Presumptive paroxysmal dyskinesia in 41 dogs: is the diet change enough?

Paroxysmal dyskinesia (PD) in dogs comprises episodic, involuntary, nonepileptic movement disorders. Recent evidence suggests that PD may be associated with gluten sensitivity, paralleling human gluten-related neurologic syndromes.

Characterize clinical features, gastrointestinal comorbidities, gluten-related serology, and response to a gluten-free diet (GFD) in dogs with presumptive gluten-sensitive PD. We hypothesized that dietary modification would decrease episode frequency, particularly in dogs with gastrointestinal signs, seropositivity for anti-gliadin and anti-transglutaminase-2 immunoglobulin A antibodies or both.

Forty-one client-owned dogs with presumptive PD.

Retrospective review of dogs diagnosed with presumptive PD at a single institution between 2019 and 2023. Inclusion criteria included > 1 episode, video-documented episodes, normal interictal neurologic examination, serum gluten-related antibody titers, and ≥ 6 months of follow-up after transition to GFD.

Gastrointestinal signs were reported in 33/41 (80.5%) dogs; 21/41 (51.2%) had at least 1 positive antibody titer. After dietary change, 24/41 (58.5%) dogs achieved complete resolution, 15/41 (36.6%) showed partial response, and 2/41 (4.9%) remained unchanged, regardless of antibody status. All owners reported gastrointestinal improvement. Nine dogs relapsed after initial response: 6 after gluten ingestion, 1 associated with stress, and 2 despite strict GFD. Response to GFD was not significantly associated with gastrointestinal signs or antibody status.

Although dietary response was not significantly associated with antibody status or gastrointestinal signs, GFD led to substantial clinical improvement in most dogs with PD across multiple breeds, supporting a potential link between gluten sensitivity and PD, and a possible role of the gut-brain axis in disease pathogenesis.