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Signs of neurologic dysfunction in dogs with central versus peripheral vestibular disease

Mark T. TroxelDepartment of Clinical Studies, Matthew J. Ryan Veterinary Hospital of the University of Pennsylvania, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104.
Present address is Massachusetts Veterinary Referral Hospital, 21 Cabot Rd, Woburn, MA 01801.

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 DVM, DACVIM
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Kenneth J. DrobatzDepartment of Clinical Studies, Matthew J. Ryan Veterinary Hospital of the University of Pennsylvania, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104.

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 DVM, MSCE, DACVIM, DACVECC
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Charles H. ViteDepartment of Clinical Studies, Matthew J. Ryan Veterinary Hospital of the University of Pennsylvania, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104.

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 DVM, PhD, DACVIM

Abstract

Objective—To determine the frequency of specific signs of neurologic dysfunction in dogs with central vestibular disease (CVD) or peripheral vestibular disease (PVD) and whether the degree of head tilt, rate of nystagmus, and number of beats of postrotatory nystagmus can be used to help distinguish CVD from PVD.

Design—Prospective clinical study.

Animals—40 client-owned dogs with vestibular system dysfunction.

Procedure—A standard neurologic examination was performed, along with an expanded vestibular system examination that assessed the degree of head tilt, rate of nystagmus, and number of beats of postrotatory nystagmus.

Results—Dogs with CVD were significantly more likely to be nonambulatory than were dogs with PVD. Dogs with PVD were significantly more likely to veer or lean in 1 direction and to have resting nystagmus than were dogs with CVD. Median rate of resting nystagmus was significantly higher for dogs with PVD, but no significant differences between groups were detected in regard to presence or degree of head tilt, presence of positional ventral strabismus, and number of beats of postrotatory nystagmus.

Conclusions and Clinical Relevance—Results suggest that nonambulatory tetraparesis is significantly more common in dogs with CVD and veering and leaning are significantly more common in dogs with PVD. Although neither the degree of head tilt nor the number of beats of postrotatory nystagmus could be used to distinguish CVD from PVD, rate of resting nystagmus may be useful in distinguishing the 2 conditions. (J Am Vet Med Assoc 2005;227: 570–574)

Abstract

Objective—To determine the frequency of specific signs of neurologic dysfunction in dogs with central vestibular disease (CVD) or peripheral vestibular disease (PVD) and whether the degree of head tilt, rate of nystagmus, and number of beats of postrotatory nystagmus can be used to help distinguish CVD from PVD.

Design—Prospective clinical study.

Animals—40 client-owned dogs with vestibular system dysfunction.

Procedure—A standard neurologic examination was performed, along with an expanded vestibular system examination that assessed the degree of head tilt, rate of nystagmus, and number of beats of postrotatory nystagmus.

Results—Dogs with CVD were significantly more likely to be nonambulatory than were dogs with PVD. Dogs with PVD were significantly more likely to veer or lean in 1 direction and to have resting nystagmus than were dogs with CVD. Median rate of resting nystagmus was significantly higher for dogs with PVD, but no significant differences between groups were detected in regard to presence or degree of head tilt, presence of positional ventral strabismus, and number of beats of postrotatory nystagmus.

Conclusions and Clinical Relevance—Results suggest that nonambulatory tetraparesis is significantly more common in dogs with CVD and veering and leaning are significantly more common in dogs with PVD. Although neither the degree of head tilt nor the number of beats of postrotatory nystagmus could be used to distinguish CVD from PVD, rate of resting nystagmus may be useful in distinguishing the 2 conditions. (J Am Vet Med Assoc 2005;227: 570–574)