Vestibular Disease in Small Animals || Facebook Live Q & A with Dr. Wong
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- เผยแพร่เมื่อ 15 ม.ค. 2020
- Is your pet walking with a head tilt? Do they seem uncoordinated and wobbly? They could have vestibular disease. In simple terms, this means balance problems. In this Facebook Live, Dr. Wong discusses vestibular disease in small animals including its symptoms, diagnosis, treatment and prognosis.
The vestibular system is the part of the nervous system responsible for maintaining balance and coordination. When the vestibular system is affected, the symptoms may include a head tilt, walking/falling/rolling to one side, abnormal eye movements (called nystagmus) and abnormal eye position (called strabismus).
The balance system is made up of two main parts: the peripheral vestibular system (the parts of the balance system within the inner ear) and the central vestibular system (the parts of the balance system within the brain).
It is important for veterinarians to determine whether the problem is affecting the peripheral (inner ear) or the central (brainstem) vestibular system as this affects the list of possible causes, the recommended tests, the treatment options and the likelihood of getting better (the prognosis).
Both peripheral and central vestibular disease can cause head tilt, vestibular-quality ataxia (leaning/falling/rolling to the side). Distinguishing between central and peripheral vestibular disease relies on finding other symptoms that could not be explained with a problem affecting the inner ear. These include vertical nystagmus (abnormal jerking movements of the eye in an 'up and down' direction), postural reaction deficits (knuckling or not replacing the paw when it is turned over), changes in level of alertness, other cranial nerve deficits or cerebellar signs.
Causes of peripheral vestibular disease include idiopathic or old dog vestibular disease, inner and middle ear infections, tumors, certain drugs and others.
Causes of central vestibular disease include brain tumors, strokes, encephalitis, metronidazole toxicity and others.
An MRI is usually required to diagnose most of these causes. CT scans and X-rays are typically. not sensitive enough. The treatment and prognosis varies for each of the diseases, so it is important to find the cause.
There are times when it is okay to not proceed with tests. The times are when the owner is unable to afford testing such as an MRI, if the owner does not want to pursue with tests, or if the pet is too sick for anesthesia. In these cases, a trial of medications can be tried. Sometimes no medications are necessary and patients will improve on their own, such as with old dog vestibular disease.
However, since many of the diseases that can cause vestibular disease are serious (such as encephalitis, strokes and tumors), it is recommended to pursue evaluation by a neurologist and advanced testing including MRI.
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Most dogs with idiopathic vestibular disease improve markedly (but not completely) within 3-5 days. It’s important to realize that other causes can seem to improve on their own (such as a stroke). Examination and testing are important to know the cause (and then the treatment and prognosis).
cant afford an MRI. maybe if prices were not so ridiculous we might can help our furry friends.
Thanks so much for this video. Our 11 year old female/spayed Boxer - "Ginger" was diagnosed with Vestibular disease just yesterday. I thought for sure that she had a stroke. Our Vet told us that her balance should return in a few days but that she might have the head tilt permanently. She said that if she doesn't improve, it could possibly be a brain tumor. I certainly hope that isn't the case! Our Ginger is the sweetest dog we've ever had. I told the Vet she had thrown up a couple times too, so she gave Ginger a shot of some anti-nausea medication and sent me home with 4 more doses in pill form. I'm surprised she didn't prescribe antibiotics since you said most peripheral forms of Vestibular disease are caused by an inner ear infection. She has had a history of yeast in her ears. I buy this stuff called Zymox Otic that contains an enzyme and seems to work really good. I live in Canada though and have to order it from Amazon in the U.S. I recently ordered some and had used it on her. I hope that wasn't the cause of her Vestibular disease though. Kinda makes me wonder because it's not sold here in Canada. But she is old and it did seem to come on suddenly like you said. I just hope and pray she gets better this weekend and that it isn't anything more serious.
How is your dog?
@@crazydoglady5 Our dog "Ginger" is doing good. I guess she was one of the rare cases where she had the Vestibular disease for almost 2 months! It was so emotionally exhausting because we kept thinking she had the version with a tumor. But in early October, after about 2 weeks of her having the symptoms, I took her to the Vet and they finally put her on antibiotics. Sure enough, that's when she started to get better. So it was either some swelling or infection in her inner left ear. She was on the antibiotic Clavaseptin for like 6 weeks! They also gave us the nerve pain medication Gabapentin. But it wasn't till around mid November that her symptoms really started to go away. And the head-tilt that they say may never go away, actually did go away! One permanent side effect of the Vestibular disease is that we think she doesn't see as good out of her left eye now. For a long time, the Vestibular disease had the entire left side of her face drooping and we could swear she had no sight in her left eye at times. The Vet had also given me a tube of this eye moisturizer and I was putting that in her left eye twice a day. We are so thankful that the disease is finally behind us. We hope she doesn't get it again. But oddly, for about a month now, she's been coughing and hacking. We know it's not Kennel Cough because we have another younger dog and she hasn't been coughing at all. I took her back to the Vet a couple weeks ago. He gave me a 10 day supply of a different antibiotic and 6 small doses of Prednisone. It's helped get her energy back up. But the coughing and hacking is still there. So not sure if she has allergies or if there is some growth or something in her throat. Probably sometime early in the New Year I'll take her back to the Vet if she's still coughing and hacking.
Thank you so much for your generous sharing of vet knowledge. So valuable.
You explain absolutely everything in perfect detail, except why MRIs are so financially unattainable for the average pet owner watching.
Thank you. You bring up one of the biggest issues in veterinary medicine, specifically specialty care.
As veterinarians, we just want to fix pets and keep families together. Costs get in the way of that.
The equipment (such as an MRI), the facilities, and the people that dedicate their lives to helping your pet all cost a ton of money.
We (vets in general and SEVN specifically), set our prices so that we can help as many pets as possible but still cover our costs and have enough left over to grow to help more pets.
That’s the simple answer-it costs a lot to have these sorts of services.
The question of why the average pet owner struggles to afford care is a bit more complicated. Economics, politics, inflation, the shrinking middle class and I’m sure other factors. All things that veterinarians aren’t experts in explaining.
Here is a blog post that explains a bit about MRI costs.
sevneurology.com/blog/dog-mri-cost/
I have one other explanation -- medicine, in general, is very profit oriented. Look at how nutrition and health are so low in the focus for prevention and treatment of chronic disease. Drug companies, make billions off sick patients. Curing and finding cause of disorders isn't economically profitable in the long term. Take cancer and its link to mitochondrial health and how standard care is still toxic treatments of radiation and chemo. When will honest physicians blow the lid off the CEOs who control medicine???
Great lecture! It is very helpful. Thank you
We have a 10 month old cat with vestibular disease. She had it when we adopted her as a baby and it has not progressed, nor has it lessened. The shelter had her screened by a vet and even a neurology specialist. No tumors or obvious issues with peripheral or central problem. She has a tilt and a lean, and also appears dizzy at times (especially when looking upward). She gets around just fine, but walks along the wall, especially when going up and down stairs, and will fall over while rubbing on you for loves. She is also pretty anxious, which I think is related.
Im looking for some long term care ideas but I can’t find anyone sharing their journey with a vestibular pet. Im throwing this out there in case someone else finds their way to this video with some experience.
I just had to have my baby put down, she was a large German Shepherd, and she couldn't walk as well. She couldn't even get up. She couldn't right herself, stayed on her side. Had the head tilt, eye movement, wouldn't eat, threw up. didn't pee for 1.5 days. I gave her Dramamine, that help with the nausea. She was about 12 years old. I used Lap of Love, for those who are familiar. They were good, really good.
Amazing lecture. Really helpful. Definitely increases confidence in properly approaching cases with vestibular signs!
I manga ńn,, qwtt
Have been struggling with a case. This really helped me localise the problem
And thank you for the video reason for that it was very enlightening
Great stuff!
How long after the sudden onset of idiopathic old dog vestibular disease would you expect to see and improvement such as a reduction in nystagmus and acute ataxia etc? Thank you
Hey Dr. Wong, I had a geriatric lab, unremarkable cbc/chem, that had vestibular ataxia x4, head tilt and falling to the right, no nystagmus nor other CN deficits, but CP deficits most pronounced in both LEFT limbs (and I believe delayed but present in the right limbs if i I recall). Is this the paradoxical type you briefly alluded to? Or am I wrong? (edward fang, DVM, ER DVM San Diego. thanks for these cool webinars!)
My new born puppy got bit on the neck by my older dog and started walking in circles tumbling over and just whining all day and night, I’m not sure if it can sleep, it can barely eat and drink. Can anyone help please. It literally can only stop for like a second and just keeps going it does not stop.
Why do Vets differ with their definition of VD? My healthy border collie experience this at 14 yrs old and it mimicked a stroke of her hind end that went out "suddenly." It took her 3 weeks to recover but her hind quarters remain weak. She can walk and jump though she may fall back on her hindquarters and at times drags her left rear toe nails when walking fwd.
Be careful what Vet you take your dog to. Some are as calluse as human doctors and see you and your pet ONLY as a down payment on their new car or boat!
Hi there I wanted to ask if I could have a copy of ur presentation?
It's very interesting and I would like to discuss this with my man.
Help. My dog had a head tilt at 9 mo. old. Took an antibiotic for suspected ear infection and was normal for 1 yr. At 18 mo. old, head tilted again, but more severe. Alligator rolling, nystagmus-horizontal, head tilt always to the right. He seems conscience. Episodes were 3 and 4 a day, lasting 20-30 sec before eyes and head returned to normal. Neuro thinks epilepsy. Spinal tap normal, exam triggered an episode when he tested balance. MRI showed only one abnormality-"prominent" rostral artery along the margins of the right rostral cerebellum at the level of the right cerebellar artery. It is prominent compared to the left on the transverse slices, however not appreciable on the sagittal or dorsal images. Could his be inflammation and not epilepsy? He took clavamox for 1 month and had no episodes for 2 wks- his longest record. I watched all your vestibular videos and Archie really looks just like that, not like epileptic seizures. I have many videos of him too. Now he's on phenobarbital and keppra- with no improvement, but my neuro still thinks epilepsy. He said the rostral artery prominence is not something he sees in epileptic dogs, so I'm wondering if that is causing these episodes. There's no real pattern to them- waking up, resting, playing, barking, stress, etc. They occur with both physical activity and non-physical. I really need some insight into this. Please help.
New A. De Lahunta :)
With the inner ear effected, is this similar to what we experience during an episode of vertigo? And if that could be an additional cause in dogs, I know antihistamines are the only thing that helps me for vertigo, could antihistamines help a dog in this situation if that is the case? Also, vertigo can be caused by unbalanced inner ear crystals in humans and there is a technique for relief of that, curious if that could be done on dogs as well.
Hello doctor
i watched the video of an argentinian women with a degree in biology, who try the pill NOOTROPIL (800 mg) or its equivalent and gave it to her dog and the dog recover almost completely. I try this pill on my dog too and it worked too. Maybe veterinarians should research on this.
Its derivative is used to treat seizures in vetmed.
If they have atrophy on one side of the head/tongue is there a risk of them choking if owner gives water by bottle?
Pls, im from Croatia, can you tell me the difference of this syndrom when a brain tumor is the cause and when its not ? My 15yrs old dog is having all this symptoms 4 days so far, today she seems a little better..we went to the vet and she said to monitore her few days and then come again
Is there something natural remedy?
also certain antibiotics can cause it..Gentamicin etc...
My 15 yr old d
Doxxy knows where he is and tries to get up but he keeeps bobbing his head up and down like in a infinity figure 8 what is this
Does this happens in rabbies or distemper or Parvo please help me out
My 6-year-old 2 and 1/2 lb Yorkie has vestibulars disease. The vet switch to food to a little softer food to put her medicine in. And she eats it real fast. But she's been bloated since I brought her home and we're going on week 3. I'm worried
She's Shone improvements as far as getting stronger. But she's still walking sideways with the head tilt.
do you ever see fever and tremors present with older dogs and vestibular disease?
I'm not a vet. As I have had many sick puppies, I always try to go into an appointment with information. That way, I can stuff the feelings and pursue the problem. My Weimaraner (14) surely must have old dog vestibular disease. At first when it happened, her eyes were going a different way, but they were slits and I couldn't tell up and down or side to side. I was thinking she was a goner, but now she was fine going to the park, then bam couldn't stand straight. My family told me to put her down immediately. Now, I see that in a few days she could approach normal again. Thanks for a very informative lecture Dr. Wong! PS I also saw on another site a few people discussing rubbing Cayenne pepper on the gums for quick healing. It's not scientific, but what's the harm, eh?
Seems cruel to rub cayenne pepper in anyone’s mouth, especially if they’re recovering from vestibular disease.
I am a vet and to cure this, you don’t put cayenne pepper in the dogs mouth, you put it in the owners mouth and it cures this form of stupidity every time.
My dog seems to have something like that, she can walk, and jump semi responsive, gets jumpy when I go to touch her but she doesn't have the head tilt...any help with the cause?
Tough to say without seeing. Especially if no head tilt.
@@SEVNeurology os there a way I can send u a video?
@@SEVNeurology can i have an email so i can share my cat symptoms.. please i need your help
Hello -- we have a senior cat who has suddenly starting moving erratically at rest. Then, seconds later she seems fine. Can you please consult with us? Please contact me. Thanks,
Hi Lura. Where are you located? Please call one of our offices for an appointment to evaluate your cat.
My old dog has all the symptoms of the Peripheral type but he does get vertical nystagmus. I have a video of him and the nystagmus on my channel. He has had about 6 episodes in the last 3 years and every time he makes a full recovery within two days, never any residual head tilt.
Vertical nystagmus is strongly suggestive of central disease.
@@SEVNeurology I guess what I am asking is, is it normal for a dog with Central Vestibular Disease to consistently fully recover?
@@Keechak Depends on the underlying cause. The fact that there are multiple/recurrent episodes suggests that he's not making a 'full recovery', but the fact that it's been going on for over 3 years makes "terrible" things like brain tumors less likely. Possibly a stroke/multiple strokes?
@@SEVNeurology that is something I will bring up with his vet thank you!