Health Concerns: Nervous System
Lucky, my 14 year-old Labrador Retriever, had a sudden onset of falling to the right, looking drunk, tilting his head to the right and having wiggly eyes. I brought Lucky to my veterinarian who diagnosed a “peripheral vestibular disorder” and recommended rest. I am worried Lucky had a stroke. Can you tell me more about peripheral vestibular disorders.
Dear Pet Owner:
Lucky is likely suffering from “Geriatric Peripheral Vestibular Disease” based on your description of the clinical signs and Lucky's age. The long-term prognosis, thankfully, is very good. The vestibular system is responsible for balance and starts in the inner ear and travels into the brain. Diseases affecting the nerveS outside of the brain (ie peripheral vestibular disorders), in general, have a better prognosis then those diseases affecting the brain itself (central vestibular disorders). Clinical signs seen with peripheral vestibular disorders include looking drunk, falling to one side, having a head tilt towards one side and having abnormal eye movements, called nystagmus. Many owners with dogs that have suffered a vestibular episode will think the pet has had a stroke because the signs are sudden in onset and involve the brain. Technically speaking a stroke means that there has been impairment of blood supply to the brain that has resulted in the neurologic signs. There is no evidence of impairment to the blood supply to the brain in dogs with geriatric peripheral vestibular. The cause at this point is unknown. The treatment for geriatric vestibular disease is controversial, as many patients will get better on their own over time. Nonetheless many veterinarians will treat these patients with steroids and antibiotics.
My pet beagle suffers from epileptic seizures. When he has one he seems to be awake but I can't get him to recognize me. Is he in any pain during a seizure?
Dear Pet Owner:
Epilepsy is a relatively common condition in dogs. It occurs less commonly in cats. Epilepsy is a sudden discharge of excessive electrical impulses in the brain resulting in a seizure or convulsion. The cause of this electrical discharge is unknown (idiopathic) but in many cases it has a hereditary component.
Epilepsy is usually first seen in dogs between 2-4 years of age. Almost all breeds of dogs, including mixed breeds have been affected. German Shepherds, Beagles, and Cocker Spaniels are known to have a hereditary predisposition to this condition. Epileptic seizures seldom last more than five minutes, but to an unprepared owner they are can be extremely upsetting and seem to last much longer. Most seizures occur in three distinct phases. The first phase is called the Aura and is the period before the seizure during which the affected animal seems overly anxious. It may shun or demand attention and seem confused. This phase usually lasts less than one minute.
The second phase is the actual seizure. Each attack may be different and can range from mild muscle spasms to severe convulsions. Although your pet may cry and seem painful they are usually unconscious at this point and do not feel any pain. Do not try to console your pet by holding him. They are unaware of what you are trying to do and may unintentionally hurt you. You can be most helpful by making sure that they cannot hurt themselves while convulsing by blocking stairwells, moving chairs, lamps, etc. The third phase occurs immediately after the seizure and is characterized by confusion, weakness and panting. This is the post-ictal phase. The severity and duration of this phase depends on the severity of the actual convulsion. Temporary blindness and total exhaustion may follow a severe seizure episode.
Status Epilepticus is a continuous seizure that demands immediate veterinary attention. If a seizure lasts for more than five minutes or if your pet has a seizure followed immediately by another one, contact your veterinarian right away.
Treatment for epilepsy does not cure the disease. Instead, treatment controls the frequency and severity of seizures. Most dogs will come under control with standard doses of Phenobarbital alone or additional medications may be prescribed by your veterinarian. The level of these drugs in the bloodstream can be tested by your veterinarian for optimal control at a therapeutic range. Unfortunately, even under the best of care a few dogs are impossible to adequately control. These cases may be normal for long periods of time and then suffer from cluster seizures (a great number of seizures in a short time period). These patients require 24-hours hospitalization and close monitoring.
Frantz, my 3 year-old Dachshund has had 2 episodes of neck pain that was treated with steroids and completely resolved. Now, however, for the past week Frantz is extremely painful when he lifts his head and seems drunk in all of his legs. What should I do?
Dear Pet Owner:
Frantz is likely suffering from a herniated disc and needs immediate care by a specialist who deals with the nervous system. Disc disease is very common in Dachshunds and usually affects Dachshunds between 1 and 6 years of age. Signs can be as mild as some discomfort to as serious as complete paralysis. Other breeds commonly affected include Beagles, Llasa Apsos, Cocker Spaniels and Dalmations. The specialist will likely recommend an MRI to determine the exact disc that is causing the problem. An MRI is a noninvasive test that allows precise determination of the offending disc. Alternatively the specialist may recommend a myelogram if an MRI is not available. The myelogram has the disadvantage of being an invasive test that involves injecting contrast material around the spine and then taking radiographs to evaluate the spine. In addition, the MRI is more precise with regards to determining the cause of the problem. Regardless of whether an MRI or myelogram is done, if the signs are severe and recurring, surgery will be recommended. This involves removing the herniated disc from the spinal canal through an incision under the neck. In general, in dogs like Frantz that are painful and mildly uncoordinated in all four legs, the prognosis is excellent with approximately 90% of patients returning to normal after surgery. Post-operatively Frantz will be required to rest at home for 4-8 weeks.