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Differential Diagnosis: Tremors

Mark Troxel, DVM, DACVIM (Neurology), Massachusetts Veterinary Referral Hospital, Woburn, Massachusetts


|January 2020|Peer Reviewed

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Following are differential diagnoses* for dogs presented with tremors (ie, repetitive myoclonus).

  • Primary neurologic disease
    • Steroid-responsive tremor syndrome (ie, little white shaker syndrome)
    • Cerebellar disorders
      • Congenital action-related tremors (eg, hypomyelination/ dysmyelination)
      • Cerebellitis (infectious, immune-mediated)
      • Neoplasia
    • Idiopathic episodic tremors (eg, idiopathic head tremors, benign postural tremors [geriatric dogs])
  • Toxin exposure
    • Tremorgenic mycotoxins (penitrem A and roquefortine)
    • Metronidazole intoxication (more commonly causes central vestibular dysfunction rather than tremors)
    • Other less common toxins
      • Amphetamines/pseudoephedrine
      • Bromethalin
      • Carbamates
      • Cocaine
      • Ethylene glycol
      • Heavy metals (eg, lead, aluminum)
      • Ivermectin
      • Macadamia nuts
      • Marijuana
      • Metaldehyde
      • Methylxanthines (eg, caffeine, theobromine, theophylline)
      • Organophosphates
      • Paintballs
      • Strychnine
  • Endocrine/metabolic disease
    • Hepatic encephalopathy
    • Hypocalcemia/eclampsia
    • Hypoglycemia
  • Infectious disease
    • Canine distemper virus
    • Rabies
  • Iatrogenic disease
    • Blood transfusion reactions
*These differential diagnoses are listed in no particular order, as there is no published literature to accurately describe frequency/incidence to the author’s knowledge.


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