"Bella", a 2-yr FS Silky Terrier, was referred to Cornell University Hospital for Animals on 3/19/02 with a chief complaint of tremors. Bella was acquired from a pet store, and was an indoor dog with no travel history. She had no history of vomiting, diarrhea or sneezing, and Bella was reportedly healthy prior to onset of signs. Since 11/01, Bella stopped voluntarily jumping up onto the owner's bed. In 1/02, Bella may have tumbled down the stairs, perhaps causing, or resulting in, her current clinical signs. In 2/02, Bella started to show signs of decreased appetite, decreased drinking, twitching, tremors, weakness/collapse, and lateral recumbency that was worse in the mornings and seemed to improve through the day. During her episodes of collapse, Bella would try righting herself up, but was too weak to do so. By 3/02, Bella also had epiphora, ptyalism, a weak bark, and a wet cough that was worse in the mornings. Referring complete blood count, chemistry panel, and pre- and post-prandial bile acids were all within normal limits, with creatine kinase levels at the low range of normal.