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Neurological Diseases and Disorders of Dogs

Neurological Diseases and Disorders of Dogs

also 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 MRI

also see Canine Dementia Symptoms

Neurological problem in Brittany

Neurological problem - in Brittany

Question: Dear Dr. Mike,Thank you again for your message re. my 13 yr. old Brittany, Mike. Itwas very helpful. I have another question.I have taken Mike to the vet re. this problem several times. Thisbehavior is not usually present when he is in motion. Usualy the problemoccurs when he is standing still. He will seem to sort of flinch and then sortof 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 hewill fall over. It seems that he sort of staggers when this happens. Ifhe was standing still and it happens when he has begun to walk or run he willalso stagger and bump into things. When he runs his gait is straight. Iwas told he is just getting old and is losing muscle control. I amconcerned that he may have a brain problem. He does have some spinal (possiblydisc) problems from running, jumping all over the place which he would stilldo now if I let him. He can run in my yard which is a couple of fencedflat acres but he tends to stay close to me now. When we are out he isalways on a leash/halter. He is fine when we go for our walks, wants to gofaster than I do. I won't be doing any surgery unless it is something minor or aninjury as I don't want to do it to him at his age. I just wondered ifanything 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 isprobably correct. Brain tumors are not highly unusual in dogs and otherneurologic disorders can also occur. Another consideration would be hypoglycemia.This can cause transient loss of consciousness and signs that look likeneurologic signs (seizures, muscle tremors) in some dogs. Checking theblood sugar levels several times will usually allow this problem to bediagnosed or ruled out. Liver disease sometimes causes this sort ofbehavior, as well. So it might be a good idea to check a serumchemistry panel the first time that blood sugar is evaluated since a panel wouldhave both tests. High blood pressure can sometimes cause similar signs, too.These are the things that I can think of that might cause the signsthat you are seeing. I think that it is worth looking into some of theseproblems, since there are treatments available for several of them.Good luck with this. I am sorry that there was such a long delay inresponding to your question.Mike Richards, DVM12/31/2001

 

Auditory-triggered spasms in elderly sheltie

Question: Hello. I have spoken with my veterinarian about mydog'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 hassome hearing in the upper registers (she can hearwhistles). Certain noises seem to cause brief spasms(crumpling paper, clapping, snapping fingers). Atfirst my veterinarian thought it might be a simple"surprise" response to having heard something, but thespasms often continue if the noise continues (repeatedrapid clapping will cause repeated rapid spasms). Thespasms also occur now if she's outside in heavy rain,and seem to be triggered by large raindrops fallingon her. The spasms are sometimes strong enough to knockher over. They have been increasing in intensity andfrequency, but she's had them for about the last fiveor six years.She also has occasional head tremors which seem to besomewhat stress related -- they're triggered by theairconditioner blowing on her in the car or often whenshe's in a new situation.Basically, I'm wondering if there is any informationabout auditory-triggered spasms, and if there is somesort of medication that she might benefit from. I'lllist her medical history in case that will help:About 4 years ago she was seen at Purduefor unexplained fevers, treated with Baytrill andrecovered; this past fall she was bitten by (possibly)a brown recluse on the underside of her jaw and hasrecovered. Those are the only two serious illnessesshe's had in the 16 years. She has cataracts and isnow 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 confirmwhether there is any indication that any of these disorders actually occurin dogs.There are two possible explanations that I can find for the behavior youare observing. The first is an overreaction to the acoustic startle reflex.Everyone has a threshold at which they will startle from a loud noise butsome people startle much easier or have unusual startle reflexes. In peoplethis is supposed to be associated frequently with schizophrenia. I have hadsome patients who I truly thought exhibited behavior consistent with myvery limited understanding of what schizophrenia is, but I have not seenanything confirming this condition really exists in dogs. There is a humandisorder, tardive dyskinesia, in which there are alterations in the facialreflexes that might resemble what you are seeing. This occurs in people dueto the effects of medications for other pyschological disorders but itseems to be due to a reduction in dopamine in the brain. I know that youprobably haven't been using medications for years, so this wouldn't be thesame problem exactly, but selegiline (Anipryl Rx), which is approved foruse in cognitive dysfunction in dogs, is a dopamine sparing agent and mightbe helpful if there is a similar neurotransmitter problem caused bysomething other than drug use. Other possible medications for thiscondition would be clomipramine (Clomicalm Rx) and fluoxetine (Prozac Rx)because they are selective seritonin re-uptake inhibitors (SSRIs), and lowlevels of seritonin are also supposed to play a role in this condition.There would be a small chance that this is some variation of caninecognitive disorder, although that condition usually involves behavioralchanges such as loss of housebreaking, forgetting meal times, standing atthe wrong side of the door --- things that show a decrease in cognitiveability.The other possible explanation that seems possible is a seizure disorder,which could be associated with a problem in the brain, especially somethinglike a brain tumor. If this is the case, it might be helpful to use seizurecontrol medications. My guess is that this would be considered to be afocal seizure disorder, which means that there might be more choices inmedication that for generalized seizures. In general, though, I think thatphenobarbital is still the most commonly recommended starting medication.If it is helpful there may be no need to look for other medications but ifit is not, there would be other possibilities for focal seizures, includinggabapentin (Neurotin (Rx)) and felbamate (Felbatol Rx).Tremors are usually an entirely different problem and the causes of tremorsseem to be more of a mystery. There is a clinical condition most commonlyreferred 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 ormetabolic disease that affects the nervous system secondarily. It can behelpful if an underlying condition can be identified. It is not uncommon totry corticosteroids in the hope that tremors are occurring secondary toimmunologic disturbances affecting the nervous system but we have not hadmuch luck with this approach. We have tried selegiline in a couple oftremoring older patients without luck, yet, either. I have not tried theSSRIs 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 haveseen this sort of sensitivity in a couple of patients with painfulneurologic conditions. Puppies with hydrocephalus seem to react badly tosounds sometimes and we have seen jerking motions in a couple of dogs withcervical disc disease or agenesis of the dens when there were sounds orwhen they were approached suddenly. I think even slight motion sometimescauses pain. Usually there were signs of severe pain, at times, in thesepatients, though. The possibility of a pain response is just something tothink about so that a pain response isn't missed.I hope that some of this information is helpful. I'm sorry that I can'tfind more information on the possibility of disorders such as schizophreniain dogs. It seems logical that dogs might have a problem with this sort ofdisorder but I guess that we are really hampered by our poor communicationskills when it comes to our pets. It is just hard to evaluate for illnesseslike this without being able to talk to our patients.Mike Richards, DVM7/2/2001

 

Treating Spinal cord problem

Question: Dr. Richards,My Pom was diagnosed as either having a herniated disc or arthritis of thelower spine. She was on prednisone but was taken off prednisone due tofear of the possible formation of gastric ulcer. We are to put her onbuffered aspirin in an effort to help ease the pain/discomfort. Myunderstanding is that the prednisone could help her gain some strength inher hind legs (she sometimes falls on her butt when she has to squat to peeor poo). Will aspirin or some less invasive drug, do about the same thingi.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 thefirst few days in spinal cord injuries. If it seems necessary to usecorticosteroids we tend to use them for one to three days and then switchto non-steroidal anti-inflammatory medications. I think that pain control,when it can be achieved, allows the pet to use the limbs and back, makingthe arease stronger.Buffered aspirin is regular aspirin that has added ingredients meant todecrease the acidity of the aspirin. The usual ingredients that are addedare magnesium hydroxide, aluminum hydroxide, calcium carbonate ormagnesium-aluminum hydroxide. There is a web site on aspirinhttp://www.healthgate.com/choice/med-emerg/dih_f/chapter/mono/mg009000.shtmlwhich lists the milligrams of each of these additives.Mike Richards, DVM3/19/2001

 

Head injury in Cairn Terrier

Question: Hello,My 14 year old Cairn Terrier was injured 1 week ago in an accident involving a horse. Her head waskicked below the left ear. Immediate response was a coma and termination of breathing. A fewminutes later with artificial respiration, she was revived and rushed to an emergency clinic where shewas 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 administeredsteroids to calm the shock and help reduce her labored breathing. She was also put on pain killersand oxygen. After she was stabilized (still very comatose at this point), she was taken to the RaleighNC 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 whichtime she began eating on her own and was able to come home. A week later, she still actsunbalanced and her head is cocked to one side. Vision on right side is unresponsive to menacinggestures. She eats nocturnally, which is new to her. She pants almost all the time, which makes mewonder if she is in pain. What can I be doing to help her recovery? Would small doses of aspirin behelpful? I still feel a large lump on her head and her neck is still swollen. In the last two days, I havealso noticed new bruising appearing along her underside, which I am not sure is related...but itconcerns me too.

Answer: Diane-The area that was damaged may cause problems with the facial nerve and that might be causing thelack of a menace reflex. Sometimes the nerve is just compressed by swelling in the area and willfunction again after a few day and other times it is damaged by the traumatic event and function willnot return. It is also possible to have partial return of function and many pets will do well if they getpartial function.The lack of balance and head tilt may be due to inner ear damage or due to a brain injury. In eithercase, there is a chance of recovery as the injuries heal. We have had several dogs who did notrecover from head tilts but went on to learn to function very well despite the constant head tilt. I can'tremember a dog that didn't learn to correct the balance problems, or recover from them, so I amhoping 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 incase 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 thesemedications can cause panting which might last for several days, depending on which corticosteroidswere used (if any). I think it is best to assume that pain is the cause and to treat for it, since we can'task. 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 toa drug reaction or an unrecognized injury. It can be hard to find every injury in trauma cases on theinitial 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 underpressure at your first vet visit. I hope that the good work has resulted in a good outcome.Mike Richards, DVM3/10/2001

 

Severe Head trauma

Question: Doctor,This is a bit of a reversal question, regarding thefeasibility of applying a human medical technique to dogs.We have a son who had a Traumatic Brain Injury, TBI, and has ahigh recovery, in large part due to aggressive management of hisInter(intra?) Cranial Pressure by Medical College of Virginia. Hewent 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, threegrandchildren, etc.) was with us for a few days. Our88-lb Husky-x-Shepherd Cross, a 2 year old neutered male,is very friendly with their dogs at their house, usually. However, heattacked 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 topenetrate the skull. To cut the story short, in spite of immediateveterinary attention, she had seizures, and is now hemi-plegic, & will probably haveto 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 tothe 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 majormetropolitan area that were using them, and her own four vet. practice did not have theknowledge or equipment.Some veterinarian needs to look into this. I'm sure that theprocedures 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. Thedrains, the ICP pressure gauge, and the hyper-oxygenation are not reallyexpensive 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 articlein the Journal of the American Veterinary Medical Association advocatingthe use of intracranial pressure measurement and surgical treatment tolower intracranial pressure. Truthfully, this has not really caught on inveterinary medicine, probably more due to the necessary aftercare duringrecovery from severe head injuries than due to the immediate difficulty orexpense. There are several large veterinary emergency centers at whichdecompression surgeries are becoming more and more common. When advancedimaging techniques, like CT scans and MRI scans become reasonably pricedenough that big EVCs can afford them, it is likely that this sort ofsurgery will become even more common.Hyperbaric oxygenation is still controversial in veterinary medicinebecause it appears to increase survival but not to decrease the disabilityinduced by the injuries to the brain originally, which in veterinarymedicine is usually considered to be an unacceptable outcome sincecontinuous patient care during the recovery and rehabilitation period fromthe injuries is not usually available.We are able to do more and more for our patients but we are still limitedby economics and practicality when dealing with injuries that will requirelong term skilled care. Often, the initial expense, or the initialexpertise in a procedure is not really the limiting factor. In veterinarymedicine, the cost or inconvenience of longer time care is often wherelimitations arise and these sometimes make good emergency choices bad longterm choices. More and more, though, pet owners are willing to put thetime, money and effort into this sort of care so it is likely we will seemore and more use of procedures like those you ask about.Mike Richards, DVM1/23/2001

 

Head trauma treatment in dogs -continued

Question: Mike-There are some practices equipped to treat head trauma using some, orall, of the methods outlined in your note. There has been at least onearticle in the Journal of the American Veterinary Medical Associationadvocating the use of intracranial pressure measurement and surgicaltreatment to lower intracranial pressure.Thanks for the prompt and thoughtful reply.Guess I'll have to poke around some more on the net, & withfriendly vets, before I convince myself that canine ICP monitoring andreducing is not cost effective when used appropriately.

Answer: Mike-The big thing to remember in making this evaluation is the aftercare -- ifthere is a dedicated owner and a continuous care facility working withthem, this could easily be considered to be cost effective. If either ofthese factors are missing, then cost effectiveness really isn't the issue,the problem becomes maintenance of the short term gain afforded by thedecompression techniques --- if there is no physical and rehabilitativetherapy for the patient, does it make sense to help them reach the pointwhere that would benefit them? This is an issue that is a really goodexample of the major problem with veterinary medicine, the lack ofsocietal support for really intensive health care efforts in situationslike recovery from brain injuries, or spinal cord injuries. We can oftenhelp immensely in the short term but that falls way short of providing agood path back to full recovery.I don't mean to question whether it would be good if there were more placesthat offered this sort of care. That was the one of the major reasons thatMichal and I established the VetInfo web site. We knew that a lot ofveterinary patients were not getting the best care possible becauseveterinarians and veterinary clients did not always know that reallyadvanced care was possible for their pet's condition. I am absolutelycertain that a neurologic injury rehabilitation center could make it inveterinary medicine but there might only be room for one or two in thecountry right now. As time goes on and people expect even better care forpets, you probably will turn out to be an visionary in this field --- one ofthe early voices pointing out that it was possible to help pets withneurologic damage. I am pretty sure more vets would be willing to invest inthe equipment for the short term care if they knew there was a place tosend pets for the long term care afterwards.Mike Richards, DVM1/23/2001

 

Muscular dystrophy in Chesapeake Bay Retriever

Question: Dear Dr Richards;During the past 10 weeks we have been working with our Vet., Dr. JonathanSmith, investigating a weakness in the rear legs/hips of our 11 month oldCBR...x-rays of Roscoe's hips showed no abnormalities..further x-rays of his legssuggested "physitis at insertion of tibia crest"...a second set of x-raystaken 6 weeks after the initial set showed no improvement (weekly cartopheninjections were administered plus Omega 25 and metacam caps were givendaily)...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...thereport from our first visit with Marlene included the possibility of M.D.,yesterday we visited her for a second time (two weeks since the firstvisit)...long a short is that we are focusing on M.D. as the issue and justhow 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 tosimilar to Roscoe's to ignore.Jonathan and I are discussing biopsy or EMG (can't say I know what EMG isother 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 themuscles respond properly to electrical stimulation, as would occur whenstimulated by the nervous system. This type of testing helps determine ifthe problem is a muscular problem or a neurologic one and can help topinpoint specific problems in some cases. Muscle biopsies are necessary todefinitively identify muscular dystrophy. It would be worth contactingAuburn at one of the email addresses listed on the site you sent the linkfor. They may be interested in doing some research on Chesapeake Bayretrievers, too. Dr. Shelton's lab in California would probably also beable 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 inheriteddisorder. There are scattered reports in other breeds, though. I think itis just less clear why it occurs in individuals in those breeds.I would recommend considering a visit to a veterinary neurologist orinternal medicine specialist familiar with doing EMGs. If the biopsysamples are taken from trouble spots identified through EMG (if that ispossible to do) it would help to ensure a better possibility of making adiagnosis.Hope this helps some. If you need Dr. Shelton's lab's address I have it atthe office and I think it is online somewhere on our site, too.Mike Richards, DVM6/12/2000

 

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 aneurologist) who have answered many of my questions, but I feel awkwardasking for another explanation since they have already given me so much oftheir time.One question asked of these doctors concerned nystagmus. In abstractsI've read it states that nystagmus is present in CA and I wondered why my dogdid not have it. I don't fully understand the answer I was given and I amhoping 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 alwaysoccur at some point in CA.?The answer provided was:Affected dogs don't usually have a resting nystagmus, but one can beinduced with movement.Could you please explain this answer and elaborate, if possible? Iwonder if my dog has normal vision now and to what extent nystagmusaffects him. That, and what method would be used to induce the nystagmus andwhy.I appreciate your time, and also your web site. I find it very informativeand helpful.Thank you, Debbie

Answer: Debbie-I do not recall seeing a case of cerebellar abiotrophy but this is myimpression of the disease based on searching through my textbooks forinformation.Cerebellar abiotrophy is a progressive disease that affects the cerebellum.Dogs with this condition are supposed to be pretty normal at birth and thento develop signs associated with a decrease in cerebellar function overtime. This is thought to happen due to a metabolic deficiency in thePurkinje's cells in the cerebellum according to the "Handbook of SmallAnimal Practice, 3rd Ed.". Signs usually associated with this areincoordination when walking, exaggerated movements and tremors when a dogattempts to move (intention tremors). These signs occur despite normalmuscular development and function. Resting nystagmus is not commonly seenwith this condition based on the textbooks.Resting nystagmus is rhythmic movement of the eyes, usually horizontallybut sometimes vertically or even in rotational motion. There is usually aslow drift in one direction and then a rapid correction in the oppositedirection. Resting nystagmus occurs when the dog is in a normal positionand is continuously present, at least for some time.Positional nystagmus is the name for rhythmic motion of the eyes thatoccurs when the dog is held in a position that it might not normally stayin, usually on its back. Often, positional nystagmus will occur in avertical direction (up and down).Nystagmus occurs because the balance system isn't working properly. Theinner ear mechanism determines the body's orientation in space. It thensends this information to the cerebellum, where processing of theinformation occurs. If the inner ear is sending inappropriate signals, thecondition is referred to as peripheral vestibular disease. If thecerebellum isn't processing the information properly, the condition isreferred to a central vestibular disease.Nystagmus is usually, but not always, present at rest in peripheralvestibular disease. Nystagmus tends to occur only when the dog is held inan on its back or in another "unusual" position in central vestibular disease.So my impression is that resting nystagmus would not be expected incerebellar abiotrophy but that positional nystagmus would be expected.If you place your dog on his back and this induces nystagmus, that would bean example of positional nystagmus.Even in dogs and cats born with congenital nystagmus, the effect on visionappears to be something the dog or cat can compensate for and functionnormally. This is not a disorder of the eyes themselves but rather thevestibular system, which they are only one part of.I hope this helps. If the explanation isn't clear or just brings up morequestions, feel free to write again.Mike Richards, DVM7/4/2000

 

Head tilt

Q: Dear Sir/MadamI noticed my dog, Simba, his head tilting to left side about six weeksago.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 hasnot improved. He now decided to refer my dog to a neurosurgeon forinvestigation.Prior to that he had hear infection which was treated with anbioticointment.He seems to be very bright, active, perfect balance, except when helooks at you with his tilting to left side,has good appetite, no limping.Yours sincerelySujuk

A: Sujuk-There is a condition referred to as "peripheral vestibular syndrome" thatseems to occur due to inflammation of the nerves between the inner ear andthe cerebellum. It used to be called "geriatric vestibular syndrome" butthen it was recognized in younger dogs on occasion and acquired the moregeneral name. We have seen this condition at least once or twice in youngdogs 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 outcomewas that simba may have neuro pathway between his ear and the brain had beendamaged. He had also tested aspirated fluid from his ear, the result wasnegative. This excludes the middle ear infection.Can you please tell me that would it be possible for a dog under 2 year oldhave that kind of conditions?RegardsSujuk

A: Dear Sujuk-Having your dog examined by the neurologist was probably the best thing foryou to do. I am hoping that the visit turned out well. It is good that yourvet is willing to refer cases to a specialist. It shows that your vet iswilling to have his or her work reviewed by someone else and that he or sheis willing to put the pet's needs first.Mike Richards, DVM

 

Stroke in Yorkie - rare

Q: Dear Dr. Richards,My 10 yr old Yorkie seems to have suffered a stroke. My Vet startedher on prednisone. Several friends have asked why the Vet didn'd start her onaspirin. Since my Vet is now on vacation, I can't ask him. Could youplease 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 moreinfrequent than humans.The condition most commonly confused with a stroke in dogs is peripheralvestibular syndrome. This condition causes a sudden loss of balance. Thedog's eyes often have a rhythmic side to side or up and down motion knownas nystagmus. The dog's head may tilt to one side. There are a number ofother conditions that can also cause symptoms that might be confused withstroke, so it is important to keep communicating with your vet to ensurethat he or she is aware of the progress of the problem.Due to the fact that strokes are a fairly infrequent condition in dogsthere is not much information about how to treat them available in theveterinary literature. I don't know if aspirin is helpful after a stroke indogs.Many veterinarians use prednisone early in the treatment of peripheralvestibular syndrome. I just tell people to wait the condition out. Inalmost all cases the dog will show improvement in 24 to 48 hours and thesymptoms will resolve in a few days to three weeks. A few dogs have someresidual signs with a minor head tilt probably being the most commonpermanent effect.There is a definite possibility that your vet is treating for anothercondition, so please do not discontinue the medication until you have achance to talk to your vet.Good luck with this.Mike Richards, DVM

 

Hydrocephalus

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 levelshave 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 foryour great service. Maureen

A: Maureen-The standard medical treatment for hydrocephalus is to use prednisone andfurosemide to control the symptoms.Prednisone is thought to decrease the production of cerebrospinal fluid. Ifless fluid is produced there is less pressure on the brain when the fluidcan not drain properly. It is usually possible to get to an every other daydosage which reduces the long term side effects associated with prednisone.It is also acceptable in some patients to use prednisone during crisisperiods and to discontinue use between those times. Panting is not anunusual side effect when using corticosteroids. Muscle weakness can occurbut I think I'd be more suspicious that it was associated with thehydrocephalus than with the administration of prednisone. Muscle tremorsare occasionally reported by my clients in their pets on corticosteroidsbut infrequently enough that I am not sure if they are coincidental or aside effect. Behavioral changes are often noted by owners when pets are oncorticosteroids so some change in attitude or behavior is not too surprising.Furosemide (Lasix Rx) is a diuretic. It works by decreasing the volume offluid in extracellular spaces including the volume of cerebrospinal fluid.Diuretics do sometimes result in electrolyte imbalances. Potassium loss isa particular concern since it is more likely when furosemide and prednisoneare used together. In dogs it is fairly rare for a clinically importantelectrolyte imbalance to occur but monitoring potassium, sodium and calciumlevels on a periodic basis is still a good idea. Supplementing electrolytesin general may not be that good an idea since sodium increases can lead tofluid retention. You might want to discuss potassium supplementation withyour vet, though.I checked through the books I have at home and the online databases andthere just isn't much more information on treatment of hydrocephalus. Thisis one of many diseases that have not been treated aggressively in the pastbut attitudes towards treating young pets with chronic life-threateningconditions is changing and I think more and more information will becomeavailable as owners such as yourself pursue treatment options.Mike Richards, DVM

 

Neurologic injury

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 massagetherapy. 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 muchJoanne

A: Joanne-I am sorry to take so long in replying. I can't tell you if the alternativemedicine treatments would be helpful. There just isn't enough informationon most of the alternative treatments and specific injuries. Time alone isoften helpful but four months is a long time after a neurologic injury andrecovery will progress very slowly in most cases for neurologic signs thatpersist more than a few weeks.If you are near the veterinary school in Wisconsin or the veterinary schoolin Iowa, it may be helpful to get an opinion from a neurologist.Specialists see the difficult cases and sometimes can either help or give amore 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

 

Encephalitis in Corgi

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

 

Pug Encephalitis

Q: 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

also see Seizures in Dogs