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Relapse

Just about a year after her first attack of vestibulitis Nala has had another attack.  Paula was at home this time when it happened and it was nowhere near as bad as the first attack.  This time she didn’t have the obvious eye twitching (horizontal nystagmus) and didn’t get sick.  I took her out first thing in the morning yesterday before going to work and she showed no signs of any distress.  A few hours later, however, I received a call from Paula letting me know Nala had another episode.


Paula took Nala to the vet as a precaution and all the blood tests came back negative (as expected) but we wanted to be sure.  One test the vet performed on Nala was to roll her onto her back and check her eyes.  As soon as Nala was inverted the horizontal nystagmus presented immediately (a sign that this episode was indeed a recurrence of the “old dog vestibulitis”, also called “old dog vertigo”, “Idiopathic Peripheral Vestibular Disease” or simply “vestibular disease”).  The vet said it’s extremely rare for a dog to have multiple attacks, so I suppose we can be proud our dog is so “special”. 🙂


Nala’s first attack was 5/30/2004.  I’d say it took Nala a week before she was walking on her own last time, but she fell down often.  After a couple weeks she seemed pretty steady but it was a few months before she could shake her head without falling down.  Her second attack happened yesterday, 6/7/2005.


Some tips:
Get a comfortable harness for your dog that wraps around your dogs chest  Having something that can help you to lift and support your dog “luggage-style” gives the animal the ability to move around.  Physical therapy is great for dogs as well as humans.  The more the dog is able to get the sensation of walking upright the more it will be able to learn where its body should be.


To help your dog eat straddle them with your thighs holding their mid-section in place.  Nala is able to stand on her own but has trouble eating because anytime she puts her head down she looses her balance.  By standing over her I can prevent her from swaying side-to-side, allowing her to eat comfortably.  Some dogs may be defensive about their food, so be aware that being close to your pet may make them uncomfortable, you may be able to help them relax by facing the opposite direction, supporting them but have your back to their head.


The slick floors that are funny when your normal dog is chasing you are an absolute ice rink for a dog with vestibulitis.  Your dog can slip an go down very hard because they don’t know which way to twist.  It’s important you help the dog balance, especially in the first few days of re-learning to walk.  Putting down old towels or blankets can help your dog to keep its footing.


With the loss of the inner ear for balance your pet will be relying on muscle memory and eyesight for balance.  This means when it’s dark your dog will be more off balance.  Leaving a night light on will help to stave off confusion and be sure the area you take your dog out to go to the bathroom is also well lit.  Your pet has gone from using muscles, eyesight and inner ear for balance down to just muscles and eyesight.


Make it a point to walk your dog over to the water.  You may not notice your dog periodically wander over to take a drink during the day, they get thirsty and do want to get a drink.  If they can’t walk over on their own, they’ll really be parched.


Finally: don’t panic.  As doting “parents” Paula and I are both very protective of Nala and it pains us to see her out of sorts.  Remember that your pet is uncomfortable, but probably not in tremendous distress (esp. if they are still eating and drinking).  As our good friend Tom pointed out last night: “it looks like the tail’s not broken.”  Nala responded with an enthusiastic tail thumping on her bed.

17 replies on “Relapse”

hope nala is improving all the time i can compleatley understand how you must be feeling it was as though i wrote that letter myself as with my dog hooch a french bulldog she has had 3 episodes of vestibulary disease from the age of 9 months she is now 3 years of age she too has recovered each time she is still recovering from her last one only happened a week aga same thing she was fine in the morning started with the head tilt then progressed quickley down hill from there we nurse her through it giving her time and doing all the things you also do with nala as you learn to ajust to situations accordingly to make it more comfortable not saying its easy to see them roll but you learn to cope and deal with it the best way possible for the welfare of your best friend hooch tends to get these every spring summer she has not yet had one in autum or winter months is this the same with nala hope all goes well for you both sarah and hooch

My dog was just diagnosed 2 and a half weeks ago. She’s been doing pretty good for the last week. Pretty much back to normal except she’s still a little shaky walking. Tonight she’s already had another episode. I’m just researching to see if reoccurrence is normal? So far the symptoms are less severe. Do you have any suggestions for me and my dog?

Thank you for this helpful information. My 14 year old Springer just had his second bout of vestibular disease in about six months. I agree that a harness is a wonderful support for keeping him from falling when going outdoors.
This is day 10 of this episode, and he still does not have a good equilibrium. Several days after the vet gave him a shot of Cortizone, he got bad diarrhea. Did you have that issue with Nala? Another question: how soon is it OK to take the dog on a long car ride after the vestibular episode? And is there anything to protect him from being dizzy on the drive?

Sorry to hear that Jan. I know for us it was so scary to see our pup struggling.

I wish I could remember if Nala had stool issues, but unfortunately I don’t. The first episode she was given cortisone as a precaution in case there was brain swelling that was causing the episode. When the the second episode happened the doctor didn’t recommend any medication (which we were good with as the first time it didn’t appear to help).

As for a car ride, I think that anything that will make your pet comfortable lying down would be good. A bed with soft walls they can lean against may give them support around corners. If your dog is crate trained, filling their crate with familiar bedding and smells would provide a familiar and safe refuge.

I think (insert standard “I’m not a veterinarian” disclaimer here) that a car trip would be just fine. If you can, do some short drives around town first to see how your pet reacts. If your pet can be lying down comfortably (for their comfort and safety) they will likely be comfortable. Think about how it feels to be reading in a car when it changes direction, this is nauseating for many people (myself included). The reason we don’t like this is that your eyes are getting the message from the book and peripheral vision that you are sitting still. Your ears, however, are shouting “hey, you’re falling over!” If your dog’s inner ear is no longer working correctly there is a good chance that riding in the car will be no less comfortable than lying down on solid ground.

My suggestions would be:
* A crate if the dog is crate trained and you have space inside your car for one
* If your dog views a crate as more punishment than den, a secure place in the back of a wagon or SUV with lots of bedding and no risk of luggage shifting onto them
* If you have a sedan (or want your pet closer) use one of the sling/hammock-type pet seat covers that create a U-shaped valley by hanging from the front and rear head rests (search for “dog car seat hammock” on your search engine of choice to see lots of pictures)
* As with any trip with your pet, take lots breaks to get fresh air, water and use the facilities (it may slow down progress a bit, but your body will thank you for the breaks as well)

If you do end up taking your dog with you on the drive, please let me know how it goes and if you discover anything else that works well.

Thank you for sharing your story. It’s heartbreaking to watch our dogs go through this and I hope Nala is doing better! My Australian Shepherd had her first attack about 4 months ago then it happened again about 4weeks ago. Then 3 nights ago she had a seizure and now tonight we found her again unable to move and had had her third episode. I too was trying to find whether reoccurring episodes was normal. It doesn’t seem so but I really don’t know. Do you have any other helpful tips for us? I’m just praying this isn’t the end of the road for her. Thank you for sharing your experience.
Liz

Sorry to hear about your pup. Other than the notes I’ve made in posts and comments, the best two pieces of advice I can offer are:
1. Be patient with your dog. They may have difficulty moving and bladder accidents are common (don’t be mad or punish them).
2. Trust your vet. There is all sorts of folk wisdom on the web, not all of it good. Your vet has years of training and access to the most up to date resources.

I really hope your shepherd recovers quickly.

My dog Amy at 14yrs had her first attack 6th june this year, she has just had a second attack 4th august. This one was not a quarter as severe as her first but was more worrying because it came back so soon. As always she has remained happy, tail wagging and greeting you. Its a little harder for her as she has limited sight and hearing. It doesn’t stop her being happy though. I have no idea what the future is but she’s family and we are in this together

Sorry to hear that you have gone through this as well. My seven year old pit had his first severe bout of vestibular at the end of October 2017. They’re movments (nystagmus) resolved in about 3 days and he was walking and balancing well in about two weeks. Finally interested in playing again. His head tilt remained as well as facial drooping or paralysis (horners syndrome). We had an MRI done as well as a spinal fluid sample taken and x rays and blood work but all is normal. They are calling it idiopathic vestibular. My concerns have started again as about 3 weeks after the incident his face would tense up. Wondering if it could be his muscle feeling coming back into his right side? It’s been very challenging not knowing what this is and why it’s happening. It happens every few days and doesn’t last long at all. Still concerning for us because we are afraid of a vestibular reoccurrence. Any thoughts?

The big tell for us when Nala was having a vestibular-related incident was her eyes. You’re obviously already familiar with that and for us, I recall, it was very frightening because it really seemed so frightening and confusing to our dog. Nala’s recovery was a very gradual process, so it wouldn’t surprise me if your pit were still in the process of getting used to the new normal.

I think the key thing is to trust your pup. He’ll know when he’s uncomfortable and will retreat if he’s had enough. It’s nice that he is getting interested in playing, that gives you a good measure for his level of comfort. If he doesn’t want to play, he’s probably ready for rest and pampering.

Just know you’re doing all the right things. The fact that you’re willing to pay for the MRI and other tests means you are getting a ton of extra information. Even after all the tests if they’re still saying it’s idiopathic vestibular that is, in a weird way, good news in my inexpert opinion. It’s a diagnosis of something that is, in most cases, a temporary discomfort for your dog. It’s typically not painful and it’s something they learn to live with.

Our greyhound had failing kidneys at the end of his days and he was clearly uncomfortable. Vestibulitis is a bump in the road, not the end of the line. Think of it as an excuse to buy your dog a new fluffy bed and squeaky toys. To be honest, the new bed and toys are to give you something to distract yourself. Your dog is probably just as worried about you because you’re suddenly so concerned about him. Sit down on the floor with him and let him take care of you. 🙂

Hello,

I just ran across your blog/site. I just had to put my dog Sunny down a week ago today. Sunny was a 14/15 yo chow/retrieve mix and had a host of issues I’m not sure your dog had (Atypical Cushings, Hypo-T, Laryngeal Paralysis, likely Neuropathy, and then he had two Vestibular events (Idiopathic) after his thyroid meds were adjusted. The second time around the doctor inverted him and saw the nystagmus (it wasn’t apparent standing up). Sunny had an MRI done last May and no tumor was found. As far as his VS went, they just pretty much said well, he’ll likely always have it. He had a residual head tilt. A few months later he started circling. He always laid one one side or there other – and often would lay in the most uncomfortable looking positions – like completely curled around to the left with his head to the right. I’m at a loss as Sunny was dropping weight pretty drastically which can be caused by Cushings and Neuropathy. I just can’t seem to find information on how recurrent vestibular disease affects the brain. I would think the nerves would be shot. At the end, he was incontinent (fecal and urinary), muscle wasting, and it seemed like he was trying to will his body to move but couldn’t. He would stand up against things seemingly to balance himself? His sleep cycles started getting off – and he was up and down and up and down. I think he also had some cognitive dysfunction as he would get stuck somewhere unable to navigate and turn.

I took him to my regular vet about a month before he passed and it was just a strange visit. They didn’t recommend lab work – and I didn’t request it. I did request fluids. I can’t even tell you why I didn’t think labs were appropriate. A dog losing half his weight and continuing to lose weight should probably have their blood work monitored (last time was in Sept). I also should have took him immediately back to his Neuro doc so she would determine if the nystagmus was still present. Maybe all he had was the VS? Wow, I certainly hope not, I’d probably go off the deep end if I learned i put my dog down when he only had VS.

Bottom line, I had to walk him everywhere. When I would take him outside he would just lay down in the grass – not even sniffing the air. It was like he was just done. His head carriage was low – and eventually his front legs were weakening too. He could barely stand up long enough to eat his entire meal so I had to give it to him in courses. It was awful to see my once vibrant life loving dog – reduced to such a state. Car rides didn’t do anything for him, it was almost as if all he could do was to focus on how bad he felt.

Hi Darlene,
I’m so sorry to hear about Sunny’s passing. Just know that you did the right thing for him, though. I have always believed that our pups let us know when they are ready to say goodbye. And if Sunny’s quality of life was starting to decline, then you absolutely did the right thing. I’m sure that Sunny’s 14+ years on this earth were the absolute BEST he could have ever had, thanks to you and your love for Sunny.
It seems almost unfair that we have these wonderful little creatures on this earth for such a short time. But someone once told me, after I had to put my 12 yr old Golden Retriever down, that a dog’s life is so short because they spend every minute of their life giving complete unconditional love. A lifetime of human love, condensed into the life of wonderful 4-legged furry companion…man’s true best friend 🙂

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