Paroxysmal gluten sensitive dyskinesia (PGSD) in Border Terriers
There is a condition known as paroxysmal gluten sensitive dyskinesia, or PGSD. Previously, it was called canine epileptoid cramping syndrome (CECS) and Spike’s disease. This is a form of paroxysmal dyskinesia (PD) affecting Border Terriers.
What is PGSD?
In paroxysmal disease, the affected dog initially appears normal but periodically develops various symptoms associated with the disease before resuming normal behaviour. Dyskinesia refers to an involuntary movement of the body. Therefore, in this condition, seemingly normal dogs suddenly develop tremors, cramps, or other movement problems.
What causes PGSD in Border Terriers?
CECS is probably not a good name for the condition since it implies epilepsy. The term paroxysmal gluten-sensitive dyskinesia now seems more appropriate. Based on a study conducted by Mark Lowrie (practicing neurologist at Movement Referrals), gluten sensitivity has been linked to PD in Border terriers. It is now possible to test Border terriers for gluten sensitivity through blood tests. The syndrome may have a genetic basis, but no specific genetic abnormality has been identified.
What are the signs of PGSD?
An affected animal may experience episodes of staggering and wobbliness, be unable to stand, experience trembling attacks, or experience cramping in the stomach, neck, leg, and back. Dogs may adopt an unusual position in cramping attacks or have their legs rigidly held out or bent up, unable to stretch. The attacks do not cause unconsciousness, although some dogs find them distressing and behave abnormally.
Border terriers can suffer from episodes as early as six weeks of age and up to seven years old. They can last from a few minutes to several hours and sometimes occur in clusters. During times between attacks, dogs appear to be completely normal. There is an increase in intestinal motility in many affected dogs during an episode, resulting in gurgling tummy sounds (borborygmi). There may also be mild to severe gastrointestinal symptoms such as diarrhoea or vomiting between episodes.
How do I diagnose PGSD?
Video recordings are extremely helpful to distinguish PGSD from other conditions like epileptic seizures (fits).
Distinct episodes of involuntary muscle movement disorders are common. As a result, most animals appear completely normal between attacks.
It may be necessary to perform an MRI scan of the brain, and to collect some fluid from around the brain (cerebrospinal fluid (CSF) tap) for analysis. In order to exclude metabolic disorders or hormone imbalances, blood and urine testing may also be conducted. In order to confirm the diagnosis, serological tests are performed on a simple blood test for gluten sensitivity.
Can PGSD be treated?
PGSD is currently best managed with a gluten-free diet, although improvements may take several weeks to appear. The episodes should completely disappear if a gluten-free diet is strictly followed. To monitor compliance with the diet, a repeat test for gluten sensitivity is recommended at 3 months to ensure a strict diet is being followed.
What is the prognosis?
PGSD, or indeed any form of paroxysmal dyskinesia, is not life-threatening. Dyskinesia episodes may be disturbing and upsetting to observe, but no dog has ever died from them. In any case, these episodes clearly impact a dog’s quality of life, so any treatment available should be pursued if side effects are limited.
The majority of dogs with PGSD can lead relatively normal lives. Attempts to ameliorate the episodes will require lifelong dietary restrictions. When an episode occurs, you can only comfort and reassure your dog. Because the disease is suspected to have a genetic component, dogs affected by the disease should not be bred, and it makes sense not to repeat matings that resulted in affected puppies.