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Dr. Kara
Dr. Kara, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 16918
Experience:  Over 20 years of experience as a veterinarian.
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My 15 year old dog fell down the stairs. He has been disoriented

Customer Question

my 15 year old dog fell down the stairs. He has been disoriented ever since. His face tilts to the left much like a stroke survivor. He drifts to his left. He will eat if hand fed. Will get up to drink water. And will get up to go pee maybe twice a day. What can I do for him and is it something he will recover from? No visibile pain.
Submitted: 2 years ago.
Category: Dog Veterinary
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 fellow is disoriented, has a head tilt, to the left and leans to the left is not eating unless hand fed and is hesitant to get up and move around. I don't think that his fall led to this, rather I suspect he fell because he is off balance.Does he have rhythmic back and forth or circular eye movement? (like this dog : ) Does he have an ear infection, or has he had one recently?I think your fellow 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 he can get very dizzy and as such have trouble with coordinated movement. They will often fall or lean to one side, and have a head tilt.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 (antinausea drugs, anti-inflammatories and antibiotics) as most dogs do get better with supportive care. Prognosis if this is caused by a lesion outside the brain is very good in most cases. We can check bloodwork to make sure organ failure or low thyroid hormone are not the cause of his symptoms. 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) at 1mg per pound of body weight orally every 8 hours. Side effects are sedation and dry mouth as well. To stimulate his appetite start a bland diet of 1/3 boiled hamburger (or white skinless chicken), all fats and juices drained off mixed with 2/3 boiled, plain white rice. Feed several small meals a day. If he still won't eat even after medication to decrease his 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 hoursOR2) Prilosec (omeprazole) at a dose of one 10mg tablet per 20 to 40 pounds of body weight every 24 hoursThese are acid reducers and should help him feel a little less nauseous. They are quite safe and can be used for several days if necessary. If after a week’s time there is no improvement or he is worse then he 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 he 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: let me know if you have any further questions.
Expert:  Dr. Kara replied 2 years ago.
Hi Ann,

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

Dr. Kara