What is Causing this Dog's Seizures?

Case Study 3

What is Causing this Dog's Seizures?

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Signalment/History: 13 year old, f/s, Shih-Tzu with a 3-4 week history of anxious behavior and grand mal seizures; peracute onset of dysequilibrium 3 days prior to presentation. Normal TPR systolic bp 135-155. Note: on exam, even when stressed, heart rate did not exceed 80 bpm.

Question: In the accompanying video, which of the following group(s) of signs is the dog exhibiting?

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Question: A brain MRI was done. The five axial images shown are axial images at the level of the interthalamic adhesion. Can you identify the abnormal finding?

Click on the images to enlarge

SagLarge
AXT2LargeAXT1ContrastLargeAXT2StarLarge

T2 (no contrast)

T1 (no contrast)

T2 star (no contrast)

AXT1ContrastLargeAXFLAIRLarge

T1 (contrast)

FLAIR (contrast)

AXT1ContrastLargeLines

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Follow up: Several days after discharge vestibular signs were decreased but the seizure episodes increased in frequency. Some of the episodes were very mild and consisted of brief collapse, but during others, the dog would cry out and have a gran mal seizure. Seizure often occurred immediately after struggling while receiving anticonvulsant medication. The patient was re-evaluated and a cardiac arrhythmia identified. See ECG tracing, below.

Question: What abnormality is indicated from this ECG tracing?

ecg strip

 

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