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White Shakers Syndrome
Contributed By: Christine Swingle

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DESCRIPTION:

This syndrome is a unique generalized tremor that occurs in young, predominately small dogs. Because this syndrome was initially seen in larger numbers of dogs with white coats, the name White Shaker Dog Syndrome has also been used to describe it.  

Dogs with WSS have a fine tremor of the entire body. Young dogs (9 months to 3 years old) of either sex are most frequently affected. The tremor is usually persistent throughout the day and will worsen with handling, excitement or stress. The magnitude of the tremor may increase or remain persistent without therapy. Other clinical signs associated with a neurological system abnormality, such as head tilts, limb weakness and seizures are occasionally seen.

The disease is most often associated with a mild central nervous system inflammation (nonsuppurative encephalomyelitis). This inflammation commonly affects the cerebellum, and dysfunction of this part of the brain may be one of the initiators of the tremor. Some veterinarians hypothesize that the cause might be from an underlying virus, but there has been no research to support that theory and no definitive infectious cause has been found for this inflammation. Also, it is not known if the inflammation is the true cause of the tremor or if there is some other associated neurotransmitter abnormality that results in abnormal firing of nerves.

 Diagnosis:

Generally made with clinical descriptions and symptoms. Blood cytology, chemistry and x-rays, as well as a physical exam, are usually normal and have not proven valuable to aid in a diagnosis. The disease is rarely fatal.

Symptoms:

WSS is characterized by a sudden onset of constant tremors all over the body, including the head and eyeballs. Chaotic random eye movement is called opsoclonus. Rapid, involuntary, rhythmic eye movements, often indicative of central nervous system dysfunction is called nystagmus. The tremors are exaggerated by handling, forced locomotion, excitement and high levels of stress. It decreases but may not completely disappear with total relaxation. Putting the dog in a crate in a minimally darkened room, where there is quiet, has helped reduce the tremors during times of stress. The dogs are alert and responsive and have no deficiency in cranial nerve function. The tremors may be severe enough to cause an ataxic gait, but strength remains normal. On occasion, one of these dogs convulses. At the onset of the syndrome, and usually for a short period of time, the animal may refuse to eat. Therefore, great care and TLC must be given to encourage eating and drinking, or, this must be done by hand. Eventually, they return to eating and drinking on their own. Some dogs benefit by elevating their food and water bowls off the ground, so the dog does not have to lower its head as much. 

Treatment: 

No specific therapy exists but supportive therapy includes reducing the tremors with diazepam (Valium) and anti-inflammatory drugs (corticosteroids). It has been suggested that neither alone is rapidly and consistently effective. The use of both types of drug simultaneously has been more effective and reliable, according to Dr. Alan Parker’s experience. Early diagnosis is beneficial when beginning treatment, as many dogs will respond in a few days to immunosuppressive levels of corticosteroids. Some dogs may have to be maintained on low levels of these drugs for a number of months, but there are some dogs that never require them. When giving steroids, it is very important not to decrease the corticosteroid dose too quickly.

According to Dr. Parker, if treated, the duration of therapy is critical; premature cessation of therapy usually leads to a relapse. Simultaneous use of oral prednisolone (1-2[rarely 4] mg./kg, Q24h for four weeks, then ½-1 mg/kg, Q24h for two weeks, then ½-1 mg/kg Q48h for two weeks, and then ½-1 mg/kg Q72h for four weeks) with oral diazepam (1/2-1 mg/kg, Q8h for four weeks, then ½-1 mg/kg, Q12h for four weeks and then ½-1 mg/kg, Q24h for four weeks) is preferable. Clinical signs usually decrease during the second day and the dogs are usually 80 percent normal by the fifth day. Vaccinations are not recommended for WSS dogs as relapses could occur within a month of vaccination.

Personal Experience:

I had a WSS Westie (diagnosed at age 3) that got worse when given the drugs. I felt as if I was going to have to put Cody down but I persisted. He did not eat or drink unless I put it directly into his mouth. It was approximately two and a half weeks from the start of the symptoms, through diagnosis, when Cody began to eat and drink on his own. Today, when things get stressed, Cody is isolated in a quiet and peaceful room for about 15 minutes to one half-hour. I have also found that a homeopathic remedy called Calming Essence or Rescue Remedy (Back Flower Remedies Ltd., and available in health food stores) helps him greatly during times of excitement and stress. There might come that moment when you think the only answer is euthanasia. DON’T GIVE UP. If I had, my Cody would not be here today, and at age 10 he is going strong.

References:

Dr. Alan J. Parker, MRCVS, PhD, Diplomate ACVIM (Neurology)
Chief of Staff, Small Animal Hospital
Dept. of Veterinary Clinical Medicine
College of Veterinary Medicine
University of Illinois
1008 West Hazelwood Drive
Urbana, IL 61801 
Phone: 217-333-5311

Alexander deLahunta, DVM, PhD
College of Veterinary Medicine
Cornell University
Ithaca, New York 14853-6401
Phone: 607-253-3547

Rodney S. Bagley, DVM
Dept. of Veterinary Clinical Medicine and Surgery
College of Veterinary Medicine
Washing State University
Pullman, Washington 99164-6610

For additional information you may contact Christine by phone or email as follows:

Phone:	860-872-8045 (available after 7pm)
Email:	Click here to email Christine

***Disclaimer*** Any information contained on this site relating to various medical, health, and fitness conditions of Westies and their treatment is for informational purposes only and is not meant to be a substitute for the advice provided by your own veterinarian. You should not use the information contained herein for diagnosing a Westie's health - you should always consult your own veterinarian.