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Facial paralysis
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Member Since:
26 May 2009
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2 June 2009 - 11:05 am
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My 12.5 year old castrated Belgian sheepdog was diagnosed with synovial cell sarcoma in his elbow. He had a left front leg amputation in early march, 2009 and has had 3 IV treatments with doxorubicine..  His 4th chemo treatment is due June 4, 2009. He has been doing very well. On June 1, 2009 he presented with facial paralysis on his left side. He now has an appointment with a neurologist on June 4.

Question: Is it possible that the facial paralysis is NOT due to a mass on his facial nerve? Could it be an inner ear infection, vestibular diesease or idiopathic? My general vet saw no evidence of an  infection of the external ear but confirmed the facial paralysis.. Will a CT scan give a definitive diagnosis?

Thank you so much,

Susan Spinhirne


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22 August 2008
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2 June 2009 - 4:35 pm
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 It is true that a mass could cause facial nerve paralysis, and a CT scan would be the best way to find it. I have also seen paralysis secondary to hypothyroidism.  Is the eye on that side sunken with an elevated third eyelid?  That is a condition called Horner's Syndrome which could be due to a tumor in the chest.

Most of these are actually ideopathic, which means no known cause and some will resolve in a few weeks/months.  You need to use artificial tears daily if the dog can't blink.

A neuro consult is a great idea!  Please tell us how it turns out.....

Pam

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2 June 2009 - 5:13 pm
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Hi Pam,
Thank you for responding so quickly. Beacon's eye is not sunken and the third eyelid is not visible. He has a very slight head tilt and his balance is poor. He walks with his head down now also. His chest rads were clear 2.5 weeks ago so I fear the worst, a mass somewhere.
Beacon has been taking soloxine 0.5mg twice a day for several years and the last time his thyroid levels were checked, they were normal. Maybe the doxorubicine has effected his thyroid? For two days after his chemo he does not eat so I don't give him the thyroid. I will ask to have his levels check again.
I will post after the neuro consult. I have agreed to a CT scan if necessary so I hope all this can be done on June 4th. I feel like I am watching my beautiful dog just slip away.
Thanks again,
Susan and Beacon

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6 June 2009 - 8:43 am
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tazziedog said:

 It is true that a mass could cause facial nerve paralysis, and a CT scan would be the best way to find it. I have also seen paralysis secondary to hypothyroidism.  Is the eye on that side sunken with an elevated third eyelid?  That is a condition called Horner's Syndrome which could be due to a tumor in the chest.


Most of these are actually ideopathic, which means no known cause and some will resolve in a few weeks/months.  You need to use artificial tears daily if the dog can't blink.


A neuro consult is a great idea!  Please tell us how it turns out…..


Pam


Hi,
My dog's CT was clear as were his chest rads. I decided not to do an MRI and spinal fluid exam because of the risks and because if he has a brain tumor, the treatment is hospitalization and radiation for 3 weeks. I don't think my 12 year will survive this. So time will tell if he has idiopathic vestibular disease and idiopathic facial paralysis, or a new or met brain tumor on the brain stem. My local vet who saw him Monday thought he looked better yesterday, Friday but today, Saturday he looks the same to me. The nystagmis is gone but his balance is poor. How long before I can decide that he is not going to improve and that he does in fact have a tumor on his brain stem? Also, we are awaiting the ear culture and will do a thryoid check once he is back taking his soloxine every day for 1 week. I am giving him artificial tears. I have a wonderful team of vets but it is great to have your input as well. Thank you so much,
Susan


Member Since:
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7 June 2009 - 4:19 pm
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If he had nystagmus and a head tilt then there is a good chance that he has idiopathic vestibular disease.  It can take dogs up to 2 weeks to recover from this, but they should have gradual improvement daily.  The drug meclizine may help with balance issues, but what they really need is supportive care and "tincture of time".

Pam

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8 June 2009 - 7:43 am
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I am hoping it is idiopathic and not a mass on the facial nerves and/or brain stem. Thank you for suggesting meclizine. He is currently taking maropitant but tomorrow is the last day he can be taking it. I don't see any improvement since yesterday and I noticed today some tongue involvement.

Thank you so much for your help,

Susan

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13 June 2009 - 3:43 pm
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Any ideas on treatments for Beacon's poor balancelance from vestibular disease and for his facial paralysis? We don't know if it is idiopathic or a mass. It is almost two weeks since onset and there is no improvement. It may even be worse.

Thanks so much,

Susan


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22 August 2008
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13 June 2009 - 11:04 pm
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If it has been 2 weeks then I am afraid that it is probably not idiopathic 🙁   Have you tried the meclizine?  It usually only helps in the acute phase but it can't hurt.  My only other suggestion is prednisone which I think that he is already on.  I am sorry to say that I would be most worried about a tumor somewhere.  If he is getting worse then you might have some hard decisions ahead.  I wish that I had better news for you.

If he is still eating and getting around okay despite the head tilt then I would give it more time.

Pam

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14 June 2009 - 7:10 am
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I talk to the oncologist tomorrow. She wanted him to take the Cerenia and to not give him pred. Maybe she is worried about his ability to fight the cancer. I will ask her again tomorrow. He only walks when he has to, like to potty or get a drink or change positions. He goes outside and just stands until I offer him a treat for walking a few steps. He is very wabbly, thank goodness for the Ruff Wear harness .. He is eating his treats. He licks me and wags his tail but is not his old self, a wild man at 12. I am guessing he is not in pain because he is eating. The oncologist is a 6 hour round trip or I would take him. I am afraid his next trip will be to euthanize him. They want to write him up because so little is known about his cancer-synovial cell sarcoma. It goes to the lungs but his seems to have gone into his beautiful head, his facial nerves.

Thank you for all your help.I guess there are no magic answers any more. This is so hard.

Susan

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15 June 2009 - 5:06 pm
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Hi Pam,

 Beacon is now taking pred. My question now is, because it suppresses the immune system, will it enable the cancer to progress faster? Beacon's attitude is already better with one 10mg dose. He is to have 2pills a day. He weighs about 53 pounds,

I am going to try getting by with just one pill as I am worried about the side effects.

Susan


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22 August 2008
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16 June 2009 - 6:18 am
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Pred can have some side effects but that should diminish as you lower the dose. We tend to start high and then taper down to a low maintenance dose.  It may decrease the immune system a bit but it also may help decrease any inflammation associated with tumors. I would follow your vet's dosage directions initially and then taper as directed according to how the dog is doing.

Pam and Tazzie

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