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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 24432
Experience:  University of California at Davis graduate veterinarian with 44 years of experience
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My dog had what we thought was a stroke on Tuesday -

Customer Question

Hi.
My dog had what we thought was a stroke on Tuesday - unbalanced, head tilted, legs turned out. Walking in circles.
However when I took her to the vets they noted she was anemic blood count of 29. They are thinking now it may be some sort of kidney prob linked to her neurological eposide. She is eating a little, not as much as she was. She is urinating well and drinking but has not had stools in a few days.
I think after I give her her medicines she changes - little appetite. Not as bright, sleepy. Etc
Submitted: 11 months ago.
Category: Dog Veterinary
Expert:  Dr. Michael Salkin replied 11 months ago.

I'm sorry to hear of this with Holly. A head tilt is pathognomonic for vestibular (balance) disorders. These disorders can be peripheral (involving the inner/middle ear(s)) or central (involving the cerebellum and/or brainstem. If Holly is aimlessly walking in large circles, a central vestibular disorder should be considered. Brain tumor is the most common of those disorders. If Holly is walking in tight circles, a peripheral vestibular disorder is more likely.

Mild anemia isn't unusual in our geriatric dogs and nonregenerative (she's unable to replace the red blood cells she lacks) anemias are also common secondary to any chronic inflammatory disease. Can you upload a copy of her test results to our conversation? I understand that you might not have a copy of the results at home but her vet should be able to give you one which you could scan into your computer and give me the link or you can photograph the page(s) and upload the images by using the paperclip icon in the toolbar above your message box (if you can see such an icon) or by using an external app such as dropbox.com. I not only review the test results but also note which tests should have been performed but weren't.

Customer: replied 11 months ago.
Hi,
Thanks for the reply
She no longer has the head tilt it disappeared after 1-2 days and has regained her balance and walks well and has continued to.improve each day. In the mornings one leg is a wee bit off.
In the mornings she is in good forum- seems bright.
But after I give her her meds she seems to detereate.
The vet mentioned that Holly is reproducing her red cells despite having such a low count.
Is it normal for dogs mood to change after medicine?
The vet also mentioned that when u touch Holly eyes she does not respond.
Do you have any ideas what it could be? The vet thinks as she has responded so well to medicine that it could be in fact liver related- cancer, cirrhosis etc. and will run tests on Tuesday. Which I can upload for you.
I have been giving her red meat today to help with her anemiaThanks
Expert:  Dr. Michael Salkin replied 11 months ago.

That's a good sign and one that wouldn't be expected with the more dangerous central vestibular disoders such as brain tumor or strokes. If you're not seeing a good repsonse to her drugs, I recommend that you stop all of them. No treatment has been shown to accelerate natural resolution of the "old dog vestibular disorder/idiopathic vestibular disorder" - the most common of the balance disorders at Holly's age.

She may be regenerating red blood cells but I need to see how well she's doing that. For example, even if 60,000 reticulocytes (immature red blood cells) were seen per microliter of blood, that's considered no regeneration; 150,000/ul is considered just slight regeneration.

Yes, steroids are known to cause behavioral changes in pets and people. The antiibotic may be making her uncomfortable as well. Which antibiotic was prescribed, please?

I want very much to review her test results. Please return to this conversation with them rather than opening up a new question.

Expert:  Dr. Michael Salkin replied 11 months ago.
Hi,
I'm just following up on our conversation about Holly. How is everything going?
Dr. Michael Salkin