An extreme case of masticatory myositis

Abstract

Lucy, an 8-year-old female spayed Labrador retriever mix, presented to the Triage Service at Cornell University Hospital for Animals due to signs of respiratory distress. Lucy's owner indicated a history of inappetance, intermittent cough, and difficulty walking for the past two weeks. Initially, Lucy presented to the referring veterinarian (rDVM) who recorded a right hindlimb lameness, fever of 104.3 degrees Fahrenheit, and tachypnea. Cephalexin was prescribed to treat a possible bronchitis seen on chest radiographs. The following day she re-presented to the rDVM. Serum chemistry revealed a mildly increased alkaline phosphatase (ALP). Tachypnea was still evident yet her lungs ausculted normally, so a week-long course of Deramaxx for possible blunt trauma to the chest was initiated. Ptyalism, progressive intermittent inappetance, and white mucoid sputum were observed for several days. She was rechecked by the rDVM one week later, at which time a complete blood count (CBC) documented a leukocytosis. Heartworm test was negative at this time. She was treated with more cephalexin, aminophylline as a bronchodilator, and instructions for nebulization and coupage at home. Within five days, Lucy stopped drinking abruptly, and would only eat via syringe force-feeding. Her owner mentioned that she did not tolerate pilled medications; Lucy had become increasingly stubborn over the last several days and would clench her mouth shut when her owner attempted to medicate her. After approximately two weeks since her original symptoms, Lucy presented to Cornell.