Masticatory Muscle Myositis...Oh My! Learn About this Scary Dog Disease!
July, 2013; Masticatory Muscle Myositis (MMM). We had never heard of this dog disease. But why should we? We have a healthy chocolate lab 10 years old, going strong or so we thought. It started innocently enough. Buddy carries around his soft, squeaky toys with joy. One evening about three weeks ago I tried to pull one of his favorites, Lamb Chop, from him and he cried out in pain. Of course, I was startled and alarmed. I took a look at his mouth and saw nothing. I thought maybe a bad tooth. The following morning Buddy was carrying around a REALLY SMALL CAT TOY clenched in his front teeth. I gently pulled on the toy and he again cried out in pain. I knew then that he was having a problem.
We had been looking for a new veterinarian and based on our friends' recommendation we made an appointment with Inglemoor Animal Hospital in Kenmore, WA. Our new vet hit the jackpot with us but we've had good care from them. After the initial exam and blood taken we received some pain medication and a promise for more follow-up. Within 24 hours Buddy's left eye swelled to unnatural proportions and we went back to the dog doc.
Dr. Kemper did a bit more exam and thought the dude was suffering from Masticatory Muscle Myositis (MMM) although a blood test or biopsy would confirm the diagnosis. This disease is an auto-immune disease where the body is attacking its own. Apparently, this is interesting, dog jaws have a particular type of cell that does not exist anywhere else in the dog. Something triggered Buddy's body to see these cells as foreign and to be destroyed. It causes a kind of of lock-jaw. Poor dude could only open his mouth about 2-2.5 inches (enough to eat...whew). It is fairly unusual and even more so for an older dog. It usually strikes big dogs, like Buddy, but young.
The doc did a blood test for MMM but warned that in about 20% of cases the blood test will show a false negative. And sure enough that is what the test showed. But all the symptoms, especially the eye problem pointed to MMM and we opted to skip the biopsy. The good news is this is a disease that can be cured with slow and careful administration of drugs over the course of 6-9 months. Doc intravenously administered Prednisone to get a good dose working on our sick boy. We had a twice a day regimen of the steroid. The good news is Buddy responded extremely fast to Prednisone. His eye looked better in 24 hours and in a couple of days Buddy seemed less uncomfortable. Within a week, he could open his mouth twice as far. Good News!!! This disease causes a loss of muscle mass around the head. Poor Buddy had a pointy head before and now it is really pointy.
The bad news is he was peeing like a race horse nearly every hour...all day and all night. So for the last few weeks, yours truly has been up getting up and letting out Buddy nearly every hour (We don't have a fenced yard). Then we discovered to our horror that Buddy was using the dining area carpet as his potty ground when he either couldn't wake us or just couldn't hold it. Ok...that was really disgusting. So now the house smelled like a rental (if you are a landlord you know what that means). Nature's Miracle has worked it's miracle.
We work during the day so we began to leave Buddy in the downstairs office (no carpet) and lay out pee pads and plastic to try and save the laminate flooring. Our neighbors, Char and Mike, have been coming over three times a day to let Buddy out. I know Char retired just to do this for us! Bless them!!
The Vets knew we were desperate to find another way to treat Buddy. He obviously couldn't tolerate the Prednisone. Dr. Kemper conferred with a specialist in this disease and a new drug Mycophenolate was highly recommended. It is used to help transplant patients from rejecting the transplant part. The downside was the side effects could be nausea and diarrhea for about a week until the patient is used to it. The cost could be substantial as well. Costco to the rescue. Costco sells this drug for about $55.00 per month. Other pharmacies were quoted at $250.00 per month. Buddy has his own patient profile at Costco.
We have started the Mycophenolate earlier this week and Buddy had NO ADVERSE REACTION! We have to gradually reduce the pee inducing drug very slowly or it could have a major impact on Buddy. As of this writing we give him a dose once a day. For those 12 hours he is "under the influence" he is peeing every hour and clearly uncomfortable. We decided to administer the bad drug at night (no sleep for a while) so he could be left safely in the house during the day and we could stop imposing on the neighbors. Every five days we reduce the dose by about 50%. We should be down to no Prednisone in about 15 days (hooray).
The best news happened just today. Buddy picked up his favorite big toy today. He carried it around and then was able to release it with no problems. We are on the mend.
For information on Masticatory Muscle Myositis (MMM) http://vetneuromuscular.ucsd.edu/cases/1999/may99.html
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