by Anne Jones RN, BSNE
We sometimes get health reports into our bichonhealth.org web site about dogs that have had a stroke. Yet several veterinarians have told me that it is rare to see in a dog a true stroke of the type of cerebral vascular accident that is seen in humans. Of the people involved with publishing and writing for this magazine, two of us have had dogs with symptoms that looked, at first glance, to be a stroke. Happily for both of us, the condition was something far less threatening to the dog.
Heidi recently sent me a description of her dogís experience that was very much like the event that occurred in one of my dogs several years ago. Just as I had done then, she thought her beloved lab mix was a goner. She was about to leave the country and had a very short time to make a decision to put her down if that was to be the eventual outcome. Fortunately there was time for lab work. But let me describe what was going on with our dogs.
In Gingerís case, she did not want to come out of her crate one morning. I donít remember if she ate but I do remember carrying her outside and putting her on the ground, only to see her fall to one side. She lay on her side and when I encouraged her to stand, she immediately fell over again. Nothing would entice her to stand and she seemed to be too weak to stand without help when I lifted her to her feet. I was devastated. She was far too young at age twelve to lose her this way. I donít think I even called the veterinary clinic Ė I just put her in the car and we drove there expecting to hear the worst kind of news.
This was not the first time I was told that dogs rarely have strokes but it was the first dog of mine that was diagnosed with canine peripheral vestibular disease. Let me explain what it is.
Vestibular disease is an inflammation of the inner ear, the vestibule being a cavity at the entrance to the cochlea of the inner ear. While the initial symptoms happen dramatically, the condition may take time to develop. The first sign the owner has is when the apparently healthy dog falls over, tries to get up, falls again and then wanders around Ė if it is willing to make the effort to walk Ė staggering like a drunken sailor! Perhaps the dog will walk into a chair or the wall. If the dog is outside, on a porch or a deck, it may fall down the steps in an effort to get to the ground below. There will be vomiting and a failure to eat. The condition is similar to Meniereís disease in humans in its effect on your pet.
The onset of the disease may be associated with some other infection but that is not clear. It does seem to happen more often in older dogs than in the young. Ginger was about 12 and Heidiís lab mix is 15. Ginger will soon be 17 so you can see that it has not adversely affected her life in the long term. Humans describe nausea associated with inner ear disease and dogs will have vomiting associated with the disorder. Deafness may be an aftereffect. With either vestibular syndrome or inherited deafness, only one ear may be affected.
Another common complaint is head tilt and, at the time of the initial occurrence, there will likely be some inability to focus the eyes so that they shift from side to side. Owners will usually think of stroke, poisoning or brain tumor when all this is taking place and I suspect many a dog has been euthanized before determination is made that this is a mild, relatively short term condition that can be treated.
As to treatment, this is in dispute. In Gingerís case, she was given medication but I was told that she would as likely recover without it. Heidiís dog was, I believe, given antibiotic. I gave the medication for a short time and then stopped because my vet said it was not necessary in the absence of other disease. I do not believe in giving our dogs any medication that is not needed! Nothing changed when I stopped it so I was correct to discontinue in her case. If there is other sign of infection, the appropriate treatment should be used. Donít misunderstand what I am saying here. Vestibular disease will clear up without treatment in most cases but it may be sometimes coincidental to other illness.
Remember these signs of peripheral vestibular disease and consider it as a possibility if your dog exhibits these symptoms. But do take the dog to the vet because there is always a possibility of poisoning or illness! The signs to look for are:
A well dog that staggers and falls with no prior sign of sickness
Vomiting that may be the yellow foamy type
Rhythmic shifting of the eyes from side to side
Refusal to eat or drink
The primary signs will continue for at least a couple of weeks in some instances but may start to clear up sooner. If they persist longer than three weeks, you must consider that a more serious disease may be present. Ginger still has head tilt some of the time, even 4 years later, and has a tendency to be a bit unstable if she moves suddenly. I watch her come up steps and she sort of levitates. But then her Uncle Sunny used to jump straight up in the air and then move forward to enter our motor home so maybe that is a familial trait!
Back to your dog with vestibular disease: feeding will be trial and error for a few days and you may have to hand feed a bit at a time. Remember that this causes extreme nausea and your primary concern should be fluids to maintain hydration. Watch carefully for other indications that this is NOT vestibular syndrome and get the dog back to the vet if other signs occur. The five listed above are the common signs that indicate inner ear disease. And donít panic. Especially do not rush to euthanize the dog without giving time for recovery. I fear others have done so and it makes me sad each time we get a report that the dog ďhad a stroke and was euthanizedĒ. Now that you know, this will NOT happen to your dog.
Riley started her day normally, at over 15 years of age she still goes on the run with myself and my 11 year old Jack Russell. She does not keep up, but goes at her own pace, knowing that I will "pick her up" on the way back. We always walk once we reconnect but at some point on the way to the truck she began to get disoriented and confused about where the truck was. Once we got home she began staggering and swaying her head from side to side, her eyes were darting quickly as well from side to side. I called the vet and rushed her up there, sure she was having a stroke.
I was floored when they told me what it was, and assured me she would make a full recovery and very quickly. She was of course given a blood and urine database, as it has been suggested that there is a correlation between old dog vestibular syndrome and hypothyroidism, so blood work should be done to rule out this problem. This disease also has a feline counterpart, feline idiopathic vestibular disease. When a case of vestibular disease presents, it may be a good idea to wait a few days to see if improvement occurs being doing diagnostics beyond a routine/blood urine database. These two conditions are idiopathic, meaning the medical profession does not know why they occur. They do know that they represent problems in the periphery (nerves of the middle ear rather than the actual brain.) There is a more serious, much less frequent central (in the brain) version.
The vet also noted some wax build up in her left ear, and that was the direction of the tilt. They did a deep ear cleaning and put her on a round of antibiotics. They also gave her anti-nausea drugs but she never needed them.
For two days I had to carry her to the lawn to use the bathroom (she is sixty pounds). I hand fed her and put a little "personal" water bowl inside her igloo. She wanted to stay in the igloo so I made sure she was warm, and I was half way in that igloo for hours every day, comforting her.
By the time I returned ten days later (she'd been in the care of my best friend), she was walking, smiling and wagging her tail! I'm happy to report she is back to her usual chipper self again, with only a slight head tilt and slight stagger to show for her ordeal. I will only walk her now, no more runs, and might routinely have her ears cleaned if recommended. Other than that we are happily back to normal!
Editor The Bichon Frise Reporter