Dysautonomia in Dogs: Symptoms, Diagnosis, and Treatment

Dysautonomia in dogs, also called Key-Gaskell syndrome, is a rare neurological disorder that affects the autonomic nervous system, which controls automatic body functions such as heart rate, breathing, digestion, urination, and pupil size. 

When the autonomic nervous system does not work properly, dogs can develop symptoms affecting several areas of the body, including the eyes, digestive system, heart, and urinary tract. Symptoms may appear suddenly or develop gradually over several weeks. 

Canine dysautonomia is a serious condition that is often fatal.  

There’s currently no cure, so treatment focuses on supportive care, managing symptoms, and maintaining a dog’s comfort and quality of life. 

What Is Dysautonomia in Dogs?

Dysautonomia in dogs is a neurological disorder that affects the autonomic nervous system. The autonomic nervous system controls many of your dog’s bodily functions, such as: 

• Drooling 
• Eye pupil size 
• Heart rate 
• Breathing 
• Digestion 
• Intestinal movement 
• Blood pressure 
• Urination 
• Body temperature  

Dysautonomia in dogs causes dysfunction within the nerves of the autonomic system. It can affect a dog’s eyes, digestive system, heart, and urinary or respiratory tracts.  

While this condition is typically fatal, it’s relatively rare in dogs. 

Symptoms of Dysautonomia in Dogs

Symptoms of dysautonomia in dogs may come on quickly, within a few hours, or over several weeks.  

Signs of dysautonomia in dogs can vary but often include: 

• Loss of appetite and weight loss 
• Dry heaving and gagging 
• Vomiting and diarrhea 
• Constipation 
• Difficulty swallowing 
• Dilated (enlarged) pupils and decreased tear production 
• Fear/avoidance of light 
• Protrusion of third eyelids 
• Keratoconjunctivitis sicca (dry eye) 
• Changes in heart rate and blood pressure 
• Dry nose and mouth 
• Coughing 
• Difficulty breathing 
• Difficulty urinating 
• Poor control of bladder and bowel movements 
• Overall weakness

Symptoms such as difficulty urinating or swallowing, weakness, and having trouble breathing warrant an immediate trip to the veterinarian. 

Causes of Dysautonomia in Dogs

The exact cause of dysautonomia in dogs is not fully understood.  

Key-Gaskell syndrome may be triggered by exposure to certain environmental factors.  

The intake of plants, toxins, or contaminated food or water may contribute to the development of the condition.  

However, specific agents have not yet been determined. 

How Veterinarians Diagnose Dysautonomia in Dogs

Diagnosing dysautonomia in dogs typically involves your vet performing a physical exam on your dog, identifying their symptoms, and taking diagnostic tests. 

Your vet will ask you several questions to get a thorough history of your dog's health, a timeline of their symptoms, and possible incidents that might have led to dysautonomia.  

This history may provide clues as to which organs are being affected. While there is no specific test for dysautonomia, the following procedures may be used: 

• Eye exams, such as a Schirmer tear test 
• Imaging, such as X-rays and abdominal and/or cardiac ultrasound, echocardiogram 
• Atropine response test, which will check your dog’s heart health 
• Biopsy 
• Necropsy, which is a post-mortem exam done to collect organ and tissue samples  
• Histopathology, which is when a pathologist views organ and tissue samples under a microscope to look for changes that indicate disease  

Treatment of Dysautonomia in Dogs

Unfortunately, there’s no cure for dysautonomia in dogs.  

Your vet will focus on supportive care, symptom management, and keeping your dog comfortable.  

These treatments aim to ease your dog’s symptoms and improve your dog’s quality of life. Some dogs may be able to live with the condition, while others may not. 

Dogs with symptoms like KCS (dry eye) and constipation tend to live longer with this disease because they are easier to manage with medications like eye drops and stool softeners. Dogs who develop aspiration pneumonia or suffer heart abnormalities have a shorter survival time. 

The following are the most common therapies offered to dogs with Key-Gaskell syndrome: 

• Fluid therapy: Dysautonomia can cause dehydration due to decreased creation of saliva and tears. Intravenous (in the vein) or subcutaneous (under the skin) fluid therapy may be recommended to keep your dog hydrated. 
• Nutritional support: Some dogs may have a hard time eating, which might require a feeding tube. Your vet may also recommend food that is easily digestible such as Hill’s Science Diet a/d. These treatments may be used until your dog is no longer gagging and their weight loss has stopped. 
• Gastrointestinal support: Your vet may prescribe medication to ease vomiting, nausea, and other gastrointestinal (GI) symptoms. Medication that helps with your dog’s GI movement can help lessen any issues. Prescribed medications may include omeprazole, famotidine, and metoclopramide.  Stool softeners, such as StrellaLab Pumpkin Powder, can also be given to stop constipation. 

• Eye and nose support: Eye drops such as Optimmune can help treat dry eyes. Humidifying the air and using artificial tears and lubricants can also keep your dog’s eyes and nose moist. Products include Optixcare Eye Lube, Bag Balm, or Dermoscent BioBalm. 

• Urinary support: Your vet may also suggest medication, frequent bladder expression (manually removing urine), or placing a urinary catheter in your dog’s bladder at the start of treatment. 
• Treatment for infection: Antibiotics, such as Clavamox, may be given to treat or prevent secondary bacterial infections in your dog. 

Recovery and Management of Dysautonomia in Dogs

The course of dysautonomia in dogs can vary and the condition can’t be cured, only managed.  

If a dog is provided treatment for their symptoms, they can be managed for a few weeks to months in some cases. However, because this condition is progressive, it will continue to worsen over time. 

The severity of symptoms, disease progression, and response to treatment all play a role in determining your dog’s quality of life. 

Dogs managing Key-Gaskell syndrome should be watched closely.  

Your vet will regularly monitor their vital signs (temperature, breathing, and heart rate), water intake, urination, body weight, and bowel movements.