8 Week old Puppy with Jaw Issues

[JPF0730]

I have an 8-9 week old puppy (born 10/2/13) that is having difficulty opening her jaw. We noticed it on Thanksgiving. She was painful when I rubbed her ears, by her TMJ.  Upon further inspection I found that she can only open her mouth about 1/2".  She is a "feist" (a certified terrier mix really). She is currently 4.5 lbs. I took her to the vet Friday. He palpitated her jaw area and found that her lymph nodes were swollen.  He is quite perplexed by the situation.  He prescribed Metacam (for inflammation & pain) and Clavamox drops due to the swollen lymph nodes.  The nodes were bilaterally and symmetrically swollen.
She continued to eat over the weekend, but seemed to have a hard time manipulating food.  She tries to yawn and it seems to get stuck.  I ground the kibble in a food processor and she can handle those pieced better.
Her nodes became slightly  more swollen over the weekend and she was scheduled to go back in for sedation x-rays today anyway.  I took her in and they sedated her and took two x-rays of her head.  They tried to manipulate her jaw while she was relaxed and they were unable to.  They sent the films to a radiologist and she did not find any abnormalities.  The blood we had drawn on Friday should be back in the morning, but the Dr. is afraid that it is going to come back perfectly normal. Dependent on blood work - a fine needle aspirate is the next step and then a CT scan. I really can't afford a CT scan right now.  Anyone have ANY idea of what might be going on?  

Other than this issue she seems fine.  She plays, eats, drinks, sleeps and even chews on toys she can get her mouth around.  She plays with my other dog. She barks and growls. No vomiting. No diarrhea. She gained weight between her Friday and Monday appointments (0.3 lb) so she is thriving in every other way.  We have had her just over 2 weeks so it is hard to determine if this is something she was born with or something that she contracted. Either way it seems to be progressing.

[Margot49]

Thank you so much for the update!!  Many that post don't do that and it dies help the rest of us.

Glad your Vet is addressing those issues and pray things get resolved.

Just a note, and this may mean absolutely nothing in regards to the dog, but I had major problems on that antibiotic and am still having GI problems months later.  Ask the Vet if you can or should be giving a probiotic with that or when it is finished.  Good luck and do keep us updated.

[JPF0730]

I tried to post earlier, but something happened to it. So, I'll try again.  The blood work came back fairly normal.  The CK levels were slightly high, but not high enough to indicate myositis. They had thought about doing a fine needle aspirate, but the two main diagnosis (strangles and myositis) were treated pretty much the same way, but the myositis was treated more aggressively.  So, he upped her antibiotic to clindamycin. We had to stop the Metacam (NSAID) and wait a week to start the immunosuppressive doses of steroids.  During this time the swelling has almost completely disappeared and the lymph nodes are back to normal.  The jaw mobility is still not normal, but it is a little better than what it was. We are going to wait to start the steroids to see if the antibiotics alone will clear it up. No true diagnosis. But she seems to still be thriving regardless.  Thank you for all your comments and concerns.  It seems you were all on the same page as the vet.

[Margot49]

Well, no updates from the owner.

I am not that familiar with strangles but any ideas help.  I will have to look that up.  Perhaps I am and just not familiar with the term.

Yes, those are all possibilities.  It was the additional swollen nodes that made me look that up.

Owner said they were going to do xRays so hope we get an update.

[Ghilly]

Margot and Shannon, masticatory myositis ran through my mind as well, and then I also thought that it could be the early signs of puppy strangles.  Normally, with puppy strangles, there are other outward signs, such as pustular lesions around the muzzle and ear pinnae, but it could just be that the lesions have not yet appeared.  Puppy strangles usually appears between the ages of 3 weeks and 4 months, so the puppy is definitely at the prime age for it to occur.  

There is also the chance that the puppy could have injured itself, unbeknownst to the owner.  I had a puppy dislocate his jaw when he was running, tongue lolling out, happy as a clam, when he tripped and fell on his little puppy face.  When he fell, instead of clamping his mouth shut, he fell so that it forced his mouth OPEN, and it forced it so FAR open that the jaw just popped out of its hinge.  It swelled immediately and he wasn't able to open his mouth about as wide as the OP says her puppy can open his.  Now while the puppy in question might not have a dislocation, there could have been a severe enough injury to cause the swelling and immobility.  Puppies are always busy, so there's always the chance that it could also be an injury that nobody was aware had occurred.

Ghilly

[Margot49]

Sounds like that to me too,Shannon.  That is why I sent the link.  Not sure how many Vets might think of that, especially if they haven't seen it, although can't say I have ever heard of this in a puppy,but again, could have gone undiagnosed.

[shannon781]

It sounds like masticatory myositis. Has your vet mentioned that? It can be tested for on blood work. Is your dog showing any other signs of pain anywhere else? Dogs can also get craniomandibular osteopathy, but the xray of the jaw should have revealed a sclerotic (bright/dense bone) mandible. This should also be on the list.

[Margot49]

http://www.marvistavet.com/html/body_masticatory_myositis.html

Sorry, on the iPad.  Hope that works. Try that link

[Margot49]

This may be a shot in the dark but look up Masticatory Myositis.