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Dr. Kara
Dr. Kara, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 16536
Experience:  Over 20 years of experience as a veterinarian.
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My dog is off balance and leaning to the left while walking.

Customer Question

my dog is off balance and leaning to the left while walking. I just took her to the vet yesterday she has the beginning stages of bad hips she on muscle relaxers and glucocamine powder she is walking in circles
Submitted: 2 years ago.
Category: Dog Veterinary
Customer: replied 2 years ago.
It has been way over 10 minutes
Expert:  Dr. Kara replied 2 years ago.
Hello, my name is***** and I have over 20 years of experience as a veterinarian. I am sorry to hear that your girl is leaning to the left and circling. I agree that this does not sound like bad hips or an ACL injury and secondary arthritis.
We prescribe muscle relaxants like Robaxin (methocrabamol) in cases of back pain and intervertebral disc disease to relieve painful muscle spasms. I have not used them for dogs with bad hips or ACL injuries. Unfortunately this drug can make some dogs groggy and thus uncoordinated, and possibly lean, so it's possible that her symptoms are secondary to that drug. I would not expect her to circle however nor would I expect her to lean to just one side. It is worth stopping the muscle relaxer and see if it helps. But I think that she may have something else going on.
I know that she is leaning but is her head tilted to the right or left?
When she tries to walk is she circling or leaning only to one side or walking very slowly with a wide stance and then leaning and falling over?
Does she have rhythmic back and forth or circular eye movement?
(like this dog : http://www.youtube.com/watch?v=NaB7OJRLVQ4 ).
If the answer to these questions is yes then she may have vestibular disease. Vestibular disease is a malfunction of the balance system, either a problem in the inner ear itself or in the nerves that take information to the brain or in the brain itself. Episodes often come on suddenly.
With vestibular disease she can get very dizzy and as such have trouble with coordinated movement. They will often fall or lean to one specific side.
Does she have a history of an ear infection?
There can be several causes of vestibular disease. They range from very benign causes such as idiopathic (meaning we don't know the cause but they resolve on their own with supportive care) to middle ear infections or polyps, brain infections (bacterial, fungal or viral) or even a primary brain lesion such as a blood clot, bleeding or a tumor.
If we cannot identify a cause then we will often treat the patient symptomatically (anti-nausea drugs, anti-inflammatories and possibly antibiotics if an ear infection is a concern) as most dogs do get better with supportive care.
Her prognosis if this is caused by a lesion outside the brain is very good in most cases.
We may check bloodwork to make sure organ failure or low thyroid hormone are not the cause of her symptoms. If she isn't improving in 3 to 5 days then blood tests should be done to make sure all is well internally.
At home you can give Gravol also known as Dramamine (dimenhydranate) to control nausea, which is also used for carsickness. The dose is 4mg to 8mg per pound of body weight every 8 hours. Side effects are mild sleepiness and dry mouth.
Or you can try Benadryl (diphenhydramine only, do not use products with acetaminophen or decongestants as they are toxic for dogs) at 1mg to 2mg per pound of body weight orally every 8 hours. Side effects are sedation and dry mouth as well.
To stimulate her appetite and help with nausea start a bland diet of 1/3 boiled, lean hamburger (or boiled, white skinless chicken), all fats and juices drained off mixed with 2/3 boiled, plain white rice. Add warmed low salt chicken or beef broth to get additional fluids into her and make the food more palatable. Feed several small meals a day.
You may need to hand feed her and offer her water or ice cubes to lick as she may have difficulty negotiating eating and drinking on her own.
If she still won't eat even after medication to decrease her dizziness and offering a bland diet then to help with nausea at home you can give either:
1) Pepcid ac (famotidine) at a dose of one 10mg tablet per 20 to 40 pounds of body weight every 12 hours
OR
2) Prilosec (omeprazole) at a dose of one 10mg tablet per 20 to 40 pounds of body weight every 24 hours
These are acid reducers and should help her feel a little less nauseous. They are quite safe and can be used for several days if necessary.
If she starts vomiting or refuses to eat she may need hospitalization for supportive care, fluids and injectable medication for nausea.
If after a week's time there is no improvement or she is worse then she needs further diagnostics to try and identify the cause. Serious central nervous system (the brain) causes are more likely and thus prognosis is much more guarded.
Things such as an MRI or spinal tap are indicated at that point.
If she is not improving a referral to a neurologist is best as they can perform this advanced testing.
Please see this link if you would like to read more about vestibular disease: http://www.petside.com/condition/dog/vestibular-disease-canine
Please let me know if you have any further questions.
Expert:  Dr. Kara replied 2 years ago.
My apologies on the slow response, I had a lot of information to try and convey and I am not a very speedy typist, please read it over and feel free to reply with further questions if you have them thanks, ***** *****
Customer: replied 2 years ago.
She is eating fine and her eyes don't look like the you tube video she seem happy just tips her head to the left and walks like she drunk and can't see bump into things but she can see for sure
Expert:  Dr. Kara replied 2 years ago.
Thank you for the further information.
I am glad to hear that she is eating fine and that she doesn't have nystagmus. Not all dogs with vestibular disease do have nystagmus (rhythmic eye motions) and those that don't are less likely to be nauseous.
But the head tilt and leaning are clear indications that her balance system (vestibular system) is affected.
You can imagine though if your balance system is off and the world seems tilted how difficult it is to walk and it makes sense that she would move like she is drunk.
I would try confining her away from stairs and keeping her quiet, giving her either Benadryl or Gravol, and I would not give her any more of the muscle relaxants, and see how she comes along.
In most cases we should see some sort of improvement in 48 to 72 hours.
Expert:  Dr. Kara replied 2 years ago.
Hi,

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

Dr. Kara