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Ask Doc Sara Your Own Question

Doc Sara
Doc Sara, Veterinarian
Category: Dog
Satisfied Customers: 952
Experience:  I am a dog and cat veterinarian with a lifetime of experience in our family veterinary hospital.
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My dog is finding it difficult to stand up and keeps falling

Customer Question

My dog is finding it difficult to stand up and keeps falling over
Submitted: 1 year ago.
Category: Dog
Expert:  Dr. Jo replied 1 year ago.
Hello,I'm Dr. Jo and I'm here to help you with your question about Lilly. I'm so sorry she isn't doing well, but glad you're looking for the information you need.You may join the conversation at any time by typing in what you want to say then clicking REPLY. That way we can chat back and forth until you're satisfied with the information I've provided and are happy to give me a positive rating. To let me know you're there and that we're properly connected and that you understand how the website works, please type in a short reply, then I'll continue the conversation. Rest assured I have a lot of information to discuss with you, but I want to be sure you're ready to proceed first, so I don't waste my time.
Expert:  Doc Sara replied 1 year ago.
Hi there I'm Dr. Sara. I'm a licensed veterinarian who works exclusively with dogs and cats. I'm not sure if you still need help, as you haven't replied yet to our request for more information, but if you are still in need, I'd like to give you a few of my thoughts. When I hear of an older pet who is suddenly "falling over" the first thing I think about is vestibular disease. The vestibular system is our balance system, so if she is falling over like she's off balance, then this info could potentially apply to her: I know that vestibular symptoms like that can be very scary and it's tough to see them struggle. When I see pets like this, I generalize my thoughts into two big categories. I do my physical exam but usually the only issues I see are the head tilt, etc. I always look in the ears because a bad ear infection can cause these types of symptoms. If the ears are OK then I move on to these two:One is 'idiopathic old dog vestibular disease', which is a common problem in older dogs. The 'idiopathic' part means that we do not know why it happens. It starts all of a sudden, and usually resolves on its own within a few days to a week. Many pets that get this type of problem go back to normal in a week or two with sometimes very mild remaining symptoms like a head tilt. This is the most common reason for all-of-a-sudden onset of a head tilt, circling, and clumsiness in an older dog.I lump the other causes into 'brain problems' or central vestibular disease. There are some cases when it's obviously central vestibular disease, for instance if the nystagmus (the way the eyes jerk around ) is vertical vs horizontal. Vertically beating eyes = central vestibular (or brain) disease. Most of the time, though, it's not possible to tell a primary 'brain issue' from idiopathic vestibular disease except to either pursue further diagnostics like the MRI, etc, or to wait and see how the pet progresses over time. Typically if a brain tumor is present, these pets are NOT going to get better, but rather progressively worse, whereas with idiopathic vestibular disease, the pet is going to improve steadily over the next few days. Some vets use steroids as a general 'shotgun' therapy to decrease any inflammation in the brain (for instance, around a tumor) and also as an appetite stimulant. I think that the majority of these guys don't eat because they are motion sick, so I also treat them with motion sickness medications as well.If it's idiopathic vestibular disease, it tends to get better no matter what we do. If it's an ear problem (peripheral) , your vet would have seen this on physical exam and addressed it. If it's central vestibular disease like a brain tumor or other brain lesion, then you're looking at a much worse prognosis. We don't typically do brain surgery, and it's also difficult to biopsy a brain tumor to see what kind of chemotherapy should be used. Sometimes in the diagnostic testing leading up to an MRI, cancer or other major health problems are uncovered that also complicate matters, especially in an older pet.In summary, the most common issue is the idiopathic syndrome that resolves on its own in a few days. If it doesn't start to improve in a few days, then you're left with the decision whether to pursue further (and much more expensive) diagnostics. In a dog of her age, unfortunately, the chances of finding a problem that is easily fixable are not good. Please let us know how she is doing!~Dr. Sara

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