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Mouth spams -- seizures or dental pain?

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Hi everyone! My 8-year-old greyhound Chips was diagnosed with epilepsy about 3.5 years ago after three seizure episodes. Her seizures happened at night or in the early morning; she would stand up from sleeping and be completely unresponsive to us, panting and drooling heavily, one time she peed herself, and it would take a few minutes for her to reemerge after which she'd be disoriented and thirsty. Textbook! She has been on a consistent dose of phenobarbital and has not had any seizures since beginning that medication.

Over the last three days, we have noticed an onset of extreme chattering that looks almost like a jaw spasm or tremor. It happens as she is licking her lips or swallowing, usually when lying down, happening throughout the day and night but not constantly, and she is responsive when it happens. We tried to brush her teeth and she ran away which is unusual since she loves the toothpaste flavor. So after about 36 hours we brought her to the ER vet last night (because of COVID, we couldn't get an appointment with her regular vet until next week or her neurologist until the end of the month). The ER vet suggested two possibilities: focal seizures or a response to dental pain. Chips's teeth are in bad shape and we have not gotten her a dental cleaning yet that we know she needs. You'll know from my description of her previous seizures that this would be a completely different type of seizure. 

Right now she is on a painkiller and an antibiotic with the hope of treating any dental pain to see if the spasms continue. So far, she has been drinking/peeing/pooping normally and eating much better (we are soaking her dry food in water and she scarfs it down; usually she's a slow and picky eater). Provided nothing changes, we hope to get a blood workup done next week at her regular vet to check the pheno levels.

But I am curious if anyone else has seen this symptom? It's not regular greyhound chattering, which she also does -- this is something else.

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I would agree that it's probably a focal seizure of some kind, but that doesn't mean the outward expression of it - the teeth chattering and jaw movement - aren't being caused by something dental.  If her seizures are being well-controlled with her usual routine, and she's had this level of meds for a while, she may need to have them bumped up.  Dogs can develop a tolerance to seizure meds that necessitates ocassional increases.

It's always scary to contemplate sedation with a seizure dog, but dental health is extremely important as it can really cause systemic physical  issues down the road if not dealt with promptly.  If you have the means and an area specialty hospital in your area you might consider using a canine dental specialist.  It's more expensive, but they have complete surgical and emergency equipment and special training in canine dentistry beyond what a regular vet has available. 

Regardless, really discuss the sedation protocol with whatever vet is going to do the dentistry beforehand and agree on  what's going to be used and for how long.  

Good luck.

Chris - Mom to: Lilly, Felicity (DeLand), and Andi (Braska Pandora)


Angels: Libby (Everlast), Dorie (Dog Gone Holly), Dude (TNJ VooDoo), Copper (Kid's Copper), Cash (GSI Payncash), Toni (LPH Cry Baby), Whiskey (KT's Phys Ed), Atom

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