The Clinical and Serological Effect of a Gluten‐Free Diet in Border Terriers with Epileptoid Cramping Syndrome

Abstract

BackgroundCanine epileptoid cramping syndrome (CECS) is a paroxysmal movement disorder of Border Terriers (BTs). These dogs might respond to a gluten‐free diet.ObjectivesThe objective of this study was to examine the clinical and serological effect of a gluten‐free diet in BTs with CECS.AnimalsSix client‐owned BTs with clinically confirmed CECS.MethodsDogs were prospectively recruited that had at least a 6‐month history of CECS based on the observed phenomenology (using video) and had exhibited at least 2 separate episodes on different days. Dogs were tested for anti‐transglutaminase 2 (TG2 IgA) and anti‐gliadin (AGA IgG) antibodies in the serum at presentation, and 3, 6, and 9 months after the introduction of a gluten‐free diet. Duodenal biopsies were performed in 1 dog.ResultsSerum TG2 IgA titers were increased in 6/6 BTs (P = .006) and AGA IgG titers were increased in 5/6 BTs at presentation compared to those of controls (P = .018). After 9 months, there was clinical and serological improvement in all BTs with CECS strictly adhering to a gluten‐free diet (5/5). One dog had persistently increased antibody titers. This dog scavenged horse manure. On the strict introduction of a gluten‐free diet this dog also had an improved clinical and serological response. The diet‐associated improvement was reversible in 2 dogs on completion of the study, both of which suffered a relapse of CECS on the re‐introduction of gluten.ConclusionsCanine epileptoid cramping syndrome in BTs is a gluten‐sensitive movement disorder triggered and perpetuated by gluten and thus responsive to a gluten‐free diet.

A presumptive case of gluten sensitivity in a border terrier: a multisystem disorder?

“…Thoracic radiographs and an abdominal ultrasound examination did not reveal abnormalities. Serum anti-transglutaminase 2 i (TG2 IgA, 1.007; reference interval 0.129–0.285) and anti-gliadin ii (AGA IgG, 0.724; reference interval 0.092–0.162) antibodies were increased compared with previously reported controls (Lowrie and others 2015). …”

“…Similarly, in patients with neurological manifestations, gastrointestinal symptoms are only detectable in 10 per cent of the cases, but biopsy evidence of CD can be found in up to one-third (Hadjivassiliou and others 2008). This is true in Border terriers with PGSD where despite a history of chronic diarrhoea and vomiting there were unremarkable histological abnormalities of the small intestine (Lowrie and others 2015). …”

“…As the inflammatory bowel disease improved, the micronutrient deficiency might have been corrected, improving the neurological signs. However, observations in people and dogs (Ghazal and others 2012, Lowrie and others 2015) contradict this hypothesis whereby a patient may present with neurological signs in the absence of an enteropathy and improve on a gluten-free diet. A more feasible explanation for the gastrointestinal, neurological and dermatological signs described is an immunological link between the three.…”

Paroxysmal Dyskinesia in Border Terriers: Clinical, Epidemiological, and Genetic Investigations

“…Neurological clinical signs completely resolved after introduction of a gluten‐free diet. Recently, increased concentrations of antitransglutaminase and antigliadin antibodies were identified in the serum of 6 Border Terriers with CECS . A strict gluten‐free diet resulted in clinical and serological improvement in all dogs.…”

Gluten exposure and multisystem disease in dogs

“…While sharing some similarities with coeliac disease, canine gluten-sensitive enteropathy was originally considered different to the condition in people in several respects; for example, AGA IgG antibody levels were lower and serum immune complex levels were not elevated, whereas they are in people (Hall and others 1992), so a systemic immune response did not seem to be involved, and a mucosal delayed hypersensitivity response was not ruled out. However, gluten exposure has recently been implicated in paroxysmal gluten-sensitive dyskinesia (PGSD) in Border terriers (Lowrie and others 2015), a condition previously known as canine epileptoid cramping syndrome.…”