VESTIBULAR DISEASE OF GERIATRIC DOGSA case study by Allison Kirchgatter

WHAT IS GERIATRIC VESTIBULAR DISEASE?

The vestibular system controls balance Geriatric vestibular disease is characterized by sudden and non-progressive loss of balance

http://www.vcahospitals.com/main/pet-health-information/article/animal-health/vestibular-disease-in-dogs/856

WHO IS AT RISK FOR GERIATRIC VESTIBULAR DISEASE?

Geriatric dogs; usually older than 8 years old More frequently affects medium to large breed dogs

HOW DO YOU RECOGNIZE GERIATRIC VESTIBULAR DISEASE?

Geriatric vestibular disease is characterized by a sudden onset of the following symptoms:

Wobbly, loss of balance, inability to walk Disorientation Head tilt Nystagmus (uncontrolled eye movement) May or may not present with nausea and vomiting from the

dizziness

http://www.myvetcare.com.au/Ringwood_East_Vetcare/Blog/Entries/2013/6/1_geriatric_vestibular_syndrome.html

HOW WILL GERIATRIC VESTIBULAR DISEASE BE TREATED?

The patient should receive: Intravenous fluids Meclizine- a medication to prevent motion sickness caused by the

dizziness Cerenia- an anti nausea medication A Urinary catheter may need to be placed if the animal cannot

stand to urinate to prevent skin wetness and irritation

WHAT SHOULD BE EXPECTED POST-TREATMENT?

Prognosis for geriatric vestibular disease is very good Rapid improvement and recovery is expected Most dogs make a nearly full recovery within 2-3 weeks

DIFFERENTIAL DIAGNOSIS Geriatric vestibular Syndrome can often present with similar

clinical signs of a brain tumor. Vestibular Syndrome is sudden, and will resolve, whereas

neoplasms grow slowly and present with symptoms that progress over time.

An MRI would be needed to definitive diagnosis to determine which disease process is occurring

Geriatric vestibular Syndrome will show rapid improvements with proper hospitalization and supportive care, while a tumor will not.

CASE STUDY: KOBY WEST

13 Year old Neutered male Golden Retriever 112.6 pounds

Koby presented at IVS unable to walk Koby’s owner noted that he was weak and

stumbling, then Koby fell and could not stand.

KOBY’S PROGRESS: PRESENTATION

Koby presented as non-ambulatory, but was able to stand if we assisted him.

Clinical sings: Tremors Head tilt to the left Vertical nystagmus (eye twitching up and down)

PROGRESS: 24 HOURS

Koby remained unable to stand unassisted His head continued to tilt to the left His nystagmus switched from vertical to horizontal Koby still refused to eat (possibly due to persistent nausea)

PROGRESS: 48 HOURS

Koby stood up on his own and was able to walk with assistance His nystagmus and head tilt both decreased in severity Koby’s owners came to visit and were able to get him to eat He developed a small cutaneous lesion (a hot spot) on his

elbow from laying down for extended periods of time This was clipped, cleaned, and he was started on Cephalexin to

prevent infection

PROGRESS: 72 HOURS

By the 3rd day of hospitalization Koby was able to stand and walk by himself

Nystamus and head tilt had resolved Appetite returned Koby was discharged and sent home

Over a month later, the owners report that Koby is doing well