I've just started seeing a 7 yr F(S) French Bulldog that suddenly developed a head tilt to the left and ataxia in Feb/19. This dog has been deaf from birth and has visual impairment but overall is a happy dog at home. Can be easily panicked though, so owner has hesitated to have xrays of bulla and neck done as would need sedation.No otitis externa apparent. The rDVM put the dog on prednisone and she improved back to normal, but when the meds were stopped the issues recurred. She was put back on a longer course of prednisone but this time there was no improvement. When I saw her she had the head tilt to the left and was holding her head flexed downward as well, She was weak on the hind quarters and slightly ataxic but had normal withdrawl and knuckling correction of all 4 limbs. She has been on Atopica the last couple of years and will lick her feet but had no skin lesions or erythema, though her haircoat felt a bit dry and was somewhat thin on her caudal thighs. She has been eating dry D/D diet and has always had a good appetite, but a couple of days prior to my first visit had stopped eating her usual food, though she would eat treats. She used to get loose stools fairly often but hasn't in a while. Snores and has flatulence. Drinks a fair bit of water and her head often feels hot to touch though she likes to be covered up with a blanket and to lie in the sun. Tongue was pink, slight lavender tinge with a very thin white coat. Pulse was slightly weak, moderate to deep and slightly wiry. She was sensitive on palpation of GB 20,21, GV 14,BL-10,11,18,25, GB-30 and BL-54 She had quite a bit of muscle spasm in the neck and tight triceps. Her pulse improved with GB points. I have acupunctured her twice using GV 14, GB 20,21, 34, BL-10,11,25,40,18,23. She is holding her head slightly less flexed forward and at times with less tilt. Wishful thinking? I started her with Traumeel, Spascupreel and Gelsemium homaccord. In light of the time of onset and improvement of pulse with GB points I'm wondering about a Shao yang issue. I see some Blood deficiency and stasis but also Damp/Damp Heat with possible food allergy issues, flatulence. I started Benefit Hips and Knees but wondered if Bu Gan Tang might be helpful if we could get her to take it. I'm a bit concerned with no x-rays if a hemivertebra may be present we are not aware of, and didn't know if chiropractic would still be advisable. Any thoughts you may have would be most welcome. Many thanks again, Llewanda
Question Details
Head Tilt In A Dog
by
LJH
-
June 5, 2019 View Case Report
I've just started seeing a 7 yr F(S) French Bulldog that suddenly developed a head tilt to the left and ataxia in Feb/19. This dog has been deaf from birth and has visual impairment but overall is a happy dog at home. Can be easily panicked though, so owner has hesitated to have xrays of bulla and neck done as would need sedation.No otitis externa apparent. The rDVM put the dog on prednisone and she improved back to normal, but when the meds were stopped the issues recurred. She was put back on a longer course of prednisone but this time there was no improvement. When I saw her she had the head tilt to the left and was holding her head flexed downward as well, She was weak on the hind quarters and slightly ataxic but had normal withdrawl and knuckling correction of all 4 limbs. She has been on Atopica the last couple of years and will lick her feet but had no skin lesions or erythema, though her haircoat felt a bit dry and was somewhat thin on her caudal thighs. She has been eating dry D/D diet and has always had a good appetite, but a couple of days prior to my first visit had stopped eating her usual food, though she would eat treats. She used to get loose stools fairly often but hasn't in a while. Snores and has flatulence. Drinks a fair bit of water and her head often feels hot to touch though she likes to be covered up with a blanket and to lie in the sun. Tongue was pink, slight lavender tinge with a very thin white coat. Pulse was slightly weak, moderate to deep and slightly wiry. She was sensitive on palpation of GB 20,21, GV 14,BL-10,11,18,25, GB-30 and BL-54 She had quite a bit of muscle spasm in the neck and tight triceps. Her pulse improved with GB points. I have acupunctured her twice using GV 14, GB 20,21, 34, BL-10,11,25,40,18,23. She is holding her head slightly less flexed forward and at times with less tilt. Wishful thinking? I started her with Traumeel, Spascupreel and Gelsemium homaccord. In light of the time of onset and improvement of pulse with GB points I'm wondering about a Shao yang issue. I see some Blood deficiency and stasis but also Damp/Damp Heat with possible food allergy issues, flatulence. I started Benefit Hips and Knees but wondered if Bu Gan Tang might be helpful if we could get her to take it. I'm a bit concerned with no x-rays if a hemivertebra may be present we are not aware of, and didn't know if chiropractic would still be advisable. Any thoughts you may have would be most welcome. Many thanks again, Llewanda
Replies
by
naturevet
June 6, 2019
Hi Llewanda,
I would definitely evaluate the situation chiropractically. Atlas fixations can be a cause of what you're seeing, or can result from vestibular disease and perpetuate the symptoms. If fixations are found and gentle manipulation is used, such as with an Activator at a low impact setting, there should be minimal risk of doing any harm, obviating the need for immediate Xrays. The exception would be if the dog has a fever at all, in which case you would want to rule out discospondylitis. If the head region is hot, it is a consideration.
After any mobilizing therapy, ensure the pulse is not now superficial and toneless and broad.
If it is, you need an acute acting CNS anti-inflammatory like Chai Ge Jie Ji Tang (Bupleurum and Kudzu). If the pulse moderates to normal, then a neck/atlas fixation is likely the primary problem. Otherwise, if the pulse is not impacted, then I agree with your musings. You could use Xiao Chai Hu Tang and Bu Gan Tang together, to cover the gamut of muscle spasm and nerve inflammation. The western herb Valerian root, widely available in drug stores and natural pharmacies, is an effective neck muscle relaxant, particularly if you can find a liquid version. We use that in our practice in these types of cases, and could send some to you if you need it.
Hopefully that helps you out. Let us know how things go!
Steve
I would definitely evaluate the situation chiropractically. Atlas fixations can be a cause of what you're seeing, or can result from vestibular disease and perpetuate the symptoms. If fixations are found and gentle manipulation is used, such as with an Activator at a low impact setting, there should be minimal risk of doing any harm, obviating the need for immediate Xrays. The exception would be if the dog has a fever at all, in which case you would want to rule out discospondylitis. If the head region is hot, it is a consideration.
After any mobilizing therapy, ensure the pulse is not now superficial and toneless and broad.
If it is, you need an acute acting CNS anti-inflammatory like Chai Ge Jie Ji Tang (Bupleurum and Kudzu). If the pulse moderates to normal, then a neck/atlas fixation is likely the primary problem. Otherwise, if the pulse is not impacted, then I agree with your musings. You could use Xiao Chai Hu Tang and Bu Gan Tang together, to cover the gamut of muscle spasm and nerve inflammation. The western herb Valerian root, widely available in drug stores and natural pharmacies, is an effective neck muscle relaxant, particularly if you can find a liquid version. We use that in our practice in these types of cases, and could send some to you if you need it.
Hopefully that helps you out. Let us know how things go!
Steve
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