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Neurological Diseases and Disorders of Dogs
Neurological problem in Brittany
Auditory-triggered spasms in elderly Sheltie
Treating spinal cord problem
Head injury in Cairn Terrier
Severe head trauma
Muscular Dystrophy in Chesapeake Bay Retriever
Cerebellar abiotrophy and nystagmus
Head tilt
Stroke in Yorkie
Hydrocephalus
Neurological injury
Inflammatory Brain Disease
Neurological Problems - rapid progression
Encephalitis in Corgi
Sudden disorientation in blind dog
Difficulty walking on awakening
Pug Encephalitisalso see Meningitis
also see Myasthenia Gravis
also see Head tremors
also see seizure control
also see White Shaker Dog Syndrome
also see Granulometous meningioencephalitis (GME)
also see Degenerative Myelopthy
also see Epilepsy
also see Hepatic Encephalopathy
also see Motion and Motor Problems
also see Seizure
also see Trauma
also see Vestibular
also see Fibrocartilaginous embolism
also see Brain tumor
also see MRIPlease note: The most recent medical information is at the top of the page to least current at the bottom.
Neurological problem - in Brittany
Question: Dear Dr. Mike,
Thank you again for your message re. my 13 yr. old Brittany, Mike. It
was very helpful. I have another question.
I have taken Mike to the vet re. this problem several times. This
behavior is not usually present when he is in motion. Usualy the problem
occurs when he is standing still. He will seem to sort of flinch and then sort
of have the movement go through his body-I don't know how else to describe it.
If he is eating or drinking (I have raised his dishes) and this happens he
will fall over. It seems that he sort of staggers when this happens. If
he was standing still and it happens when he has begun to walk or run he will
also stagger and bump into things. When he runs his gait is straight. I
was told he is just getting old and is losing muscle control. I am
concerned that he may have a brain problem. He does have some spinal (possibly
disc) problems from running, jumping all over the place which he would still
do now if I let him. He can run in my yard which is a couple of fenced
flat acres but he tends to stay close to me now. When we are out he is
always on a leash/halter. He is fine when we go for our walks, wants to go
faster than I do. I won't be doing any surgery unless it is something minor or an
injury as I don't want to do it to him at his age. I just wondered if
anything glaring came to mind so I could understand better.Thank you, Beverly
Answer: Beverly-
I think that your instinct that this is a neurologic problem is
probably correct. Brain tumors are not highly unusual in dogs and other
neurologic disorders can also occur. Another consideration would be hypoglycemia.
This can cause transient loss of consciousness and signs that look like
neurologic signs (seizures, muscle tremors) in some dogs. Checking the
blood sugar levels several times will usually allow this problem to be
diagnosed or ruled out. Liver disease sometimes causes this sort of
behavior, as well. So it might be a good idea to check a serum
chemistry panel the first time that blood sugar is evaluated since a panel would
have both tests. High blood pressure can sometimes cause similar signs, too.
These are the things that I can think of that might cause the signs
that you are seeing. I think that it is worth looking into some of these
problems, since there are treatments available for several of them.Good luck with this. I am sorry that there was such a long delay in
responding to your question.Mike Richards, DVM
12/31/2001
Auditory-triggered spasms in elderly sheltie
Question: Hello. I have spoken with my veterinarian about my
dog's condition, and she is at a loss to explain it.
I have an elderly (16-year-old) sheltie mix breed,
spayed female. She is almost totally deaf, but has
some hearing in the upper registers (she can hear
whistles). Certain noises seem to cause brief spasms
(crumpling paper, clapping, snapping fingers). At
first my veterinarian thought it might be a simple
"surprise" response to having heard something, but the
spasms often continue if the noise continues (repeated
rapid clapping will cause repeated rapid spasms). The
spasms also occur now if she's outside in heavy rain,
and seem to be triggered by large raindrops falling
on her. The spasms are sometimes strong enough to knock
her over. They have been increasing in intensity and
frequency, but she's had them for about the last five
or six years.She also has occasional head tremors which seem to be
somewhat stress related -- they're triggered by the
airconditioner blowing on her in the car or often when
she's in a new situation.Basically, I'm wondering if there is any information
about auditory-triggered spasms, and if there is some
sort of medication that she might benefit from. I'll
list her medical history in case that will help:About 4 years ago she was seen at Purdue
for unexplained fevers, treated with Baytrill and
recovered; this past fall she was bitten by (possibly)
a brown recluse on the underside of her jaw and has
recovered. Those are the only two serious illnesses
she's had in the 16 years. She has cataracts and is
now very vision impaired.Thank you for any help you can give me. Nancy
Answer: Nancy-
I have some information at this time but have been unable to confirm
whether there is any indication that any of these disorders actually occur
in dogs.There are two possible explanations that I can find for the behavior you
are observing. The first is an overreaction to the acoustic startle reflex.
Everyone has a threshold at which they will startle from a loud noise but
some people startle much easier or have unusual startle reflexes. In people
this is supposed to be associated frequently with schizophrenia. I have had
some patients who I truly thought exhibited behavior consistent with my
very limited understanding of what schizophrenia is, but I have not seen
anything confirming this condition really exists in dogs. There is a human
disorder, tardive dyskinesia, in which there are alterations in the facial
reflexes that might resemble what you are seeing. This occurs in people due
to the effects of medications for other pyschological disorders but it
seems to be due to a reduction in dopamine in the brain. I know that you
probably haven't been using medications for years, so this wouldn't be the
same problem exactly, but selegiline (Anipryl Rx), which is approved for
use in cognitive dysfunction in dogs, is a dopamine sparing agent and might
be helpful if there is a similar neurotransmitter problem caused by
something other than drug use. Other possible medications for this
condition would be clomipramine (Clomicalm Rx) and fluoxetine (Prozac Rx)
because they are selective seritonin re-uptake inhibitors (SSRIs), and low
levels of seritonin are also supposed to play a role in this condition.There would be a small chance that this is some variation of canine
cognitive disorder, although that condition usually involves behavioral
changes such as loss of housebreaking, forgetting meal times, standing at
the wrong side of the door --- things that show a decrease in cognitive
ability.The other possible explanation that seems possible is a seizure disorder,
which could be associated with a problem in the brain, especially something
like a brain tumor. If this is the case, it might be helpful to use seizure
control medications. My guess is that this would be considered to be a
focal seizure disorder, which means that there might be more choices in
medication that for generalized seizures. In general, though, I think that
phenobarbital is still the most commonly recommended starting medication.
If it is helpful there may be no need to look for other medications but if
it is not, there would be other possibilities for focal seizures, including
gabapentin (Neurotin (Rx)) and felbamate (Felbatol Rx).Tremors are usually an entirely different problem and the causes of tremors
seem to be more of a mystery. There is a clinical condition most commonly
referred to as "old dog tremors" that occurs but not for a known reason,
unless there is something new that I haven't heard about this condition.
Some tremors occur as a secondary problem in neurologic disease or
metabolic disease that affects the nervous system secondarily. It can be
helpful if an underlying condition can be identified. It is not uncommon to
try corticosteroids in the hope that tremors are occurring secondary to
immunologic disturbances affecting the nervous system but we have not had
much luck with this approach. We have tried selegiline in a couple of
tremoring older patients without luck, yet, either. I have not tried the
SSRIs yet but I know that some vets are currently trying these medications.There is a chance that you are seeing an odd pain response, too. We have
seen this sort of sensitivity in a couple of patients with painful
neurologic conditions. Puppies with hydrocephalus seem to react badly to
sounds sometimes and we have seen jerking motions in a couple of dogs with
cervical disc disease or agenesis of the dens when there were sounds or
when they were approached suddenly. I think even slight motion sometimes
causes pain. Usually there were signs of severe pain, at times, in these
patients, though. The possibility of a pain response is just something to
think about so that a pain response isn't missed.I hope that some of this information is helpful. I'm sorry that I can't
find more information on the possibility of disorders such as schizophrenia
in dogs. It seems logical that dogs might have a problem with this sort of
disorder but I guess that we are really hampered by our poor communication
skills when it comes to our pets. It is just hard to evaluate for illnesses
like this without being able to talk to our patients.Mike Richards, DVM
7/2/2001
Question: Dr. Richards,
My Pom was diagnosed as either having a herniated disc or arthritis of the
lower spine. She was on prednisone but was taken off prednisone due to
fear of the possible formation of gastric ulcer. We are to put her on
buffered aspirin in an effort to help ease the pain/discomfort. My
understanding is that the prednisone could help her gain some strength in
her hind legs (she sometimes falls on her butt when she has to squat to pee
or poo). Will aspirin or some less invasive drug, do about the same thing
i.e., allow them to squat?By the way, what is the difference between buffered and regular aspirin? Tony
Answer: Tony-
It is my personal opinion that corticosteroids rarely help much after the
first few days in spinal cord injuries. If it seems necessary to use
corticosteroids we tend to use them for one to three days and then switch
to non-steroidal anti-inflammatory medications. I think that pain control,
when it can be achieved, allows the pet to use the limbs and back, making
the arease stronger.Buffered aspirin is regular aspirin that has added ingredients meant to
decrease the acidity of the aspirin. The usual ingredients that are added
are magnesium hydroxide, aluminum hydroxide, calcium carbonate or
magnesium-aluminum hydroxide. There is a web site on aspirin
http://www.healthgate.com/choice/med-emerg/dih_f/chapter/mono/mg009000.shtml
which lists the milligrams of each of these additives.Mike Richards, DVM
3/19/2001
Question: Hello,
My 14 year old Cairn Terrier was injured 1 week ago in an accident involving a horse. Her head was
kicked below the left ear. Immediate response was a coma and termination of breathing. A few
minutes later with artificial respiration, she was revived and rushed to an emergency clinic where she
was diagnosed with a crushed ribcage and labored breathing and advice given to put her to sleep.
Needless to say, I rushed her another vet who upon x-rays found no internal injuries, and administered
steroids to calm the shock and help reduce her labored breathing. She was also put on pain killers
and oxygen. After she was stabilized (still very comatose at this point), she was taken to the Raleigh
NC University Vet Hospital. A Cat scan was not risked, due to having to put her under for the test.
They did not administer any additional drugs, but kept her under surveillance for two days at which
time she began eating on her own and was able to come home. A week later, she still acts
unbalanced and her head is cocked to one side. Vision on right side is unresponsive to menacing
gestures. She eats nocturnally, which is new to her. She pants almost all the time, which makes me
wonder if she is in pain. What can I be doing to help her recovery? Would small doses of aspirin be
helpful? I still feel a large lump on her head and her neck is still swollen. In the last two days, I have
also noticed new bruising appearing along her underside, which I am not sure is related...but it
concerns me too.Answer: Diane-
The area that was damaged may cause problems with the facial nerve and that might be causing the
lack of a menace reflex. Sometimes the nerve is just compressed by swelling in the area and will
function again after a few day and other times it is damaged by the traumatic event and function will
not return. It is also possible to have partial return of function and many pets will do well if they get
partial function.The lack of balance and head tilt may be due to inner ear damage or due to a brain injury. In either
case, there is a chance of recovery as the injuries heal. We have had several dogs who did not
recover from head tilts but went on to learn to function very well despite the constant head tilt. I can't
remember a dog that didn't learn to correct the balance problems, or recover from them, so I am
hoping that will be the case for your dog, too.I don't know what to say about the aspirin. I think that I would probably avoid it in this case, just in
case there is continued hemorrhage into the damaged area.Panting may occur due to pain or it might be a side effect of medications used in the initial treatment,
since it is really common to use corticosteroids to treat the initial swelling in trauma and these
medications can cause panting which might last for several days, depending on which corticosteroids
were used (if any). I think it is best to assume that pain is the cause and to treat for it, since we can't
ask. Your vet can help with pain relief.It is best to ask your vet to check out changes such as the new bruising, just in case these are due to
a drug reaction or an unrecognized injury. It can be hard to find every injury in trauma cases on the
initial examinations so it is best to have things like this rechecked.Good luck with this. You have done a good job initially and then in the decision making under
pressure at your first vet visit. I hope that the good work has resulted in a good outcome.Mike Richards, DVM
3/10/2001
Question: Doctor,
This is a bit of a reversal question, regarding the
feasibility of applying a human medical technique to dogs.We have a son who had a Traumatic Brain Injury, TBI, and has a
high recovery, in large part due to aggressive management of his
Inter(intra?) Cranial Pressure by Medical College of Virginia. He
went on to get his bachelor's, and then an MS in Rehabilitation Counseling.
One of his dogs is a Therapy Dog, and works in hospitals.This Christmas our entire family (five children, spouses, three
grandchildren, etc.) was with us for a few days. Our
88-lb Husky-x-Shepherd Cross, a 2 year old neutered male,
is very friendly with their dogs at their house, usually. However, he
attacked their 5 to10 pound neutered female geriatric dog, engulfing her head in one bite.
He bit hard enough to break the skin, but apparently not hard enough to
penetrate the skull. To cut the story short, in spite of immediate
veterinary attention, she had seizures, and is now hemi-plegic, & will probably have
to be put down. Due to the experiences with head trauma in our family,
we inquired if any of the procedures that were used on him could be applied to
the dog, specifically referring to monitoring ICP, IC drains to relieve pressure,
hyper-oxidation, etc. Our vet did not know of any veterinary practices in the major
metropolitan area that were using them, and her own four vet. practice did not have the
knowledge or equipment.Some veterinarian needs to look into this. I'm sure that the
procedures that saved our son's brain were developed on dogs at some point,
and could save a lot of other dogs even if it is too late for Annie. The
drains, the ICP pressure gauge, and the hyper-oxygenation are not really
expensive compared with a lot of other useful veterinary/medical tools.
Answer: Mike-
There are some practices equipped to treat head trauma using some, or all,
of the methods outlined in your note. There has been at least one article
in the Journal of the American Veterinary Medical Association advocating
the use of intracranial pressure measurement and surgical treatment to
lower intracranial pressure. Truthfully, this has not really caught on in
veterinary medicine, probably more due to the necessary aftercare during
recovery from severe head injuries than due to the immediate difficulty or
expense. There are several large veterinary emergency centers at which
decompression surgeries are becoming more and more common. When advanced
imaging techniques, like CT scans and MRI scans become reasonably priced
enough that big EVCs can afford them, it is likely that this sort of
surgery will become even more common.Hyperbaric oxygenation is still controversial in veterinary medicine
because it appears to increase survival but not to decrease the disability
induced by the injuries to the brain originally, which in veterinary
medicine is usually considered to be an unacceptable outcome since
continuous patient care during the recovery and rehabilitation period from
the injuries is not usually available.We are able to do more and more for our patients but we are still limited
by economics and practicality when dealing with injuries that will require
long term skilled care. Often, the initial expense, or the initial
expertise in a procedure is not really the limiting factor. In veterinary
medicine, the cost or inconvenience of longer time care is often where
limitations arise and these sometimes make good emergency choices bad long
term choices. More and more, though, pet owners are willing to put the
time, money and effort into this sort of care so it is likely we will see
more and more use of procedures like those you ask about.Mike Richards, DVM
1/23/2001
Head trauma treatment in dogs -continued
Question: Mike-
There are some practices equipped to treat head trauma using some, or
all, of the methods outlined in your note. There has been at least one
article in the Journal of the American Veterinary Medical Association
advocating the use of intracranial pressure measurement and surgical
treatment to lower intracranial pressure.Thanks for the prompt and thoughtful reply.
Guess I'll have to poke around some more on the net, & with
friendly vets, before I convince myself that canine ICP monitoring and
reducing is not cost effective when used appropriately.
Answer: Mike-
The big thing to remember in making this evaluation is the aftercare -- if
there is a dedicated owner and a continuous care facility working with
them, this could easily be considered to be cost effective. If either of
these factors are missing, then cost effectiveness really isn't the issue,
the problem becomes maintenance of the short term gain afforded by the
decompression techniques --- if there is no physical and rehabilitative
therapy for the patient, does it make sense to help them reach the point
where that would benefit them? This is an issue that is a really good
example of the major problem with veterinary medicine, the lack of
societal support for really intensive health care efforts in situations
like recovery from brain injuries, or spinal cord injuries. We can often
help immensely in the short term but that falls way short of providing a
good path back to full recovery.I don't mean to question whether it would be good if there were more places
that offered this sort of care. That was the one of the major reasons that
Michal and I established the VetInfo web site. We knew that a lot of
veterinary patients were not getting the best care possible because
veterinarians and veterinary clients did not always know that really
advanced care was possible for their pet's condition. I am absolutely
certain that a neurologic injury rehabilitation center could make it in
veterinary medicine but there might only be room for one or two in the
country right now. As time goes on and people expect even better care for
pets, you probably will turn out to be an visionary in this field --- one of
the early voices pointing out that it was possible to help pets with
neurologic damage. I am pretty sure more vets would be willing to invest in
the equipment for the short term care if they knew there was a place to
send pets for the long term care afterwards.Mike Richards, DVM
1/23/2001
Muscular dystrophy in Chesapeake Bay Retriever
Question: Dear Dr Richards;
During the past 10 weeks we have been working with our Vet., Dr. Jonathan
Smith, investigating a weakness in the rear legs/hips of our 11 month old
CBR...
x-rays of Roscoe's hips showed no abnormalities..further x-rays of his legs
suggested "physitis at insertion of tibia crest"...a second set of x-rays
taken 6 weeks after the initial set showed no improvement (weekly cartophen
injections were administered plus Omega 25 and metacam caps were given
daily)...
As agreed to by Jonathan I took Roscoe to a very respected Holistic Vet, Dr.
Marlene Smith, to review both sets of x-rays and further assessment...the
report from our first visit with Marlene included the possibility of M.D.,
yesterday we visited her for a second time (two weeks since the first
visit)...long a short is that we are focusing on M.D. as the issue and just
how to proceed.
I found an article in the internet by Dr. Bruce Smith of Auburn.
..www.vetmed.auburn.edu/srrc/ARMD.html listing traits that are simply to
similar to Roscoe's to ignore.
Jonathan and I are discussing biopsy or EMG (can't say I know what EMG is
other that a more comprehensive test of the muscles) as the next step...Have you heard of M.D. in CBR's? Any thoughts or ideas?
Best Regards, Dave
Answer: Dave-
An EMG is an electromyelogram. This is a test that helps determine if the
muscles respond properly to electrical stimulation, as would occur when
stimulated by the nervous system. This type of testing helps determine if
the problem is a muscular problem or a neurologic one and can help to
pinpoint specific problems in some cases. Muscle biopsies are necessary to
definitively identify muscular dystrophy. It would be worth contacting
Auburn at one of the email addresses listed on the site you sent the link
for. They may be interested in doing some research on Chesapeake Bay
retrievers, too. Dr. Shelton's lab in California would probably also be
able to do the biopsies if Auburn didn't pan out.I have only seen reports of muscular dystrophy in golden retrievers,
Labrador retrievers and Belgian Groenendaeler shepherds, as an inherited
disorder. There are scattered reports in other breeds, though. I think it
is just less clear why it occurs in individuals in those breeds.I would recommend considering a visit to a veterinary neurologist or
internal medicine specialist familiar with doing EMGs. If the biopsy
samples are taken from trouble spots identified through EMG (if that is
possible to do) it would help to ensure a better possibility of making a
diagnosis.Hope this helps some. If you need Dr. Shelton's lab's address I have it at
the office and I think it is online somewhere on our site, too.Mike Richards, DVM
6/12/2000
Cerebellar abiotrophy and nystagmus
Question: Dr. Richards,
I have a dog with Cerebellar Abiotrophy (CA).
Recently, I have been in touch with two wonderful doctors (a geneticist and a
neurologist) who have answered many of my questions, but I feel awkward
asking for another explanation since they have already given me so much of
their time.One question asked of these doctors concerned nystagmus. In abstracts
I've read it states that nystagmus is present in CA and I wondered why my dog
did not have it. I don't fully understand the answer I was given and I am
hoping you'll be able to explain it to me.I asked the question:
At what age is Nystagmus usually present in dogs with CA? Does this always
occur at some point in CA.?The answer provided was:
Affected dogs don't usually have a resting nystagmus, but one can be
induced with movement.Could you please explain this answer and elaborate, if possible? I
wonder if my dog has normal vision now and to what extent nystagmus
affects him. That, and what method would be used to induce the nystagmus and
why.
I appreciate your time, and also your web site. I find it very informative
and helpful.Thank you, Debbie
Answer: Debbie-
I do not recall seeing a case of cerebellar abiotrophy but this is my
impression of the disease based on searching through my textbooks for
information.Cerebellar abiotrophy is a progressive disease that affects the cerebellum.
Dogs with this condition are supposed to be pretty normal at birth and then
to develop signs associated with a decrease in cerebellar function over
time. This is thought to happen due to a metabolic deficiency in the
Purkinje's cells in the cerebellum according to the "Handbook of Small
Animal Practice, 3rd Ed.". Signs usually associated with this are
incoordination when walking, exaggerated movements and tremors when a dog
attempts to move (intention tremors). These signs occur despite normal
muscular development and function. Resting nystagmus is not commonly seen
with this condition based on the textbooks.Resting nystagmus is rhythmic movement of the eyes, usually horizontally
but sometimes vertically or even in rotational motion. There is usually a
slow drift in one direction and then a rapid correction in the opposite
direction. Resting nystagmus occurs when the dog is in a normal position
and is continuously present, at least for some time.Positional nystagmus is the name for rhythmic motion of the eyes that
occurs when the dog is held in a position that it might not normally stay
in, usually on its back. Often, positional nystagmus will occur in a
vertical direction (up and down).Nystagmus occurs because the balance system isn't working properly. The
inner ear mechanism determines the body's orientation in space. It then
sends this information to the cerebellum, where processing of the
information occurs. If the inner ear is sending inappropriate signals, the
condition is referred to as peripheral vestibular disease. If the
cerebellum isn't processing the information properly, the condition is
referred to a central vestibular disease.Nystagmus is usually, but not always, present at rest in peripheral
vestibular disease. Nystagmus tends to occur only when the dog is held in
an on its back or in another "unusual" position in central vestibular disease.So my impression is that resting nystagmus would not be expected in
cerebellar abiotrophy but that positional nystagmus would be expected.If you place your dog on his back and this induces nystagmus, that would be
an example of positional nystagmus.Even in dogs and cats born with congenital nystagmus, the effect on vision
appears to be something the dog or cat can compensate for and function
normally. This is not a disorder of the eyes themselves but rather the
vestibular system, which they are only one part of.I hope this helps. If the explanation isn't clear or just brings up more
questions, feel free to write again.Mike Richards, DVM
7/4/2000
Q: Dear Sir/Madam
I noticed my dog, Simba, his head tilting to left side about six weeks
ago.
I took him to my local vet and he could not find any thing wrong with it.
But I noticed a lot of brown gunk in his left hear. So I took him back.
The vet decided to put him on anbiotic and cortesone, but the condition has
not improved. He now decided to refer my dog to a neurosurgeon for
investigation.Prior to that he had hear infection which was treated with anbiotic
ointment.He seems to be very bright, active, perfect balance, except when he
looks at you with his tilting to left side,has good appetite, no limping.Yours sincerely
Sujuk
A: Sujuk-
There is a condition referred to as "peripheral vestibular syndrome" that
seems to occur due to inflammation of the nerves between the inner ear and
the cerebellum. It used to be called "geriatric vestibular syndrome" but
then it was recognized in younger dogs on occasion and acquired the more
general name. We have seen this condition at least once or twice in young
dogs in our practice. Usually this clears up in a few days to a few weeks.
So I hope it is what the neurologist is referring to.Mike Richards, DVM
Part 2
Q: Dear Mike,
I took my dog the neurologist. He performed all the tests, and the outcome
was that simba may have neuro pathway between his ear and the brain had been
damaged. He had also tested aspirated fluid from his ear, the result was
negative. This excludes the middle ear infection.
Can you please tell me that would it be possible for a dog under 2 year old
have that kind of conditions?Regards
Sujuk
A: Dear Sujuk-
Having your dog examined by the neurologist was probably the best thing for
you to do. I am hoping that the visit turned out well. It is good that your
vet is willing to refer cases to a specialist. It shows that your vet is
willing to have his or her work reviewed by someone else and that he or she
is willing to put the pet's needs first.Mike Richards, DVM
Q: Dear Dr. Richards,
My 10 yr old Yorkie seems to have suffered a stroke. My Vet started
her on prednisone. Several friends have asked why the Vet didn'd start her on
aspirin. Since my Vet is now on vacation, I can't ask him. Could you
please tell me if you think aspirin is appropriate therapy? Why or why not?
Thank you very much,Debra
A: Debra-
Strokes are very rare in dogs. They do occur but they are much more
infrequent than humans.The condition most commonly confused with a stroke in dogs is peripheral
vestibular syndrome. This condition causes a sudden loss of balance. The
dog's eyes often have a rhythmic side to side or up and down motion known
as nystagmus. The dog's head may tilt to one side. There are a number of
other conditions that can also cause symptoms that might be confused with
stroke, so it is important to keep communicating with your vet to ensure
that he or she is aware of the progress of the problem.Due to the fact that strokes are a fairly infrequent condition in dogs
there is not much information about how to treat them available in the
veterinary literature. I don't know if aspirin is helpful after a stroke in
dogs.Many veterinarians use prednisone early in the treatment of peripheral
vestibular syndrome. I just tell people to wait the condition out. In
almost all cases the dog will show improvement in 24 to 48 hours and the
symptoms will resolve in a few days to three weeks. A few dogs have some
residual signs with a minor head tilt probably being the most common
permanent effect.There is a definite possibility that your vet is treating for another
condition, so please do not discontinue the medication until you have a
chance to talk to your vet.Good luck with this.
Mike Richards, DVM
Q: Dr. Richards,
We have just had a dx. ofhydrocephalus given for our 6 yr old female JRT, and I was wondering what sort of experience you have had with the treatment that has been prescribed. The Neurologist at the university has decided to try furosemide and prednisolone to see if they will have some effect on the excess fluid in the brain. I was wondering how successful this treatment is and if there would be any side effects that you have seen with them. So far we have seen (other than the expected frequent urination) panting, shaking(which looks like she is shivering) slight anxiety, and muscle spasms in the extremities much like people get when their potassium levels
have been depleted. Would there be good reason to supplement her diet with electrolites to compensate for the fluid loss?
We sure do love your site, and hope that it remains afloat! Thanks for
your great service. MaureenA: Maureen-
The standard medical treatment for hydrocephalus is to use prednisone and
furosemide to control the symptoms.Prednisone is thought to decrease the production of cerebrospinal fluid. If
less fluid is produced there is less pressure on the brain when the fluid
can not drain properly. It is usually possible to get to an every other day
dosage which reduces the long term side effects associated with prednisone.
It is also acceptable in some patients to use prednisone during crisis
periods and to discontinue use between those times. Panting is not an
unusual side effect when using corticosteroids. Muscle weakness can occur
but I think I'd be more suspicious that it was associated with the
hydrocephalus than with the administration of prednisone. Muscle tremors
are occasionally reported by my clients in their pets on corticosteroids
but infrequently enough that I am not sure if they are coincidental or a
side effect. Behavioral changes are often noted by owners when pets are on
corticosteroids so some change in attitude or behavior is not too surprising.Furosemide (Lasix Rx) is a diuretic. It works by decreasing the volume of
fluid in extracellular spaces including the volume of cerebrospinal fluid.
Diuretics do sometimes result in electrolyte imbalances. Potassium loss is
a particular concern since it is more likely when furosemide and prednisone
are used together. In dogs it is fairly rare for a clinically important
electrolyte imbalance to occur but monitoring potassium, sodium and calcium
levels on a periodic basis is still a good idea. Supplementing electrolytes
in general may not be that good an idea since sodium increases can lead to
fluid retention. You might want to discuss potassium supplementation with
your vet, though.I checked through the books I have at home and the online databases and
there just isn't much more information on treatment of hydrocephalus. This
is one of many diseases that have not been treated aggressively in the past
but attitudes towards treating young pets with chronic life-threatening
conditions is changing and I think more and more information will become
available as owners such as yourself pursue treatment options.
Mike Richards, DVM
Q: Dear Dr. Richards,
4-1/2 months ago my Rottweiller had eye surgery. When I went to pick him up the next day he was crippled and we had to lift him with a blanket wrapped around his stomach. Little by little he got to the point where he could at least walk and get up the 3 stairs to the deck to come in the house. Last week I took him for his heartworm check (to a different vet) and she said it's neurological and won't get better, only worse. I got another opinion with the same result. I know if was either from dropping him or an anesthetic overdose, but that's not the important issue now. Is there anything I can do for him? He's 6 years old and I love him to death. I took him for acupuncture last week and to an animal therapist yesterday for ultrasound treatment and massage
therapy. She also uses an aqua treadmill for the atrophy. He runs like a rabbit with both hind legs together. I can live with that if he doesn't get worse. I'd really appreciate your opinion. Do you feel I'm wasting my time and money on these alternative treatments?
Thank you very much
Joanne
A: Joanne-
I am sorry to take so long in replying. I can't tell you if the alternative
medicine treatments would be helpful. There just isn't enough information
on most of the alternative treatments and specific injuries. Time alone is
often helpful but four months is a long time after a neurologic injury and
recovery will progress very slowly in most cases for neurologic signs that
persist more than a few weeks.If you are near the veterinary school in Wisconsin or the veterinary school
in Iowa, it may be helpful to get an opinion from a neurologist.
Specialists see the difficult cases and sometimes can either help or give a
more accurate prognosis if they can not help.Mike Richards, DVM
Inflammatory Brain disease - Yorkie
Dear Dr. Richards, Thank you so much for your reply. I am at more peace with myself regarding the loss of Stumpy, as I have learned more about the prognosis of brain diseases through your email, and conversations with the University of Florida Small Animal Clinic and with my local Vet. Given the fact that Stumpy started showing signs of Central Vestibular Disease over the past two weeks of his life i.e., head tilting to one side, imbalance, falling over, rapid eye movement, walking in circles the Doctors at the University strongly suspect that he had either neoplasia or inflammatory brain disease. One such disease is very common in Yorkies (Hydrocephalus). He also stated that inflammatory diseases are more common than brain tumors and are even more common in Yorkies. The prognosis for rapid progression is very poor for both. Given Stumpy's CSF tap came back normal in February, our vet was leaning toward idiopathic epilepsy. It turns out that many of these brain diseases can hide from the CSF tap. Since Stumpy was responding to the Phenabarbital and showed no nuerological signs of Central Vestibular Disease up until early May, we thought he would be okay. Even up until the first week in May he was running around the yard, barking, etc. he was like a new dog, until he started showing signs of Central Vestibular Disease. By then, it was too late, as his problem was very rapid progression. I only wish we had more time to attempt to help Stumpy.However, from all I heard about this terrible disease, it does not appear that we would have been able to change the outcome.
I am thankful that Stumpy did not have to go through any more pain and medication if the chances for complete recovery were so very low. I was also informed that he probably suffered some brain damage already from the severe seizures he had when this first started back in January. I know that the University has their own policy however, given the fact we had just put Stumpy through a month of testing at our Vet, we didn't want to have to immediately put him through any more testing since he had improved greatly at the time. The University also informed me that they lost 3 dogs over the past month due to the anesthesia required for the MRI. Since Stumpy had improved, we didn't want to take that chance at that time. They also mentioned that they all surgery is considered experimental and that in Stumpy's situation being that it was a progressive problem, the chances of even operating were very very low. Please feel free to post this on your Web page if you feel it will be helpful to other pet owners. Thank you again for taking the time to respond!
Answer: We are very sorry for your loss and will gladly share your information with our other readers.
Neurologial problems - rapid progression
Q: Dear Dr. Mike, My 4 year old dalmatian, Emma, was a healthy dog until about 5 days ago. When we woke up in the morning, the dog had great difficulty getting up. After she got up, she appeared shakey and weak. I took her to the vet that afternoon, but with all the excitement of going there she had no symptoms when we arrived. The vet diagnosed intestinal problems, probably because I did not describe the symptoms well enough and he did not witness them. Of course the pills did not work and the condition got worse. Over the last few days, it has progressed to the point where most of what the dog does is lay around tremoring. It is extremely difficult for her to get up and her walking is poor. She also seems to have muscle spasms or seizures in the head/shoulder/neck region and cannot hold her head up normally. We went back to the vet two days ago and he diagnosed tetanus as a possibility and prescribed ampicillin. He also made a videotape to send to a canine neurologist here in Davis, CA. I am waiting for either the pills to work or to hear from the other vet and the dog only seems to be getting worse. The dog does not seem to be in great pain and just stopped eating yesterday. That has me worried. Are we doing the right thing? I appreciate any advice you have to offer. I like and trust my vet but I feel like we are receiving a 'shotgun' approach to the diagnoses. Thank you- Scott and Emma
A: Scott-
If these problems persist I really think the best approach is to take your dog to the veterinary school at UCD since you live in Davis. There are several possible causes of the symptoms you describe. Polyradiculoneuritis, tick paralysis and botulism are the ones I think of right away. Tetanus does occur in dogs sometimes but is pretty rare. There are other possible problems like a diffuse neuropathy, weakness associated with metastatic cancer or possibly myasthenia gravis, although the progression of signs seems a little fast for that. One of the advantages of veterinary schools is that they have lots of specialists and can sometimes sort through these sorts of problems more quickly than a general practitioner.
I hope things are getting better.
Mike Richards, DVM
Q: OUR PARENTS HAVE A WELSH CORGY THAT THE VET THINKS HAS THIS DISEASE. THIS WAS DETERMINED AFTER BLOOD AND LIVER TESTING (LIVER IS CLEAR AND HEALTHY, NO SIGN OF TUMOR ON THE BRAIN). THE DOG HAD SEIZURES, LOST OF BOWEL CONTROL, USE OF LEGS ETC. HE IS IN VERY GOOD HEALTH OTHERWISE AND IS RESPONDING TO MEDICATION. IS THERE ANY INFO ON DOGS GETTING THIS DISEASE. WAS ONLY ABLE TO FIND INFO ON COWS/HORSES HAVING IT. APPRECIATE ANY INFO. THANKS
A: Chuck or Linda- I can not find a reference to a special predilection to encephalitis in corgis but all dog breeds are susceptible to various forms of encephalitis. Canine distemper and rabies are viral forms of encephalitis. A few unfortunate dogs develop encephalitis as a reaction to distemper vaccination. Bacterial and fungal encephalitis can occur, protozoal infections can lead to encephalitis and it sometimes occurs for no apparent reason in conditions such as granulometous meningoencephalitis.
Hopefully, seizure control has worked to resolve the clinical signs and none of the infectious diseases were present.
Mike Richards, DVM
Sudden disorientation in blind dog
Q: I have an 8 y/o neutered mini schnauzer that has a variety of health problems. He has been diagnosed with SARDS (he is totally blind)
The situation that has arisen with him is that he has become totally disoriented within the last week. He has been blind since last Sept., and has gotten around quite well. Out of the blue, he started running into everything, and just doesn't seem to know where he is at all. If we call him, he will start out in the opposite direction from us. We have to constantly guide him and carry him to wherever he needs to be. He has now totally quit trying to get around. He was trying last week to navigate throughout the house, and was running into everything, and getting stuck in areas. Now he has just given up. What do you think could have caused this? Could it be neurological? Could he be losing his hearing?
A: We recently had a similar problem with a client's dog that had been blind for a while and then suddenly started running into things. We were not able to determine a cause in that dog. Unfortunately, I have not been in contact with the owners to see if it improved, so I can't fill you in on what happened. I would worry about neurological disease, liver problems (leads to increase in blood ammonia levels and this can cause confusion or depression) and vestibular syndrome. It is very tough when a pet has multiple problems.
Mike Richards, DVM
Difficulty walking on awakening - Rottie
Q: Hello. I have a four year old rottweiler who twice in the past 3 months has awakened in the morning walking real weird. His rear end is rounded and drags on the floor and his legs are sort of caught under neath him. It looks like walking is a struggle for him. The first time, he was leaking urine while walking, the second time he wasn't. Other than these 2 episodes,he has been fit as a fiddle. Any suggestions?
A: Joe- Rottweilers are prone to a couple of degenerative spinal cord diseases but signs usually show up earlier than four years of age. Just in case, they are leukoencephalomyelopathy and neuroaxonal dystrophy.
Leukoencephalomyelopathy usually occurs in 1 to 3 year old Rotts and is a moderately slowly progessing spinal cord and brain disorder that starts out with a decrease in proprioception (ability to correctly position the legs) and progresses to a gait abnormalities and weakness in all four limbs.
Neuroaxonal dystrophy causes weakness or inability to use all four legs, nystagmus (abnormal eye movements) and tremors or other neurologic signs. It usually occurs in young Rottweilers ( 4 months to a year or so). The clinical signs may progress over several years once they start, though.
Rottweilers are also prone to hip dysplasia and several orthopedic problems like osteochondrosis dissecans which may also lead to an abnormal gait and difficulty getting up in the morning.
It is also possible that this is seizure activity and that the waking up process may be the entire length of the seizure (many seizures last for a few seconds only).
Your vet can help sort through these possibilities and any others that may be apparent on clinical exam but not from the history of the problem alone.
Mike Richards, DVM
My first pug died at age 4 of meningoencephalitis. I now have her litter-sister, age 6, (a blind black pug named Helen Keller) & I'm concerned that I might lose her to the same awful condition. What is the cause of this deadly inflammatory disease? Is it genetic? Recessive? None of the other litter-mates have had this problem (there were 5 in the litter). Many thanks! I look forward to your reply.
A: I am assuming that your reference to meningioencephalitis is to granulometous meningoencephalitis (GME) or to Pug Encephalitis which is thought to be a related, chronic form of GME. As far as I know, pugs are the only breed affected and the problem is thought to follow family lines. Unless there is new research I couldn't find, the exact mechanism of inheritance does not appear to be known. It usually shows up by 4 years of age, though, so there is a very good chance Helen Keller won't get it. It sure sounds like that was a hard-luck litter, though. It is time they had a little luck.
Mike Richards, DVM
Last edited 01/11/07
