Dysautonomia in Dogs

Canine dysautonomia causes the degeneration of the enteric, peripheral, central, somatic, and autonomic nervous system. Dysautonomia affects humans as well; it is called Key-Gaskell syndrome and it is usually fatal just as with dogs. Since dysautonomia affects the autonomic nervous system, the heart rate and breathing are uncontrolled and this is ultimately the cause of death. The worst part about dysautonomia is that the cause is not known, although it is seen mostly in the rural midwest states in North America, namely Kansas and Missouri. Also, it is more prevalent in dogs that spend more than half their time outside and seems to prefer younger dogs, with the average age of only three years old.

Dogs with canine dysautonomia disorder suffer from a dysfunctional autonomic nervous system. Symptoms range from digestive to motor function and the first signs of trouble may be that your dog is having trouble urinating and loss of bladder and bowel control, or you may notice the lack of appetite and extreme weight loss. This fatal disorder also makes it impossible for the body to regulate the heartbeat, temperature, blood pressure, and breathing. Unfortunately, there is no successful treatment for dysautonomia, but some dogs recover after a few months of aggressive treatment, although it is rare.

The disruption of your dog’s digestion is the most commonly reported symptom, but this can vary from case to case. The nervous system controls the most important vital functions and you may notice that your pet is acting clumsy, confused, sleepy, or cannot stand. Other likely clues that your dog has dysautonomia are:

• Painful urination
• Dilation of the eyes
• Lack of pupil reaction to light
• Inflammation of the bladder
• Dry mouth, nose, and eyes
• Loss of appetite
• Obvious loss of weight (extreme)
• Vomiting
• Diarrhea
• Losing control of bowels and urination
• Sleepiness
• Weakness
• Lack of tear production
• Photophobia (fear of light)
• Swollen third-eye
• Abdominal tenderness
• Coughing
• Depression
• Loss of motor reflexes
• Muscle degeneration
• Slow, weak heart rate
• Breathing difficulty
• Death from loss of autonomic nerve control

The cause of dysautonomia is unknown, but there are some animals that are more susceptible than others:

• Living in the Midwest (Missouri and Kansas mostly)
• Being outside most of the time
• Access to rural areas and wildlife
• Dogs younger than five years old

If you cannot get an appointment to see your regular veterinarian, take your dog to the closest animal hospital or clinic. Dysautonomia is a life-threatening emergency and you cannot afford to wait for an appointment if you believe your pet has this dangerous disease. The veterinarian will need to give your dog a thorough examination to begin with, including pupil reaction time, reflexes, blood pressure, body temperature, oxygen level, breath sounds, pulse, and respiratory rate. The lack of pupil contraction and absent reflexes are usually indicative of dysautonomia and your dog’s blood pressure, temperature, and heart rate will usually be abnormal. An echocardiograph (ECHO) is an important tool in diagnosis and will likely show systolic dysfunction and enlargement of the atrium or aorta. An electrocardiograph (EKG) will also be performed to check the electrical and muscular functions of your pet’s heart.

Although most blood work will be unremarkable, the veterinarian will still need to perform certain tests to rule out other illnesses and injury. Some of the tests performed may be a serum biochemical analysis, complete blood count (CBC), liver enzyme panel, urinalysis, and fecal examination. Another important step in diagnosing dysautonomia is radiography. Abdominal and thoracic x-rays and ultrasound will usually show bladder distention, enlarged esophagus, and aspiration pneumonia. If the veterinarian needs a more detailed view, an MRI or CT scan may be needed.

Treatment for dysautonomia is not usually successful no matter how early it is found because there is no known cure at the moment. There are certain medications that can help in some cases, although it is uncommon. Special foods and fluids are also helpful in making your dog more comfortable.

Fluid Therapy

It is important that your dog is well hydrated, so the veterinarian will administer intravenous (IV) fluids, artificial tears, and humidified air for dry mucous membranes.

Medications

Some of the medications that have been successful for at least a short time are pilocarpine and bethanechol for stimulating muscles and boosting nervous system activity, domperidone or other prokinetic drugs for the gastrointestinal system, corticosteroids, and antibiotics for infections. 

Special Diet

The veterinarian may prescribe a special diet high in protein, carbohydrates, vitamins, and fat to prevent wasting disease, which is a loss of muscle mass. If the diet is unsuccessful, intravenous (IV) feeding may be necessary for a certain amount of time.

Hospitalization

The veterinarian will admit your dog to the hospital for at least 24 hours for treatment and observation. Your dog may be well enough to go home after that, but usually does not last since there is no cure.

Prognosis for dysautonomia is grave and if your dog is able to survive, the quality of life may be poor. This is why most pets that are diagnosed with the disease are usually euthanized within a few weeks or months, depending on the severity. There are rare cases of survival, but the disease is fatal in most dogs.