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Lisa, Certified Vet Tech
Category: Dog
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Experience:  AAS Vet Tech. Bully breed rehab & Behavior modification
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12 year old pug vomiting and diarrhea. Took to vet and was

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12 year old pug vomiting and diarrhea. Took to vet and was put on Flagyl for a week. One week later, pug has vestibular incident; severe head tilt to his right, back legs collapsing. Took back to vet who said protein deficiency, high white blood cell count, low red blood cell output. Put on prednisone and sent to a vet specialist for liver workup, ultrasound. Specialist is concerned about the liver and high blood pressure. Pug is sent home with high blood pressure medicine. Now has continuous vestibular problems (walking into things, off balance, legs collapsing, unable to get up a small back step), diarrhea, chattering teeth. Vets did not treat vestibular condition yet that is why I took him in. I am weaning him off the prednisone with the vet's OK. He is eating and drinking a lot of water. Good urine output but diarrhea. Any insight on what I can do to help my beloved pug? I don't want to subject him (or me) to more tests and drugs but don't want him to be in pain or put him down when there might be something to help him.
Hello! My name is XXXXX XXXXX it will be my pleasure to help you with your dog today.

Geriatric vestibular syndrome is actually something we see very frequently.

This disorder is more common in older dogs and thus the name geriatric vestibular syndrome -- but it can occur in middle aged dogs, too, so the name was changed. Idiopathic just means "happens for no known cause" -- so it is a good name but not the preferred one. It does sum up the situation well, though.


For some reason dogs can suddenly develop vestibular disease. The problem seems to be due to inflammation in the nerves connecting the inner ear to the cerebellum (which controls balance and spatial orientation). It usually lasts between a couple of days and three weeks.


A few dogs have residual signs beyond this time, such as a head tilt. This disease normally affects dogs that seem normal up until the signs appear. Then there is sudden loss of balance with many dogs unable to even stand up. Rhythmic eye motion known as nystagmus is usually present. Dogs may be nauseous from the "sea sickness" effect of vestibular disease. Most dogs will not eat or drink unless hand fed or given water by hand because they have a hard time with the fine motor movements necessary to eat or drink from a bowl. As long as they are nursed through this condition almost all dogs will recover. There is no known treatment, although many vets will send out medications to help with the nausea associated with the head tilt and the nystagmus (shimmering eyes).


Some dogs do have relapses but most do not.


Usually, if this is vestibular syndrome, it will clear up in a few days to a couple of weeks. However, since he is an older guy, it may be best to give your vet a call in the morning and ask them to send out some Flagyl to help get the diarrhea under control until the vestibular syndrome passes.


I hope he's feeling better soon.


Customer: replied 3 years ago.

I already know about geriatric vestibular syndrome. That information can be found on the internet.

My pug has already been given Flagyl. He has already been seen by two vets and a specialist. I explained the course of events in my note.

My concern is that the vets are more interested in what is going on with his liver and I am more concerned with the continued and recurring vestibular syndrome. It is going on 3 weeks now. Everything I have read said that it should be cleared up and that it should not have recurred. Could it be something else? He has his head down, he is chattering and making little moaning sounds. But he wants to follow me around, but he is like a drunken sailor. Can you offer any insight and something other than what I can look up on the internet for free?

With all due respect, the reason you were able to find it on the internet is becuase vestibular syndrome is very, very common, and although it's distressing to see your dog like that, it's not a fatal disease, and there are many cases of dogs who get a recurrance of the issue.

The reason your vets are more concerned about the liver is because an elevated liver value indicates a problem with the liver. A dog can live for years and years with ongoing vestibular syndrome...they can't live with a non-functioning liver.

I understand that you're frustrated and want to see your dog getting better, but your vet are absolutely correct in the way they're treating him. At our clinic, we'd actually be keeping your dog in-house, or having him come back every day for liver testing.
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I'm just following up on our conversation about your pet. How is everything going?


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