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Key-Gaskell Syndrome in Dogs

What Is Key-Gaskell Syndrome in Dogs?

Key-Gaskell Syndrome, also referred to as canine dysautonomia, is a neurological condition observed in dogs. It impacts the autonomic nervous system, which regulates various bodily functions such as drooling, pupil size, heart rate, breathing, digestion, intestinal movement, blood pressure, urination, and body temperature. Dysautonomia disrupts the normal functioning of the autonomic nerves, leading to issues in the eyes, digestive system, or urinary tract. Though relatively rare, this disorder is often fatal for affected dogs.


Symptoms of Key-Gaskell Syndrome in dogs can manifest rapidly within a few hours or gradually over several weeks. The signs of dysautonomia can vary, but commonly include:

  • Loss of appetite and subsequent weight loss
  • Dry heaving and gagging
  • Episodes of vomiting and diarrhea
  • Constipation
  • Swallowing difficulties
  • Enlarged pupils and reduced tear production
  • Sensitivity to light leading to fear or avoidance
  • Protrusion of third eyelids
  • Dry eye condition known as keratoconjunctivitis sicca
  • Alterations in heart rate and blood pressure
  • Dryness of the nose and mouth
  • Coughing
  • Breathing difficulties
  • Trouble urinating
  • Poor control over bladder and bowel movements
  • General weakness

Symptoms such as difficulty urinating or breathing should prompt an immediate visit to the veterinarian for evaluation and treatment.


The precise cause of dysautonomia in dogs remains unclear. Key-Gaskell syndrome might be initiated by exposure to particular environmental factors. Factors such as ingestion of plants, toxins, or contaminated food or water could play a role in its onset. However, specific agents responsible for triggering the condition have yet to be identified.The precise cause of dysautonomia in dogs remains unclear. Key-Gaskell syndrome might be initiated by exposure to particular environmental factors. Factors such as ingestion of plants, toxins, or contaminated food or water could play a role in its onset. However, specific agents responsible for triggering the condition have yet to be identified.


Diagnosing Key-Gaskell syndrome typically involves a comprehensive approach by your veterinarian, incorporating a physical examination, symptom identification, and diagnostic testing.

Your veterinarian will inquire about your dog’s medical history, symptoms timeline, and potential triggering incidents to gain insight into the affected organs. While there isn’t a singular diagnostic test for dysautonomia, the following procedures may be employed:

  • Eye Examination:
      • Your vet will conduct a Schirmer tear test to assess tear production in your dog’s eyes. This involves placing a special paper strip in the lower eyelid to collect tears over 60 seconds for analysis.
  • Imaging:
      • X-rays can reveal evidence of aspiration pneumonia, esophageal dilation, intestinal enlargement, and bladder swelling.
      • Fluoroscopy can confirm esophageal dysfunction by providing real-time images of your dog’s esophagus.
      • Abdominal ultrasound enables visualization of internal organs, potentially confirming intestinal motility issues if present.
  • Echocardiogram:
      • Ultrasound of the heart can detect enlargement of the left atrium and ventricle, indicating compromised heart function. Symptoms may include weakness, exercise intolerance, heart murmurs, or irregular heartbeats.
  • Pharmacologic Tests:
      • Pilocarpine application to the eye can assess iris control, indicating sensitivity to certain medications.
      • An Atropine challenge test evaluates heart health by monitoring heart rate response to atropine administration.
  • Biopsy/Necropsy/Histopathology:
    • Veterinary pathologists may analyze intestinal tissue samples to examine the condition of the mesenteric plexus, a nerve network within the gut.
    • In some cases, diagnosis may only be confirmed postmortem by examining nerve cells in the spinal cord and brain base. Acute cases show nerve cell degeneration, while chronic cases exhibit both cell loss and increased supportive cell types.


Regrettably, dysautonomia in dogs lacks a definitive cure. Veterinary care primarily revolves around providing supportive measures, managing symptoms, and ensuring the comfort of the affected dog. Treatment approaches may encompass:

  • Fluid Therapy:
      • Replenishing your dog’s fluid intake, either intravenously or subcutaneously, helps combat dehydration resulting from reduced saliva and tear production.
  • Medications:
      • Administration of various medications aims to alleviate symptoms and improve the dog’s quality of life.
  • Nasogastric Feeding Tube:
    • In cases where eating becomes challenging, the placement of a nasogastric feeding tube facilitates the delivery of food and medication directly to the stomach through the nose.

These interventions seek to alleviate symptoms and enhance the dog’s well-being. Some dogs may adapt to living with the condition, while others may face greater challenges. Dogs experiencing symptoms like dry eye (KCS) and constipation typically have better prognoses, as they are more manageable with medications such as eye drops and stool softeners. Conversely, dogs developing aspiration pneumonia or encountering heart abnormalities may have shorter survival times.

Common therapies for dogs with Key-Gaskell syndrome include:

  • Fluid Therapy: To counter dehydration resulting from decreased saliva and tear production.
  • Nutritional Support: Utilizing feeding tubes or easily digestible food to address feeding difficulties until symptoms improve.
  • Gastrointestinal Support: Medications to alleviate vomiting, nausea, and other GI symptoms, along with stool softeners to manage constipation.
  • Eye and Nose Support: Use of eye drops, humidification, and lubricants to treat dry eyes and maintain moisture in the eyes and nose.
  • Urinary Support: Medications or urinary catheterization to address urinary issues.
  • Treatment for Infection: Antibiotics to manage or prevent secondary bacterial infections.

These treatments collectively aim to enhance the dog’s comfort and manage the symptoms associated with Key-Gaskell syndrome.

Living and Management

The progression of dysautonomia can vary, and while the condition cannot be cured, it can be effectively managed. With appropriate treatment targeting their symptoms, dogs may start showing improvement within 24 hours to three to four weeks. Factors such as the severity of symptoms, disease advancement, and response to treatment collectively influence the dog’s quality of life.

Close monitoring is essential for dogs coping with Key-Gaskell syndrome. Your veterinarian will regularly assess vital signs including temperature, breathing, and heart rate, along with monitoring water intake, urination, body weight, and bowel movements. This vigilant observation ensures timely adjustments to the treatment plan and helps maintain the dog’s overall well-being.

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