Wednesday, 22 June 2011

Masticatory Muscle Myositis

Kiri during the first episode!
In 2003 Kiri was diagnosed with Masticatory Muscle Myositis (MMM) .. and No, I’d never heard of it either! To be honest, not many people had and it was down to our Vets experience and quick diagnosis that Kiri is still here in 2011 to tell the tale.
Within a couple of days her face became so badly swollen that she had no stop and indeed from a side profile she looked more like a Borzoi than a GSD. Though she managed every last crumb of her meal she seemed to be having difficulty opening her jaw and she was coughing whilst eating.(Let me point out at this stage that the meaning of life for Kiri is food; she would have sucked it up through a straw if necessary – a factor that would later contribute to saving her life)
The vet reckoned that there was a possibility of a foreign body in her mouth or throat, or she had had a severe allergic reaction to something. But she was in so much pain that they really couldn’t examine her. She suggested a course of steroids over the Week-end and if she hadn’t improved an X-ray on Monday.
Within 24 hrs the swelling on Kiri’s face had reduced dramatically and she looked almost her usual self; there was just a slight dip on her temple that bothered me somewhat, I rang the vet and she suggested this could be a reaction to the high dose of steroids, but felt it necessary to continue the treatment. (Thank God she did!)
By Sunday night there was a drastic change to Kiri’s face. At the time it appeared as if the swelling had gone down but hadn’t known when to stop, giving her head a skull-like appearance, and by now the front of her mouth would not open more than an inch or so. (But yes she could still eat).
The diagnosis following this visit to the vets on the Monday was MMM. They hadn’t even been able to open Kiri’s mouth under anaesthetic, a classic symptom of the condition. They informed me that it is an immune mediated disease found in many large breeds of dogs. Kiri was prescribed a course of steroids, starting with 60mg daily to be reduced over the next 6mths. I was also told to provide her with bones and chew sticks as physiotherapy for her jaw. As MMM is a disease that only goes into remission and never really goes away long term use of steroids was necessary.
Over the next week Kiri’s face deteriorated, the condition affected the muscle behind her eyes giving them a sunken look and I suppose due to the pressure on the tear ducts, her eyes where also weeping. On a good note after spending a day on a chew stick about the size of a stick of rock (normally would have been demolished within an hour), there was a drastic improvement in the mobility of her jaw proving that the physio was almost as important as the steroids.
Looking Good-A recent photo, Kiri with Oliver Blue
Kiri responded well to treatment, and though on the advice of a specialist 10 days after starting her steroids the dose was cut in half. This was because she was losing muscle tone on her limbs and it was felt that the steroids themselves were causing this problem. We always had a bit of trouble with Kiri’s weight; much to my husband’s disapproval I affectionately called her “fatty.” During this time her greedy nature surely saved her life, somehow she ate every meal, but still managed to loose 6kg.
Kiri was 12 in February and is in very good health for a German Shepherd of her age. She was lucky to only have over the years 2 further “episodes” but none as serious as the first. Her very low dose of steroids (15mg a week) has kept her on an even keel, and though to others she may still look slightly strange to us she is still beautiful as ever!


kim said...

Well i have never heard of this condition either! I was near to tears reading her story,but looking at her now she is so beautiful and so very lucky to be as LOVED as she is xxxx Well done xxxx

Tali said...

Thanks Kim