Beagle Pain Syndrome

Beagle Pain Syndrome

by Darlene Verenski

Does your Dog Suffer from this Potentially
Fatal and often Undiagnosed Disorder?

It began on Sunday night when our ten-year-
old beagle, Dallas, wouldn’t eat his dinner. By
Friday morning he was blind and by that
afternoon it appeared to be a life or death
situation. Thanks to his general vet he was
referred to a veterinary neurologist and
diagnosed with a disorder known as “beagle
pain syndrome” in time for treatment.

What is “Beagle Pain Syndrome”?

“Beagle pain syndrome” (BPS), the name
used by researchers at the College of
Veterinary Medicine, Cornell University, is the
most common name for a naturally occurring
disorder characterized by recurring episodes
of fever and neck pain that persist for at least
3-7 days. Inflammation occurs in the brain
and spinal cord as well as inside and around
the small to medium sized arteries throughout
the body, specifically in the extramural
coronary arteries of the heart. The few studies
done to date have not discovered a cause. It
is speculated that the condition is an immune
mediated disorder due to its course of flare-
ups (exacerbations) and remissions and also
because of its response to corticosteroids
(Veterinary Pathology, July, 1995). There is
possibly a genetic factor: one study mated
two affected beagles and one in seven of their
offspring were also affected with onset of
symptoms at a young age.

What are the Symptoms?

Patricia M. Robidoux, breeder of beagles for
over thirty years and Webmaster of the Regal
Beagle website, relates her experience with
her dog Spencer: “We first noticed Spencer
was lethargic, shuddering and seemed to be
in pain. He walked with a "hunch" in his back
and was hesitant about climbing up on the
sofa or going up steps.” These symptoms are
commonly the first observed in the syndrome.

Most frequently observed symptoms in this
syndrome include lack of appetite, fever over
101 degrees, discomfort when being lifted,
painful opening of the mouth and an
unwillingness to move. The characteristic
“hunched stance” is a unique feature of
Beagle Pain Syndrome. The dog stands with
back arched, neck extended and head
lowered (Toxicologic Pathology, 1989). The
tail is also lowered due to neurological
changes that affect the muscles of the
hindquarters. Diarrhea is a less common
symptom. Poor coat and skin condition have
also been reported. Blindness, which affected
Dallas, is considered a rare effect.

What can be Expected During the Course
of the Syndrome?

We noticed the first symptom in our beagle,
Dallas, on Sunday night when he refused his
dinner. This was unusual for him, but we had
traveled that weekend and assumed that he
was simply tired and out of routine. The next
morning, he was very lethargic. His tail, which
usually wagged eagerly, was hanging limply.
Within twenty-four hours he could no longer
manage to climb the six-inch step into the
house on his own.

Tuesday morning I scheduled an appointment
with the vet. By the time we got there he
seemed much better; tail wagging, walking
normally, acting interested in his
surroundings. The vet noticed that his coat
was a bit thin and suggested that a thyroid
disorder might be the problem. Dallas had
blood drawn, and we went home to await
results. Dallas was doing so much better that
he was able to go for his walk that evening.

Wednesday morning was a different story.
His posture was hunched and he seemed
unable to lift his head or his tail. He walked
with a staggering gait and lost his balance
with every few steps. He was unable to lift
either of his back legs to urinate, and he
yelped when we tried to pick him up. He
refused all food we offered to him.

Studies have shown that BPS has a sudden
onset that usually occurs in young beagles;
the age of onset was between four and forty
months in most studies. Clinical symptoms
last approximately three to seven days
followed by two to four weeks of remission (no
noticeable clinical symptoms). Most laboratory
results return to normal during the periods of
remission as reported by Terence J. Hayes,
V.M.D., Ph.D., (Toxicologic Pathology, 1989,
the Society of Toxicolgic Pathologists). There
is typically a repeat of this pattern for several
cycles followed by a long period of remission.
Symptoms in some cases, however,
continued unremittingly for one to two months.
Ensuing loss of physical condition, especially
atrophy of head and neck muscles, and
increased head and neck pain can be
expected as the syndrome progresses.

We adopted Dallas when he was already
approximately 5 years old. Since he was
nearly 10 years old when we first saw
symptoms it is likely that he had the first onset
as a puppy and was in a state of remission
until this occurrence.

What Tests are Used to Diagnose the
Syndrome?

The diagnosis of B.P.S. is often a process of
elimination. When other reasons for the
symptoms are eliminated the diagnosis
becomes clearer.

The first test the vet suggested for Dallas was
a blood workup to determine whether or not
his thyroid was functioning properly.
Hypoactive thyroid can cause lethargy, poor
skin condition and deconditioning of coat.
When the results of the thyroid test came back
negative and Dallas’s muscle pain was
increasing, the vet suspected an arthritis like
condition called Polymyositis in which the
muscles become painfully inflamed. A blood
test was done to measure serum muscle
enzyme concentrations. The enzyme
concentrations were found to be normal.
Dallas was kept overnight at the vet clinic and
scheduled to see the neurologist the next
morning. He was kept on I.V. fluids to avoid
dehydration and given a mild painkiller. When
we picked him up the next morning to take
him to the neurologist we were told that things
had become worse over night. Dallas was
now blind.

Dr. Mimi Noonan, D.V.M., specializing in
neurology, examined Dallas and although she
suspected “beagle pain syndrome” his
blindness was of concern to her. She
believed that glaucoma might have been the
cause. She called a veterinary
ophthalmologist and Dallas was sent over for
an emergency evaluation. The
ophthalmologist determined that the
blindness was due to pressure on the back of
the eye from swelling in the brain. Dallas was
whisked back to the neurologist. Since Dallas
had such a great amount of brain swelling by
the time he returned to the neurologist, a
spinal tap would have been more dangerous
than helpful in her opinion. In order to take
the swelling down fast and give him the best
chance of survival he was treated with I.V.
Manitol and Dexamethasone.

In most studies of beagle pain syndrome
blood tests were done first. Results
consistently showed elevated white blood cell
counts that increased with progression of the
syndrome. Hemoglobin and hematocrit were
usually slightly decreased. Serum total
protein was normal, however most dogs
showed an imbalance between albumin
levels (decreased) alpha 2 globulins
(increased). During active episodes of the
syndrome most dogs show a nonregenerative
anemia. Blood was also tested for infectious
organisms and none were found.

Urinalysis is commonly done to test for
aerobic and anaerobic bacteria, mycoplasma
and fungi. In studies performed by J.C. Scott-
Moncrieff et al urinalysis in all dogs was
normal (Jour. Amer. Vet. Med. Assoc., Nov. 15,
1992).

The next test usually performed is a spinal tap
to determine if there is a bacterial or viral
cause for the brain and spinal cord swelling.
In beagle pain syndrome, these tests are
negative. This test was not done with Dallas
due to the severity of his case and the
necessity to begin treatment as quickly as
possible (after treatment to decrease the
brain swelling any spinal fluid tests would be
invalid).

Following a negative cerebrospinal fluid
analysis some dogs were tested for Systemic
Lupus Erythematosus, which has symptoms
similar to the debilitating symptoms of BPS. A
negative SLE test makes beagle pain
syndrome the most likely diagnosis.

How is Beagle Pain Syndrome Treated?

Antibiotics were used unsuccessfully in
several studies of beagle pain syndrome,
even in animals that showed signs of bacteria
in feces or urine (no bacteria were found in
cerebrospinal fluid). Dogs treated with
Prednisone, a corticosteroid, (1.1mg/kg of
body weight, by mouth every 12 hours)
showed dramatic improvement within the first
12 hours of treatment. All clinical signs and
laboratory abnormalities disappeared. Dogs
maintained on a low-dose, alternate-day
administration of prednisone (.25 to .50mg/kg
every other day) for several months remained
free of clinical signs. Symptoms returned
within two weeks of stopping the
corticosteroid treatments (Jour. Amer. Vet.
Med. Assoc., Nov. 15, 1992). It was shown in
some studies that the corticosteroids
treatments could be gradually reduced over a
one to two month period and then eliminated
without the return of symptoms. It is important
to monitor the dog for symptoms in the future
and restart corticosteroid treatment if
symptoms return. Side effects of steroid
treatments include increased appetite and
increased thirst. “Because of the high
dosages of steroids, Spencer drinks water by
the bucketful and wants to eat everything in
sight. The medication also tends to make him
quite sluggish, so he lies around a lot.
Basically he acts like a 10-year-old dog except
when food and water are involved,” explains
Patricia Robidoux.

Dallas was treated initially with I.V. Manitol
and Dexamethasone to quickly bring down his
brain inflammation. Within the first 24 hours
he dramatically improved, although he
remained blind and was still weak. He began
eating normally and his tail was once again
wagging. He even barked when he heard us
come into the clinic to take him home. After
the initial I.V. treatment he was put on a
course of Dexamethasone pills, .50 mg every
eight hours, to keep the inflammation from
returning. Every two weeks we reduced his
dose by one pill per day. Finally, almost 4
months later we eliminated the
Dexamethasone. Dallas has remained
symptom free for the past five months, and
although he is now farsighted, his vision is
fairly normal.

Spencer is also doing well. “You would never
know that Spencer had ever been so ill,”
writes Robidoux, “He's a very active little dog
who loves to play! Although he still shows
symptoms of necrotizing vasculitis* every few
months, we treat him with Prednisone the
second we notice a problem.”

*Necrotizing Vasculitis is one of the many
other names for B.P.S.

Addendum: Our beagle, Dallas passed away on March 25, 2010 at the age of 18. He had a long and fairly healthy life after overcoming this syndrome. He will be greatly missed.