IS IT A STROKE OR VESTIBULAR DISEASE?

“Autumn is a second spring when every leaf’s a flower.”   Albert Camus, French novelist

Most of you have known someone who has experienced a stroke and many of you have witnessed the onset of a stroke.  So, it's not unexpected that you might think the same signs appearing in your dog or cat would signal the onset of a stroke.  However, don't be so quick to think so.

Vestibular Disease in the Dog

The vestibular system senses the position of the head and body in space, in relation to gravity and movement. This helps the animal maintain balance and coordinate eye movements with movement of the head. This system will alert the brain if the dog is standing, sitting, lying down, falling, spinning in circles, and keeps the body balanced. The vestibular system is comprised of nerves that start in the brain and continue to the inner ear, where the semi-circular canals of balance are located. If there is an abnormality within this apparatus, head tilt, incoordination, rolling or falling, and/or involuntary rhythmic eye movements (nystagmus) may be seen, as well as dizziness, imbalance, salivation and vomiting (which may be present as a result of dizziness). Vestibular disease affects the ability of the brain to recognize abnormal body positions and also affects the brain's ability to correct these abnormalities.

Disorders of the vestibular system are divided into central vestibular disease and peripheral vestibular disease.  Central vestibular disease occurs due to an abnormality within the brain. Peripheral vestibular disease, the more common of the two, occurs due to an abnormality within the nerves of the inner ear. Canine vestibular disease occurs when the nerves connecting the inner ear with the brain become irritated and your dog loses his sense of balance.Most cases of vestibular disease are peripheral and no known cause is determined. These are referred to as idiopathic.

Vestibular disease typically affects older dogs with an average age of 12 to 13 years.  Animal afflicted with vestibular disease become suddenly very dizzy and the symptoms can be very drastic and frightening to the owner.

There are a number of conditions that can contribute to the development of canine vestibular disease, or peripheral vestibular syndrome. Chronic or recurrent ear infections, head injury and stroke can all play a role, as can tumors and meningioencephalitis. All of these things can damage the nerves of the inner ear and make them likely to become inflamed.

Middle ear infections are a frequent cause of vestibular disease in younger dogs. These can occur when ear infections become chronic. Treating the ear infection can resolve the symptoms of vestibular disease, though they may be likely to recur.

Canine vestibular syndrome is often the result of a brain lesion or infection of the brain. It also occurs in older dogs for reasons vets don't understand. This type of canine vestibular disease, the idiopathic form, occurs all at once and then resolves on its own just as suddenly, days or weeks later. Most dogs make a full recovery from this type of canine vestibular syndrome, though symptoms may recur.

Diagnosis

Vestibular disease can affect an animal very suddenly. Due to the signs of head tilt, circling and staggering, many owners feel their pet has had a stroke. Fortunately, strokes are rare in animals.

Identification of vestibular dysfunction is based on recognition of the specific signs. The veterinarian diagnoses the cause of the disorder with a medical history and examination. Other disorders that result in signs similar to vestibular disease include:

• Inner ear infections
• Thiamine deficiency
• Head trauma
• Metronidazole (antibiotic) toxicity
• Middle ear polyps
• Middle ear cancer

Diagnostic tests are needed to determine the presence of an underlying disease or cause for the vestibular disorder and to differentiate vestibular disease from other disorders affecting the balance system of the body. Vestibular disease, for which an underlying cause cannot be determined after thorough diagnostic evaluation, is called idiopathic.

Your veterinarian will take a complete medical history and perform a thorough physical examination including a complete neurologic examination and complete examination of the ear canal.

Further tests may include:
• A complete blood count (CBC or hemogram)
• Serum biochemistry tests to evaluate blood glucose, liver and kidney function and electrolytes
• Urinalysis
• Other diagnostic tests may be recommended based on the results of the history, physical examination and initial laboratory tests such as spinal tap, CT scan, MRI or skull x-rays.

Vestibular diseases:

Ear infection--Infection of the middle/inner ear is a common cause of vestibular disease in the dog. Most cases can be diagnosed by a thorough examination of the ear with an otoscope. Ear culture, X-rays, computed tomography or magnetic resonance imaging is sometimes necessary. If bacteria cause the infection, treatment consists of appropriate antibiotics.

Canine idiopathic vestibular syndrome:

This is also a common cause of vestibular disease in the dog. Another name is geriatric vestibular syndrome. Older dogs (mean age 12.5 years) are primarily affected. There is a sudden onset of incoordination (which can be severe), head tilt, nystagmus and occasionally vomiting. The cause of this syndrome is unknown. Diagnosis is based on the signs and excluding other causes of vestibular dysfunction. Affected dogs usually improve spontaneously within 2 weeks, although there may be a mild, persistent head tilt. Nursing care is important during recovery. Unfortunately, affected dogs are sometimes euthanized because of the severe signs and concerns that the patient has a brain tumor or stroke.

Treatment

Results of the history, physical examination and initial laboratory tests will determine the need for further diagnostic tests and will help determine the appropriate treatment for your pet's vestibular disorder. Treatment will be dictated by the underlying cause. When possible, the specific underlying cause of the vestibular disorder should be treated. Idiopathic peripheral vestibular disease generally slowly improves over the course of one to two weeks and little treatment is needed.

Pets afflicted with idiopathic vestibular disease usually recover within two weeks. Many will show great improvement within 72 hours. Some pets will require treatment for the nausea and motion sickness they may experience from the dizziness. Dogs that are vomiting may require IV fluids to keep them hydrated. At home, the owner must pay special attention to keeping the pet confined in order to prevent injuries such as falling down stairs or falling into pools and ponds. It is important to make sure the pet continues to eat and drink normally.

Successful long term treatment will depend on the cause of your dog's vestibular disease. Common causes include ear infection, hypothyroidism, toxicity, cancer and encephalitis. In the case of ear infection or infection-caused encephalitis, antibiotics are successful in treating both the infection and the resulting vestibular disease. In the case of hypothyroidism, thyroid supplementation is quite effective and the vestibular disease usually goes away within two months. Toxicity is usually treated with medications administered in the ear. In cancer cases, tumors located in the inner ear or brain can be a root cause of vestibular syndrome. Shrinking or removing the tumor (when possible) is usually an effective treatment.

Home Care and Prevention

Call your veterinarian promptly if your pet is showing signs of vestibular disease. This is a frightening experience for your pet so speak calmly and soothingly. Make sure he does not injure himself. For idiopathic vestibular disease, there is no known preventative since the cause is not known. For other causes, avoid traumatic incidents by keeping your dog on a leash or in an enclosed area. Keep your pet vaccinated and avoid exposure to poisons or toxins.

Canine vestibular syndrome usually improves quickly, though if your veterinarian doesn't see any improvement within 72 hours he will begin testing for other possible causes, including stroke and brain tumors. If you can help your dog through the initial stages of vestibular disease, then he'll probably regain full motor control within a matter of weeks.

Help your dog cope with vestibular syndrome by hand feeding him while he recovers. Your dog may be too dizzy or nauseated to eat on his own. If your dog seems to have lost his appetite, offer him treats that he enjoys. Soft morsels will be easier to chew and digest. Elevate your dog's water bowl so that he can drink more easily during his recovery. Helping a dog to take care of urination and defecation by supporting the body may be necessary.

Nursing care and good home care is crucial during the recovery process. While vestibular disease is not a life threatening condition, it's quite distressing to see your beloved dog exhibiting symptoms. Recovery time varies in accordance with the age and overall health of your dog. It's crucial to ensure that your dog rests and has plenty of quiet time throughout his recovery. To help your dog regain a sense of balance, keeping his feet on the ground and eyes on the horizon will help. The prognosis for a dog with vestibular disease is generally very good. Even when they do not recover 100 percent, they still can lead good, full lives. If you sense that your dog is relapsing or worsening, contact your veterinarian immediately.

Adapted from:
http://www.petplace.com/dogs/vestibular-disease-in-dogs/page1.aspx

http://www.petside.com/condition/dog/vestibular-disease-canine

http://www.ehow.com/way_5406044_treatment-vestibular-disease-dogs.html

http://www.vetinfo.com/vestibular-disease-dogs.html

http://www.canine-epilepsy.com/vestibular.html

In cats, this disorder pretty much follows the outline for dogs, except that it does seems to appear more commonly in the late spring and early fall and more predominately in cats of senior age. 

SPORTS NEWS

The Pittsburgh Steelers lost to Houston, offering a pathetic effort on both offense and defense.  Our next 2 games are at home and should be winnable; however, something is still missing from the team's efforts.



PERSONAL STUFF

The torn calf muscle has severely limited Helpful Buckeye's range of exercise possibilities.  It's been 2 weeks since it happened and my ankle and foot are still swollen, although the calf seems to be starting to get some strength back.  I'm hoping to get back on my bike this week so I can begin to regain my conditioning level.  I need to get back to a certain level of capability before the 79-mile race in Tucson the week before Thanksgiving...if I can't, it might just be a 4-day vacation in Tucson.

Fall has arrived in northern Arizona...not just with all the color in our aspens, but also with some snow on our big mountains.  Since this is my favorite season in Flagstaff...and I am really looking forward to getting back outside on my bike, here are a few quotes to further express my feelings about the season:

“Winter is an etching, spring a watercolor, summer an oil painting, and autumn a mosaic of them all.” Stanley Horowitz

“October poplars are flaming torches lighting the way to winter.” Nova Blair

“In the garden, Autumn is, indeed the crowning glory of the year, bringing us the fruition of months of thought and care and toil. And at no season, save perhaps in Daffodil time, do we get such superb color effects as from August to November.” Rose Kingsley

“Every leaf speaks bliss to me, fluttering from the autumn tree.” Emily Bronte

“Autumn carries more gold in its hand than all the other seasons.” Jim Bishop

“I cannot endure to waste anything as precious as autumn sunshine by staying in the house. So I spend all the daylight hours in the open air.” Nathaniel Hawthorne

...and on that note from our good friend, Nat, Helpful Buckeye vows to not waste any more precious autumn sunshine by staying indoors...my bike awaits me...I'm outta' here!

~~The goal of this blog is to provide general information and advice to help you be a better pet owner and to have a more rewarding relationship with your pet. This blog does not intend to replace the professional one-on-one care your pet receives from a practicing veterinarian. When in doubt about your pet's health, always visit a veterinarian.~~