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Poppy - vestibular disease?

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Alarums and excursions in the night. Freddy woke me up some time around 1am to say there was something wrong with Poppy. She seemed to have got stuck in a trough in the bed clothes and was unable to right herself but when I lifted her out she was still thrashing and coughing and choking - it looked almost like a fit. I put the light on and found she was unable to stand and was panicking, so I nursed her upright until the coughing gave way to rapid panting, and then that eventually eased and she fell asleep. She slept peacefully next to me for several hours and then got a bit restless so I took her to the pad in the bathroom - she could by then stand but fell over when she tried to shake.

I went online (3.45am…) and made a vet appointment - one free with her usual vet for 9.45, which felt miraculous as you can imagine, especially on a Monday morning. Back to bed where she slept and I snoozed, another bathroom trip around 5 - still falling when she tried to shake but managed a few steps to do a pee more or less on the pad, and we went back to bed again. We got up around 6.45 and I carried her out for a poo - she promptly tried to shake and fell over despite me being ready to catch her. I debated giving her breakfast but she was enthusiastic about the treat wrapped pill so I got the bowls out. Instant transformation - prancing on hind legs, tail wagging, apparently back to normal - or what passes for normal these days. When I made the vet appointment I feared it might be for euthanasia, but now I am wondering about vestibular disease, possibly related to hepatic encephalopathy.

Meanwhile Freddy did a massive poo on the pad while I had Pop in the bathroom and someone other than Poppy vomited on the bedroom rug - I was firmly into sort-it-in-the-morning zone by then!
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Oh gosh. How upsetting to see her like that! I will be checking back in as soon as I wake up for an update on the vet appointment. With the poo and the mystery vomit, I’m wondering if the gang might have gotten into something?

I’ve struggled with vertigo myself, and it took years to determine that it’s very likely related to my cervical spine. But! I also had one episode that was diagnosed as a likely allergic reaction. There can be so many triggers, and they can overlap.
 

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Hugs
 

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Discussion Starter · #9 ·
Home from the vet but not really any the wiser - by the time I got there she was so completely recovered there wasn’t really anything upon which to base a diagnosis. Heart steady, temperature normal, gum colour good, no eye flicker, abdomen comfortable, balance no worse than it usually is, alert and focussed on my treat pocket - everything absolutely normal for Poppy. It could have been a very brief episode of vestibular (although there are no symptoms of it now), could have been a TIA, could have been one of the odd things that can happen with encephalopathy, could have been something else altogether. Whatever it was she has recovered rapidly and apparently completely, so her vet has recommended benign neglect: watching out for another episode and in the meantime upping her metronidazole to a 1/4 tablet daily rather than every other day for a few days to damp down the internal bacteria that produce the urea that drives hepatic encephalopathy. He certainly does not recommend subjecting her to invasive tests that would add little or no evidence to what we have already and that would not change the treatment plan. The aim is to keep her comfortable and happy, and we are succeeding in that.

We had a very short walk on the way home and Poppy is now snoozing at my feet while I drink a much needed coffee. I think an afternoon nap may also be on the agenda - recommendation was for Poppy to take it easy today and normal exercise from tomorrow, so she may stay at home or in the car when I take Sophy and Freddy out later.

There is one thing I have noticed recently - she now tends to take treats on the left side of her mouth rather than the centre. She is not showing any signs of discomfort when I clean her teeth, so I don't think that is the cause.
 

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Such a confusion of feelings: relief for a swift and apparently full recovery, but lingering uncertainty and disquiet for lack of answers. At least Poppy is comfortable and happy, blissfully content with chicken treats and a lap to warm herself on.
 

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Discussion Starter · #13 ·
Interesting, Heartland. Poppy gets a B vitamin supplement but there may, of course, be absorption issues. She has been bright and cheerful and even bouncy all day - hard to remember how very ill she seemed only hours ago.
 

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it might have been a TIA, Flower had one were she was just going in circles then stopped, turned out her blood pressure was through the roof
 

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I debated giving her breakfast but she was enthusiastic about the treat wrapped pill so I got the bowls out. Instant transformation - prancing on hind legs, tail wagging, apparently back to normal
I'm so glad she's feeling better.
I'm not quite sure how to interpret this (above), did she eat a significant amount of food and then get better? Possibly low blood sugar?
 

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Discussion Starter · #20 · (Edited)
I don't think it was low blood sugar: the recovery was fairly steady through the night and the bounce back came at the thought of breakfast, not after eating it. It seems it is possible for a bout of vestibular disease to last just a few hours and clear with a night's sleep although nystagmus - the eye flicking that is a common symptom - usually lasts longer. And a TIA is, by definition, transitory. I suppose it could even have been a muscle spasm in her back, but it did not look anything like the ones Sophy has suffered from in the past.

Pop's vet warned me that sometimes dogs have a series of these minor episodes before a major one, so I am prepared for more. I thought we were in for another bout when she woke me up panting in my ear in the early hours and I went straight into coping mode - nursing her upright, checked her eyes for nystagmus, cuddled her down against me. It took me a while to twig that what she actually wanted was to go out for a poo! Once that was sorted she slept till well after 6 and woke up hungry for breakfast.

Meanwhile I have yet again been down the Hepatic Encephalitis research rabbit hole and the general principles seem to be to adjust protein levels to the maximum that does not trigger symptoms; to avoid constipation and ensure several large, soft poos a day; and to control the level of “bad” bacteria in the gut with pro- and anti-biotics and the regular poos. So very much what I have been doing, although I have not had to be too fussy about protein levels till recently. There is a debate around animal or vegetable protein, especially for dogs, but red meat is a no-no and chicken, white fish, eggs and cottage cheese are all recommended, especially cottage cheese. I plan on measuring out the minimum levels Poppy needs in addition to her canned food in teaspoonfuls rather than grams and to stick to just above that for a couple of weeks, then increase slowly in steps.
 
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