Vestibular Dis-ease

[MelissaC]

Hello- I am looking for some input as to the next step I should use to help Barney a 14 yo ESS recover fully after a bought of vestibular dis-ease.

He presented with the normal loss of coordination, and he vomited a little white foam. He did have nystagmus too, but it was different than my previous dogs, in that it went up and then down to the right as opposed to the vertical slide to the left. We did take him to the vet so we could get him checked out and start anti-nausea medicine, and an antibiotic just in case there was an ear infection causing the inflammation. While we were there we also used the cold laser, in the hopes to decrease inflammation-since then I am worried that it was a mistake.

While on the antibiotic and anti-nausea medicine, we started adding a homeopathic combination by Hyland called Motion Sickness
It had most of the commonly suggested remedies for Vestibular Syndrome in it and it was accessible. He did improve a bit after using it, but it didn't seem to last nor push him towards a full recovery. I was able to get Cocculus Indicus in a 200c and tried that too, with only a slight improvement in his balance. A little bit after that we tried using some prednisone to see if it would help the vestibular symptoms and some arthritis issues he was having; however, it did not make any noticeable difference.

Next I tried making the motion sickness blend on my own and ordered a 30c potency of all of the ingredients listed in the Motion Sickness blend, again some improvement, but nothing dramatic even with trying different dosing patterns.

Barney right now, shows changes in his vision-I think he can see light, but I am not sure what else; It is really hard to tell and changes from day to day. I know a change in light really affects him. I feel like his hearing has diminished recently, and he has a lot of difficulty eating- almost like he has difficulty controlling his tongue. He circles to lay down, but I believe it is more a nerve signally issue than a neurological sign. He has a lot of fatty tumors and they seems to be more prominent now. Mornings are drunken sailor time. I find if you rub his body and stabilize him he can get a good bit of balance fairly quickly. Any ideas or input would be really helpful! I am going through the repertory, but it is slow going with all his symptoms past and present. Thank you all!

 

[Dr. Sara]

Dear Melissa,
First, let’s review vestibular disease. This is to ensure that what you are seeing is truly idiopathic vestibular disease (IVD), and to explain the condition to others reading this. IVD is a condition of older dogs, and cats of all ages. The dog has a sudden onset of signs, developing within an hour, related to abnormal functioning of the peripheral vestibular system. The peripheral vestibular system includes the vestibular apparatus within the inner ear, and it responsible for telling an individual which way is up. The signs of IVD are nystagmus (involuntary rapid flicking of the eyes) to the sides or in a circular fashion, head tilt, and severe loss of balance. The loss of balance may cause a dog to turn, fall, or even roll toward the affected side. Some dogs will have nausea and vomiting because their balance is so severely affected.

Idiopathic means that we don’t know the cause of this problem, so IVD must be differentiated from diseases which look similar. Problems that can mimic this are:
1- ear infection / trauma / drugs with inner ear toxicity,
2 - neurologic disease in some hypothyroid dogs,
3 - tumours of the cranial nerve supplying the area,
4 - vasculitis
5 - central vestibular disease.

The central vestibular system is not involved in IVD, so the dog has normal strength and proprioception (unconscious ability to tell where their feet are), though it can be hard to evaluate strength and proprioception when a dog’s balance is severely affected. Inner ear infections or inflammation can cause signs similar to IVD, but dogs with IVD will have a normal otoscopic (internal ear) exam. Some people refer to IVD as a stroke, because it looks somewhat similar to a stroke in people. A stroke is a caused by a problem with blood vessels in the brain, and it is extremely rare in animals.

Signs of IVD are most severe in the first 1 - 2 days. Dogs with IVD spontaneously improve over the course of a few days to weeks. Some dogs will have a residual head tilt and balance problems. Conventional medical treatment is supportive, assisting the patient with eating and drinking. Some dogs with severe nausea are given anti-nausea drugs. Some vets give steroids, but there is absolutely no evidence that steroids help at all, and neurologists say steroids should NOT be used for IVD.

I have found that it is helpful to hold animals who have IVD signs, or to hold your body against them, particularly when they are eating or drinking. Animals with vestibular problems can’t tell which way is up, but if their human is holding them, most dogs are not as anxious or disturbed by this orientation problem. I suspect that they know that we are solid, and if they are held, they are more able to ignore the nervous stimulus that is telling them that the world is spinning around.

Holistic treatment, particularly homeopathy, helps animals with IVD recover faster and more completely. Herbal treatment with ginger has been reported to help nausea, and acupuncture and Chinese herbal combinations are also reported to help. Homeopathy resolves IVD so quickly and smoothly, however, that I have never needed any other treatment. Several remedies stand out in treatment of IVD:

Aconite - symptoms come on very suddenly, patient is restless and anxious; may occur after injury
Cocculus - dizziness with nausea, restless and agitated, often in sympathetic individuals, may occur after grief
Gelsemium - dizziness with falling, trembling, often quiet individuals, may occur after fright or overexertion

Of these three, the remedy that I use most often is Cocculus. I dissolve the medicine in water, and give it as needed. I generally use a low potency of 6X, 6C, or 12 X, given up to three times daily. Decrease the frequency of dosing as your boy improves.

I do not use combination homeopathic medicines for this, as they do not seem to help nearly as much as the appropriate medicine. Some dogs will need treatment, at a decreasing frequency, for a few weeks.

Of course, depending on the signs, there are many homeopathic medicines that may be more suited to a particular individual. As this is an ongoing problem, constitutional treatment will be the best way to treat your dog’s problem. I would suggest that you consult with a homeopath to resolve the signs in your fellow.

 

[Dr. Jeff]

Thanks for your wonderfully informative reply Dr. Sara.

Regarding your next steps Melissa, I wonder how long has this been going on?

Because of possible changes in Barney's vision, you may want to consider investigating whether there might be more going on than just geriatric (and idiopathic) vestibular dis-ease.

It's also help to know that this is a flare up of his pre-existing imbalance and not really an acute dis-ease. Even tho it came up suddenly.

Therefore, acute prescribing is often not that helpful.

I'd also advise staying away from combinations of homeopathically-prepared remedies as they can actually worsen balance and decrease Vitality.

There's lots more about this distinction (homeopathic vs. homeopathically-prepared) in the homeopathy folder and elsewhere oon this forum.

Click/tap here for one discussion of this important topic.

Fantastic that you already stopped the combination Motion Sickness remedy!

 

[MelissaC]

Dr. Sara, and Dr. Jeff,

Thank you so much for your input! I am grateful a forum like this exists.
Barney will be going to the vet sometimes this week to get a check up on his vision and some new masses that have appeared. In the meantime, I am going to order the lower potency Cocculus and find a homeopathic vet to work with on an ongoing basis.. Again, thank you both for your guidance!

 

[Dr. Jeff]

You're very welcome Melissa.

You can find a vet homeopath referral list here:

Find a Vet – The Academy of Veterinary Homeopathy

theavh.org

I'd especially advise checking out Dr. Judy Herman:

Our Team — Animal Wellness Center

Meet Judith K. Herman, DVM and her staff at the Animal Wellness Center in Augusta, Maine.

www.judithhermandvm.com