Abstract
Neuromuscular diseases are uncommon in the clinical routine of dogs and cats and their diagnosis is a challenge for the veterinarian. Thus, this paper reports the clinical diagnosis and established therapy in a four-year-old female without a defined breed with a history of ataxia and tetraparesis, especially after exercise. Due to the history and clinical signs presented, acquired myasthenia gravis was suspected and the therapeutic diagnosis was chosen using anticholinesterase neostigmine, for being simpler, faster and more accessible. The patient presented a significant improvement in clinical status after administration of neostigmine intramuscularly, returning to normal ambulatory activity after administration of the drug intravenously, thus making possible the diagnosis of the disease. Treatment was instituted using pyridostigmine bromide associated with corticosteroid in a immunosuppressive dose for a period of six months, observing complete remission of the clinical signs without recurrences until the present moment.
Highlights
Myasthenia gravis (MG) is a disorder caused by a reduced number of functional acetylcholine receptors (AChR) in the post-synaptic membrane of neuromuscular junctions (Batmaz et al, 1998), and may be congenital (MGc) or acquired (MGa) (Sato, 2015)
The literature describes the development of MGa in dogs as age-related and is classified as bi-modal, as it can occur between four months and four years old or between 9 and 13 years old (Dewey & Costa, 2016), which corroborates with our case report in which the animal was four years old
Radiographic studies of the cervico-thoracic region are always necessary to assess the presence of megaesophagus, secondary pneumonia and rule out thymoma, since MG can occur as a paraneoplastic syndrome to this mediastinal neoplasia (Sato, 2015)
Summary
Myasthenia gravis (MG) is a disorder caused by a reduced number of functional acetylcholine receptors (AChR) in the post-synaptic membrane of neuromuscular junctions (Batmaz et al, 1998), and may be congenital (MGc) or acquired (MGa) (Sato, 2015). A radioimmunoassay test (RIA) for the detection of antibodies against AChR is the gold standard for the diagnosis (Shelton, 2002) This test is expensive for the guardian of the animal and is not readily accessible for veterinarians in Brazil. This report describes the diagnostic and therapeutic approach in a dog with clinical signs suggestive of MGa. A 4-year-old mixed breed female dog that was seen at the Veterinary Hospital/UFRRJ, had a history of lameness and had been suffering from intermittent paresis in the pelvic limbs (PL) for 30 days, with progressive evolution to the thoracic limbs (TL) over the latter 15 days. Two weeks after the association of the two drugs, the animal was able to walk normally and the guardian of the dog did not report any further episodes of regurgitation. The dog has been in follow-up for one and a half years and there has been no recurrence of the symptoms during this time
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