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Dr. John
Dr. John, Texas Veterinarian
Category: Dog Veterinary
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Experience:  Over 14 years of clinical veterinary experience
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I got home from work tonight and my 13 YO pitbull mix is

Customer Question

i got home from work tonight and my 13 YO pitbull mix is knuckling with both front paws and walking "drunk". i have given her metacm for inflammation and tramadol for pain. she has improved very slighlty, everything we are reading suggests possible stroke or vestibular disease, she has had arthritis n her rear limbs most of her life, thus having the meds here at the house. articles suggest possible improvement with 12-24 hours, does this sound like anything familiar, it is sudden onset occuring sometime between noon today and 6 this evening
Submitted: 1 year ago.
Category: Dog Veterinary
Expert:  Dr. Gene replied 1 year ago.

Hi there.

Few questions for you:

1. Is it just the front paws that are knuckling over or the rear as well?
2. Does the "drunk" walking seem to be affecting both sets of legs, just front or just rear?
3. Does the head seem tilted to one side?
4. Are the eyes straight or moving rapidly side to side?

Customer: replied 1 year ago.
knuckling only in front paws, but both paws, weight listing the right, more of a full body lean rather than a head tile, eye equally dialated, didn't contract when i check with flash light, no nystagmus. the drunk walking affecting front limbs, problems with balance but rear legs seem normal
Expert:  Dr. Gene replied 1 year ago.

Thank you.

I agree that vestibular disease or stroke are definitely toward the top of the list of possibilities. Other alternatives are: disc herniation in the neck, brain tumor and infection of the spinal cord or surrounding vertebrae. Vestibular disease is a syndrome that can be caused by numerous different conditions, including brain tumors (which are probably the most common cause of vestibular disease and other brain related neurologic dysfunction in older dogs.

Vestibular disease recovery is variable and it depends on the specific cause. Idiopathic vestibular disease (i.e. one with no known cause) can take weeks to months to resolve on its own but can show some initial improvement in the first day or two which usually plateaus after that.

Stroke - typically blockage of a blood vessel leading up to the brain or spinal cord in the neck with a piece of cartilage or blood clot - can improve relatively quickly on its own, but most cases just continue to deteriorate.

Because most potential causes of what you're seeing are not the self resolving kind and because prognosis for recovery from neurologic dysfunction is best when the diagnosis is made quickly and prompt treatment is instituted, it's best that you don't wait to see if this gets better on its own. I would not give more meloxicam, because if steroids are needed to suppress swelling/inflammation, the combination of meloxicam and steroids (if given within a few days of each other) can increase risk of stomach ulcers. I would try to take her to the nearest vet ER tonight...

I hope this helps; please let me know if you have any other questions!

Here is a link with more info on vestibular disease:

Customer: replied 1 year ago.
if it were disk herniation would it not be painful on palpation?
Customer: replied 1 year ago.
i have palpated her head to toe and am getting no painful response, nor is she acting painful
Expert:  Dr. Gene replied 1 year ago.

Theoretically, but in reality, it's not always apparently painful either depending on how/where you palpate or it may be because of dogs' inherent ability to hide signs of pain. Some dogs with obviously painful areas don't react in a way that we would interpret as pain.

I would not take her lack of response as a lack of pain. It takes some expertise in palpation to detect painful areas, but even with that, many dog's just don't react. Even if it's not a herniated disc, the prognosis for recovery is still way better if the problem is treated as soon as possible...

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