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Dr. Altman
Dr. Altman, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 7023
Experience:  Practicing small animal veterinarian for 15 years.
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Our 11 year old Sheltie, a puppy mill rescue we adopted when

Customer Question

Our 11 year old Sheltie, a puppy mill rescue we adopted when she was 5, has started having tremors of the head. Sometimes just her head shakes, but sometimes they seem to be a little stronger, and she starts to loose her balance. It only lasts 1 or 2 seconds, and then she seems fine. She was diagnosed with degeneration of the spine about 4 years ago. Our vet took X-rays the other day of her spine, but nothing definitive showed up. She started her on Prevacox but so far I haven't seen that it is doing anything. I don't know what the next step should be, but I want to to something to find out what is going on. She doen't seem to be in any pain, and is still eating well.
I would appreciate any thoughts.
Thanks you for your attention
Submitted: 1 year ago.
Category: Dog Veterinary
Expert:  Dr. Altman replied 1 year ago.

Dr. Altman :

Welcome! I am Dr. Altman, a licensed veterinarian and happy to answer your questions today.

Dr. Altman :

So sorry to hear she is having these issues

Dr. Altman :

How often are these tremors occurring? Are they becoming more frequent or more severe? Lasting any longer ?

Customer:

Some days she might have 2 or 3, other days 4 or 5. Of course, these are the ones I see. I guess she could have more when I am not looking

Dr. Altman :

Do they occur more frequent when she is trying to do something like eat or drink? These are what we call intention tremors...

Customer:

No, I haven't seen any connection to eating or drinking. Sometimes when she is trying to pee or poop, she might have one, then she starts to loose her balance.

Dr. Altman :

Is there any way you could video tape one? I know it is difficult when they are so random and so short but it really can help your vet visualize the issue and even send the video to a neurologist for an outside opinion. Sorry , are they seeming to be more frequent or severe since they were first noted?

Customer:

I think they are a little more frequent now. They started after she had her teeth cleaned. We ended up taking her to an Emergency clinic the weekend they started, and the vet there wondered if it might have something with the way they positioned her head while cleaning her teeth. She had never had one before that, at least that we had seen. I'm not sure I could take a video, but I guess I could try.

Dr. Altman :

I know it would be difficult but visualization of these events can be very telling. I have had a few cases that I have been able to forward to a neurologist and get recommendations since they were able to see the clinical signs the pet is showing. Is she responsive to you when they occur? Her eyes able to focus and respond to your voice?

Dr. Altman :

I do worry when they increase in frequency. My recommendation would be to log everything: daily frequency, severity of one to ten (ten being worst), responsiveness, length they last. The more information you can give the better to get a diagnosis

Customer:

Another problem is that she is deaf, so she can't respond. Her eyes seem to close a little, at least her eyelids droop somewhat when it happens.

Dr. Altman :

The increased frequency along with her age does have to put some things on the list such as petite mal seizures, tumor, encephalitis (less likely). If they are increasing in frequency it might be worthwhile to discuss getting her on an antiseizure medication to see if they do reduce in frequency and/ or severity. This in itself will be diagnostic but she would need to be on the meds for a few weeks to see any change

Dr. Altman :

Unfortunately with seizures often we will not get a diagnosis unless an mri/ ct is performed and even then it can be ideopathic meaning we simply don't have an answer. But this can rule out a tumor if this is something you would consider

Customer:

I will definitely start keeping a log. I would definitely consider getting an mri/ct. I hate so much not knowing what is going on. And, I know it could be really serious, but isn't there a chance if could be something that could be controled? She is the sweetest little girl, and went thourgh so much in the puppy mill, it just kills me to see this happening and to not be able to do anything for her.

Dr. Altman :

Absolutely with a diagnosis it very well could be controlled

Dr. Altman :

I would consider discussing a referral from your veterinarian to a specialist, ideally a neurologist to consider your options and get you answers

Dr. Altman :

Logging the events along with a videotape can be very very telling

Dr. Altman :

Does this information make sense? Can I clarify anything or assist with any additional questions today?

Customer:

Thank you so much for your suggestions. I will start with the log, and will try to get a referral.

Dr. Altman :

You are very welcome

Dr. Altman :

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Customer:

Thank you again.

Dr. Altman :

You are very welcome, you both will be in my prayers

Dr. Altman, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 7023
Experience: Practicing small animal veterinarian for 15 years.
Dr. Altman and 2 other Dog Veterinary Specialists are ready to help you
Expert:  Dr. Altman replied 1 year ago.
Hi Connee,

I'm just following up on our conversation about your pet. How is everything going?

Dr. Altman
Customer: replied 1 year ago.

Things are still about the same. Our vet consulted with a specialist who said in order to possibly get a diagnosis, he would have to do a CT scan, a myelogram, and a spinal tap, then he felt that the treatment would be to put her on prednisone. I really don't want to put her through all that, so I said why don't we go ahead and try her on prednisone now. So, I am supposed to go to our vet to get some pills today.


Do you think there is any merit in this?


Thank you so much for following up. I really appreciate it.

Expert:  Dr. Altman replied 1 year ago.
I definitely think steroids are an option if you are unable to pursue a neuro consultation. But please make sure there is a "washout" period after previcox prior to starting the steroids since the combination can cause stomach upset/ ulceration (typically 2-3 days between).

Also I would advise discussing antibiotics:
One that passes the blood brain barrier such as baytril to treat an encephalitis and one such as doxycycline to treat possible tick-borne viral causes that can also present with these signs...

Please let me know if I can be of any further assistance to you both!
Customer: replied 1 year ago.

Thank you again, so much! The "washout" period was not mentioned to me, so I am so glad I haven't started the prednisone yet. I will wait 2-3 days as you said. I certainly don't want to cause more problems for her. And, I will ask about the antibiotics.


Thanks!

Expert:  Dr. Altman replied 1 year ago.
Perfect, you are very welcome

Also please make sure that you give food with the prednisone because it can cause stomach upset in some pets...
Customer: replied 1 year ago.


Thank you again! Your suggestions have been very much appreciated.

Expert:  Dr. Altman replied 1 year ago.
You are very welcome, please do not contact me with any additional questions!

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Dr. Altman
Dr. Altman
Veterinarian
6882 Satisfied Customers
Practicing small animal veterinarian for 15 years.