Q: LUCKY, MY 14 YEAR-OLD LABRADOR RETRIEVER, HAD A SUDDEN ONSET OF FALLING TO THE RIGHT, LOOKING DRUNK, TILTING HIS HEAD TO THE RIGHT AND HAVING WIGGLY EYES. I BROUGHT LUCKY TO MY VETERINARIAN WHO DIAGNOSED A "PERIPHERAL VESTIBULAR DISORDER" AND RECOMMENDED REST. I AM WORRIED LUCKY HAD A STROKE. CAN YOU TELL ME MORE ABOUT PERIPHERAL VESTIBULAR DISORDERS?

A: Lucky is likely suffering from "Geriatric Peripheral Vestibular Disease" based on your description of the clinical signs and Lucky's age. The long-term prognosis, thankfully, is very good.

The vestibular system is responsible for balance and starts in the inner ear and travels into the brain. Diseases affecting the nerve outside of the brain (i.e. peripheral vestibular disorders), in general, have a better prognosis then those diseases affecting the brain itself (central vestibular disorders). Clinical signs seen with peripheral vestibular disorders include looking drunk, falling to one side, having a head tilt towards one side and having abnormal eye movements, called nystagmus.

Many owners with dogs that have suffered a vestibular episode will think the pet has had a stroke because the signs are sudden in onset and involve the brain. Technically speaking, a stroke means that there has been an impairment of the blood supply to the brain, which has resulted in the neurologic signs. There is no evidence of impairment to the blood supply to the brain in dogs with geriatric peripheral vestibular. The cause at this point is unknown.

The treatment for geriatric vestibular disease is controversial, as many patients will get better on their own over time. Nonetheless, many veterinarians will treat these patients with steroids and antibiotics.

Q: Frantz, my 3 year-old Dachshund has had 2 episodes of neck pain that was treated with steroids and completely resolved. Now, however, for the past week Frantz is extremely painful when he lifts his head and seems drunk in all of his legs. What should I do?

A: Frantz is likely suffering from a herniated disc and needs immediate care by a specialist who deals with the nervous system.

Disc disease is very common in Dachshunds and usually affects Dachshunds between 1 and 6 years of age. Signs can range from mild discomfort to complete paralysis. Other breeds commonly affected include Beagles, Llasa Apsos, Cocker Spaniels and Dalmations.

The specialist will likely recommend an MRI to determine the exact disc that is causing the problem. An MRI is a noninvasive test that allows precise determination of the offending disc. Alternatively, the specialist may recommend a myelogram if an MRI is not available. The myelogram has the disadvantage of being an invasive test that involves injecting contrast material around the spine and then taking radiographs to evaluate the spine. In addition, the MRI is more precise with regards to determining the cause of the problem.

Regardless of whether an MRI or myelogram is done, if the signs are severe and recurring, surgery will be recommended. This involves removing the herniated disc from the spinal canal through an incision under the neck. In general, dogs like Frantz who are painful and mildly uncoordinated in all four legs, have an excellent prognosis and approximately 90% of patients return to normal after surgery. Post-operatively, Frantz will be required to rest at home for 4-8 weeks.