Information and survey results below.
 © COPYRIGHT 2008
Permission must be granted for publication in whole or part

Head Tremors In the Bulldog- Partial/ Focal Seizures, Paroxysmal Dyskinesia.

By Kathy Jacobsen

The topic of this article, very simply put is: head tremors, fly biting and circling behaviors in our beloved Bullies. Looking at the title, however, it becomes painfully apparent that these neurological anomalies that we are seeing in the bulldog today fall into the "gray" area of veterinary and human neurological disorders.

What qualifies me to discuss such a topic, you might ask? My answer to you would be good old experience. I have been in bulldogs for close to  16+ years, had 7 litters and of those 7 litters have had 5 dogs/bitches who have exhibited 1 or more of these behaviors. I plan on reviewing the scientific findings from articles I have pulled from the internet and then share my experience, including what I did to minimize the behaviors along with how well it worked on each dog.  Let's start with some general definitions taken directly from the literature:

Epilepsy: "a chronic condition characterized by recurrent seizures. It is a disorder of the brain where abnormal electrical activity triggers further uncoordinated nerve transmission. This uncoordinated and haphazard nerve tissue activity scrambles messages to the muscles or your dog's body and the coordinated use of muscles is then inhibited." The characteristic seizure activity seen in epilepsy are classed as-
 
Seizures: involuntary contraction of muscles, caused by an electrical storm in the brain that can be everywhere at once and can be seen on EEG. Partial seizure where the abnormal electrical impulses begin in a small area of the brain and may or may not migrate to other areas of the brain.

Focal/Partial seizures
Simple focal seizures (minor motor or focal motor seizures) when consciousness is preserved. The area of the brain that is affected is the area that controls movement. Usually the face is affected, resulting in twitching or blinking. This is usually limited to one side of the face.  The dog is usually alert and aware of it's surroundings.  Complex focal seizures when consciousness is altered ie the pet is staring off into the distance but you cannot gain their attention.  This seizure will originate in the area of the brain that controls behavior and is sometimes called a psychomotor seizure. The dog's consciousness will be altered and he may exhibit bizarre behavior such as unprovoked aggression or extreme irrational fear. He may run uncontrollably, engage in senseless, repetitive behavior or have fly-snapping episodes where he appears to be biting at imaginary flies around his head.

2. Grand Mal (tonic-clonic) seizures  which begins with an involuntary contraction of all skeletal muscles and loss of consciousness.

3. Paroxysmal Dyskinesia is a movement disorder. There are brief attacks of the symptoms with the dog appearing perfectly normal between the episodes; the same way there are discrete attacks of seizures in epilepsy.  Dyskinesia refers to an abnormal, involuntary movement or posture. Movement disorders usually originate from the deeper areas (the basal nuclei) of the brain. These areas are responsible for translating the commands from higher brain areas (e.g. get the ball) into movements (e.g. stand up, begin trotting, etc). The distinction in the human between seizure activity and dyskinesias is based on looking for abnormal electrical activity on the surface of the brain with an EEG.

By definition, seizures have abnormal EEG activity, while paroxysmal dyskinesias do not. People with paroxysmal dyskineasis often experience a decrease in episodes as they age while epileptic people and dogs will worsen with age.    Let's talk now about Head Tremors in the Bulldog. In my experience, head tremor activity in the Bulldog usually starts around the age of 2 years old. The motion you will see will almost always be a fast side to side rocking motion (ear to shoulder  ear to shoulder) occurring in rapid succession. Occasionally I have seen an up and down motion (like they are shaking their heads to say yes) but for the most part it is the same fast rocking. The way it was defined to me was that the neuron cluster that controls a certain motor function, in this case head movement, begins to fire continuously. The reason for this rapid fire is truly unknown.

I have not experienced any drooling or other body part involvement.  It has always been isolated to the head. When you call the dog's name they can stop the bobbing motion for a few seconds and will look at you, then it will kick in again. They can move their heads and watch you move from place to place, they can even walk around etc. Scenario I: The bully will be sleeping very soundly and all of a sudden the head will start rocking  usually from side to side very quickly- occasionally you might experience one bobbing up and down. This sudden head motion will cause the bully to awaken suddenly. An episode will last from 15 to 30 seconds, sometimes longer. It may stop on its own and then as the dog lies down to go back to sleep the head tremor will reoccur.

Scenario II: A bitch will be pre-season or just come into season. Males head is bobbing for all it is worth. Scenario III: A bitch is post whelp, in the milk let down phase of lactation, and trying to nurse a litter of hungry pups. In this case the bitch has had surgical trauma as the result of a C section, is in pain, is not eating and is trying to make milk. This, in my opinion is different than the head tremors described in Scenario I and II.   When you see this What Do You Do? The first time we experienced this phenomena was a scenario III post  whelp I panicked. I grabbed the puppies off the bitch and almost caused one to aspirate. When I gained a little composure I called a breeder friend of mine and explained what I was seeing. She told me that it was not uncommon and I should try to get some sugar, honey, Karo syrup into her. The thought is that the blood sugar had experienced a sharp drop at that point in time thus stimulating this type of a response. We gave the girl the Karo and low and behold the tremors stopped within a couple of seconds. The next time we witnessed this behavior  was a little different. The bitch was not post whelp. However, she was 3 days prior to coming into season. She had been sleeping on the couch. We gave her honey. It stopped. Started up 15 minutes later we repeated the karo. Same result.

We gave her frozen yogurt, same result. This went on for almost 24 hours with the length of time between episodes varying from 10-15 minutes to as long as a half hour. Needless to say we packed her up and went off to the vet who said: this is not unusual in this breed. Normally we don't do anything. Epilepsy meds have proven to be ineffective for the most part; phenobarb has too many side effects. The Veterinarian stated that they suspect it has something to do with the growth activity at this age or stress, which can cause a sudden drop in glucose levels in the blood.  There can be different things or circumstances that can trigger an episode. Such as a traumatic experience, and injury, hormones, etc. In this girls case we have determined that it is a hormone trigger, specifically at the time of a progesterone spike associated with ovulation. The vet recommended Calcium and Taurine supplementation twice daily. As you know calcium is one of the minerals needed for healthy nerve growth and electrical conductivity, Taurine is an amino acid that works with Calcium. The Vet said she might grow out of it.  So, we took that information and we asked for a referral to a neurologist.

This specialist did all of the neurological tests and determined she was fine. She ordered ionized calcium levels along with several other specific blood tests. The results all came back normal. She recommended an MRI to determine if there was an injury or tumor. We declined this step at the time, due to finances but decided if she showed any other neurological symptoms such as falling down or aggression, which could be indicative of an injury or tumor, that we would come back to do the MRI. Six months went by on the Calcium, Taurine supplementation to which we added a heaping tablespoon of Ricotta cheese every morning and every couple of days a heaping bowl of frozen vanilla yogurt with honey in the evening. No incidents. The day we bred her  in at the time of the progesterone spike indicating ovulation that we were waiting for she had one mild episode then nothing for the entire pregnancy. The episodes started up the second week of lactation when the calcium bolus given at the time of the C- section was gone and 6 hungry puppies were pulling on her calcium/glucose levels.  Five months have since passed and she has been just fine  no episodes.

My Recommendations:
1. If your dog exhibits this head bobbing behavior a. DON'T PANIC!!! This could only worsen the situation by adding additional stress on the dog. b.  Give them a bowl of ice cream or frozen vanilla yogurt with honey to get the situation under control. If you don't have any of those then Ensure, Pediasure, Karo syrup all work because of the sugar and or calcium content. Liquids work quicker because they are absorbed into the mucosa of the mouth.

2. Call your veterinarian and advise of the situation. Schedule an appointment for a visit and have your vet do a health screening with blood work. Odds are the blood work for calcium and sugar will be fine.

3. Keep a record of each episode, every time one occurs  describe it in great detail, time it occurred  how long, how frequent. Give this info to the vet when you see him.

4. IF they do not get any worse than the head bobs  don't do anything else but observe and document. If the behavior changes in any way  call the vet, you may need additional assistance at this point.  Two other behaviors I would like to mention briefly are the fly chasing and the circling behaviors. Fly chasing is just that, the dog seems to be chasing and trying to catch imaginary flies. Again, if you call the dog by name he will stop and look at you then resume the behavior. The other is circling. This looks like VERY slow motion tail chasing. Usually in the same direction each time it happens. IF you call the dog they will stop to acknowledge you then start up again. In this case, I go over and give my girl a nudge and she stops and resumes whatever she had started to go outside to do.

This seems to happen outdoors only, so I sometimes wonder if bright sunlight is the trigger mechanism for her. In any event  both of these behaviors are neurological events. Basically harmless. Both of these dogs are on the same calcium and taurine supplementation. The supplementation has basically eradicated the fly chasing in the one dog and the episodes of circling are fewer with the other dog.  In closing I would like to say that these behaviors are basically just annoyances to you and the dog. I would never discourage you from having the dog checked by a Veterinarian. Remember, every dog just like every person is different and they react differently to certain stimuli and medications. I suggest you try this regimen and if the behavior continues see your veterinarian for more extensive testing and follow up.

Results from a survey from owners who sent information.

By Cathy Kittell

Subject: Head Shake Survey Results

Hello All-
Below is the results of the questions, I'm sorry if it's difficult to read but I wanted to put as much detail in it as possible.
The ONLY common thing I could see here is that of the bullies that had surgery, the head shakes started after that.  The first question I asked my vet was could it be an effect of the anesthesia, but he had no clear answer.
I hope this information helps some of you, I am going to forward it to a friend of mine who is a breeder and is doing a study along with the University of PA.
Please feel free to email me if you have any questions or if you would like more information on a specific question/answer.
Give all of your bullies a big hug.  I hope that someday we can find answers to all of our questions, and we are all together in this!! Thanks, Cathy
Head shake Survey Results-14 People Responded

9 male bullies  average weight 60 lbs.
5 female bullies  average weight 50 lbs.

Ages:

Males:                                                  Females:

21 months                                            16 months

4 years                                                 16 months

4 ½ years                                             4 ½ years

16 months                                            1 year

2 years                                                 1 ½ years

10 months                                             4 years

6 years

2 years

One surveyed was a rescue, one was purchased at a pet store.  All else through a breeder.

Average age the bullie was brought home was 8 weeks, the oldest was the rescue at 2 years.

Age at the start of the head shakes:

Males:                                                  Females:

18 months                                            8 months

14 months                                            1 year

3 years                                                 1 year

1 year                                                   1.3 years

1 year                                                   4 years

13 months

2 years

10 weeks

3 ½ years

1 year


Surgeries:

5 surgeries for males:                            4 surgeries for females:

Palate & nares                                      cherry eye

Neutering only                                      2 spay

Entropian                                              entropian & palate

Cherry eye & neutering

Entropian

Only one female had head shakes begin BEFORE surgery, all else, males & females head shakes began after surgery.

13 people feed 2 times a day

One free feeds-male

One feeds once a day-male

Most feed Eukanuba or Wellness.

Vitamins:

Males:                                                  Females:

Pet tabs                                                Pet sun Cholrella now, prior Solid Gold Semeal

Ester C & fish oil/flax seed                    Pet tabs

Pet tabs, grizzly salmon oil &                Vitamin mix    
Glucosamine

Nupro powder & glucosamine

Vet Vists:

Males:                                                

8 were brought to the vet, 3 had blood work done, no problems found

Females:

3 were brought to the vet, one with blood work done, no problems found.  One vet thought it could be epilepsy and wanted to put her on medication, but the owner did not do it.

With the exception of two people who said their bullie's head shakes occur when standing, walking or sitting, all others happen when lying down.

The average time of a head shake appears to be between 3-5 minutes, some as short as 1 minute and as long as 10 minutes.

Food used to stop it: ice cream, jelly, cheese, peanut butter, ice cubes, water.  Others will use toys or petting, stroking and talking.

All dogs are responsive when these occur.

The average time a head shake has occurred in one day is 3-5 times.

The longest period without a headshake has been 1 ½ years.  Others range from 5 weeks to 5 months.

One male stopped at 17 months

One female at 11 months.

One female at 1 ½ years

Additional information:

I had sent the video of Zimmer's head shakes to my vet who in turn sent it to a neurologist, Dr. Eric Glass at Red Bank Veterinary here in NJ.

Here is the reply from Dr. Glass:

Thanks for sharing the videotape with us.

The videotape is a classic; the videotape shows a great example of what is referred to as "idiopathic head bobbing syndrome"; we see this most commonly in the bulldog, doberman and boxer although I have seen it in a lab as well as in some mixed breed dogs; the head bobbing can be either up and down or side to side; usually activity, such as concentrating on food or a toy, makes it go away but not always; it can be very episodic in the sense that it may go away for months only to reappear; sometimes it seems to increase in frequency; the exact cause is not known nor is the anatomic dx; we believe strongly it has something to do with the stretch receptors in the neck
- ie the gp or maybe gsa fibers in mm bundles - although this is only a theory; we use to teach that it had something to do with basal nuclei of the brain like parkinsons but that is unlikely.

I have scanned a few dogs but have not found anything as of yet; the good news is that it absolutely does not harm the dog; in fact the dog does not seem to even be bothered at all; it bothers the owners immensely but all you need there is some good client communication; the key with this dz is NOT to treat it as a seizure with anticonvulsants as that absolutely does not work; I unfortunately had to get involved in too many of these cases that are on super high doses of anticonvulsants - one from Penn that almost died -18000K later in their ICU - they came for a second opinion - stopped all the meds and the dog was perfectly fine; we have tried lots of meds to no success but who cares as it does not affect the dog.

I usually tell vets to treat the owner not the dog in these cases as client education is the key.

Dr. DeLahunta, Dr. Kent and I have an article coming out in July compendium on involuntary mvmt disorders - we have described this syndrome in that article.
                                             
© COPYRIGHT 2008
Permission must be granted for publication in whole or part


Bulldogsworld ® would like to extend a very special Thank You to Kathy Jacobsen and Cathy Kittell
for the great work in this link

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Head Tremor VIDEO at bottom of this page
Head Tremors in the Bulldog
By Kathy Jacobsen

Head Tremors are a NON Life Threatening neurological event that happens in not only the Bulldog, but the boxer, the Chinook, the dachsund and several other breeds as well.

It is characterized by a fast side to side rocking motion (ear to shoulder – ear to shoulder) occurring in rapid succession. Occasionally you may see an up and down motion (like they are shaking their heads to say yes) but for the most part it is the same fast rocking. The dog actually looks like a “Bobble Head Doll”.  The event itself can be compared to Parkinsonism – where the patient experiences the finger rolling but can’t control it.  The most important observation is the consciousness level of the dog.  If the dog responds to your voice calling it’s name, can walk, eat, do it’s business etc then it is most likely a non-lethal/just annoying event.  If consciousness changes you should seek assistance from your Vet.

Scientists and Veterinarians who are familiar with the syndrome believe that the neuron (nerve) cluster in the brain that controls a certain motor function, in this case head movement, begins to fire continuously.  The reason for this rapid fire is truly unknown at this time.

In my experience, head tremor activity in the Bulldog usually starts around the age of 12 months and can go on till they are 3 years old.

What Causes Head Tremors:
As stated the cause for this syndrome is unknown, however, we have been able to identify certain triggers that may set it off:

•The Bully going thru the developmental stages – while a pup’s bones are growing the demand for calcium is very high.  As you know a bulldogs head matures till he is about 3 yrs old.  So we believe that the demand for calcium to build quality bones may be too great and this area of the brain cannot absorb enough calcium ions at the genetic level to keep the nerves healthy.  Usually an overabundance of acetylcholine, which is the chemical that enhances electrical conductivity between nerves, will cause a nerve to rapid fire.   Nerves require calcium and minerals in order to develop correctly. – Calcium deficiency?
•We have seen it in Bullies who are within 6 mos. to a yr of having a surgical procedure or experienced some type of trauma.  Anesthesia?
•Absolutely nothing at all:  The bully will be sleeping very soundly and all of a sudden the head will start rocking.  This sudden head motion will cause the bully to awaken suddenly.  An episode will last from 15 to 30 seconds, sometimes longer.  It may stop on its own and then as the dog lies down to go back to sleep the head tremor will reoccur.  REM sleep?
•A bitch that is pre-season or has just come into season.   We have seen 2 of our males doing the head bobbing in relation to a bitch in season. – So testosterone, hormones in general?  We always knew when one of our girls had a progesterone spike because her head would start to bob.
•A bitch is post whelp, and is in the milk let down phase of lactation, and trying to nurse a litter of hungry pups.  In this case the bitch has had surgical trauma as the result of a C section, is in pain, is not eating and is trying to make milk.
•Of course, Head Tremors can also be a symptom of a brain/nervous symptom abnormality, such as a tumor.  So if the head tremors are particularly violent or last for more than 24 hours at a time – you may want to see a Neurologist and have an MRI done.

What to Do When Head Tremors Happen?
If they are truly head tremors there are several things you can do.  We are not sure if some of them really help or not – but they will make you feel better. REMEMBER – this is a NON Life Threatening event – so the Bully is not in any danger.
•Do absolutely nothing – they will stop on their own – once the nerve runs out of acetylcholine.
•We add a calcium supplement to the daily diet.  Both in pill form and by adding ricotta cheese, or yogurt or frozen vanilla yogurt or vanilla ice cream to their diet daily.  Only thing you need to watch is how much cheese because they will gain weight with the ice creams/cheese.
•Keep a record of each episode, every time one occurs – describe it in great detail, the time it occurred – how long, how frequent.  Give this info to the vet if/when you see him.
•IF they do not get any worse than the head bobs – don’t do anything else but observe and document.  If the behavior changes in any way – call the vet, you may need additional assistance at this point.
•Observe the behavior –
oIf it is just the head involved.  If the dog can walk, respond to you, eat, go out and do its business – then it truly is a head tremor.
oYou can take the dog to the Veterinarian for a general exam.
If you do go to the Vet then request the following tests be done:
•Sugar
•Calcium ion levels
•Liver Enzymes
•Albumen
•Platelet counts
If you would share these results with us we would appreciate it.  We are putting together a data base of all info on Head tremors regardless of what the trigger is.  Send to:  bullchow@embarqmail.com.
oIf the behavior is other than above then an emergency trip to the Veterinarians is definitely called for: for example:
The dogs entire body is shaking and he is lying on the ground
If there is a change of consciousness – in other words if you call the dog and it appears to be staring into space, doesn’t recognize you
These are the signs of epilepsy or other neurological issues and the dog needs to be treated ASAP!!!
•Call your veterinarian and advise of the situation.  Schedule an appointment for a visit and have your vet do a health screening with blood work as indicated above.  .

What NOT to DO:
•DO NOT PANIC!!!!!
•Do NOT allow your Veterinarian to treat for Epilepsy if the symptoms indicate that it is truly just head tremors.  There are A LOT of Veterinarians out there who have never seen this before and the first thing they want to do is put them on Dilantin, Phenobarbital or Valium.  If you allow this – then you may lose your bully.  There have been way to many bullies treated for Head Tremors with Epilepsy remedies and the end result is over sedation, (because the epilepsy meds do not work on the area of the brain that is impacted for head tremors – the Epilepsy literature [what there is of it for head tremors} is very clear about this.) followed by nausea, vomiting, aspiration and then full blown pneumonia.
In closing I would like to state that it is CRUCIAL to make sure you have a Veterinarian who knows bulldogs VERY well.  IN the wrong hands a simple situation like Head Tremors can become a deadly experience for your Bully.  I am not trying to scare you I am just sharing information about experiences other Bully owners have had because they do not know about this simple annoying idiosyncrasy of the Breed.

Addendum to this article:
There have been some recent developments with Head Tremors appearing as a symptom that require mentioning here.  This applies mainly to the Bulldog Breeder.
In the past few months there have been 4 bulldog bitches that we are aware of who have experienced Head Tremors during the last week of their pregnancies.

This is cause for concern because these Head Tremors are a symptom of something more acute happening to the bitch.   We recommend that during the first half of the pregnancy you go to the Veterinarian and have baseline values pulled for the following:
•Sugar
•Calcium ion levels
•Liver Enzymes
•Albumen
•Platelet counts
Send a copy of the results to Karen at Whelpwise – if you plan on using Whelpwise to monitor prior to delivery.  (If you would send a copy to me at bullchow@embarqmail.com, I will add it to the database).
We then suggest if you see ANY head tremor activity during the pregnancy you take your bitch to the Veterinarian immediately and repeat these tests (sending a copy to Karen and or myself.)

If you have any questions about this article, feel free to call me at 908-479-4409 or email me at bullchow@embarqmail.com.