QUESTION

Thank you for your excellent information on vestibular attacks. My 15 year old dog has had a few very minor attacks (loss of balance/acting drunk) lasting just a few mins over the past 7 years. However, last Dec. she suffered a major attack and couldn't walk or eat for a few days. We gave her a short course of steriods and she made an excellent recovery and has been extremely fit and healthy for the past eight months. Three weeks ago she suffered another major attack, again with all the classic symptons. She was making a good recovery but had not yet regained her balance 100%. The day before this major attack she had what seemed like a small fit - shaking all over which lasted a few minutes. On reflection this seemed to have been triggered by a loss of balance - lying on a wobbly bed. Again, earlier this week she looked up suddenly and again had another small 'turn'- shaking all over and giddy, but was again fine after a few mins. Yesterday, she had another fairly major attack - couldn't stand or eat but by the end of the day was able to stagger outside. I wondered whether the small shaking episodes are bring on the more major attacks and whether you think the small episodes are linked to ear disease? Reading your previous corrspondance her major attacks defintely sound like central vestibular attacks as she has weakness down one side. Any advice very gratefully received.

Judith

ANSWER

Dear Judith,
From what you are describing I would be highly suspicious that your dog is having periods of cerebral haemorrhage. The small bleeds will sometimes lead to an appearance like a minor epileptic fit but a large on will lead to the classical nystagmus (flickering of eyes) and one sided weakness and head tilt. Until relatively recent years it was not thought that these small haemorrhages occurred in dogs but just in people. The increasing number of dogs that are having MRI and CT scans have shown this to be relatively common. The aim at treatment is to rest the dog and try to prevent further bleeding occurring (assuming this to be the cause) and then trying to reduce swelling of the brain and trying to improve brain function. You are usually talking 2-3 days before the main symptoms start to reduce properly and sometimes can be looking at up to a week. Vivitonin which I have discussed a lot previously has the advantage of speeding the repair process and reducing the severity of any further attacks by keeping the oxygen tension of the brain at a higher level. This decreases the risk of bleeding occurring and stops the brain from swelling up as much. The use of Aktivaite or Hills B/d food is then trying to improve the overall functional ability of the brain and thus helps in regaining congnitive function and general awareness in the dog. Other causes include brain tumours etc which will not be detected without scans being done. I would look at definitely keeping on with Vivitonin longer term and also consider either of the aktivaite or B/d to try to improve overall quality of life in the longer term. Steroids from my understanding have a very limited role in treating central vestibular disease in the older patient like this and if used should be used at a one off high dose rather than an extended period as they can reduce the effectiveness of repair if continued longer term.

James Haddow