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Discussion Starter · #1 ·
Hi All,

My boy is 10 years old and for the past couple of weeks it seems that he is experiencing pain when opening his jaw. It seems to be getting worse. He doesn't have to be eating, it happens when he yawns too. Now it's very bad and he doesn't open his jaw much. It's very sad. His teeth and gums look fine.

We took him to the vet but they didn't find anything. I google searched and found that this might be MMM (masticatory muscle myositis)? If so, shouldn't the vet have known about this condition? Also, the only symptoms are pain when opening the jaw, nothing else. And this is the first time we are experiencing this at 10 years old. Advice?
 

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Hi All,

My boy is 10 years old and for the past couple of weeks it seems that he is experiencing pain when opening his jaw. It seems to be getting worse. He doesn't have to be eating, it happens when he yawns too. Now it's very bad and he doesn't open his jaw much. It's very sad. His teeth and gums look fine.

We took him to the vet but they didn't find anything. I google searched and found that this might be MMM (masticatory muscle myositis)? If so, shouldn't the vet have known about this condition? Also, the only symptoms are pain when opening the jaw, nothing else. And this is the first time we are experiencing this at 10 years old. Advice?
sounds very likely.
MMM is pretty rare… my vet had been in practice for 15yrs at the time my dog was diagnosed and he was her first case. She’s since had 3, and because of him, knew to test for it right away. it’s expensive and only a couple of labs in the states that run the test, but i’d definitely go that route! sooner than later…..a favorable prognosis is dependent on early detection.
i’m at work now but i can come back and answer any questions or share the details of our journey a little later.
in the meantime…
 

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Discussion Starter · #3 ·
Thank you for sharing.

So, is prednisone the only treatment for this? And do you recommend it after all of those side effects? I guess no choice, huh?

I don't want to sedate my dog. How does the vet check for this? Unfortunately we have used up all of our pet insurance for the year. Would it be possible to just have the vet prescribe us the medication?
 

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Thank you for sharing.

So, is prednisone the only treatment for this? And do you recommend it after all of those side effects? I guess no choice, huh?

I don't want to sedate my dog. How does the vet check for this? Unfortunately we have used up all of our pet insurance for the year. Would it be possible to just have the vet prescribe us the medication?
MMM is an autoimmune disease, so the idea is to reduce the inflammation but also suppress the immune system so that the body stops attacking itself. Prednisone is the best (and cheapest by far) drug to accomplish both. Cyclosporine is another, i kept it on hand as a back up should another relapse occur since Keystone began having a hard time on Pred, but its pricey!! and the third drug discussed is a type of chemo drug, i don't recall the name, but the internist advised against it for use in German Shepherds.

You shouldn't have to sedate your dog. MMM can be discovered most often through bloodwork. If the bloodwork is inconclusive or the results are borderline, many ppl will then opt to have a muscle biopsy done in order to get a definitive diagnosis. A biopsy would obviously require sedation but again, that isn't usually necessary.

I don't know that any vet would prescribe a drug like prednisone, especially in such a high dose, just for a suspected illness (although they may be comfortable starting him on it while awaiting test results)...... Nor would i be comfortable as a pet owner to be honest. During Keystones relapse he had to stay on a much higher dose of Pred, for quite awhile longer and in the end, ended up with a complex UTI as well as early signs of liver disease - thankfully both resolved, but it wasn't easy. I believe the bloodwork was around the $250-300 mark (this was specifically for the MMM test, on top of the routine bloodwork which i'd already had done earlier)... and the Pred worked out to be ridiculously cheap, i wanna say $5-$20/mo.

As far as maintenance, i've moved towards a more holistic approach. Keystone is on a (anti-inflammatory) raw diet and regularly gets both EFA and tumeric supplements... i can't say for sure that it's made the difference, but this is the longest he's gone relapse free, approaching 4yrs...... so i'm leaving well enough alone.

Best of luck.
 

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Discussion Starter · #5 ·
MMM is an autoimmune disease, so the idea is to reduce the inflammation but also suppress the immune system so that the body stops attacking itself. Prednisone is the best (and cheapest by far) drug to accomplish both. Cyclosporine is another, i kept it on hand as a back up should another relapse occur since Keystone began having a hard time on Pred, but its pricey!! and the third drug discussed is a type of chemo drug, i don't recall the name, but the internist advised against it for use in German Shepherds.

You shouldn't have to sedate your dog. MMM can be discovered most often through bloodwork. If the bloodwork is inconclusive or the results are borderline, many ppl will then opt to have a muscle biopsy done in order to get a definitive diagnosis. A biopsy would obviously require sedation but again, that isn't usually necessary.

I don't know that any vet would prescribe a drug like prednisone, especially in such a high dose, just for a suspected illness (although they may be comfortable starting him on it while awaiting test results)...... Nor would i be comfortable as a pet owner to be honest. During Keystones relapse he had to stay on a much higher dose of Pred, for quite awhile longer and in the end, ended up with a complex UTI as well as early signs of liver disease - thankfully both resolved, but it wasn't easy. I believe the bloodwork was around the $250-300 mark (this was specifically for the MMM test, on top of the routine bloodwork which i'd already had done earlier)... and the Pred worked out to be ridiculously cheap, i wanna say $5-$20/mo.

As far as maintenance, i've moved towards a more holistic approach. Keystone is on a (anti-inflammatory) raw diet and regularly gets both EFA and tumeric supplements... i can't say for sure that it's made the difference, but this is the longest he's gone relapse free, approaching 4yrs...... so i'm leaving well enough alone.

Best of luck.
Glad to hear yours is doing well.

Okay, so after his visit to another vet today they told us that it is not MMM (I don't know the details, I wasn't there). But they did not draw blood, it was just a visual examination. They do not know what is the problem. We have been prescribed 400mg gabapentin and 150mg rimadyl daily. The rimadyl says "to reduce inflammation" but the gabapentin doesn't say anything. Also, the gabapentin says indefinitely? I remember once in the past he was prescribed gabapentin. He was acting odd and we took him off of it early, and he was back to normal. Any experience or knowledge on these? I'm going to call the vet tomorrow to try to get more details.
 

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Glad to hear yours is doing well.

Okay, so after his visit to another vet today they told us that it is not MMM (I don't know the details, I wasn't there). But they did not draw blood, it was just a visual examination. They do not know what is the problem. We have been prescribed 400mg gabapentin and 150mg rimadyl daily. The rimadyl says "to reduce inflammation" but the gabapentin doesn't say anything. Also, the gabapentin says indefinitely? I remember once in the past he was prescribed gabapentin. He was acting odd and we took him off of it early, and he was back to normal. Any experience or knowledge on these? I'm going to call the vet tomorrow to try to get more details.
thank you!!
…and yes, i’ve used both drugs for various issues in the past. rimadyl may cause stomach upset or loose stools… but most dogs tolerate it OK short term. gabapentin is for nerve pain… also tolerated well by most but has a sedative affect and my dog gets a bit wobbly on it. i’d use it as prescribed until his symptoms resolve, then as needed.
 

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Discussion Starter · #7 ·
thank you!!
…and yes, i’ve used both drugs for various issues in the past. rimadyl may cause stomach upset or loose stools… but most dogs tolerate it OK short term. gabapentin is for nerve pain… also tolerated well by most but has a sedative affect and my dog gets a bit wobbly on it. i’d use it as prescribed until his symptoms resolve, then as needed.
Thank you.
 
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