Dr. Salkin~ Thank you so much for your email! I have been so worried all day at work and your information has put me at great ease for the 1st time in a long time. I can easily "live with" him like this, I just don't want to be selfish if he is living a miserable existence, which doesn't seem to be the case to me, but dogs are so stoic. I have just been on this emotional roller coaster for what seems like an eternity now - reading that vestibular generally lasts about 3 weeks and most all dogs return to normal, etc. The ups and downs are so frustrating and I'm just not seeing the results I'd hoped to see by now - which led me to question the dreaded brain tumor I've read so much about.. The only other concern I have is that I have read numerous times that vestibular episodes usually don't occur more than once in a dog. Is this the case? I understood your response to mean that he had another attack last night. Can this happen repeatedly? Just worried about his safety more than anything - last night he was inches away from the fireplace mantle when he fell over. Btw - he seems "OK" today - he's not quite as wobbly as he was right after it happened last night. Really no change from the past week or so before that, however - but he is up & staggering around, which is somehow comforting to me at this point. I have also been having acupuncture and vet chiropractic done on him the past few weeks- not really sure if I'm just throwing my money away since I don't think it's helped a great deal, but I suppose it can't hurt. With regard to the Gabapentin - unfortunately, it was abruptly withdrawn the other day. My vet said that unless he was prone to seizures to begin with (which he wasn't) withdrawing abruptly should not cause seizures. I still wonder about that after last night, though. Again - thank you so much for your response. I will definitely check with my vet about a current culture & sensitivity test. I know when he was in last week, she flushed his ear out - which she does about once a month. A few months ago before all this happened- he had e-coli bacteria in that ear that was cleared up with antibiotics.
Again, your response is very reassuring and you are much appreciated for taking the time to discuss this with me. Lisa
He is still on the Prednisone - the vet actually upped his dosage to 15 mg twice a day for a week and it was just lowered back down to 10 mg twice a day, so hopefully that does explain his recent increased thirst and hunger, etc. I actually researched Cushing's disease previously and he does display many of the symptoms, so it is definitely worth looking closer into. It might also explain the delay in his ear infection healing and recurring and him possibly being recently diagnosed with hypothyroidism? Panting being a common symptom is very scary, as well. If he does have this disease, would him taking corticosteroids on a daily basis just make things all the more worse if his body is producing too much to begin with? I also read where abnormally high corticosteroid levels can cause muscle, tissue and ligament weakness - would this might also explain his prolonged ataxia? I don't notice any hair loss or protruding belly & I remember the vet saying not long ago that she couldn't feel an enlarged liver. I have all his recent (5/11) test results I'd love to show you, but when I scan them, it converts them into a pdf file & I am unable to copy or paste. Not sure what to look for in the test results to see if it could indicate Cushing's - but I suppose the readings could have changed recently anyway if he's in the early stages of the disease.
Thanks so much! Hopefully he doesn't have this - although it doesn't look to be terminal - just hard to diagnose and potentially expensive.. I'll definitely ask my vet about it.
I just cannot thank you enough for your time and help with all this. I guess I've gotten so wrapped up in trying to find a way to get him back to his old self, I don't really think logically sometimes. I will say that he had a really good day yesterday & it keeps me going. Up & around alot & it seems maybe a little less of a head tilt - sometimes you don't know whether it's the placebo effect or really happening. Ha! I know I need to brace myself for the inevitable, just not ready to let him go. But when will I ever be? Hopefully it's not Cushings and I so appreciate you explaining all this so clearly. You have truly made me feel better about all this somehow, regardless of the outcome and I truly appreciate it. He & I have gotten closer than ever since I've been trying to nurse him back to health. It's great how dogs sense that and respond positively. I feel in my heart that it's helped him recover to the point he has now - albeit not a whole lot-it's something. He's never been a very affectionate dog, so I'm enjoying the closeness now. You have helped me more in the past few days with this than anyone else ever has & I thank you. Your patients are SO fortunate to have you as their vet! I'll keep in touch from time to time, if that's OK.
Thanks again & the best always,
Thanks for your comforting response. Before starting him on Prednisone back in September of last year, he just ate and drank normal amounts. I really just started noticing excessive hunger & thirst over the past week or so, which seems to correspond with the time frame that the vet had increased his Prednisone dosage. He's been back down to a total of 20mg/day for a few days now, not to mention the 750mg of Cephalexin he's been on for about a week or so - so hopefully there's a correlation there. I re-read some info on Cushings again yesterday and one article talked about pet owners bringing their dogs in to the vet for urinating on the carpet constantly, when this was never a problem before. That had about convinced me this disease was the culprit, (on top of other similar symptoms) since he has been going on the carpet alot lately and before, I think he would've soon burst before doing that. Thank goodness for carpet cleaners! But botXXXXX XXXXXne, he's drinking alot more now, for whatever reason, so of course he has to go more. When I'm home in the evenings, I just automatically let him out often - to get some exercise & sniff around, if nothing else, so he has way fewer accidents. I had also noticed more of a pot belly on him recently, but he's always had a slight one, being short & stocky and he has been eating like a pig lately. I am keeping it in check though - the last thing he needs is to add more problems by being overweight and/or diabetic. I do notice recently that when I give him a rawhide to chew on, it definitely preoccupies him and I can get more done upstairs at the house without him constantly crying and searching for me. Ha!
I definitely saved our chat (& printed it for Chazz's ongoing file I've put together - ) and will touch base again soon.
Again - I just can't say enough kind words to express my deep appreciation.
And a great sense of humor?! Really?!
Wish you were practicing in Oklahoma, but seeing as how (I'm assuming) you're in Hawaii - you'd have to be certifiable to ever leave paradise, for this place especially! We're fighting almost a month straight now of 104-106+ degree temperatures! Unbelievable.
So- horrible night last night. Chazz started panting and pacing around the house around 10pm and it basically did not stop until about 2am. I actually made the mistake of leaving him downstairs with my husband. I had already begun noticing some agitation and unsteadiness at this time, but he (Chazz) had dozed off for a while - seems like carrying him up the stairs just makes him worse sometimes anyway - so I left him down there to sleep. I woke up hours later to noises and found that he had somehow managed to make it past the blocked stairwell and get all the way upstairs - this has happened once before. I'm sure he injured himself at some point. By the time I found him, he was in the guest bedroom and seemed so confused that he was walking into corners and into any opening, just standing there until he'd start roaming around again, bumping into furniture, etc. I thought for sure he would collapse at some point, so wobbly, getting himself so agitated and walking in circles like that, but he didn't. He didn't whine or cry during any of this. I tried getting him to lay (or even sit) down, but he wanted none of it. After a while, I carried him back downstairs & let him outside and back in, where this behavior continued to go on, but he did take breaks between, lying down on the tile in the kitchen, seeming to calm down a bit. I layed with him petting him for hours, then I finally fell asleep on the couch around 4 or so. Today he seems much more wobbly and unstable on his feet (than he usually is in the daytime) & is sleeping. I was unsure last night whether to give him a Tramadol or even Meclizine in case he was dizzy. I haven't given him the Meclizine for many weeks now, as I mentioned before. I ended up giving him a 1/2 Tramadol, because I had given him a full dose hours earlier at dinnertime. I called my vet this morning, but she is out of the office today. The ups and downs are killing me. It actually crossed my mind last night about whether I'm just being selfish here and just seeing what I want to see when it comes to his recovery and whether or not I should consider euthanization, he looked so miserable. Is there any light you can shed from your experience why he seems to be improving during the day, but worsens at night? I know we discussed possible dizziness or one of the drugs kicking in or wearing off - just not sure what I'm missing here or what to do. He basically takes all the same meds in the pm too - then most evenings lately, gets worse a few hours later. Last night was actually worse than when all this began over a month ago. Is there anything I can do (i.e., give him) in the evenings to try to prevent this, or more importantly, what can I do (give him?) to try to calm him down and get him to lie down and rest if he's in the middle of one of these episodes? Is this par for the course for a vestibular dog and something we'll just have to live with every night - or does it sound like something else may be going on that I need to have checked out? Gotten to the point where I don't even want to take him to the vet, etc., in the car - as he doesn't do very well, which makes sense I suppose. Don't know if this is a mixture of dizziness and pain or something going on in his brain, or what. The craziest part is - he was doing great early yesterday evening, chewing on his bone, relaxed and seemingly fine - this is why euthanizing seems seems so outlandish (not to mention impossible) to me most all of the time, but a very harsh reality in the middle of the night, helplessly watching your dog go through this. Any advice is, as always, appreciated. Funny - I always try to make my comments brief in the interest of your time, but I want to make sure I don't leave anything out that might be relevant &/or helpful. Thanks again!
Thanks again. Just reading your replies calms my nerves somehow. I am more than willing to follow your advice and take him off the meds. I have actually considered this many times, but am afraid of some rebound reaction, I guess - especially since one is for his thyroid I really often wonder if he even needs to be on it - since I read how their levels can fluctuate at any given time. Testing hasn't been done to see if his levels are even back to normal yet. Not sure if he's in pain as well, as far as the Tramadol. Also, I guess I just have it in my head now that we're still trying to kick an ear infection, that taking him off the ceph would just be counterproductive. But I suppose taking him off everything for just a few days would probably be the best way to try to solve this, if you think it's safe. Truth be told, each time the vet has added another med, I just cringe - I hate giving him all these pills. I totally agree that there is a secondary anxiety disorder going on. If you get a chance, please check out ehow dot com and look up "sundowning syndrome in dogs" (Cognitive Dysfunction Syndrome) that I just came across! (not sure if copying & pasting the link will come through to you OK) This is exactly what went on last night and many others!! I never thought this situation with him would get to the point of controlling my life & thoughts, but again, he has always been here for me & I've always felt that dogs were put on this earth for us to enjoy & nurture. I simply cannot give up on him. Just a few minutes ago - he was just standing in the kitchen looking up at me wagging, so go figure. Still "off" today more than I've seen him the past several days, but not the same dog I was up with all last night. Something I keep forgetting to mention is recently, the bone at the top of his skull is protruding more, to the point where I can see it sticking up out of the top of his head - right between his ears. I can literally feel the point of the bone - it's very hard. I've been attributing this to the way his head & ear have been tilted, but now I don't know.. I will skip all his meds tonight and for the next couple days and keep you advised, if this in fact what you'd recommend. Thanks again for not only helping us both, but allowing me to somehow relieve my own anxieties by writing all this down and attempting to work through it in my own mind, not to mention your patience and caring and all your personal time you've taken with me. It just means so much, regardless of the outcome of this and I will forever be grateful. No vet has ever taught me so much in such a short period of time.
Thank you. I can't imagine there being anything wrong with your cognitive abilities. To be clear, what is the "AB" - all his meds? Do you feel that he could be suffering from CDS/Dementia, based on the identical symptoms? I'm not expecting a miraculous recovery at this point, I'm afraid - just want to try to make him (& the family) as comfortable as possible, I guess. All the websites mention "may get stuck in corners and can't find their way inside, stare into space, seem confused, panting, eliminating in the house - all at night/sundown". Do you not think that Anipryl could alleviate any of these night time symptoms?
Thanks for making me smile. Well-he's starting it again tonight. It has everything to do with him getting up & looking for me - making sure I didn't leave him downstairs by himself. After so much time has passed, he stands at the foot of the stairs crying and whining, getting more & more agitated. Thanks for the clarity on the AB - I figured but am too scared to assume anything anymore. Ha! I guess my botXXXXX XXXXXne is - if I don't see any improvement over the next few days, weeks(?), do I continue taking him to the vet to try new methods of treatment (of course my budget has become quite modest over the past month or so with his care), or do I just need to sit back & let nature take it's course? My biggest fear is not having done something when I could/should have, even the tiniest thing that could've yielded great improvements. I did not give him any of his night time meds - so hopefully we'll see a difference. He's lying around alot more tonight between searches so far than he was last night. All of a sudden I'm kind of at a loss and maybe reality is finally sinking in, I just need to be sure there's not something I could be doing. Not sure how many more nights both he and my family can go through this.
Thanks for your candidness on the Anypril. I would take your word over any website. It really helps to know beforehand.
As always, my sincerest thanks.