hypothyroid on Soloxine, 0.8mg 2x daily

Dog shows every physical sign of masticatory myositis
Related Discussions
Avatar_dr_f_tn
Hello
I am very sorry to hear about your dog.
First of all, I want to be sure you are aware that Vetsulin has been recalled and the current recommendation is to stop using this immediately and have your vet give you a prescription for insulin, which is available at just about any pharmacy.

Therapeutic rationale for treatment of this is geared to reduce inflammation without using prednisone or other steroids.

Traditional Chinese Medicine dictates that Masticatory myositis often appears to be caused by Blood deficiency. An herbal formula that may be used for this is Bu Gan Tang (Nourish the Liver Decoction). Patients that benefit from this usually have no or minimal evidence of spleen compromise or dampness changes (mucoid stools, very gassy).
Jia Wei Si Wu Tang (Augmented Four Materials Decoction) may also be beneficial for this condition on older dogs like yours. The starting dose of granular concentrate is 60mg per pound of body weight or approximately 1/4 teaspoon per 15 pounds of body weight divided into 2 daily doses.

Acupuncture is a very important part of the treatment of masticatory myositis!
Points to consider include LIV 3 and SP 6 to nourish Blood and Yin, LI 4 to regulate the face, and St 6 and BL 7. The practitioner should also consider BL 17, BL 18, ST 36 and CV 12 to help engender Liver Blood. Other useful points are ST 7 and ST 10.

Antioxidants naturally help to reduce inflammation. They are both beneficial and safe for this condition and are recommended to be used along with Acupuncture and Chinese herbs.

Carnitine, Vitamin E and Selenium are the three anti-oxidanmts that have proven to be helpful for many cases of masticatory myositis in dogs. A therapeutic trial of an antioxidant combination is safe and warranted. A product currently available, that is a natural, safe, patented antioxidant combination called VitaLife may be a valid consideration for  your dog.

I hope this information is helpful to you and if I can offer any other suggestions, it would be my pleasure.

Thank you,
Dr. Carol Osborne, DVM  



4 Comments
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1108024_tn?1258255685
Thank you so much!!!  I do plan on getting him acupuncture at our appointment next week.  Also, I am aware of the vetsulin recall, but my vet told me it was just a certain batch that was affected, not all vetsulin product.  Is that incorrect?  I order 6 vials at a time, so I got this batch prior to the FDA warning.

He's doing a little better today, day to day he gets better and worse.  I will absolutely try to find the herbal formulas you suggested, and will bring a copy of this to the Holistic Vet on the 23rd!  Thanks again for your time!!!

Jamie & "Satan" (satan's little helper III)
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685623_tn?1283485207
Just a point of clarification:  Intervet, the company that makes the Vetsulin product, is unable to assure the FDA that each batch of their product is stable.  If you purchased the product prior to the warning, you should watch for any signs of hypo or hyperglycemia.  And, as Dr. Carol said, you may want to ask your veterinarian about substitute products if you can't use the Vetsulin.

Although the product was not recalled per se, veterinarians are urged to watch for complications with their diabetic patients.
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Avatar_dr_f_tn
Hello,

My personal recommendation after talking to over a dozen people this morning in the same situation with respect to Vetsulin is instead of monitoring and waiting for a blood sugar problem to occur, which can be life threatening, is to stop using it and return it to your vet for a full refund. Then ask your vet to call you in a prescription at any pharmacy.

You will save quite a bit of money, the insulin at the pharmacy is also available as porcine zinc insulin (PZI) and it is both stable and safe. Vetsulin is PZI but costs much more because of the dog label.

Thank you,
Dr. Carol Osborne, DVM
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