One of my puppy buyers from 3 years ago has contacted me. I have not heard from them since the pup was 16 weeks old. It was a simple email letting me know the dog has been dx'd with MMM (masticatory muscle??) and she stated she didn't know much about it but was wondering how the rest of the litter has been doing. She didn't ask for anything...
I've read up on this MMM from past posts here as well as several internet articles and can't find much on the issue. There seems to be no concrete reason why the dog would have this. It's not clear on genetics or if this is just a fluke.
I would like to reply, but don't want to come off defensive nor do I want to lay blame anywhere. I feel terrible as the owner is a special needs to begin with. I don't know the severity of this, or if they've caught it early. I would like to show my empathy, however, have tons of questions and don't want to overwhelm them with questions either.
Anyone have a tactful way of replying?

I can't offer any advice, but a person posted earlier about the same disease. Scroll down and ask her. Good luck.

First of all, MMM is unusual in Labs- more often seen in Goldens and Rottweilers. It can only be truly diagnosed with a muscle biopsy, taken from the muscles of the face. It is an auto immune disease, affecting the Trigeminal nerve and causes severe muscle atrophy- so much that a dog may not be able to eat or drink. muscle mass all around the head will shrink, even the eyes will sink in without muscles holding them in place. Many vets will see a slack jaw and say it is MMM and give steroids. The problem is, if it is not MMM, but an infection that started in the mouth area and the dog is given steroids, they will suppress the immune system and the infection will really get bad, even affecting the Trigeminal nerve!
These folks need a good neurologist, biopsy and treatment. It is not something a GP should be handling. They need to know why, if it is MMM, the immune system was suppressed. Vaccinosis? Yard chemicals? Good luck, I hope he feels better soon.

Hi,

I have a dog who was diagnosed with MMM at 3 1/2 months of age, one of the earliest cases. My vet treated it, under the assumption of MMM, and my dog is fully recovered. Yes, the only true diagnosis is a muscle biopsy. I was not willing to do that to my puppy as he'd already been under anesthesia for xrays. We were very thorough with our treatment. We anesthetized and took a good look in the mouth for entry wounds and swelling. Then placed the dog on pain meds and antibiotics thinking it was an infection. It was obvious that this was not helping so decided to treat with prednisone. If it was MMM the pred would start working almost immediately. Within 24 hours of the immuno-suppresive dose of pred my dog showed improvement. Most will treat the symptoms assuming it's MMM. If caught early enough you can avoid head atrophy. But, it can come back. My vet is an Irish Setter breeder so had some knowledge of the disease. I see no reason why the owners could not work through this with their general vet. Their vet could contact the MMM guru at UC Santa Barbara. The jury is still out on whether it's genetic with most thinking it's not...kind of like strangles. But, I will tell you that I am hearing or more and more Labs with MMM.

Given a course of steroids when an infection is present will suppress the immune system to the point an infection could kill. Almost lost a dog this way. I would rather do the biopsy. Only a small section of the muscle tissue is needed. Having said that, there is a blood test for MMM, but it has a lot of false negatives.
I will only caution that the assumption of MMM can be a costly mistake.

It sounds almost like Bells Palsy in humans.

Thanks for the info everyone. I did send off a reply yesterday morning, and rec'd the email back from her stating : "Don't you worry about it - I don't think it had anything to do with either of us - maybe we should have caught it a few months ago BUT she got better - about 6 mos ago her jaw locked up - couldn't eat or drink. We went to Vet and she knocked her out to get an x-ray and try to open her mouth - apparently she wimpered even while out so we had her on pain killers. This was the first time MMM was mentioned and another x-ray was suggested but after $1500.00 bill we decided to wait and see - another $500.00 could wait - shouldn't have. She was also put on prednisone.

Few weeks later we noticed she was better but peeing everywhere, no control, so we got a urine sample(that was good for a laugh) and they thought she had a mild bladder infection and went on antibiotics and then seemed great. Having read about this I now think bladder problems were problems with prednisone - think they drink so much more - so we let her out really late and so far so good....I am just so relieved it isn't cancer and am very optimistic about this. Her left side behind ear has dented in - ear looks much lower - muscle connected with jaw has wasted and don't think it will get better but it won't get worse - didn't think about taking away all her balls and chew toys but that makes sense - thanks! She wouldn't touch anything if it hurt but still.....

I only contacted you to see if anyone else had it - was worried it was my fault but don't think that now because she is going to be fine - and even cuter crooked!

Glad you are still breeding - such great dogs - thanks"

I think she is handling it very well and did offer myself for any questions and that I had a pretty nifty group of people here to help contribute to information. I was ultra sensitive and very empathetic. I only wish this could be traced back, so I can avoid the situation in the future.

I appreciate all the feedback from everyone as well. Thank you!

I just learned that tick borne disease can cause the symptoms of MMM. I'd mention this to the dog owner.