02/24/16

CECS is a Gluten Sensitivity

The idea that CECS is a Gluten Sensitivity has been presented by recent research.

They were actually quite confident with the link between the two, saying in the research,

Canine epileptic cramping syndrome in [border terriers]s is a gluten-sensitive movement disorder triggered and perpetuated by gluten and thus responsive to a gluten-free diet.

This is pretty exciting stuff! CECS (short for Canine Epileptoid Cramping Syndrome, or sometimes called ‘Spike’s Disease’)  is an unusual condition found almost exclusively in border terriers. These dogs are normal dogs except for when they have an ‘episode’ or a seizure. During an episode, the dog will ‘cramp up’. Typically, they remain conscious, but can’t walk, and sometimes appear worried following an episode.

Chip, a border terrier that does not have CECS

Chip, a border terrier that does not have CECS

So far, there has been no real diagnostic test or explanation for the condition. In December 2013, a study looked at CECS, but it was an owner-survey, information-gaining exercise. Which is important, but doesn’t give us answers!

It was so important that it actually spurred this research. In the December 2013 study, 50% of dogs were found to ‘respond’ (i.e. have less episodes) on a gluten-free or hypoallergenic diet.

So now let’s welcome this lovely small study titled ‘The Clinical and Serological Effect of a Gluten Free Diet in Border Terriers with Canine Epileptoid Cramping Syndrome‘, which begins to look at how we can both diagnose and treat CECS. Exciting stuff!

The aim of the study was to work out if a gluten-free diet would effect dogs with CECS. Not only did the researchers want to know if the dogs stopped having episodes, but if their blood looked different with and without gluten. Naturally, they wanted to know if these things were correlated.

The dogs involved were 6 border terriers (an equal mix of male and female). Each dog:

  • Had had CECS for at least 6 months
  • Had been diagnosed with CECS via veterinary observation (including video)
  • Had had at least 2 CECS episodes
  • Had not tried gluten-free diets before

For interest sake, the average age of onset for CECS in this small sample was 2.6 years.

Winnie, another border terrier who does not have CECS

Winnie, another border terrier who does not have CECS

Once recruited, the dogs had blood taken and the owners were given instructions for the dog going on a total gluten-free diet (Hypoallergenic Canine Dry from Royal Canin). The dog underwent a general physical examine (and some dogs went through more intensive procedures, owners consenting) and all were determined to be healthy, beyond the presentation of CECS.

The blood was again taken at 3, 6, and 9 month periods.

The blood was tested for antibodies which are considered important in diagnosing gluten sensitivity in humans.

The blood of non-CECS border terriers was also taken and tested.

The owner was asked to keep a record of the incidents of CECS in their borders.

Are you ready for the results? They’re pretty compelling.

So all that changed in these border terriers’ lives was that they were put on a completely gluten free diet. With this one change, all of the borders terriers, when they adhered to the gluten free diet, stopped having seizures within 4 weeks. Three dogs did not have seizures at all once they started the diet.

Two dog owners, upon completion of the trial, accidentally fed their dogs treats with gluten… And the dogs had seizures again. So not only did a gluten free diet stop seizures, the reintroduction of gluten caused seizures.

Now let’s talk about “Dog 6″. Dog 6′s owner is the epitome of why these kind of studies, where dogs are left with their owners, are hard work! Throughout the study, Dog 6 was a dog that continued to have seizures. Dog 6′s owner presumably fed the dog the gluten free diet, but then allowed the dog to continue to graze on horse poo when out and about.  This issue wasn’t identified until late in the study and so Dog 6 was excluded from the serum results listed in this article. However, when Dog 6′s owner actually did was they were told and stopped the horse poo eating, Dog 6 stopped having seizures too! When Dog 6′s blood was tested 3 months after the study ended (but 3 months into the owner actually doing it right), that dog’s blood results was consistent with the other dogs, and it too had ceased having episodes.

Why is this study such a big deal?

Up until now, we have had no way to diagnose nor treat CECS. (In fact, one of the criteria established in the 2013 study of CECS indicated that if a dog fails to respond to epilepsy medication then it probably is CECS. Nice to know, but not a great deal of help.)

The blood results from these dogs showed high levels of relevant antibodies in affected dogs while they consumed a diet with gluten. The presence of gluten-associated antibodies could be used to diagnose CECS.

Clearly, a treatment has been identified too: avoid gluten!

Other areas that are of interest:

  • Signs of gastrointestinal upsets could be a sign of gluten problems, or of future CECS. Vomiting, soft stools, or belly grumbling was reported in 2 of the dogs featured in this study. The presentation of belly problems and CECS together can be an indication of just one problem – gluten sensitivity!
  • The story of ‘Dog 6′, to me, really shows the importance of owners in being vigilant. I feel that many dog owners take a rather lazy approach to food elimination diets, but elimination means to completely remove. If you don’t completely remove, you can’t say that it’s been tried!
  • In humans, celiac disease has sometimes been associated with a rash… Which makes me think back to the correlation between CECS and skin-conditions in borders identified in the 2013 study.

Another quote from the study:

These investigations support the hypothesis that CECS is a manifestation of gluten sensitivity, making this the first [sudden onset] movement disorder in veterinary medicine with a serological link to gluten.

What research from here?

This is a very small study, and it’s important that we do more research before making solid conclusions. This study itself suggests further research:

  • With a larger sample size
  • More research into the correlation of gastrointestinal upsets and CECS
  • A double-blind randomised placebo-controlled trial

But in the meantime, while we’re waiting to know more, these researchers (and I!) recommend that, if you have a border terrier with CECS, you switch the dog to a diet that eliminates all gluten foods.

 

Reference:

Lowrie M, Garden OA, Hadjivassiliou M, Harvey RJ, Sanders DS, Powell R, & Garosi L (2015). The Clinical and Serological Effect of a Gluten-Free Diet in Border Terriers with Epileptoid Cramping Syndrome. Journal of veterinary internal medicine / American College of Veterinary Internal Medicine, 29 (6), 1564-8 PMID: 26500168

 

Further reading:

Gluten Sensitivity Triggers Epileptoid Cramping Syndrome in Border Terriers

 

CECS is a Gluten Sensitivity

 

01/10/14

CECS in Border Terriers

ResearchBlogging.org Regulars of this blog will know that I breed border terriers, and I am excited to share with you some new and ground breaking research within the breed.

In December, the Journal of Small Animal Practice published an article on canine epileptoid cramping syndrome (or CECS) in border terriers. This is exciting because it is the first academic article to consider this condition in border terriers, and it therefore documents and legitimises the condition.

 

This is Chip (Au & NZ Ch Dalshoj Chippendale ME TD). He does not have CECS but he is a border terrier.

This is Chip (Au & NZ Ch Dalshoj Chippendale ME TD). He does not have CECS but he is a border terrier.

Research Design

  • A small study of 29 border terriers.
  • There were 33 respondents in all, but 4 dogs were excluded for not meeting the criteria.
  • Recruitment took place through veterinarians, using dogs that had diagnosed and treated for CECS.
  • In 14 of the cases, owners were questioned about their dog’s episodes. In 15 cases, videographic evidence was used.
  • In order to be included in the study, dogs had to:
    • Have a one year history of episodes (i.e. abnormal involuntary hyperkinetic movement)
    • These episodes did not include epilepsy-like symptoms (like loss of bladder or bowel control, hyper salivation, or loss of consciousness)
    • Have other medical ruled out (if possible)

 

What happens before a CECS episode?

  • 18 out of the 29 owners felt they could predict the onset of an episode.
  • 11 out of the 29 dogs became ‘quieter’ before an episode.
  • 6 out of the 29 dogs sought comfort in their owners before an episode.
  • 4 out of the 29 dogs would vomit bile or eat grass before an episode.
  • While most episodes were unpredictable, some owners felt that excitement, waking from sleep, and stress were all triggers.

 

So what does a CECS episode look like?

  • Generally, an episode lasts from 2-30 minutes.
  • All owners felt their dog was uncomfortable during the episode.
  • Most dogs had difficulty walking (27 of the 29 participants).
  • Most of the time all four limbs are affected (25 of the 29 participants).
  • Most dogs had at least some time that they were unable to stand (22 of the 29 participants).
  • Most had a mild tremor (21 of the 29 participants).
  • Most had the head or neck affected (21 of 29 participants).
  • Most had dystonia (muscle tremors) (22 of the 29 participants).
  • Many had the back and abdomon affected (16 of the 29 participants).
  • Some licked the air (14 of 29 participants).
  • Some excessively stretched (14 of 29 participants).
  • Some had all four limbs go rigid (14 of 29 pariticpants).
  • Some had the tail affected (11 of 29 participants).
  • Some dogs got a rumbly tummy (11 of the 29 participants).

 

What happens after an episode?

  • Most owners (18 of the 29) described their dogs as acting similar after an episode as before.
  • 11 of 29 respondents were quieter after an episode.
  • 4 of the 29 participants sought human company after an episode.
  • 2 of the 29 participants were hungry after an episode.

 

What helps reduce symptoms?

  • Most owners found the condition could be managed by diet. 19 of the respodents changed their dog’s diet as a result of their condition, and over 50% thought that this helped.
  • Drugs did not help the condition (including phenobarbital, potassium bromide, and buscopan).
  • Once an episode had started, none of the owners in this study thought they could change the course of the episode.

 

What is CECS correlated with?

  • In short: Not much!
  • Dogs appeared normal despite: blood tests, magnetic resonance imaging, cerbospinal fluid collection and analysis, and neurological examinations.
  • “No significant underlying metabolic, cardiovascular, respiratory, orthopaedic or other neurological conditions were identified in any respondent.”
  • 15 of the 29 borders also had skin disease.
  • There is “an apparent association” between CECS and digestive or food intolerance issues.
  • CECS is not epilepsy. Dogs who have CECS differs from epilepsy as affected dogs remain conscious during an episode, have longer episodes, and do not respond to medication.

 

Implications for Breeders

  • Most dogs had their first episode before 3 years. This may mean that only breeding borders 3 years and older, who are asymptomatic, is a way forward. (But some dogs started cramping at 0.2 years, and some at 7 years, so there’s no guarantees.)
  • 10 of the 29 owners (34%) felt that CECS had a negative impact on the dog’s quality of life. While this is a significant number, it is reassuring to think that most owners (66%) therefore did not think that CECS negatively impacted on their dogs life. This is not a way to justify breeding CECS affected dogs, but it is reassuring to know that the condition does not seem to be incredibly debilitating in many situations.
  • Skin disease is correlated with CECS. Any dogs affected by skin disease should not be considered for a breeding program.
  • For those trying to determine the inheritance of CECS, it is important to note that CECS is not epilepsy. A condition that can be controlled by medication is almost certainly not CECS, and it would be hazardous to lump the two conditions together.

 

Congratulations and thank-you to those border terrier people who have been campaigning and working behind the scenes for research like this for many years.

I hope this is the first of much research to come.

This is Clover (Ch Burrowa Blue Flame ME TD DWDF.S) and Chip (Au & NZ Ch Dalshoj Chippendale ME TD). Neither of them are CECS affected, but they're pretty cute.

This is Clover (Ch Burrowa Blue Flame ME TD DWDF.S) and Chip (Au & NZ Ch Dalshoj Chippendale ME TD). Neither of them are CECS affected, but they’re pretty cute.

 

Reference:

Black V, Garosi L, Lowrie M, Harvey RJ, & Gale J (2013). Phenotypic characterisation of canine epileptoid cramping syndrome in the Border terrier. The Journal of small animal practice PMID: 24372194

01/30/13

Puppies 2012 – The Ninth Week and Beyond

Just because the puppies have left our homes doesn’t mean that we’re no longer involved in their new lives!  We are always available to our puppy buyers to help them with any problems they may have, or just offer advice.  We have had puppy buyers contact us with vaccination queries, toilet training advice, feeding advice, and just to share lovely stories about their puppies. Here are some pictures for you to enjoy.

“Douglas” (was “Jakkalberry”) the sleepy cowboy puppy.

"Boomer" kept his name in his new home.

“Boomer” kept his name in his new home.

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11/14/12

Puppies are here!

Clover had her puppies on Tuesday 6th of November 2012.  Six puppies, 3 boys and 3 girls.  All good weights, healthy, happy, strong, drinking well. They have been given temporary names, because I find calling puppies “1st boy” and “3rd born” and “last born” tedious. This post is just to show you some puppy pictures. Enjoy!

 

First born, “Alfalfa”, bitch.

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11/10/12

Preparing for Puppies

So we have been undertaking puppy preparations here, in anticipation for Clover’s upcoming litter. We have many basic things, as we have had litters before – thermometers, heat lamp, whelping box, and so forth. So, really, the only stuff we had to get is the fun stuff!

 

Leave with Work

I put in leave with work, as I pretty much don’t work when I have puppies. I need to be here for the whelping, and I need to be here to clean, socialise, and just generally care take puppies. At a young age, they are not too strenuous. As they get older, the elimination increases, and so does the work load!

 

Clover in the whelping box, the blanket over the top is to make it more den like for her. The whelping box is next to our bed. You can see to the right the towels ‘ready to go’ on top of a column heater. The brown blanket is lining a box, which has a hot water bottle inside – ready for puppies when they’re born. The blue toy outside the whelping box is Clover’s personal touch!

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