Saturday, February 27, 2010

Peripheral (Old Age) Vestibular Syndrome



click here for article or here for more information

At age 14  Truman is experiencing this now & it is very upsetting to witness.  His head tilts to one side, his eyes dart back & forth like he's watching a tennis match resulting in vertigo, a loss of appetite, a disinterest in  drinking water, an inability to keep his balance, stand or walk properly. If his eyes were moving up & down  (rather than  back & forth) it would be a death knell.

The syndrome is caused by an inflammation of the nerve that runs between  the ear & brain. In Truman's case, it seemed to come on suddenly. One minute he was playing outside, the next minute he was panting in distress.

The prognosis depends on the possible cause: idiopathic (unknown origin), ear infection, brain tumor. It is feasible the first two could resolve themselves, possibly with residuals (head tilt + walking in circles). The third cause is inoperable.

My heart breaks every time I see him in the hospital (2x daily). Today I got him to wag his tail, we traded kisses & he tried his best to stand on his own when I asked him to.

Day 10 -> 02 Mar 10   Today Truman received his 2nd acupuncture session. When he saw me,  he wanted to get up to greet me, needles & all. He is on Tramadol, eating, drinking, peeing & pooping.  His eyes have stopped shifting from side to side but he has a confused look about him.

He can stand by himself if he's on a surface that offers some traction.  Walking is a veeeery slow process w frequent rest stops & he leans to the left against his handler. For his own protection, he is held aloft by a harness but currently he is carrying most of his weight.

The vets feel he is on the right track, recovering from an episode of idiopathic old age vestibular disease. That's good. It could have been much worse.

Most dogs recover; some w residual weakness & head tilt, some enjoy a full recovery. I don't care as long as he is comfortable & not in pain.  Other than this, the vets concur that he is in fine health.

Day 17 -> 09 Mar 10 Truman has been home for less than a week. In that time I don't think he has improved much although he is getting around by himself for the most part.

We spread runners & mats all over the house but he walks around them. He won't even sleep on them, instead preferring the hard wood floor. However, in the last day or so  he  has agreed to lie on his beds scattered around the house & office.

We've decided to rename him "Lurch" (from the Addams Family) because he walks in spurts, i.e. he no longer has his light, agile movements. And he definitely lists to the left. Frequently he pauses, either because he's lost in thought or he's gathering his forces for the next lurching steps.

When stopped & looking at us, his head seems a little straighter but when walking his head tilts left (where else?) so he is prone to walking in circles.

We do not let him out alone, i.e. he is always on a lead just in case he needs help balancing himself.

However, he is compensating & where I can say he has improved is that he now climbs a few steps without much ado & he can get through a body shake w/o falling over. He cleans out his dish with his head twisted & his appetite hasn't been affected.

He refused my help climbing onto the sofa the other day but did it himself & then got off because he couldn't find a comfortable spot for himself. This was good because I got to sit on the sofa.

He manages a three legged piddle with more grace than before & is eating, drinking, peeing & pooping normally.

His personality is pretty much intact, as charmingly demanding & demonstrative as before. He is a little less vocal but definitely makes his wishes known.

He was discharged with Tramadyl (pain med) which is being tapered so we can see what happens & an antibiotic as a precaution against an inner ear infection which could possibly aggravate his situation.

He is noticeably stiff in his hind quarters but that's his arthritis. And he is getting acupuncture & rehabilitation for that. He has legitimate loss of hearing for normal communication but I lean down & yell in his ear when necessary. He still remembers commands.

The vets tell me he may never get over the disease but  will compensate to the point where I might not even notice the difference.

He will never be the graceful & precocious Truman that I once knew but he's still my best pal & I know he has good spirit & a strong, stubborn, independent will which will serve him well. There is no reason to believe that he won't be with us for a while longer.

5 comments:

  1. Jan - I'm so sorry to hear this news about Truman and I will keep my fingers crossed for the best for him. Luc is also 14 now and while he is still healthy I know that can change at a moment's notice. I cherish every moment.

    Thinking of you....

    ~ Evelyn

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  2. So sorry Jan. How long until you will know the cause?

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  3. Jan, I'm so sorry to hear about Truman's illness. I don't know that this will help at all, but I will share it anyway. I had a bout with a vestibular problem a few years back. It occurred the morning after two-plus hours in the dentist's chair (which they tell was only coincidental). After a week of not being able to do anything but sit in a chair with my eyes staring straight ahead, a friend told me that her SIL had had a similar event which was resolved by her seeing a physical therapist who performed something called an “Epley Maneuver”. So I found someone in Olympia who could do it and over the course of about three treatments in five days we actually got rid of my symptoms. It was simple, involving her placing my head in certain positions and holding each position for a couple of minutes until the small calcium crystals in the inner ear went back to their usual positions (misplacement of these crystals is a common cause of balance problems). She could tell when they went back to their proper positions as the nystagmus (rapid movement of the eyes) stopped. Obviously, I don't now if this is involved in Truman's problem, or even if this maneuver can be applied to dogs, but you may want to look around for a human therapist who performs this procedure (not many do; I could find only two in Olympia) and pick their brains.

    http://www.dizziness-and-balance.com/disorders/bppv/bppv.html

    Best of luck to your beloved boy. I will be thinking of him and sending loving and healing thoughts his way. Please give him a gentle hug from me.

    All my best,

    Cathy Jensen

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  4. So sorry to hear about Truman's nystagmus. Our dog, Rugby, had a bout with this twice during her old age. The first time was a deep ear infection, and the second was an allergic reaction to a new ear cleaning solution. The bouts lasted about 4-5 days each time. Get well wishes to Truman.

    Emily and Bennington Bear
    Greenville, NC

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  5. Hi Jan,
    Thinking of you and Truman and hoping for the best. I hold a special feeling for Truman having known him via internet all these years and because he and Tallulah were born the same year. T passed at age 11 which seems eons ago. I have not had the luxury or the pain of seeing any of my Beloved Bouvs thru "old age" symptoms. My Beloved Audrey passed last year at just age 7. Again I think of Truman and imagine getting to have Audrey for 2 life times. Truman is lucky to have you and I know he knows that:) Hoping the best for you and Truman:) Thanks for sharing!
    Cynthia, (Touluse, Cowboy, Bru and 3 fosters)TX.

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