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A 4-year-old 6-kg (13.2-lb) spayed female Maltese was evaluated because of sudden-onset right-sided head tilt and right-sided facial muscle paralysis of 4 days’ duration. Lethargy was noted a few months prior, which prompted an evaluation by the dog's primary care veterinarian. Otitis externa was diagnosed via otoscopic evaluation and treated with topical administration of antimicrobials. A CBC and serum biochemical profile
On examination at the referral center, the dog was bright and alert. Physical examination findings were unremarkable. Otoscopic examination did not reveal any discharge from either