Vestibular Disease

[snapple]

Hello Everyone,

Snapple was just diagnosed with the scarry Vestibular Disease. My vet was 90% sure of his diagnosis, but he just sent us home to have Snapple ride it out. He's had the symtoms for about 40 hours now (no balance what-so-ever). I was wondering if anyone out there can tell what I can do to help Snapple out, or if there is a possible medication, that my Vet isn't aware of, that Snapple should be on. I just feel so helpless seeing Snapple in this condition. His appetite is as good as ever. I have on a ginger and honey concotion to help with the nausea.

Thank you

[Labpaw]

We call it idiopathic vestibular syndrome, and unfortunately, only time can help. As long as the dog isn't nauseated/vomiting, I send a lot of my patients home to recover as well, simply because they recover faster and better with their own humans. :p

Many of my clients (and my own dog) have had either CT or MRI scans to rule out other causes of the symptoms (even a severe inner ear infection can cause similar issues). Some dogs take many days to weeks to recover to the point that they are able to walk/get around better. In my own personal dog's case, she was so severely affected that all she could do for about a week was cirlce/roll to the left (most are unilateral, or one sided, so they tend to favor that side). She required a lot of nursing care, but eventually she lived another 11 years (to the ripe old age of 16.5 years old... LOVE YOU CHELCY!!!) with only a very slight head tilt.

If Snapple was vomiting, or not eating, then it might become a case where it would be better managed in the hospital. Usually it requires supportive care, but just about every dog recovers and leads a normal life.

I hope that helps. I am sorry to hear about Snapple. It is hard to watch your beloved furry child go through something like this. I hope things get better quickly! Let me know if you need anything! :)

[snapple]

Thank you Labpaw for your comforting advice. I'm glad to hear that your Chelsy's episode with Vestibular Disease did not prohibit her from living a good long quality life after her bout with the disease. My concern is that my Vet did not think it was necessary to conduct any tests (x-rays, MRI, blood work etc.) to rule out inner ear infection, tumor, blood clot, stroke, liver problem, etc. I had done research on Snapple's symptoms and and they too did recomend any of the above exams to rule out any other problem that could exist besides Vestibular Disease. (I know my Vet is just trying to save me unecessarily spent money, as he knows all-to-well the major expenses I incured during Snapple's recent fight with cancer). It's just that early Thursday morning Snapple suddenly lost all control of his back legs. I had acupunture and chiropractic work done that afternoon on Snapple's low back, hips, rear legs by a Vet who also specializes in that alternative medicine, thinking he had just had a rough "training" day earlier in the day (especially for an 'ol guy), and he (or I) did not notice any symtoms of upper body malfunction, eye movement darting back and forth, or head tilt to the left at the time of those treatments.
Wondering if this could be a gradulal progession of subtle, but not really that noticable, symptoms. Snapple has had a bit of hearing loss of late, not as much cordination (catching frisbees on the fly, clearing that log we jump over on our daily runs, a different gait in his hind legs) as in the past...this could also be the case of him now being over 13 years of age too I guess.

Anyway, he seems a bit better today (his eyes aren't darting back and forth anymore, they're just kind of slowly "flickering"), but he still has that major head tilt to the left, he leans to the left, and his balance is still out of whack. He wants to shake his head, but he falls right over...which lead me to believe it might be an inner ear problem??? I know when I read the recent edition of The Whole Dog Journal, which ironically featured a cover story on Vestibular Disease and the name of the dog, pictured on the cover with the disease, is Emma, which just so happens to be the name of my other 13 year old household canine companion (pretty spooky eh), and I just got the monthly periodical the same day (Thursday) that Snapple started having his medical issues. Anyway, they advise the dog's owner not to over diagnose your dog's problem (which I suppose I am doing!) Snapple's appetite is as good as ever, dosen't experience any signs of nausea and wants to be himself (go out on our daily jaunts with me). I did not see, in my reasearch, any suggestions of making sure to keep your dog calm, rested etc., so I gave in to Snapple's desires and just took him on a nice easy, slow walk with me today (albiet it was stagering and spinning at times) on a nice open area of green grass, so when I let him off leash he could not hurt himself by running into anything, or falling on a hard surface.

Thank you again for your reply and support.

Don and Snapple

[Labpaw]

From what you describe, and I obviously only have that to go on, it really doesn't sound like an inner ear infection. They DO NOT get better with time and the dogs are often painful (often crying, pawing at the ears, not wanting to eat, etc). Also, inner ear infections are fairly uncommon. But, I do preliminary blood work, including a CBC (complete blood count), so that helps me determine if there is an infectious component to it. Like I said, from what you have described, it sounds CLASSIC for the vestibular disease. That, out of all the other options, though, has a darn good prognosis (whereas some of the others... infection, cancer, etc do not).

Its hard not to "diagnose" your dog. I know that feeling of helplessness and just wanting to know what it is so that you can gain some control and start working for the treatment! All people who care about their furry children feel that way to some degree. ;) Sounds like Snapple is one LUCKY POOCH to have you as his human! :p

[snapple]

Thanks again Labpaw, you've been a wealth of needed information, not only for my peace-of-mind in regards to the symptoms of, and the positive prognosis of living a healthy life, after toughing it out through Vestibular Disease timetable, but to also have this forum to let all the other members of the Splash Dogs family become aware if their beloved canine happens to show the same scary symptoms at some point, and not to overly panic (as I did).
I'm know the majority want to gain some sort of control over their dog's health issues. Snapple's had quite a few in his lifetime (poisoning - which he was not supposed to survive - 8 years ago. Cancer - which he was given originally only 4 to 6 weeks, but with chemo 12 to 14 months - he's now on his 17th month of total remission. A dog attack, where infection was running rampant through his body), and even with those espisodes having quite dire prognosis's, I felt somewhat in control , because of the work of wonderful Vets, as yourself, but with my research and then implementing my alternative treatments nutritionally and with holistic supplementation. Thus, my feeling of helplessness in helping Snapple deal with this Vestibular Disease. Your calming and positive words are just what "the doctor ordered", not only for me, but for Snapple too (as I'm sure he now feels my positive vibe)

Don and Snapple

[MuddyPaws]

I just wanted Snapple to know that Alex and Dustin are sending all the barks and vibes for a healthy recovery!

Be safe

[renegade]

Jasper is sending his love to Snapple - Jasper says that Snapple is his inspiration and he plans on following in his footsteps of beating the odds. We're 6 months post radiation and still cancer free. He fully plans on beating the 12-18 month timeframe! Keep us posted during this difficult time and we're thinking of you guys.

[Labpaw]

Anything for you guys! ;) I'm here if you need anything....

How is Snapple today? Hopefully feeling even better? :)

[Sassy Girl]

Oh Snapple - please tell me he is feeling better today...We're sending lots of love your way for a speedy and full recovery!

[snapple]

Snapple (and me too) would like to thank everyone who has sent their well wishes, barks, vibes and love his way during his bout with Vestibular Disease.
Today was the first day, since he came down with the disease, that he actually showed a significant improvement (still does those spin moves when outside, along with only a slight head tilt). He's trying to be his "normal" "spazy" self (running with his frisbee in mouth and chasing birds as he stumbles along). All your thoughts are being felt I'm sure!!
Snapple is glad he is an inspiration to Jasper in his road to a full recovery and expects him to beat his PB jump of 7'11", if not this year, then at least in one of his many years ahead in the Dock Diving world...I would like you to know that Snapple has actually also been an inspiration to a hand full of human friends, acquantances,and a family member, who are now (or have been) fighting cancer. A good "Poster Child"...albiet a furry one with 4 legs.

Many thanks to you all!

[Labpaw]

YEAH!!!! SO glad to hear some good news! GO SNAPPLE!!! :) :p

[ssejrnv]

JJ and all of my crew (especially Spud) want to send well wishes for a speedy recovery to Snapple. Don, the love you give Snapple everyday shows what a special dog he is and why he fights so hard to stay here and enjoy the life you give him. You both are an inspiration.
JJ and crew

[Labpaw]

Continuing to improve, I hope!!!! :p

[hershey kiss]

Snapple we hope you are doing better get well soon Hershey Kiss and crew

[snapple]

Hello to all.

And thanks to Labpaw for "checking-in" on how Snapple's doing, as the timing couldn't have been better,as I was ready to ask your opnion about updated news I recieved on Snapple's condition today.
The Vet/Acupunturist who tended to Snapple today said that his Vestibular Disease more than likely stemmed from a stroke or blood clot and Vestibular Disease is a syndrome of "something" that occured with him health wise. So, rather than do the expensive MRI to check for a tumor, blood clot in the brain (and not being able to do anything about those possibilities, because of Snapple's age, chance of survival of the procedure, etc.)so to therefore just treat the symptoms to make him more comfortable with dealing with his lack of balance and any pain associated with the disease he might be experiencing. He said the cortisone shot he was originally given by my other Vet is probably the reason why he showed some improvement a couple of days ago. And the reason for the head tilt could possibly be a lesion on that sideof the brain. That Snapple might (more than likely) experience more of these "stokes" in the future, leading to the symtoms of Vestibular Disease (lack of balance, etc.).
I just thought that Vestibular Disease, was a disease like any other, that would pass and get better with, and rid of, in time. I did not know there was so much behind it's actual cause(s).
I hope you can enlighten me further.

Thank you for your time and concern (and the concern, well wishes, and kind words from Everyone out there!!)

[Labpaw]

Obvioulsy,I am not there to examine Snapple, so this is only gerenalized information. :) But I sure hope it helps! :p

True idiopathic vestibular disease is NOT a lesion in the brain. It is related to a problem the equilibrium center in the inner ear. It is not generally related to a clot, or "vascular incident", such as a stroke, or a lesion or tumor in the brain. Those are all differentials for other causes of the symptoms, but they are NOT true idiopathic vestibular diease, per se. And you are right, the only real way to further identify the problems is by CT scan, MRI, spinal tap, etc. :( I did all that with my own dog. I am guessing that the second veterinarian is using "vestibular disease" as a catch-all phrase for a group of diseases that present similarly. I think that gets confusing, because true idiopathic vestibular disease is completely different than say a tumor, or clot, or other causes. We don't fully understand what causes it, but dogs that have it have normal CT scans, normal MRI scans, normal spinal tap results. Dogs with tumors, clots, etc have abnormalities in their tests.

I do not routinely give steroids (do you know exactly which steroid was given? The reason I ask is that there is a WIDE range of steriods and their effectiveness. Some only work for hours, and others for weeks to months) to vestibular patients, so I cannot speak to their helpfulness. I haven't seen that done before with the various vets I have worked with and for (none in the 10 years as a veterinarian, and none in the many years as a veterinary technician either). But, I would think it hard to know if the steroid injection was the reason for the improvement vs. time (which is really what is needed with vestibular disease). The time frame in which Snapple improved could be normal for vestibular dogs as well, so I guess for me, I can't really say that it was or wasn't the steroid injection.

On a very rare occasion, I have seen a dog with vestibular disease have a recurrance. It is certainly not the norm. But, if Snapple has one of the other causes for these symptoms, and it really isn't idiopathic vestibular disease, you may see it happen again. I HOPE NOT!!!! To me, that would not be a good sign for prognosis. To me, that would indicate that we are not likely dealing with vestibular problems, and we may see things deteriorate in the future.

I hope this doesn't confuse you further. Just like in any field, sometimes you ask 3 people for opinions, and you get 3 different answers. It is frustrating, I'm sure. I sure hope things are going ok for Snapple!!! Let me know if I didn't get your questions answered or you have more. Thinking of you guys!!! :D

[snapple]

Thanks Labpaw for your input, which I greatly value! (Do you make housecalls?) You did not confuse me further, in fact I have a much clearer picture of what Snapple might be dealing with.
The type of steroid Snapple was given, when I first took him to Vet last Friday, is Dexamethasone. It's 2mil per mil and he was given 1.5 CC. He weighs 35lbs. He showed his first (and only!) signs of improvement last Sunday. I am concerned that he hasn't shown any improvement since. The Vet who gave him the steroid shot said a steroid would have shown immediate effects in Snapple and not delayed until a couple of days later, as was the case with Snapple and if a tumor was pressing against the Vestibular nerve the steroid would temporarily shrink the tumor from pressing against that nerve. But, he's convinced it's just 'Ol Man Vestibular Disease. I hope he's correct!
Thanks for all you info. Vet's like you are a rare breed!

[Labpaw]

I'm glad I didn't make it worse and could help even just a little... it is a confusing topic. Housecalls.... hhmm... only if you are in CT??? :D The steroids he was given can stay in the system for a few days (in some cases a week or so), but if you think that he starts taking steps backwards, then I am going to start worrying about other things. For now, even if he is maintaining at status quo, I would be ok with that (especially since senior dogs recover considerably slower than do the young whipper snappers ;) ).

Please let me know if you need anything and I hope you are enjoying your weekend with Snapple! :p