# Masticatory muscle myositis



## Florabora22 (Nov 30, 2008)

So this weekend was a bust! Flora started showing signs of a bladder infection late Friday night, puked ALL OVER our creme colored carpet at around midnight, and ended up costing me about $300 in medications/tests/exams on Saturday. I love my girl, but her medical bills are killing me.

Anyhow, the vet we saw instantly asked me if Flora's forehead was always this "sunken." I was like, "Um... yes?" I guess I never really paid much attention to it. She fiddled around with Flora's mouth and said that she thought that Flora had a bit of trouble opening her mouth fully (I've always thought this was just b/c Flora was being a brat) and told me Flora _might _have a mild case of masticatory muscle myositis. She said it wasn't anything I should worry about, but to look it up and read on it. She also said it's a congenital disorder, and is somewhat common in Golden Retrievers.

Anyone know much about this and its prevalence in goldens? It's the first time I've ever heard of it!


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## BeauShel (May 20, 2007)

Here are some articles that I found on it
Masticatory Muscle Myositis
Masticatory Muscle Myositis
Masticatory Myositis

The third article does name golden retrievers in the article as being one of the dogs that can get it. It is an interesting article as they say a simple test can determine if she has it. And from what I have read it does sound like it has been caught early if that is what she has.


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## Megora (Jun 7, 2010)

So... am I getting this right from those articles, or is this essentially "lock jaw" ?


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## Florabora22 (Nov 30, 2008)

Well... the vet said to me that it is a muscular disorder where the muscles in her jaw may be permanently weakened or something. She did say that some dogs with acute MMM have lockjaw and have to be fed liquid diets, but that Flora is in no way that severe, and she never will be because once the disease presents itself, it doesn't really get any worse.

I will read those articles, Carol, thanks!


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## ladyhawk (Mar 9, 2010)

Hi Kim

My Shiloh presented with the loss of masticatory muscles Jan.17,2010. His symptoms started with refusal to eat and *excessive thick *drooling for a few days. Then the right side of his face drooped along with a very slack jaw.(total opposite of locking jaw w/ MMM) The vet ran a CBC that came back normal. He was started on prednisone and antibiotics. For nine days I had to hand feed him by putting food in his mouth at his molars. Day 10 of our ordeal the point of his head was thinning. I could literally watch his head deflate as each day passed. We ran the 2M for MMM which came back negative, did a thyroid panel which was low to low normal which he takes .8 of Thyro twice daily. We also put him on Doxycycline if there was a parasite causing problems. By Feb. 6th the poor guy looked like a cone head and his eyes were so sunken they would not close. He was still on the prednisone and the drug was sucking the life out of him. The 15th of Feb. my vet said we could take him to Ohio State U. for an EMG and muscle biopsy. Or we could take him to an alternative holistic vet that she works close with. At this point my husband and were done with conventional medicine and the prednisone. We did not want to put him through any procedures that would not give us the answers to what he had or how to heal him. We decided to wean him off the predisone and get him in to see the alternative vet. As soon as we lowered the prednisone you could see the life start to return to him. He had been on the prednisone 36 days. 

In March we started with Dr. Rogers who is my alternative holistic vet. She is doing acupuncture, herbs and Orijens dog food. We saw immediate improvement. He quickly regained his energy and the muscles in his head came back to almost normal in a matter of months. Fast forward to today, looking at him you would never know he had been a very sick boy 9 months ago. I still take him to Dr. Rogers for acupuncture and herbs which she switches up as we progress. It is costly but he is my heart and soul companion that I will go to the poor house for.

I hope all goes well with for you. 

Robin & Shiloh

Shiloh a few days before he got sick









Shiloh with slack jaw









Loss of muscles 1 month later









even more muscle loss 9 days later









Muscle recovery two months later (picture date incorrect- actual April 2010)









Shiloh in June (notice how much darker his nose is)


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## BeauShel (May 20, 2007)

That story with Shiloh is just amazing. And the pictures just break my heart especially at the worst time with his head sunken so badly. I am so happy that he has returned to his happy healthy self.


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## Florabora22 (Nov 30, 2008)

BeauShel said:


> That story with Shiloh is just amazing. And the pictures just break my heart especially at the worst time with his head sunken so badly. I am so happy that he has returned to his happy healthy self.


I know, I didn't expect to see such a dramatic loss of muscle in his head, but it's really there. He looks so great in his recent photos, and I'm so happy to hear you guys have found a solution to this problem.

As I said in my initial post I'm not really sure if Flora has it or if the vet was mistaken. If I had the money I'd get her tested for it, but since Flora doesn't seem to have any problems eating or anything like that, I'm not overly concerned. I'm going to keep any eye on her though, and really watch the muscles in her head to make sure there aren't any changes. 

Btw, I love Shiloh's color. He's got such a glossy coat!


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## Karen519 (Aug 21, 2006)

*Flora and Shiloh*

Kdmarsh: I hope that Flora is doing better.

Ladyhawk: What an inspiring story Shiloh has-what a beautiful boy!


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## amy22 (May 11, 2008)

Oh Kim..Im so sorry that the vet told you that. I hope that she was wrong. Please keep us updated about Flora.


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## Bella's Dad (Dec 26, 2011)

I have been meaning to write this for a while now. I guess it's a cautionary tale.

We live in England and have had Bella, our 8-and-a-half year old female golden, since she was 4 months old. In that time generally her health has been good - a few benign lumps removed, an underactive thyroid which she has ongoing meds for - but no other major issues. In mid-2009, a houseguest gave Bella a whole apple to eat. Not surprisingly, Bella got sick, with acute diarrhoea, which was clearly dehydrating her. We got her treated by the vet straight away, and she seemed to recover. We did notice after this food poisoning episode that her head appeared shrunken. I can't say for sure that the dehydration caused it - perhaps it just made us notice it.

Two years later (mid 2011), we had to face the fact that our golden had a very bony head! She didn't exhibit other severe symptoms of MMM - her appetite was good, she would happily chew toys or treats, she played catch etc - but she didn't seem to yawn _quite_ as wide as once before, and her head was definitely bonier than in previous years. We thought it best to consult our vet. If Bella had MMM, perhaps it was a slow form, and could be halted or slowed further.

Out vet seemed quite sure Bella was dealing with MMM. The vet said she could send off a sample to the USA to test, but it would be 1) expensive 2) unpleasant for Bella. The vet didn't think it was necessary to test, and saw no other explanation but MMM. She recommended we put Bella on Prednisone. 

We were warned that she would need weaning onto the drug, and weaning off it. We were told Bella's thirst would increase, as would her need to urinate. The vet requested to see Bella after she had been on the drug for two weeks to assess her progress. The vet made it explicit that she expected to see a visible improvement. 

I decided to photograph Bella regularly to monitor her appearance on MMM. Very quickly we saw the drug was giving her a hard time. She clearly did drink more, and needed to urinate very often. The drugs made her hot and weak. She would pant heavily through the night at the foot of our bed. Alarming also, her muscles appeared to be weakening. At first her front (chest) area, and then her hind quarters and back became bonier. Bella could no longer jump onto our bed for a cuddle - something she'd never had a problem with before.

We took Bella back to the vet who agreed that muscle wastage was clearly worse, not better, and that Bella needed to be taken off the pred. She had lost 3KG. We knew suddenly stopping was not wise, so the aim was to wean her off as quickly as was safe. That weaning period was heartbreaking. We felt so horrible giving pills to our dog which we could see were causing her to suffer. Some nights her breathing was so laboured, heavy and erratic, we feared she wouldn't make it through til morning. 

Then one day during the weaning-off period, Bella's nose started to bleed. It did stop, but of course we rushed her to the vet. They couldn't see a cause, but they took blood and sent it off for analysis. While we waited the day or two for results, Bella's nose would bleed several times a day. If she got slightly excited (by a knock at the front door for instance) she would bleed. 

The test results were inconclusive. Bella's blood cell counts were normal, there were no signs of cancer. There was however evidence of liver damage. The vet's advice was for us to refer Bella to a facility for further tests - head scans etc. These would cost thousands of pounds. Having spent £600+ in a month or so on vet bills we couldn't afford this. A scan might find a tumour. I asked the vet _if_ a tumour was found would we be able to realistically save Bella. The answer was no. Again, we thought our darling dog's days were numbered.

After realising I couldn't spend anymore money, the vet suggested putting Bella on antibiotics. They were inexpensive and (in their words) "couldn't hurt". Mercifully before she had completed her course of antibiotics, Bella's nosebleeds stopped. 

We don't know what caused the nosebleeds. From searching the www (and finding this excellent site and others) we have learned that prednisone can cause liver damage. In the USA vets commonly advise owners giving their dogs pred also give them milk thistle to protect the liver. We started to give Bella milk thistle with her food, as supposedly it can heal livers.

Fast forward half a year or so, we had Bella's blood tested at our new vet (we moved home). Bella's liver appears healthy. Her muscles and weight returned - she can jump on the bed for cuddles again! She still has a bony head, but she is happy and healthy (and we think beautiful).

So why am I sharing? Well maybe there's a few lessons that can be learned, and if one dog is helped it's worth it.

I guess my conclusions are:
1) Shrunken head may look like MMM, but that doesn't mean it is.
2) If you are going to give your dog prednisone, it might be wise to give milk thistle as well.

Lessons I've learned:
If you can buy insurance for your dog, buy it from birth. I did buy it a few years ago, but as there were so many exclusions, I discontinued. In the future, any dog we have will be insured from birth

Things I wonder about:
1) Although pred is a commonly prescribed steroid for animals and humans to halt muscle wastage, it appears to have caused muscle wastage in my dog.
2) Perhaps my original vet was too keen to administer expensive tests and recommend expensive procedures which couldn't help my dog. I don't want to think this is true.


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