Head Tremoring

Question: Dr. Mike--

I'm sorry I keep bugging you but I want to give you as much info as possible. Tubby had another seizure about an hour ago. It again lasted about 8-10 min. and was the same kind as before. An intermintant shaking of the head in an up and down motion. He is totally alert while he is doing it and will act as if nothing's wrong--chasing balls, getting a drink, etc...I called my vet and he decided to put him on a phenobarbituate of 90 mg. daily. For the record, Tubby is an English Bulldog. He is 16 months old and weighs about 62 lbs. Any input would help.

thank you. Sergio

Answer: Sergio-

Phenobarbital has enough potential to cause serious side effects that I would hesitate to use it without getting an opinion from a veterinary neurologist (if that is possible in your area) about the possible causes of the head tremoring, especially since this is a well recognized problem in bulldogs. I know that you are concerned but taking the time to get a second opinion from a specialist could be very beneficial. If there is not a neurologist in your area, there is probably an internal medicine specialist who does some neurology work. Your vet should be able to refer you to an appropriate specialist.

The other side of this is that some vets really believe this is a seizure disorder and there are some reports of phenobarbital helping with the problem, even though there are a number of reports of it not helping, as well. So your vet is probably just following the advice of the experts he or she believes to be correct in this situation. Disagreements over the best approach to problems like this occur and sometimes you have to be the person responsible for deciding which ones to believe -- and you should always give heavier weight to the opinion of someone who has actually seen your dog. But my advice would still be to try to get an appointment with a veterinary neurologist or internal medicine specialist before staying on phenobarbital long term.

Mike Richards, DVM 7/16/2000

Head tremors in English Bulldog

Question: Dr. Mike--

Earlier this evening I noticed what my vet thinks may have been a seizure in my Bulldog. Tubby is about 15 months old and I have never seen anything like this before. He was resting for about a half hour and then all of a sudden woke up and started shaking his head violently up and down. The rest of his body was normal. I was so concerned that I jumped up and immeditely took him to the ER. Even in the car, Tubby wanted to put his head out the window. All along, still shaking his head violently. It all lasted about 5-10 min. He seems to be fine now but I am very concerened. Is there anything I should look for? Could this be caused by over excitement? Yesterday I took him to a dog park and he ran around for a good 45 min to an hour. I'm telling you this because when he is so energetic, it looks as if he is really exhausted but he won't stop. Anyway, thank you for any input you might have.

Sergio

Answer: Sergio-

There is a problem in English bulldogs with head tremors which appear suddenly, last several minutes and then go away. Usually this will be an intermittent problem. I am not sure whether this is a focal seizure disorder or if it is some other problem. It doesn't respond very well to traditional seizure control medications and lab work, including X-rays, blood work and even MRI or CT examination is usually normal. In most instances, treatment is not considered to be necessary. This problem does sometimes occur in other dog breeds, as well. We have seen this problem in dobermans, boxers and Cavalier King Charles spaniels in addition to bulldogs.

Ear infections can sometimes cause head bobbing. I think that nausea can do this but that is personal opinion, I have not seen that cause listed in the literature anywhere. Focal seizures could potentially cause this and might respond to seizure control medications, if this becomes a major problem. It also might be a good idea to rule out low blood sugar as a potential cause of this problem or even better, to go ahead and run a blood chemistry panel to rule this out, as well as liver disease and other potential systemic problems.

The odds are high that this is just the head tremoring syndrome that occurs for unknown reasons in bulldogs but being cautious and ruling out other possible problems is a good idea.

Mike Richards, DVM 7/16/2000