# Chronic head tilt and disorientation



## rubicon (Dec 9, 2019)

My dog Erdos has had a head tilt since Thursday. My husband took him for a hike, showered him with a hose and after the nap I noticed his head was slightly tilting. I left on an errand and my husband said he deteriorated really fast. He went into the vet the next day at 5 PM and stayed until 8. They said he had a very bad ear infection in both ears and apparently it’s been happening for a long time. they didn’t take a CT scan but said if he doesn’t improve soon, they would.

There’s now fluids behind one of his ear drums and the vet said they would rather not perforate it to drain it so he has started on steroids, another anti inflammation medicine, anti fungal and antibiotics. And he has not gotten better. The first afternoon he was still in good spirits albeit walking in circles and wiping out when he tries to fetch sticks.

Gradually, he’s not eating anymore. He cannot get off the (floor) bed without crashing into a bunch of furniture and making me really nervous letting him around my baby. we don’t dare take him on hikes or to the beach anymore. We don’t even want to let him outside our gated community where there are no cars because we can’t trust him not to walk into traffic. He cannot be left alone to eat and he can hardly find his water. He just looks emaciated and depressed and scared. He always tries to follow us when we get off the bed even though it’s not very safe for him to be walking around and he hardly knows where he is. There was one walk this morning where he seemed somewhat normal and now he’s back to being disoriented and scared of his own shadow.

Other dog owners I talk to say their dog gets ear infections and the head tilt and it’s quite normal but I can’t help but wonder if this is something worse. I generally trust professionals but I really don’t want to be one of those horror stories where “doctor says not to worry but then overnight he got worse and just died”. I’m afraid to go to sleep now. I don’t want to wake up to him dead. We don’t have a follow up until Monday and if he doesn’t get at least a bit better by tomorrow I don’t know how I’ll survive the weekend.

it would really help if someone could reassure me this is nothing to worry about and their dog acted like this and got better with longer treatment. Thanks.


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## texasred (Jan 29, 2012)

June had a chronic ear infection and we tried for months to clear it up. She didn’t have the head tilt, but she was miserable. My vet referred her to a dermatologist. The dermatologist said that unless you remove (and test) the fluid behind the eardrum, you will never be able to clear up the infection. We scheduled myringotomy surgery, and she felt better immediately after surgery.

I would not put off this type of surgery, if left too long the infection will spread to the bone. Once that happens, it is very hard to clear up the infection.
My advice is get a referral to a good dermatologist, sooner than later.


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## rubicon (Dec 9, 2019)

texasred said:


> June had a chronic ear infection and we tried for months to clear it up. She didn’t have the head tilt, but she was miserable. My vet referred her to a dermatologist. The dermatologist said that unless you remove (and test) the fluid behind the eardrum, you will never be able to clear up the infection. We scheduled myringotomy surgery, and she felt better immediately after surgery.
> 
> I would not put off this type of surgery, if left too long the infection will spread to the bone. Once that happens, it is very hard to clear up the infection.
> My advice is get a referral to a good dermatologist, sooner than later.


His infection is confirmed cleared as of today and none of his problems have gone away unfortunately. We are beginning to suspect some neurological issue like vestibular disease and his right front paw has seemingly lost sensation! I’m still hoping that the infection has sufficiently damaged his middle ear that it needs time to recover but at this point it seems unlikely. 

We have an appointment with a neurologist and TBH the weekend has been completely miserable. He’s just not himself anymore, and he’s only 2 years old. His quality of life is just nonexistent.


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## Gabica (Jan 20, 2018)

Sending ESP for you guys, hopefully you can get the right specialist and good recovery. He is very young, and they often bounce back easily at this age. I remember Erdos was just a puppy yesterday.


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## texasred (Jan 29, 2012)

I’m glad he’s going to a neurologist. I’m would also look for a good Internal medicine vet.
As sometimes it takes a team to find the real cause. I hate the word idiopathic, as I always want to know the reason why.
Two years ago Shine was perfectly fine. I went to a Thanksgiving dinner, and came home to a dog that could not walk. She was in so much pain, she would cry if you moved her . The first ER vet misdiagnosed her. Thankfully I ran her up to A&M a few hours later. Their ortho department ran multiple tests, She was diagnosed with IMPA. (immune mediated polyarthritis )They transferred her to internal medicine, because they didn’t know at the time if the IMPA had a secondary cause. The normal treatment for IMPA is steroids, But if there was a secondary cause steroids can make everything worse. While all of this was going on, she had to be on strong IV pain medication. She could only be off the IV for 15 minutes or she would start to be in pain. As a precaution they started her on doxycycline, just in case it was Tickborne. All in-house tick-borne tests were negative, and it was going to take at least five days to get the results back on a more extensive tick bourne test. With her being on doxycycline, she started to improve within a couple of days. She got to come home after 4 days. When the results finally came in she had Bartonella. A tickborne disease we don’t normally see, and I had never found a tick on her.

although I can say it now, I couldn’t say it out loud at the time. With as much pain as she was in, I was very scared we were going to lose her.
So don’t give up to quickly. Sometimes these dogs can really bounce back.

Prayers you find the answers to help him.


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## Dan_A (Jan 19, 2021)

texasred said:


> When the results finally came in she had Bartonella. A tickborne disease we don’t normally see, and I had never found a tick on her.


There's apparently many vectors for this disease. Unfortunately there is much we don't understand about it other than Bartonella is all over the place. Most people and animals can clear the infection with their immune response; however, some have a hard time with it and it results in scary symptoms.

Dated, but a great article on it https://www.northcarolinahealthnews...everywhere-so-why-dont-we-know-more-about-it/


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## texasred (Jan 29, 2012)

I was also given a list of things that can transmit the disease, and even told it can be from unknown vectors. There was also a study that showed Bartonella in some cancer tumors. Even though it did not show up in the dogs blood work. They didn’t know which came first, the Bartonella or the cancer, and did it play a role in the dog developing cancer.
I like clear facts, but it some cases that’s not what you get. Shine kept being retested, until it showed she had cleared (at least in her bloodwork ) the disease. Also had her retested a year later. That also still showed negative.
Shine has never been around cats, and she stays on a preventative. Plus I routinely use sprays on her, before she’s in the field. I’m sure I will never know if it was a flea, tick, or even a fly.


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## rubicon (Dec 9, 2019)

So as an update, he went to a neurologist and got a CT scan and a spinal tap. cost us a pretty penny. My husband called me about the price and I was like “I don’t even want to know. Just pay it.”

his ear infection was indeed cleared so the problem is INCIDENTALto the infection. No relation at all. The scan showed no tumor and no stroke, which is lucky. His spinal tap revealed NO infection, but at this point all of the other diseases are ruled out save for “sterile meningitis”. The neurologist theorized it could just be some autoimmune thing.

Prognosis is good and he should regain full function in a month. but he will have to be on steroids for a long time to prevent a relapse. He is responding to treatment for what it’s worth. We’re not sure he can see with his right eye. Vet said it might come back but I’m just happy he’s better


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## texasred (Jan 29, 2012)

Big relief that he he was given a good prognosis.
Hang in there Erdos.
I know there is a Facebook group just for Vizslas with auto immune disorders. Maybe someone in that group has seen something like this before.


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## texasred (Jan 29, 2012)

Just checking on Erdos, and praying he’s improving.


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## einspänner (Sep 8, 2012)

Just seeing this now and hoping Erdos continues to improve. It's so scary when they aren't well.


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## rubicon (Dec 9, 2019)

texasred said:


> Just checking on Erdos, and praying he’s improving.


Thanks for thinking of Erdos! He is improving and his mood is getting WAY better. Still the head tilt though. Vet has forbade any swims, or long hikes, or anything fun for a month unfortunately. The steroids made him immunocompromised. I hope the tilt goes way eventually but the neurologist warned us that some damage might be permanent. Still. As long as he’s happy and mostly himself, I’ll take it ☺


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## Dan_A (Jan 19, 2021)

I find it interesting that they think the head tilt , which indicates a vestibular dysfunction within the inner ear, was "incidental" to the ear infection seeming to discount it as inconsequential. I would say that a serious ear infection is the most probably culprit for the current head tilt manifestation. You had mentioned the infection was cleared up. Did they take a culture sample from the inner ear usually done by a small needle perferation through the eardrum to verify no pathogenic or inflammatory causes? It is also quite possible that the prior ear infection , even if cleared up, may have caused lingering inner-ear damage.


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## anna wright (Dec 12, 2021)

rubicon said:


> Thanks for thinking of Erdos! He is improving and his mood is getting WAY better. Still the head tilt though. Vet has forbade any swims, or long hikes, or anything fun for a month unfortunately. The steroids made him immunocompromised. I hope the tilt goes way eventually but the neurologist warned us that some damage might be permanent. Still. As long as he’s happy and mostly himself, I’ll take it ☺


I sincerely belive you need a second opinion, and if I would have Erdos, I would take him to a differrent veterinarian - today. The steriods reduce inflamation; that might put him in better mood but the steroids also will allow free and fast spread of infection. I completely agree with Dan_A; the persistent tilt is a red-flag for the ears.


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