C O L D R I V E R V E T E R I N A R Y C E N T E R
CASE REPORTS
The vestibular system is a sensory organ of the inner ear that helps us maintain proper balance while stationary or moving. It helps stabilize eye movements and communicates with skeletal muscles to orient the head and body. Without an intact vestibular apparatus we could have blurry vision, be uncoordinated, deaf, dizzy (vertigo) or have nausea.
Senior dogs or cats can develop ear infections or colds that reach the inner ear causing a variety of neurologic signs. These older patients may take 2 weeks to recover though some animals are better within days. Weaknesses of the vestibular system may predispose a dog or cat to be car sick, sea sick, or vomit during air travel. The same animals may have a history of deafness, unsteady gait, or nystagmus (erratic eye movements). These patients may recover some or all of their vestibular function when underlying weaknesses are identified and treated. For example, hypothyroidism is a common cause of neurologic weakness and a treatable disease but veterinarians need to routinely screen for it with blood tests. Nerve fibers from the vestibular apparatus communicate with the brain stem, cerebellum, spinal cord and cerebrum as well as receive input from the body. Thus any misalignments in the spine can create nerve interference that affects incoming or outgoing information from the inner ear.
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Sheriff is a 14 3/4-year old neutered male Labrador Retriever who had a sudden onset of head tilt, hind limb weakness, ataxia (uncoordinated gait), and loss of appetite on Monday morning 11/10/08. The photograph to the right was taken at 9:00 a.m. He could not walk without support and would fall to one side. Based on physical exam, neurologic signs and history the diagnosis was acute vestibular disease. |
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Treatment of Sheriff’s inner ear congestion (vestibulitis) started with chiropractic adjustment for misaligned vertebrae that contributed to his instability. Note the asymmetry in the pelvis bones (left) though Sheriff had equal leg lengths. Dr. Kruesi adjusted cervical vertebrae, used traction and postural therapy to relieve restrictions throughout the spinal column. |
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Stimulating nerve input from the extremities (afferent pathways) improves the return flow of information (efferent) needed to stabilize the body’s position. We took video pictures to document Sheriff’s condition before and after treatment. Prior to treatment his eyelids did not blink in unison, an involuntary loss of control. Three hours after chiropractic and acupuncture he was calm, focused, his eyes had recovered the normal blink reflex and his head tilt had resolved. He could walk steadily and unassisted, getting up and down on his own. That night he slept better than he had for months. |
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Pictured at right is a “Dermo-Jec” device filled with a natural remedy for sinus congestion, Euphorbium Compositum and vitamin B-12. Dr. Kruesi treated Sheriff’s acupuncture points to relieve stagnation in the inner ear, spasm and neurologic weakness. Home care included a homeopathic remedy Vertigoheel (heelbhi.com). |
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Two days later Sheriff was still walking well, had no head tilt, a normal appetite, and was noticeably stronger. The usual time for recovery is 2 weeks. Conventional therapy is Meclizine (Antivert), an antihistamine drug. The medication reduces dizziness and anxiety to give the patient time to recover but does not correct the underlying problems. Side effects may include nausea, low blood pressure, drowsiness or diarrhea. |
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The photograph at left is Sheriff 2 weeks after his acute episode of vestibular disease. He had follow-up acupuncture and chiropractic. Sheriff’s chronic lordosis (swayback) and lumbar muscle weakness has significantly improved. He has more flexibility in his spine and made a complete recovery. Here is a video of Sheriff on 11/10/08 prior to treatment. Note the asymmetrical blink reflex, side to side: Video 1. Sheriff was unable to stand without assistance. This video was taken 2 hours after his first treatment with acupuncture and chiropractic. He has a normal blink reflex and the eyelid spasm (blepharospasm) resolved: Video 2 At 3 hours after treatment Sheriff was walking well outdoors: Video 3 Sheriff doing well 2 weeks after his episode of vestibular disease: Video 4
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For more information about our integrative approach to vestibular disease see our newsletter: Natural Pet Care, February 2009.
William Konrad Kruesi, D.V.M., C.V.A., C.A.C. 1/12/09