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Dr. Kara
Dr. Kara, Veterinarian
Category: Dog
Satisfied Customers: 16896
Experience:  Over 20 years of experience as a veterinarian.
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Hi i have a 17 year old border collie cross her legs have been

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Hi i have a 17 year old border collie cross her legs have been getting weaker over the last 6 months but 3 days ago she stopped eating (everything) then yesterday she has lost her balance she is kind of walking on a side and falling down her eyes were moving from side to side and her head is on a tilt and she was sick (frothy bile)she is still drinking bits and her tail wagging when i stroke her. Her breathing is big and slow & with every inhale her heart races she dosent appear to be in pain i am not sure she would survive a vet trip she has always panicked at previous visits and i also feel the vet would say its her time so is it best to leave her at home in her comfortable surroundings (inless she starts to appear to be in pain) or to take her to the vet anyway?
Submitted: 3 years ago.
Category: Dog
Expert:  Dr. Kara replied 3 years ago.
Hello, my name is***** and I have over 20 years of experience as a veterinarian. I am so sorry to hear about Cassie's symptoms of a head tilt, leaning, eye motions, difficulty standing and walking, and loss of her appetite.

When you say she her eyes are moving does she have back and forth or circular eye movement? (like this dog : http://www.youtube.com/watch?v=NaB7OJRLVQ4 )

Does she have an ear infection or has she had one recently?

With her loss of balance, difficulty moving and eye motions I believe that she may be suffering with vestibular disease.
Vestibular disease is a disturbance in the balance system. It can be due to a problem in the middle ear or along the pathways that send information from the middle ear to the brain or in the brain itself. Dogs with vestibular disease feel like they have just stepped off a merry-go-round, very dizzy and nauseous and the more they try to move the worse they feel.

There can be several causes of vestibular disease. They range from very benign causes such as idiopathic (meaning we don't know the cause but they resolve on their own with supportive care) to middle ear infections or polyps, brain infections (bacterial, fungal or viral) or even a primary brain lesion such as a blood clot, bleeding or a tumor.

If we cannot identify a cause then we will often treat the patient symptomatically (antinausea drugs, anti-inflammatories and antibiotics) as most dogs do get better with supportive care. Prognosis if this is caused by a lesion outside the brain is very good in most cases. We can check bloodwork to make sure organ failure or low thyroid hormone are not the cause of her symptoms.

I understand that you would prefer not to have to take her in to be examined if possible.

At home to try and settle her stomach today you can try either:
1) Pepcid-ac (famotidine) at one half of a 10mg tablet per 4 to 9 kilograms of body weight every 12 hours.
OR
2) Prilosec (omeprazole) at one half of a 10mg tablet per 4 to 9 kilograms of body weight every 24 hours.
These will reduce stomach acid and should help her feel a littel less nauseous. They are quite safe and can be used as long as necessary.

To help with her dizziness you can give Gravol also known as Dramamine (dimenhydranate) to control nausea, which is also used for carsickness. The dose is 8mg to 16mg per kilogram of body weight every 8 hours. Side effects are mild sleepiness and dry mouth.
Or you can try Benadryl (diphenhydramine) at 2mg per kilogram of body weight orally every 8 hours. Side effects are sedation and dry mouth as well.

To stimulate her appetite a couple hours after the acid reducer is given start a bland diet of 1/3 boiled, lean hamburger (or boiled, white, skinless chicken), all fats and juices drained off the meat, mixed with 2/3 boiled, plain white rice. Feed several small meals a day.

If after a week’s time there is no improvement or she is worse then she needs further diagnostics to try and identify the cause. Serious central nervous system (the brain) causes are more likely and thus prognosis is much more guarded.
Things such as an MRI or spinal tap are indicated at that point.
If he is not improving a referral to a neurologist is best as they can perform this advanced testing. I can understand if that isn't something that you necessarily would want to do at her age but that would be the next step.

Please see this link if you would like to read more about vestibular disease: http://www.petside.com/condition/dog/vestibular-disease-canine
Please let me know if you have any further questions.
Customer: replied 3 years ago.

Hi again thank you for getting back to me she was only sick once whilst her eyes were moving her eyes were more rolling but that stopped after a couple of hours she wont eat anything i have a feeling she knows its her time but my question is in your experience as a vet if the dog does not appear to be in pain is wagging tail whem cuddled and drinking bits is it better for them to go naturally in there surroundings or end it at the vets where she will panic & proberly have a heart attack thete?

Expert:  Dr. Kara replied 3 years ago.
Thanks for the questions.
If she won't eat I would try the one of the acid reducers and a one of the antihistamines I recommended to see if we can't get her feeling better and eating. I believe it is worth trying.

Natural death when a dog isn't eating isn't pleasant. It means that she will starve to death and that can take weeks if she is still drinking, depending upon her body condition. I wouldn't choose that for anyone.

She loves you very much and is trying to make you happy by responding to your affection. I know that you have had a wonderful, long loving relationship with her and this is breaking your heart. I know a veterinary visit would be stressful, but if you truly believe it is her time then I would choose to let her go gracefully at the hands of her veterinarian via a drug overdose with you at her side.
That said I would ask for an oral tranquilizer from your veterinarian that you can give at home a few hours before the visit. This will make her not care about her surroundings so much, yet still be aware enough to be comforted by your gentle touch and know that you are with her.
Some veterinarians will also make a home visit in these situations. It is worth asking about.

I know it would be ideal for her to go at home in her sleep, but reality is that almost never happens.
Please let me know if you have any further questions.
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