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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 24471
Experience:  University of California at Davis graduate veterinarian with 44 years of experience
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My dog is lethargic and his eyes seem cockeyed, he threw up once and i

Customer Question

My dog is lethargic and his eyes seem cockeyed, he threw up once and is just very sad and weak. Took him to the vets and had blood work and still sample all came back fine. I don't know what's wrong and I'm really worried.
Submitted: 1 year ago.
Category: Dog
Expert:  Dr. Michael Salkin replied 1 year ago.
I'm sorry that your question wasn't answered in a timely manner. Can you clarify, please, what you mean by "cockeyed" eyes?
Customer: replied 1 year ago.
His eyes seem to be going in different directions. The right one is pointed slightly right and the left is slightly pointed left and his third eyelid seems to be showing more than usual, almost to the point where it looks like his eyes are rolling backwards into his head. Took him to the vet for third time today and they said he was dehydrated, but other than that everything looks normal. Blood tests and stool samples are normal. We don't know what's wrong. Normally he is a very happy and energetic but now he barely moves and his eyes don't look normal. My whole family is very concerned and very worried.
Expert:  Dr. Michael Salkin replied 1 year ago.
Thank you for the update. You've described strabismus which is usually caused by lesions restricting extraocular muscle mobility or affecting the innervation. This can be trauma induced, caused by scarring from previous inflammation, or be due to abnormal innervation of the extraocular muscles involving cranial nerves III, IV, or VI. A thorough neurologic exam is indicated and that would entail referral to a specialist veterinary neurologist to which Wesley can be referred or as can be found here: www.acvim.org. Please continue our conversation if you wish.
Customer: replied 1 year ago.
Thank you, ***** ***** lazy eye be the cause if his sudden lack of energy or lethargy? He also vomited once today.
Expert:  Dr. Michael Salkin replied 1 year ago.
No, the lazy eye would be symptom of whatever is also causing his lack of energy/lethargy and vomiting.
Customer: replied 1 year ago.
Yeah it's the thing that's causing the lazy eye that we are worried about. We don't know what it is. Could it be neurological? Would a cat scan be appropriate?
Expert:  Dr. Michael Salkin replied 1 year ago.
Yes, a neurologic etiology is most likely; hence, the need to see a neurologist who is best equipped to perform both a cerebrospinal fluid tap and MRI. Our miniature breeds are over-represented for steroid-responsive encephalopathies (brain disorders) such as granulomatous meningoencephalitis (MGE).
Customer: replied 1 year ago.
Thank you, ***** ***** trying to set up a meeting with a specialist. We are working as fast as we can to get Wesley help as he has been like this since Tuesday. I don't want to be morbid, but could any of this be possibly life threatening? We are worried he may not get the proper care he needs in the right amount of time.
Expert:  Dr. Michael Salkin replied 1 year ago.
Yes, although I would be putting the cart before the horse by prognosticating at this time, a global encephalopathy (a brain disorder affecting all of the brain such as GME (I mistyped it as MGE previously) is life-threatening.
Customer: replied 1 year ago.
Ok. We are taking him to a specialist in Philly now
Expert:  Dr. Michael Salkin replied 1 year ago.
Sounds good. Please keep me posted.
Customer: replied 1 year ago.
We are taking Wesley to see a neurologist Monday or Tuesday. The specialist in Philly thinks there is something wrong with his spine, near the back of his neck. He is having trouble walking and seems to be unaware of where his feet are. The specialist said that he may have a slipped disk or something else causing pressure. He hasn't walked in a day and is kept in his cage. We carry him outside to go to the bathroom because walking is too difficult
Expert:  Dr. Michael Salkin replied 1 year ago.
Thank you for the update. I believe you're referring to a lesion in his brainstem which can cause not only the strabismus but difficulty walking and lack of conscious proprioception (not knowing where one's limb(s) are in space). I'd like to hear what the neurologist has to say, please.
Customer: replied 1 year ago.
I'm really worried Wesley is no longer eating or drinking and he can barely sit up, he's just been laying in his crate all day. I don't know what else to do for him
Expert:  Dr. Michael Salkin replied 1 year ago.
He needs supportive care in a hospital setting just to get to Monday or Tuesday. IV fluids to prevent dehydration and force feeding if necessary. If there's a 24 hour hospital associated with where the neurologist works, that's where I would take him.
Customer: replied 1 year ago.
There's a 24 hour hospital within an hours drive that I think my family is going to take him to, he's just been getting worse as the day has gone by.
Expert:  Dr. Michael Salkin replied 1 year ago.
This doesn't bode well. Be sure to bring any information - discharge papers, perhaps, from the Philly specialist - with you to the 24 hour facility.
Customer: replied 1 year ago.
He is also blind now. Here's what they think he has. GME granulomatous meningoencephalitis
Expert:  Dr. Michael Salkin replied 1 year ago.
Oh dear. Yes, that's the GME I mentioned above in my response time stamped 26 June 2015 06:49. It's treatable - usually with a combination of immunosuppressive drugs.