Vertical Nystagmus

[kayla1]

This is probably a long shot, but does anyone know anything about the causes of vertical nystagmus?

My older girl Kayla had a vestibular episode nearly five weeks ago - this episode was put down as idiopathic vestibular. She had all the usual symptoms of horizontal nystagmus, head tilt, vomiting, staggering. She has improved somewhat but is still quite tilted and wobbly. She also still shakes her head and only eats out of one side of her mouth (bowl).

However she's also had several shorter episodes which all follow a similar pattern where she has vertical nystagmus, weakness in her hind legs, tilting, staggering, trouble getting up, urinating. These episodes don't last very long, and she sleeps afterwards and then wakes up fine.

My first thought with the shorter episodes where she has vertical nystagmus was central vestibular disease, but maybe there is something else that looks similar? Stroke, seizures? The vet's not sure but is thinking neurological. At the moment I'm just monitoring but I keep wondering if there is anything else I could be doing.

[julesluvscavs]

Hi Kayla, I feel bad no one ever replied to your post in May

How is your old girl now ?

I just came across your post because ive been looking through threads of dolers whose dogs have had neurological problems.

Edited September 1, 2013 by Jules❤3Cavs

[Rappie]

Vertical nystagmus is more often associated with central disease. The shorter episodes could be transient ischaemic episodes. Has she had a neurological exam to look for other signs? If there are any postural deficits this may provide more clues.

[~Anne~]

I hope your dog has recovered now Kayla?

Without a ct scan, who really knows what is happening.

Monte suffered what we thought was an idiopathic vestibular episode in January this year. He was diagnosed with idiopathic epilepsy at approximately 2 years of age. He was 11 when he suffered the vestibular episode.

Sadly, he never fully recovered and we now consider there was something a lot more sinister happening. After his initial but slow improvement, he rapidly declined over a 2 day period, 3 months later, before going into status epilepticus.

[kayla1]

Don't feel bad Jules. :) Thanks for asking, and thanks Anne and Rappie for your replies.

Kayla is doing pretty well. She's about 90% recovered, still a slight head tilt and some staggering/stumbling. It's been a very gradual improvement, but I'm happy she's recovered this much.

Rappie, I'm not sure what is involved with a neurological exam? She's seen several vets who have examined her but she hasn't had any scans.

The vets said the next step would be MRI if she had more of the shorter vestibular episodes. Fortunately she hasn't had any recently, and I'd prefer to avoid a GA unless absolutely necessary. Also the vets said it may not change the treatment she's currently on - she was already on dexamethasone for a spinal problem, and will most likely be staying on it now since the vestibular episodes, and she also started on vivitonin after the idiopathic episode.

Anne, yes I remember reading about Monte's sad decline. I don't think it's the same with Kayla, but I'm not familiar with seizures so can't be sure.

Jules, sorry to read about Joey's problems.

[julesluvscavs]

Im glad to hear Kayla is remarkably better, still sad shes not 100 percent.. long as she comfortable and happy enough thats the main thing :)

Yes very sad about our Joey, we trying one ditch at some treatment starting tonight, the next 48 hours we will know if it will help or not. If it doesn't or gets any worse, we will be giving him his wings

Please give Kayla a kiss from me x

[Rappie]

Don't feel bad Jules. :) Thanks for asking, and thanks Anne and Rappie for your replies.

Kayla is doing pretty well. She's about 90% recovered, still a slight head tilt and some staggering/stumbling. It's been a very gradual improvement, but I'm happy she's recovered this much.

Rappie, I'm not sure what is involved with a neurological exam? She's seen several vets who have examined her but she hasn't had any scans.

The vets said the next step would be MRI if she had more of the shorter vestibular episodes. Fortunately she hasn't had any recently, and I'd prefer to avoid a GA unless absolutely necessary. Also the vets said it may not change the treatment she's currently on - she was already on dexamethasone for a spinal problem, and will most likely be staying on it now since the vestibular episodes, and she also started on vivitonin after the idiopathic episode.

Anne, yes I remember reading about Monte's sad decline. I don't think it's the same with Kayla, but I'm not familiar with seizures so can't be sure.

Jules, sorry to read about Joey's problems.

An MRI would be the next step to obtain a diagnosis, certainly.

A neurological exam is thorough but specific physical examination. The vets may have done a cursory one as part of their assessments - it involves testing the function of different nerves in the body and can take some time. It's usually a series of things like checking the gag, checking pupil responses, palpating the skull, tapping in the corners of the eyes, a menace check and then testing postural reactions and refexes - using a patella hammer, checking placing reflexes and wheelbarrowing etc. Although it can't give a specific diagnosis it can be useful to localise a neurologic lesion even if it's just as far as a central (brain) lesion or a peripheral one.

[kayla1]

Ok, no she hasn't had that. Not sure why it wasn't done. I'll ask the vet about that next time I'm there. Thanks Rappie.