The title of this blog may sound coarse but it is, nonetheless, the one trite, vet school maxim that sticks to my grey matter more than any other—perhaps because it reeks of callous, old-style vet medicine but more likely because it has actually served me well.
Garth, a geriatric yellow Lab with the droopy face and plodding gait of a doddering old man, is one of my favorite clients. So it was that when my telephone rang at 7:30 this morning (Sunday, no less) with news of Garth’s imminent demise, I was quick to get out of bed and into my car.
Garth pulled up to the back of the hospital in style, nestled in blankets in the back of a Porsche SUV (I’d like an ambulance like that). His eyes were dancing back and forth, his head was tilted to one side and tremoring, and his mom assured me that every time he’d try to walk he’d simply fall over like a drunk. He’d been like that all night.
Garth had already been to an emergency clinic near his mom’s house. The vet there told her that Garth was probably terminally ill with a brain disorder or tumor and that she would have to see a neurologist on Monday. He also offered to euthanize him before that time should she prefer to alleviate his suffering. He gave Garth some Valium for his shaking and tremoring and offered to keep him overnight. His mom elected to take him home, keep a sleepless vigil, and wait for my opinion in the morning.
Poor old guy. He was clearly uncomfortable. Confused and nauseous, he had not been able to locate his mom when called (though he tried to look for her) and refused all his favorite treats.
In case you’re thinking this is going to be one of my sad stories, just keep in mind the title of this post.
Old dogs will sometimes suffer a temporary problem with their balance system. Alternately called vestibular disease, vestibular syndrome or vestibulitis, this disorder of unknown origin is often the cause of premature euthanasia in dogs. Because the onset of symptoms are so sudden, and because dogs look so terribly afflicted, twisting and rolling on the ground as if terminally confused, it seems difficult for many people to believe their dog will ever be normal again. And because they’re usually weak geriatrics, the decision in favor of euthanasia comes easily for most people whose dogs find themselves suddenly in this dramatic situation.
The reality is that most dogs will recover on their own as symptoms slowly regress over a period of days. More rarely, the recovery period can stretch out to two or more weeks. Apart from being nauseous (you would be too if your balance system suddenly went awry and you couldn’t tell which way was up), needing assistance to get up and do their excretory business, and requiring encouragement to eat and drink, these dogs usually do just fine.
The hard part of this disorder is that it’s impossible to diagnose with 100% certainty. (It’s what we call a diagnosis of exclusion.) Because there is no specific test for vestibular disease, all cases must be thoroughly examined for other signs of disease—toxicity, nervous system cancers and infections, liver disorders, and inner ear infections can all produce similar symptoms. But spinal taps and CT scans are expensive and are not undertaken without some hazards. Routine blood work is the only test we employ (beyond a complete physical and neurologic exam).
Garth was already feeling a little better since his symptoms initially appeared. This is an excellent sign in favor of a diagnosis of vestibular disease. Almost no other cause for his neurologic signs would be likely to abate so quickly. Because common things occur commonly, vestibular disease is almost surely the cause for his distress. Both mom and Garth went home with instructions to rest and a prescription for some anti-nausea medication. Beats euthanasia in the middle of the night.
There’s a lesson here, and it’s not just about rolling dogs. It’s also about getting a second opinion before you euthanize an animal for any reason that doesn’t seem quite right. For the love of God, get a second opinion, especially if you don’t know the vet you’re dealing with. (In fact—and this is a subject of another post—I suspect this vet wasn’t even licensed. I’m looking into it.)
Now that you’ve read this, none of you out there will ever fall prey to the stress and close-call premature euthanasia Garth’s mom briefly contemplated. Now you, too, know the one thing I can never forget: don’t kill old rolling dogs.