I need an expert opionion on my 14 year old dog which i have an appointment at 4:30 today for Euthinasia! Until last

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Customer: I need an expert opionion on my 14 year old dog which i have an appointment at 4:30 today for Euthinasia! Until last tuesday the 12th he was obviously showing signs of age, slowing down, trouble with stairs , mostly walking issues. Eating and drinking fine, very alert. On the very late eve of the 12th we woke up to noise and long story short found him staggering around and falling , head cocked and major eye shifting. Took him to the emergency vet, he was diagnosed with Vestibular Disease. It is my understanding the dogs can usually still kind of walk but will fall etc. My dog did not attempt to walk from the time we got home at 3am basically til just now. He has been drinking a good amount of water, with us holding the bowl up to his mouth, very little food-- a few slices of cheese a day is all he will take. However , now he just ate a hand ful of dog food, each piece dipped in peanut butter. He really tried to stand for the first time and seems to have strength in his front legs but no strength in the back legs. We tried lifting him with a towel but he wont put any weight on the back legs. Head still tilted but eyes are not shifting as bad. They said it was not a stroke but I cant figure out what is going on with those back legs. Has he gotten so weak now theres no chance of walking . Do I postpone the Euthinasia. It took us 3 days to finally decide to put him down and now i just dont know if there is any chance of him walking again. Very hard to get him in to the vet AGAIN for another exam. Just wondering if anyone has experience very severe cases of this vertigo and its outcome on old dogs Leah Anderson
JA: I'll do all I can to help. A lack of appetite can seem worrying. Does the dog also seem more tired than usual?
Customer: Oh, he is approximately 60 pounds and a smooth Collie. Male
JA: Does the dog seem to be in any pain?
Customer: Another thing were having a hard time with. Light shivering most of the time. (that started Thursday eve)
JA: What's the dog's name?
Customer: Marcus
JA: Is there anything else the Vet should know before I connect you? Rest assured that they'll be able to help you.
Customer: No just that right now is the first time in 5 days he has had his head up with his legs out front for more than a few minutes and actually tried to stand. He has been on dramamine since he got home 150 mg a couple time a day until today, I wanted to see how he does without it. I also whoops had some left over amoxicillian from something else that i started last night just in case they missed an ear infection. I dont have enough though to even get through til tomorrow but now that he's showing a little sign of being more alert im wondering if that is helping?
Answered by Dr. Amy Leigh in 9 hours 1 year ago
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Dr. Amy Leigh
Pet Specialist
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1,730 satisfied customers

Specialities include: Dog Veterinary, Dog Medicine, Dog Diseases, Small Animal Veterinary

Thank you for contacting JustAnswer with your questions. I'm sorry Marcus is having these problems.

-My name is***** have over 20 years of experience as a veterinarian and am happy to help with your question.

-Veterinary Experts are able to provide general medical advice. We are NOT able to provide a diagnosis or prescribe medications. I can help you to determine if a veterinary visit is needed or if it seems reasonable to monitor and treat at home.

-You may be automatically prompted to consider a phone consultation for an additional fee. Unfortunately, I am not able to provide phone consultations. If you would like to continue the chat, just hit decline. If you would like a phone consultation, let me know and I will disconnect so you can speak with another Expert.

-I will do my best to respond to you as quickly as possible. Sometimes, my response may be delayed if I am helping other customers as well. I assure you that I will get back to you as soon as possible to answer all of your questions.

I'd like to ask you some questions so that I can provide the best advice possible

-It appears you are offline. I am sorry we were not able to connect to discuss Marcus' signs.

-Based on the information you provided, I can offer some general advice.

-The vestibular apparatus allows us to walk, even run, on uneven ground without falling, helps us know when we need to right ourselves, and allows our eyes to follow moving objects without becoming dizzy. The vestibular system consists of the structures of the middle ear, the nerves that carry their messages to the brain/central nervous system, and the brain/central nervous system itself.

-There are two sets of receptors involved: one to detect rotational acceleration (tumbling or turning) and one to detect linear acceleration and gravity (falling and letting us know which direction is up and which is down). Both receptors are located in the middle ear.

-From these centers, instructions are carried by nerve cells to the legs, neck, and eye muscles so that we may orient ourselves immediately. The information about being upside down is also sent to an area of the brain so that we can become consciously aware of our position.

-The following are signs of vestibular disease:

Lack of coordination
Motion sickness.
Nystagmus (back and forth or rotational eye movements

-In order to determine prognosis and choose treatment, one needs to figure out what has happened to the vestibular system. The first step is to determine whether the lesion is central - in the brain - or peripheral (in the inner ear).

-Idiopathic vestibular disease is the most common form of vestibular disease in dogs and cats. For unknown reasons, cats are most commonly affected in the northeast U.S. in the late summer and early fall.

-Idiopathic vestibular disease, begin acutely and resolve acutely. Usually improvement is evident in 72 hours and the animal is normal in 7 to 14 days, although occasionally a head tilt will persist. When a case of vestibular disease begins, it may be a good idea to wait a few days to see if improvement occurs before doing diagnostics beyond a routine blood/urine database.

-Treatment of idiopathic vestibular disease generally involves control of nausea (motions sickness) while the condition runs its relatively short course.

-If the vestibular signs have a brain origin, there could be a tumor, vascular accident, infection (especially Rocky Mountain spotted fever) or other lesion in the brain. Imaging of the brain will be important in determining the nature of the lesion and what treatment makes the most sense. This means a CT scan or MRI to image the brain; most likely a referral will be needed for this type of procedure. General anesthesia is required for CT and MRI.

-Middle ear infection is a likely possibility for vestibular disease especially if the patient has a history of ear infections. Concurrent facial nerve paralysis, creating a slackened look to one side of the face, or Horner’s syndrome where there are some eye changes, often go together with middle ear infection.

-When an otoscope is used to visualize the external ear of an animal with vestibular disease and debris is seen, this would be a good hint that there is infection in the middle ear as well. However, just because debris is not seen in the external ear does not mean that a middle ear infection is unlikely. Imaging of the middle ear bones may be in order.

-The most accessible way to evaluate the middle ear is with a set of radiographs called a bulla series (so named because it focuses on an ear bone called the tympanic bulla). If the bulla appears abnormal, the ear may require surgical drainage. The problem is that radiography is often not sensitive enough to pick up damage in the middle ear and a normal set of films does not rule out disease. In these cases, imaging such as a CT scan or MRI is better, although rather expensive. These imaging techniques, however, allow imaging of the brain tissue itself (which radiology does not), thus allowing brain abnormalities to be evaluated as well.

-Treating a known middle ear infection can be difficult. Culture of the middle ear may be necessary and oral antibiotics are needed for 6 to 8 weeks to clear the infection from the tiny bones of the middle ear. Surgery may be needed to open the tympanic bullae and flush them out.

-Amoxicillin is not typically the most effective antibiotic for treating middle ear infections but could be helping if an infection is present.

-It is also possible that he has idiopathic vestibular syndrome and is starting to improve as most dogs do.

-Dramamine is not the most effective medication for controlling the motion sickness associated with vestibular signs. You may want to talk to your veterinarian about a medication called Cerenia to help with nausea and potentially improve his appetite.

-If this is a middle ear infection and is properly treated, it is possible he will recover.

-Idiopathic vestibular syndrome typically resolves within 7-10 days. Recurring episodes may occur in some dogs.

-With either condition, he may still have a head tilt, facial paralysis, or be a bit unsteady when walking permanently. However, most dogs recovery well enough to have a very normal quality of life.

-It sounds like he is improving, so it would be worthwhile to talk to his veterinarian about antibiotics for a possible middle ear infection and give him some more time to see how he does.

I hope this information was helpful and Marcus will feel better very soon. Thank you for trusting JustAnswer with your questions. It was my pleasure to help you today. If you need further information regarding this question or need clarification on the recommendations, please let me know. I am happy to help.

Customer
Thank you

-Do you have any questions or need clarification on any of the information?

I hope Marcus is continuing to improve. Please feel free to reach out with any questions.

Customer
He never improved. Never got up. He will be euthunized today. Thanks for your time

I'm so sorry to hear that. I was certainly hopeful when you talked about his improvement. I did not mean to intrude upon your grief. My most sincere symptathy.

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Dr. Amy Leigh
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