My Dog is Sick... I think

[Ted]

While I was gone for a week both my dogs were at a kennel up here in Manchester. They take good care of the dogs and are quick to call if there are any problems. Yesterday they called me and said that my akita (Duchess) was suffering from paralysis on the right side of her face. Apparently she couldn't move the right side of her mouth, couldn't blink her right eye, couldn't move her right ear, and she had a permanent head tilt to the right. She was still able to move, but very sad. At least, that's how they explained it to me. They took her to the emergency vet clinic (since I don't have a vet up here), who had nothing useful to tell me but gave her some prescription artificial tears, as they said her right eye wasn't tearing at all. Add to this the emergency clinic was saying that this is a symptom of kidney failure, and I was expecting to show up to a dog horribly sick and needing to get put down.

Needless to say I was pretty worried, and was hoping to get her into a vet today. Well, apparently all veterinarians in Manchester take Wednesday off, so that puts me out of luck. I decided that since I was picking the dogs up today, I'd just take them home and take Duchess to her vet there to look at on Friday morning.

Then I go to pick the dogs up. What I was expecting was a sad akita who was lethargic and clearly feeling badly. What I ended up getting was Duchess being her usual bouncy self, excited to see me, and providing me with tons of licks. While her right side did seem a little more lethargic than the left, nothing too major. Her head was tilted noticably to the left. She has always had a slight head tilt, but not this noticeable. They said that this was the way she was yesterday, no improvement. Well, not exactly the picture I'd expected.

They also said that earlier today while walking she got excited, and lost control of her right side. They didn't think it was like a seziure, they thought more like a stroke in a human. But these people aren't veterinarians.

I've now had her back at the hotle with me for a few hours, and if nobody had told you there was something wrong with her, you wouldn't notice. Her head tilt seems to have decreased a bit. She is blinking in both eyes (she was earlier as well when I picked her up). Her right ear may not be quite as perked as the left, but still is working. Her mouth is working fine, as is her eye-mouth coordination (catching treats as I toss them to her - albeit not quite as well as at her peak, but better than my Rottweiler on his best day). Her right eye does seem to be a bit redder than her left eye, but it does close when she wants it to, and if I check it after she wakes up, both eyes look great.

The only thing I noticed before dropping her off was that the right side of her mouth seemed to be open and she was drooling out of it a little. This had developed recently. That was more what I was thinking of with loss of control of her mouth, but now it's shut tight, just as it normally is. So if anything that's better.

I'm not sure what to make of this. I'm still planning on taking her to the vet on Friday morning, but am wondering if they're going to find anything at all. I haven't observed her lose control of her body at any point, and if anything now she seems to be a bit better than when I picked her up. That to me sounds like seizures and then recovering from them, or perhaps mini-strokes. She's 6 years old. I adopted her a bit over a year ago and she doesn't have any history that I know of of problems other than allergies (which went away after the first few months with me).

Mainly I'm glad that having picked her up it doesn't seem nearly as bad as what I was originally picturing from the description. I'm still wondering what this likely is, and if it's something the least bit fixable or just something to look at and keep an eye on.

 

[gismo]

Sorry to hear about your dog. I'm no doctor but it sure sounds like a TIA to me.

http://tinyurl.com/canine-tia
​

 

[Let'sgoflying!]

Head tilt, facial paralysis, possibly hemiparesis or unilateral ataxia(?).
Needs a complete neuro exam, probably blood tests to properly work up.
My preference would be
a boarded neurologist.
The rule-out list is long at this point until you get more information.
Tumor, infection, hypothyroidism, trauma, toxins are on the list as well as others.
Good luck.

 

[Let'sgoflying!]

PS if he was at an emerg clinic, they should be able to tell you what that kidney status is. (BUN/Creat/Usg)

 

[gprellwitz]

Dave,
A stroke was my first thought, reading Ted's initial description he received from the kennel. You're the vet. Is that plausible? I didn't see it in your list of suspects.

 

[Ted]

Well, as of this morning she is behaving completely normal. Her head tilt is about gone (back to the way it always has been since I got her), her reflexes at her eyes, ears, and whiskers are back to normal as well. Her eyes were closing fine whenever she wanted to sleep, and her eye was not showing any signs of dryness this morning. I put the artificial tears in anyway (and will do so per the prescription until going to the vet tomorrow morning), but I'm thinking it's probably not necessary.

The emergency clinic did absolutely nothing beyond look at her and clean out her ears (thinking perhaps ear infection). I was rather disappointed with their lack of willingness to do much more. At least they gave her the artificial tears.

We'll see what the vet says tomorrow. I've had a few people say vascular disease. Given how quickly she seems to have recovered and the generally good prognosis if that's the case, I'm hoping that's what they discover.

I'm not a big believer in doing tons of tests to establish a disease that nothing can be done about. I've seen too many friends spend tons of time and money searching for a disease in their dogs and then try to fight it, only to have the dog end up dying anyway, with having suffered through the end of its life getting poked, prodded, and cut open. I can't think of anyone I know whose dog has undergone major surgery and survived more than a few months. Ideally, we'll come up with a few things to look at that are easy to test for, hopefully treatable, and then act accordingly.

 

[steingar]

While it does sound like a stroke, those saying more work is needed for a certain diagnosis are right on. However, if the dog is recovering I wouldn't bother with anything else. The only reason I myself might pursue such a thing is the possibility of an infectious disease, but if this was caused by a virus in the kennel half the dogs there would have it.

My dogs have come back from the kennel sick as well, which is why they rarely go there anymore. Kennels involve stress for the animals, and they are more likely to be exposed to other canine diseases while they are there. I am not singling out any particular kennel, it is simply the nature of the beast. I've had my neighbors take care of my dogs for the last several years, and it is worked out very, very well.

By the way Ted, you should be showering back into your house after a rescue operation. You don't know where any of those dogs have been, and you can make a wonderful canine disease vector.

 

[SCCutler]

Sounds like Dixie Belle when she had Ideopathic Vestibular Syndrome (IIRC); we called it "Crooked Doggie Disease." We were on the verge of putting her down (she could not hold food down, was very twisted-up, could not stand up and walk, etc.), when she finally started eating again, and pretty much recovered. Had several good years after that.

How old is your sweet pup?

 

[Bob Noel]

While it does sound like a stroke, those saying more work is needed for a certain diagnosis are right on. However, if the dog is recovering I wouldn't bother with anything else. The only reason I myself might pursue such a thing is the possibility of an infectious disease, but if this was caused by a virus in the kennel half the dogs there would have it.

Could dehydration cause stroke-like symptoms?

(however, I would assume that the clinic would know how to spot dehydration in a edit: dog)

 

[steingar]

Could dehydration cause stroke-like symptoms?

(however, I would assume that the clinic would know how to spot dehydration in a god)

Yes, dehydration can cause similar symptoms, but it will do so only after it has a very obvious effect on the coat. I would hope that the workers at the kennel are sufficiently observant to see dehydration before it results in neurological dysfunction.

 

[bluee]

Sorry to read about your dog. A few thoughts: a stroke, an embolism (like a stroke), or a tick disease. My German Shepherd was paralyzed and nearly died from Rocky Mountain Spotted Fever. Or maybe a thyroid problem. Thyroid problems can cause seizures and other weird symptoms.

 

[Ted]

By the way Ted, you should be showering back into your house after a rescue operation. You don't know where any of those dogs have been, and you can make a wonderful canine disease vector.

Standard after-transport practice involves a very thorough disinfecting of all cages and cleaning of the plane followed by a very thorough cleaning of myself and my clothes. I've done these transport things a few times, and preventing disease transfer is a huge deal.

Sounds like Dixie Belle when she had Ideopathic Vestibular Syndrome (IIRC); we called it "Crooked Doggie Disease." We were on the verge of putting her down (she could not hold food down, was very twisted-up, could not stand up and walk, etc.), when she finally started eating again, and pretty much recovered. Had several good years after that.

How old is your sweet pup?

She's doing great today, Spike. Still a slight head tilt, but otherwise completely back to her old self. We've got a vet appointment for tomorrow with the vet back home, and will see what he says. Hopefully good news.

 

[jlwilson]

I don't know if dogs can get Bell's Palsy, but if she was a human, that's what I would think. Glad she's doing better!!

 

[Anthony]

Glad to hear she's doing better Ted.

 

[Let'sgoflying!]

-"stroke". for decades the veterinary neurologists told us dogs and cats don't get strokes, they do not get atherosclerosis or the other things that lead to either bleeding or blood vessel blockage in the brain like humans do. Most of us in practice have seen stroke-like events (I have), I guess they listened to us and now the neurology community does say they get something like strokes. However they are pretty rare. A neuro exam very soon after the onset of signs can often localize the lesion to a certain part of the brain. The onset, progress and recovery are very similar to that of humans, even if the pathogenesis is not. There are often underlying causes that can indeed be remedied to prevent further strokes.

-idiopathic (aka 'peripheral', aka 'geriatric') vestibular syndrome. This would be unlikely if the dog truly had facial paralysis. IVS originates in the inner ear and does not radiate to adjacent structures. Similar signs though. Self-limiting disease. The only dog I can truly say "I saved from IVS" was one owned by a sailor. He insisted the dog would be on the deck for a trip while it was still in a 'drunken' state from its IVS; it surely would have fallen overboard & drowned if he hadn't listened.
The facial nerve does pass the inner ear so any infectious or inflammatory process in this area (IVS is not one of these) may cause both signs (head tilt, facial paralysis).

-Ted might look at this before he decides its not worth it to do anything involved. I'm not saying his dog has this but there are some simple things out there that do not cost a fortune to diagnose (our thyroid is about a 20-30$ test) or treat (I think the pills are 10c each)
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC341946/

Bell's Palsy - I believe (I am not an MD) that BP would be facial paralysis with no head tilt. Ted's dog has a head tilt.

disclaimer:
It is difficult enough to do vet work when the animal is right in front of you. It should be considered near-impossible to do from internet descriptions! But I will try to help with info when able. If you take away any one thing from my posts, it's what you already know - get a pro to physically look at (listen, smell, feel, etc) your pet!
Good luck, Ted and Duchess.

 

[Ted]

-Ted might look at this before he decides its not worth it to do anything involved. I'm not saying his dog has this but there are some simple things out there that do not cost a fortune to diagnose (our thyroid is about a 20-30$ test) or treat (I think the pills are 10c each)
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC341946/

Emphasis added. Yes, simple things and bloodwork by all means make sense. It's when you get into the big, expensive, complicated tests that are hard on the dog that I tend to be less enthusiastic about, because those dianogse the things that are more difficult to deal with anyway.

 

[Ted]

We went to the vet yesterday, who said he thinks the most likely fit for everything is Horner's Syndrome. The symptoms have a pretty good fit, and the good news is that the symptoms with it should come and go every now and then, but generally fix themselves.

To cover other bases in case it was some sort of weird infection, he started her on a broad-spectrum antibiotic and also some Dramamine. Apparently the Dramamine can help with the dizzy spells, because what's effectively going on is motion sickness. Yesterday she had two dizzy spells that I saw (one at the vet's office, thankfully!), but those were before she got her first round of meds. She's otherwise her normal happy, bouncy self. I'll be keeping an eye on her and see where things go.

 

[Let'sgoflying!]

Great, glad you have an answer & treatments and a decent prognosis.

'miosis, ptosis, enophthalmos, anhydrosis' we used to chant at vet school.
Interestingly that sympathetic nerve can be damaged by extreme stretching of a forelimb, the nerve passes thataway and through the chest.

Hey, did they have an explanation for the falling/weakness or head tilt? Those are not expected features of Horner's.
Hope it all works out for Duchess.

 

[Anthony]

Glad to hear it Ted. They are family members.

 

[Ted]

Hey, did they have an explanation for the falling/weakness or head tilt? Those are not expected features of Horner's.
Hope it all works out for Duchess.

He said that he'd seen it before in others that had been diagnosed. He said the other option was some other thing (vasculitis I think?), but that he thought this was a better fit.

If in a few weeks she hasn't returned completely to normal, we'll do more tests. But since she was acting fine otherwise, he didn't see a need to go out and do a ton of tests for the time being.

 

[JesseD]

We went to the vet yesterday, who said he thinks the most likely fit for everything is Horner's Syndrome. The symptoms have a pretty good fit, and the good news is that the symptoms with it should come and go every now and then, but generally fix themselves.

To cover other bases in case it was some sort of weird infection, he started her on a broad-spectrum antibiotic and also some Dramamine. Apparently the Dramamine can help with the dizzy spells, because what's effectively going on is motion sickness. Yesterday she had two dizzy spells that I saw (one at the vet's office, thankfully!), but those were before she got her first round of meds. She's otherwise her normal happy, bouncy self. I'll be keeping an eye on her and see where things go.

My parent's chocolate lab had horners syndrome. She lasted another few years. Keep an eye out for eye troubles, you may have to get medicated drops for that. Watch the food too, they sometimes swallow without chewing completely.

 

[Doggtyred]

There is a condition in humans that mimics a stroke called Bell's Palsy. It affects the MOTOR nerves in the facial nerve bundle. Sensation remains, but the entire side (and only one side) of the face is paralyzed until it resolves, which can take time.

In humans, this is a diagnosis of exclusion, which means you prove there's NOT a stroke or TIA going on before you label it Bell's... Treatment is supportive (you deal with adverse symptoms such as dry eyes by using drops) and the "cure" is time, and the body doing its own thing. I do not know if this is also a canine disorder.

Anybody reading this should remember you presume the listed symptoms are a stroke until stroke is excluded. Strokes caused by blood clots MAY be eligible for treatment with clotbusting drugs but time is UBER CRITICAL in these instances.

Less than 3 hours must have elapsed from the time the patient was last seen normal until the drug is pushed in the IV. That includes the time to call EMS, get to an ER, GET a CT scan, exclude a bleeding stroke on the CT, and screen the patient for inclusion/exclusion factors. In some locales, the decision to push those drugs is made by a neurologist, not the ER physician. That doc has to also get to the hospital if they aren't already there. EMS should know if there is a credentialed stroke center in your region, and can pre-alert a stroke center to call such a doc in before the patient gets there.

Its worth the extra 10-20-30 minutes to bypass the closest ER if it means you will be delivered to an ER/Hospital that has qualified as a stroke center, and arrive within the required time window for treatment to be offered.

 

[astanley]

Ted,

What emergency clinic did you go to? Next time, I would suggest you go to Tufts Veterinary School in Grafton. An outstanding environment, one of the best.

You can, alternatively, head to MSCPA Angell in Boston, just off of the Jamaica Way.

Cheers,

-Andrew

 

[flygirl34q]

Glad to hear it Ted. They are family members.

I think so too... and that is why I'd like to know how far pet owners here with a dog or cat would go to treat their pet. For example, would you go ahead with a painful surgical procedure if it would save their life? How about chemotherapy if a pathology report came back indicating a malignant tumor?? Would it make a difference if the pet was a young animal or an older one? I have never had to think about anything like this before and could use some insight from pet owners who have perhaps been through a similar situation.

 

[dmccormack]

We went to the vet yesterday, who said he thinks the most likely fit for everything is Horner's Syndrome. The symptoms have a pretty good fit, and the good news is that the symptoms with it should come and go every now and then, but generally fix themselves.

To cover other bases in case it was some sort of weird infection, he started her on a broad-spectrum antibiotic and also some Dramamine. Apparently the Dramamine can help with the dizzy spells, because what's effectively going on is motion sickness. Yesterday she had two dizzy spells that I saw (one at the vet's office, thankfully!), but those were before she got her first round of meds. She's otherwise her normal happy, bouncy self. I'll be keeping an eye on her and see where things go.

Glad to hear it, Ted.

Our Yellow Lab, Lad, had seizures every so often from age 5 on. He lived to nearly 13, so while the symptoms were bad, he still lived a full, long life.

 

[Anthony]

I think so too... and that is why I'd like to know how far pet owners here with a dog or cat would go to treat their pet.

Well, my German Shorthaired Pointer had both knees done and had to have his stomach and intestines opened up due to swallowing a kitchen hand towel.

Over the years I probably put aorund $8K into him. Yes, for that money he should have sprouted wings, a Lycoming and flown. When the vet asked what I wanted to do, I just answered, "anything it takes", and I'd do it again in a heartbeat.

Cats on the other hand.

Just kidding!

 

[dmccormack]

Well, my German Shorthaired Pointer had both knees done and had to have his stomach and intestines opened up due to swallowing a kitchen hand towel.

Over the years I probably put aorund $8K into him. Yes, for that money he should have sprouted wings, a Lycoming and flown. When the vet asked what I wanted to do, I just answered, "anything it takes", and I'd do it again in a heartbeat.

Cats on the other hand.

Just kidding!

Well....

That's a tough one, and I'm glad no Federal guidelines are in place -- yet...


"Sorry Mom -- I know you need dialysis but Fluffy needed a kidney transplant..."

 

[steingar]

I think so too... and that is why I'd like to know how far pet owners here with a dog or cat would go to treat their pet. For example, would you go ahead with a painful surgical procedure if it would save their life? How about chemotherapy if a pathology report came back indicating a malignant tumor?? Would it make a difference if the pet was a young animal or an older one? I have never had to think about anything like this before and could use some insight from pet owners who have perhaps been through a similar situation.

It is a funny thing you mention this, as one of my wife's friends has a dog with a nasty tumor. We talked about what we would do if one of our dogs was so diagnosed. I was quite adamant, I would not send a dog through any kind of oncological treatment. I would not have a dog treated for an incurable disease, other than to reduce pain/suffering/symptoms.

This is a potent issue for us, as one of our dogs is suffering mild renal dysplasia. It can be managed and is not affecting things overly much, but I will not go very far in trying to remediate the condition. Humans can understand why they are being made to feel uncomfortable, dogs can't. They live in the moment, and can understand nothing beyond the fact that they're being hurt. This is the largest part of the decision making process for me.

 

[Ted]

What emergency clinic did you go to? Next time, I would suggest you go to Tufts Veterinary School in Grafton. An outstanding environment, one of the best.

You can, alternatively, head to MSCPA Angell in Boston, just off of the Jamaica Way.

I didn't end up taking her to the emergency clinic, it was somethign the kennel did while I was still out of town, so it wasn't something I had a lot of input into. Were I here, I would've acted differently. Basically they took her to an emergency clinic because I didn't have a local vet to take her to.

I think so too... and that is why I'd like to know how far pet owners here with a dog or cat would go to treat their pet. For example, would you go ahead with a painful surgical procedure if it would save their life? How about chemotherapy if a pathology report came back indicating a malignant tumor?? Would it make a difference if the pet was a young animal or an older one? I have never had to think about anything like this before and could use some insight from pet owners who have perhaps been through a similar situation.

Well, I've not had to go through it with my dogs. What I have noticed is that, in most cases where people I know have spent tons of money on complicated, painful treatments for major diseases on their dogs, the dog ends up dying within a few months. So like anything else, the answer is "It depends." I elected to have surgery performed on my Rottweiler a year or two ago, but it was minor surgery for a lump that he had in his side. He was back to his old self as soon as he woke up.

On the other end of the scale, a friend of mine had a 14 year old dog (with a life expectency of 12) that got sick. They spent about $5,000 worth of surgery on her in the end. It was long, painful, and hard on the dog. She died within a week, and they claimed the doctors screwed up and she died before her time.

Everyone has to answer that question for themselves and what they'd be willing to do. But then again, I'm not a believer in extending life forever just for the sake of extending it. Everything has a "use by" date, especially humans and other living creatures.

 

[Anthony]

Well....

That's a tough one, and I'm glad no Federal guidelines are in place -- yet...


"Sorry Mom -- I know you need dialysis but Fluffy needed a kidney transplant..."

Ha, yeah. You pay out of pocket for pets. He had a lot of good years left, so it was an easy decision.

 

[Ted]

Lots of years left and a good prognosis is easy. It gets harder when they get to be senior citizens and the prognises is so-so or worse.

Fortunately, my dog seems to be doing well on the meds!

 

[dmccormack]

Everything has a "use by" date, especially humans and other living creatures.

Where is that label???!?!?!

 

[Ted]

Where is that label???!?!?!

Right next to the "mute" button that I've been trying to find on a few people I know.

 

[astanley]

I didn't end up taking her to the emergency clinic, it was somethign the kennel did while I was still out of town, so it wasn't something I had a lot of input into. Were I here, I would've acted differently. Basically they took her to an emergency clinic because I didn't have a local vet to take her to.

Gotcha. In the future, if it's your call -- consider Tufts or Angell. Tufts is world-class and really great people, although you'll pay for the quality of care. My sister works in infectious diseases there.

Cheers,

-Andrew

 

[Ted]

Thanks for the reference. I'm sure hoping to be out of here before either of my dogs need any more veterinary care!

 

[TMetzinger]

I think so too... and that is why I'd like to know how far pet owners here with a dog or cat would go to treat their pet. I have never had to think about anything like this before and could use some insight from pet owners who have perhaps been through a similar situation.

My cats are ASPCA adoptions - show animals which can be "investments" as well as family members can be different.

We make our decision based on the cost of the care, against the benefit to the pet, and what the finances are - we're not going to rob Ciara's college fund for a pet.

One cat chewed up our daughter's pom-pom and was clearly in distress and unable to keep any food down - so (on the day after Christmas) it's off to the emergency vet center for ultrasound, and two days of supportive care and IV feeding until the digestive system was passing things normally again - $950.00, but we knew that cat would have a normal and long life afterwards.

Another (earlier) cat was diagnosed with kidney failure at four years of age. It came on suddenly. The doctor gave us some options that would be $2000+ and might (20% chance) allow him to live another year. We elected to put him down.

Everybody needs to look at what they can afford, and what the potential reward will be.

 

[Let'sgoflying!]

Everybody needs to look at what they can afford

Like the guy who said today, "Do EVERYTHING, Doc! Cost is no object!" Hmm, odd how I hear that expression at least once a week.

 

[bluee]

I think so too... and that is why I'd like to know how far pet owners here with a dog or cat would go to treat their pet. For example, would you go ahead with a painful surgical procedure if it would save their life? How about chemotherapy if a pathology report came back indicating a malignant tumor?? Would it make a difference if the pet was a young animal or an older one? I have never had to think about anything like this before and could use some insight from pet owners who have perhaps been through a similar situation.

I have had several issues with my pets. My German Shepherd that my husband got for me right after we got married, she was diagnosed with a bone tumor in her front right leg when she was 12. I didn't know what to do, I couldn't make a decision and she was obviously in pain. My vet said I either had to put her down so she wouldn't be in pain, or amputate her leg, because the bone was basically disintegrating. We had her leg amputated, and she recovered well from that. Then we did chemo, five rounds, which she tolerated well. She lived another year, and died in her sleep at 13.5 years old. In hindsight, I did all that medical care for me because I wasn't willing to let her go.

My second German Shepherd nearly died from Rocky Mountain Spotted Fever. One day he fell over and was paralyzed. We saw my regular vet, and a vet neurologist, who diagnosed the RMSF (tick disease). Long story short, it took him a month to walk again, another six months until he was almost normal, but the infection took a terrible toll on his joints, he was terribly arthritic after that. Basically on a whim I decided to treat him with Vet Stem, stem cell therapy. My vet cut fat out of his side, sent it to Vet Stem in California, they spun out the stem cells, sent it back, and my vet injected it into his hips and knees. It worked great! I was very impressed. He leg lifted for the first time in a year. We had enough stem cells left over in cryogenic freeze that I was going to do it again a year later. But he died unexpectedly from hemangiosarcoma, cancer of the spleen and liver. Once my vet found the mass on his spleen and liver, she said there was nothing to be done, and he died three weeks later.

So I've done just about everything medically possible. It's cheaper than guilt.

I forgot to mention the bloat surgery. German Shepherds and other large deep-chested dogs are prone to bloat, the stomach twists, and the dog will die without surgery. My two older dogs both bloated in the middle of the night, requiring emergency surgery. They lived many years after that. My dog I have now, when she was fully grown at two years old, I had her spayed and her stomach tacked so she can't bloat.

 

[flyingcheesehead]

Basically on a whim I decided to treat him with Vet Stem, stem cell therapy. My vet cut fat out of his side, sent it to Vet Stem in California, they spun out the stem cells, sent it back, and my vet injected it into his hips and knees. It worked great! I was very impressed. He leg lifted for the first time in a year.

Wow - Yet another example of us humans treating our pets better than we treat ourselves!

I didn't know you could even do that. Cool.

And I'm going to stop right there lest I get this sent to the Spin Zone.

 

[bluee]

http://www.vet-stem.com/

I think there are fewer restrictions in treating animals. I would try Vet Stem again if I had to.