Mouth spams -- seizures or dental pain?

[ChipstheGreyhou]

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.

[greysmom]

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.

[ChipstheGreyhou]

Just wanted to post an update in case anyone stumbles upon this in the future and finds it helpful. Our greyhound went on gabapentin and an antibiotic in advance of her appointment with a dental specialist. She had nine extractions and her little face swelled up like a balloon. After a day or two she recovered well. But the spasms have continued in the months since, albeit very mildly and infrequently. Our vet has kept her on gabapentin and thinks it could be something she started doing in response to the severe dental issues and now has stuck around as a little tic at this point. I'll update this thread if anything changes but just wanted to post for future reference.

[MP_the4pack]

I adopted a greyhound from the horrid Canidrome in China.  Her mouth was so bad she couldn't eat. I didn't have her but a week before I got her mouth done. She lost her 24 teeth. 

Now I don't know what she was like when her mouth wasn't painful so I don't know if this is related to mouth pain.  But she is a big chatterer. I always know where she is in the house because I can hear her teeth clicking.

Is it coincidence? Maybe.  Could it be related to her previously sore mouth?  Maybe. 

I don't know but wanted to toss this out.

[ChipstheGreyhou]

3 hours ago, MP_the4pack said:

I adopted a greyhound from the horrid Canidrome in China.  Her mouth was so bad she couldn't eat. I didn't have her but a week before I got her mouth done. She lost her 24 teeth. 

Now I don't know what she was like when her mouth wasn't painful so I don't know if this is related to mouth pain.  But she is a big chatterer. I always know where she is in the house because I can hear her teeth clicking.

Is it coincidence? Maybe.  Could it be related to her previously sore mouth?  Maybe. 

I don't know but wanted to toss this out.

Thank you! That is so interesting -- ours is definitely doing audible clicking moreso than ever before. Poor baby! 24 teeth! It's amazing how they recover though.