Kinser - Kinser has passed on... August 1, 2016

[momofdecker]

This is not diabetes related but the collective knowledge from the folks on this forum is so great I thought I'd try asking...

Woke up this morning to find Kinser, my 78 pound mixed breed dog who is a couple of months shy of his 15th birthday, unable to get up or walk.
He was fine when we went to bed last night. Yesterday he was alert and even went for a short walk where he trotted along at a decent speed for his old age.

He had a wellness exam in November and blood work was all in normal range except for he was slightly anemic. He's on metacam and tramadol for arthritis and benadryl for allergies. He gets cosequin, vit. B12, milk thistle and fish oil supplements.

This morning he was completely off balance and would fall when we tried to get him up. I noticed his head was tilted to the right and his eyes were darting from side to side. He wouldn't eat at first but when I pulled out some chicken he ate some of that and drank some water. He leaks urine and wears a diaper - he had a bm in the diaper which he's never done before.

His breathing seems normal and he seems alert despite not being able to move. No signs of paralysis - just lack of coordination (dizziness?) makes it difficult for him to stand or walk. Will call the vet Monday morning but looking to see if anyone has any experience with vestibular disease or any advice to offer. Thanks in advance!

[jesse girl]

Re: Kinser - vestibular disease?

jesse had what i thought was vestabular that first year of diabetes. her head was tilted lasted a few day and was gone

i guess it could have been an inner ear thing because the balance was off but the symptoms did follow what appeared to be the disorder

now jess did recovere fairly quickly she was young but in a health state that still wasn't that good

never seen another episode except she got that bent tail thing that recovered also close to the same time frame

wish i could be more help holli hope for kinser to get well soon and its not a big deal as with jesse

[Judi]

Re: Kinser - vestibular disease?

oh crap Holli. I hope it wasn't a stroke. Please keep us posted.

[Joan]

Re: Kinser - vestibular disease?

With the eye movement it is for sure vestibular. The first one I had, happened to be home at the time, and thought he was having a heart attack.
After about half an hour of absolute terror on my part, he settled down, and I called my vet, and that is what he had.

The nystagmus (sp?) is the definitive sign, separating it from seizures or stroke. the really good news is that they always recover, given the chance. It can take anywhere from a few hrs (unusual) to a few days. the only thing that may remain is a head tilt. But the balance etc will be as good as new. And it is very very rare for a dog to have another attack.

Way too many people think stroke, and do something permanent before the dog has a chance to recover. Diapers esp on a large dog like this is the way to go. You will have to check with your vet on feeding etc. It will depend on how quickly/slowly he gets back to himself. My pug took about 6 hrs, but that is very unusual to be that quick..

The important thing is to keep him kind of propped on each side, put some towels rolled up around him. They lose all sense of balance and up and down. They will roll till they can hurt themselves. If they start walking too soon, they will go in circles. Best to keep him as quiet as possible. Let him tell you how and when he wants to start moving again. With my pug I kept him right beside me on the couch with towels keeping him nice an tight and he found that comforting. He was actually more comfortable on his back, but that is probably a very individual thing.

You can get BONINE at most pharmacies, incl Walmart, and it can help with their sense of balance. It may as a side effect make him a bit drowsy, also a good thing.

BTW dont let your vet tell you that if the eyes move up and down or dart more to one side than the other, that it is significant or more serious indicating brain stem involvement. That was the old school teaching that has been proven to be absolutely false.

If you need anything or want to talk further, just send me a pm and I will get right back to you. I know how scary this can be. When it happened to me the first time, it was my all time heart dog...thought I would die if he didn't recover. But he did, and we had another 4 yrs or so of good health and not another hint of vestibular.

[momofdecker]

Re: Kinser - vestibular disease?

Thanks for the tips and support. It sure came out of nowhere. His rear legs are not that great and the first thought was that they'd finally given out and that we'd be making a final vet call. Then I noticed the head tilt. Once we got him down and settled I saw the eyes. That's when we suspected vestibular and now have hope that in time it will resolve enough to give him quality of life.

The timing - Jan 26, three years ago we lost Decker. This morning was tough but we are feeling a bit more hopeful now.

I was most worried because he can't get up or walk. Everything I've read talks about a lack of balance and circling but I couldn't find any info on the inability to walk at all.

Thankfully my sister in law had a help em up harness which we've borrowed. It's been a life saver as it's the only way we can move him. He did wag his tail when John had him up. The eyes are still continuously darting around. I wonder if the continual movement (as in from about 6a - now, around 11p) is normal with vestibular. I know the movement is but the length of time concerns me a bit.

Have a mattress pad covered with a blanket on the floor close to the door. The tramadol and Benadryl make him sleepy anyway so he's resting up today. I'll be sleeping on the couch to keep an eye on him.

We are under a snow advisory until Tues night. It's storming pretty good out there right now. Good news is that the weather should make it easy to get a vet appt tomorrow as they'll probably have cancellations. Bad news is that we will have to travel in it. Fingers crossed we have decent Visability and get good news from the vet.

[Joan]

Re: Kinser - vestibular disease?

Just wondering how Kinser is doing this morning, and wishing you safe travels in your blizzard conditions.
Prayers for you both. Joan

[momofdecker]

Re: Kinser - vestibular disease?

Hi Joan. We had his vet appointment this morning. Got lucky in that the storm stopped enough to clear the drive way and for the plows to have gone through. Got to the vet and back and within 30 min afterwards it started snowing again and has not stopped.

This morning it seemed as though the eye movement was not as fast moving as yesterday. Still present and still continuous but the movement itself didn't seem to be darting around as fast. Not sure if that makes any sense?

Prior to the vet visit he was still unable to get up or walk. The practice was great about in letting us come in the exit door (more of a straight shot to the exam room) and had a rug to put down for him.

As expected - there could be three causes: idiopathic (unknown), middle ear infection, or brain tumor. The vet did ask if we've seen any improvement since yesterday morning. At the time we'd seen very little. He said typically within 24 hours you start to see some signs of improvement. But - when the husband had him up and was 'walking' him out - Kinser was able to coordinate his feet enough to walk a few steps. John still had to support him but his feet were coordinated enough to move in sync. Only for a few steps but we are taking it as a positive sign. Then when we got home he was able to stand on all fours (with support) to get a drink of water from his dish. He's been down since - but as long as we see any signs of hope we will give him time to see what happens.

The vet gave us some antibiotics to give him. His ears looked clear but just in case there was a middle ear infection - the antibiotics would address that. He wanted to try steroids - but Kinser is on the metacam for his arthritis - and we all felt we'd rather just stay with the metacam for now rather than not give him anything for 7 days (to allow for the wash out period) so we could switch to steroids.

He's been eating bits of chicken here and there and is drinking when we put the water bowl in front of him. When we take him outside he does seem to know to urinate - so has some sensation and control. And he had a bm yesterday evening but nothing today so far.

He lost his hearing a couple of year ago so when he sleeps - he usually does so pretty soundly. Got his meds into him and letting him rest for today. Will take it one day at a time and hope we see more tiny signs of hope.

If he does not show any further signs of improvement the vet said an MRI would be the next step. If it gets to that point - we won't put him through that. If there is a suspected brain tumor - an MRI would only confirm it - and the ultimate outcome would be the same with or without a dx. Given his age - we'd cook him up a steak, give him lots of love and set him free to go play with his Decker boy. Still hopeful we have more time but at the same time being realistic as to what the possibilities may be.

[jesse girl]

Re: Kinser - vestibular disease?

fingers and paws crossed holli . maybe kinser would like to spend a bit more time with the pack .

[k9diabetes]

Re: Kinser - vestibular disease?

I would disagree with Joan's vet - there are definitely cases where this kind of behavior can be stroke related. Chris experienced it and was seen by a neurologist within a couple of hours of it happening.

Anything affecting the vestibular system will cause vestibular symptoms, such as nystagmus (eyes going back and forth), unable to stand or walk, head tilt, etc. Chris had all of them. And like Joan's dog, he recovered completely within about five hours. Which is not characteristic of vestibular syndrome, which usually takes a few days to weeks to resolve.

Our GP vet at the time, who I miss desperately, recognized that some of Chris' symptoms fit vestibular syndrome but others didn't so sent us immediately to the neurologist.

The neurologist did a series of tests and the diagnosis is based on subtle differences, such as the direction of the nystagmus when the dog's body is in various positions.

Given how long Kinser has been experiencing the symptoms, I think a mini stroke, TIA, is unlikely the cause for him. We believe that was the cause of Chris' episode. But quite a few dogs have a vestibular event "just because" and it never reoccurs. Hope that's the case for Kinser.

Must have been really tough to have this happened on the anniversary of Decker's passing...

Our Jack was just diagnosed with a heart murmur and we saw the same cardiologist who cared so lovingly for Chris... made me feel like there's something in the drinking water. I don't really think there is. But I have found it interesting that Jack, like Chris, has lacked stamina all his life. Guess we have a tendency to pick that kind of dog.

Hang in there, stay warm, and know we are sending Kinser warm(er) California thoughts for a quick recovery.

Natalie

This morning it seemed as though the eye movement was not as fast moving as yesterday. Still present and still continuous but the movement itself didn't seem to be darting around as fast. Not sure if that makes any sense?

Prior to the vet visit he was still unable to get up or walk. The practice was great about in letting us come in the exit door (more of a straight shot to the exam room) and had a rug to put down for him.

As expected - there could be three causes: idiopathic (unknown), middle ear infection, or brain tumor. The vet did ask if we've seen any improvement since yesterday morning. At the time we'd seen very little. He said typically within 24 hours you start to see some signs of improvement. But - when the husband had him up and was 'walking' him out - Kinser was able to coordinate his feet enough to walk a few steps. John still had to support him but his feet were coordinated enough to move in sync. Only for a few steps but we are taking it as a positive sign. Then when we got home he was able to stand on all fours (with support) to get a drink of water from his dish. He's been down since - but as long as we see any signs of hope we will give him time to see what happens.

[Joan]

Re: Kinser - vestibular disease?

Natalie,

That is interesting on Chris' event. With Scooter he flailed wildly for nearly an hour. I went from thinking that he was having a heart attack, to realizing that his gum color was still good etc. He was absolutely frantic, eyes darting up and down, wouldn't settle at all. My next thought at the time was seizure, but have been thru that, and it was nothing like that.

He did recover almost all at once..It was about 8 hrs as I recall, and suddenly he went from almost comatose to sitting up looking for supper. I never questioned my vet, and she was the best I had ever seen, and since than as well. I did do research on it at the time, and seemed that recovery was very individual, from hours up to wks.

Scooter never had any lasting effects, no head tilt no balance etc. A bit hard to tell as he was paraplegic, but tootled around in his cart the next day as if nothing had happened. I however, aged at least 10 yrs LOL

Anyway, prayers for Kinser, and mum. Joan

[k9diabetes]

Re: Kinser - vestibular disease?

Hi Joan,

I don't think there would be very many GP vets and perhaps not even IMSs who could conduct the kinds of tests needed to determine if it's a vestibular event or something else.

No question that the vet we had at the time was exceptional. He also did complex ultrasounds and taught radiography at the local vet school. So we were very lucky. Also lucky to have a neurologist nearby and that we could be seen right away. Broke my heart when that vet retired...

It definitely is the sort of fine diagnostic that requires specific, hands-on specialized testing.

I tend to think the very quick recovery of Chris and Scooter's events points to something else like a transient blood clot. Chris was pretty much entirely back to normal within about... I'd say five hours max. And mostly recovered in about 3 hours.

Thereafter, we started giving him a baby aspirin every day because of concern that he might be throwing clots. And a cardiac ultrasound saw evidence of something inside his heart that could have been the source of a clot.

No way to know for sure without massive diagnostics that we weren't interested in doing. But the neurologist's bet, given his tests, was that it was vascular.

Natalie

[momofdecker]

Re: Kinser - vestibular disease?

I was able to upload a few videos this morning.

From Sunday evening. John walks him over to his blanket and lays him down:
https://www.youtube.com/watch?v=muuUruTXCp8


From Monday. His eyes still dart around even when he is sleeping:
https://www.youtube.com/watch?v=FvjXO0QUv9g

This is his eyes this morning. The rate of the movement does seem to be slowing down:
https://www.youtube.com/watch?v=i_nirr_Ta4w


He still is unable to get up or walk but his cognitive abilities seem to be in tact. Last night I stood him up and walked him around for a few minutes just to get him up. He wanted to lay by the couch. As he was laying there he kept looking back at the couch. So I stood him up and turned him around and he tried to get his front paws onto the couch. That's what he typically does. Before this happened he'd stand with his front paws on the couch and wait for me to boost his back end up. So we covered the couch and John lifted him up. He was one happy dog.

Around 3a he woke me as he was panting heavily. I checked on him and he seemed agitated. So I got him down and took him outside and he immediately urinated. Then walked him back in, got him settled and he went back to sleep.

He didn't want any chicken this morning and spit out his meds several times so he still has a lot of fight left in him in that regards.

I worry so much about the mobility. Reminds me so much of Decker - in the respect that the mind is sound but the body is giving out. Will give it more time and keep looking for those tiny signs of improvement. Fingers and paws crossed we continue to see it.

We've been fortunately that prior to yesterday we've had a very mild winter. We've been walking the dogs on a near by hiking trail every weekend. Kinser has been going with us and has managed 2-3 mile hikes. It takes several hours but his spirit lights right up when we take him. We keep a hand harness on him and help him up/down the hills, but other wise he wanders off lead. He sniffs to his heart's content, his eyes are bright and alert and his tail wags the whole time. We often meet other dogs and we have to hold on to him because they will get running around with Toby and Kinser will tip easily. But he gets so excited to get to say hello to other dogs as well.

Natalie - you know my thoughts on our neurology options here. I won't take him there. Their dx with Decker may have been sound but any teaching hospital that refuses medication because they don't have a confirmed reason for the dx. is a place I feel puts financial gain over quality of life - and not a place that will get my business. Add to that the fact that because they are a teaching hospital - the vets there can be exempt from having to be licensed in the state of NY - it's sad - I would expect a teaching hospital to be held to higher standards - not exemptions. I've looked around and if we need a neuro consult we will have to travel out of state as what I've found around here are not options I feel overly confident with.

[jesse girl]

Re: Kinser - vestibular disease?

yep thats what jesse had and i think jesses case may have been more sever

it looks like hes improving to me and i dont see anything that says hes not present. balance may take sometime to come back

i had an inner ear infection that took me weeks to get my balance back

[Joan]

Re: Kinser - vestibular disease?

I know it can be heart wrenching to watch your baby struggle, but I think he is doing really well. The last video of the eyes: to me that doesn't look like what I would describe as "darting". I would say maybe an anxious dog's reaction to not understanding what is going on.

He is making progress, and certainly seems happy and comfortable.

Prayers for all of you, Joan

[momofdecker]

Re: Kinser - vestibular disease?

Thanks Joan. We are still plugging along. The uncontrolled movement of the eyes stopped on Wednesday - they are pretty much back to normal at this point.

He also started eating a little bit on Wednesday. Thanks to all the tips we've learned over the years regarding how to get a picky diabetic dog to eat - we've had lots of options to try to encourage him to eat. He's still only getting about a cup of food total into him each day but I imagine if I was dizzy for four days it would take some time for my stomach to recover as well.

Thursday was a good day with some very positive movement - once we stood him up, he could stand unsupported for a few seconds (as long as he didn't move) on his own. Took video. You can see the weakness in his rear legs when I try to get him to walk. Some is the balance issue - some is weakness that existed prior to the vestibular incident. You can see the large fatty tumor on his left rear hip area. He knuckles that left rear foot as well. He was starting to do that a bit before the vestibular incident and I'm sure that will make it a bit more difficult for him to recover from. He's a stubborn old man though - time will tell.
https://www.youtube.com/watch?v=MQy8dz6xzpw

This is what happens if he tries to get up and move unsupported. Again, the struggle to get up was in existence before the vestibular incident. The balance issue he is still working through. For now we are still supporting him as he tries to move around.
https://www.youtube.com/watch?v=knRTfLOWaRY

He has about five days of antibiotics left and has become extremely suspicious of any meds we try sneaking into the small amount of food he eats. Have no idea if they are helping but know they are not hurting him at all. Pill pockets worked for a day and a half and now he's on to that as well. Keeping us on our toes for sure. Hoping that stubbornness will serve him well in gaining his balance and strength back.