Myasthenia Gravis and Dogs

1)    Can you tell us a bit about Bailey?

Bailey is now 6 years old (born 7 March 2011). She is a Saint Bernard. She is very sweet-natured, very protective and a very sensitive soul. She is very intuitive of emotion and can feel when one of us needs comforting. But just as with humans, the cortisone can make her a bit irritated. She LOVES cheese and plain yoghurt to the point of addiction, and of course any attention.

2)    When did you first notice her symptoms? 

We noticed the first symptoms a few weeks after Bailey got spayed. She has Acquired MG that was triggered by the anesthetic used during the operation. She was 1 year old. Her hind legs just started to give way and she couldn't stand up anymore. This slowly escalated to her front legs also until she was paralysed in all four legs. By then we took her to the Vet a couple of times already to try and diagnose. They came up with anything from hip dysplasia to a broken pelvis. We then took her to Bryanston Vet Hospital, where they have a Veterinary Physician called Dr. Remo Lobetti. He recognised her symptoms from seeing it once before in a Great Dane in Cape Town. By the time she got to Dr. Remo, she could hardly breathe and couldn't hold any food or water down anymore.

3)    Who diagnoses MG in dogs and who should someone go to if they suspect it? 

Most vets will never see Myasthenia Gravis in their lifetime. The best option would be to go to a Specialist Vet Hospital such as Johannesburg Specialist Veterinary Centre or Bryanston Veterinary Hospital. These are just two options of many throughout South Africa. Dogs are diagnosed either via (anti-AChR antibody titre), a Tensilon test (search on YouTube, it's interesting to see), or by trial Mestinon. We went the Mestinon route as it's quicker and more easily available, and sure enough Bailey started to improve.

4)    What treatment/ medication is Bailey on? 

Bailey was started initially on 60 mg Mestinon twice daily, and immunosuppressive doses of prednisone. She is now stabilised on 60 mg Mestinon once daily and occasional prednisone. When we notice that she is going through a bad patch, we up her Mestinon for about a month to twice daily, and then bring it down again to once daily.

5)    How does Baily cope on a day to day level? 

She copes remarkably well, as long as she takes it easy, keeps her play times short with rest periods in between, and rests well throughout the day and night. We try to keep her calm, as excitement depletes her muscle strength quickly. She struggles with temperature fluctuations. Heat wears her out really bad, and cold makes her muscles very stiff.

6)    Does Bailey have a special diet? 

She eats high quality dry food (Royal Canin kibble), as dry food swallows easier during times where her esophagus acts up. She does get extra protein (through raw egg), vitamins, and flax seed oil to boost her as much a possible. 

7)    What advice do you have for other Dog mums in this situation?

MG takes time to stabilise. It's hard at first to know when the medication is exactly right, since your dog can't tell you how they feel. You have to be very finely tuned to their behaviour to be able to tweak their medication to the right dosage. Look at them when they walk, sit with them, listen to their breathing. And never underestimate the power of cortisone :).

8)    How can someone gain support/knowledge about this topic? 

There are support groups for MG and Megaoesophagus on Facebook (Canine Myasthenia Gravis, Canine Megaesophagus support group, Upright Canine Brigade, and of course Bailey's page, Bailey the MG Super Dog). There is not much difference between human MG and Canine MG, it's the same disease in a different body, so read up on human MG site online. 

9)    Does Bailey have any other Autoimmune issues?

Like many humans, Bailey's MG goes together with another autoimmune issue. She has Discoid lupus erythematosus (DLE) a.k.a Collie Nose (which causes a dog to lose the pigmentation around the nose). I've attached a photo of her from when her nose was more affected. She has since stabilised again and her nose is looking better. 

10)  Anything you would like to share?  

Bailey also had a Myasthenic Crisis a few times, where the only thing that pulled her through were very high doses of prednisone. Many MG moms and dads underestimate the effectiveness of immunosuppressive doses of prednisone during a Crisis.