Thread: Dr. Lee?
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Old July 21st, 2009, 11:36 AM
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If I am reading the post correctly, your dog has had two episodes of head trauma (one horse, one other) and now has recurrent episodes of disorientation/lack of coordination/difficulty standing. Is this correct? Or is he having recurrent head trauma by running into things etc... which are each associated with the disorientation etc...

If it is the former, then I would think that this is secondary to the initial trauma and perhaps aggravated by the second trauma. Whether it is cervical instability, inner ear damage or cerebral damage, only MRI and radiographs with a neurologist will be able to determine this. Recommendation would be use of a halter versus a collar when leashed, fish oils (omega 3 fatty acids can help stabalize nerve cell membranes), consider holistic antioxidants or prescription diet antioxidants etc..., maintain good body weight and monitor. If the episodes become more frequent or severe, then anticonvulsant medications such as phenobarbitol, keppra, gabapentin or KBr might be considered.

If the latter is true then I would think of having his eyes evaluated by an ophthalmologist to rule out any ocular disease which may be coming and going in clinical signs. Blood pressure to rule out hypertension. ECG and heart auscultation to rule out cardiac disease (make sure we do not have partial syncopal (fainting) episodes). And then again we are back to MRI/skull radiographs to rule out inner ear disease and cerebral disease. Similar recommendations here would apply other than, if the episodes worsen - before we start anticonvulsant medications - rule out ocular and cardiovascular disease first.

I hope this helps.

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Christopher A. Lee, D.V.M., C.V.L.S.
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