A Chihuahua Double-Header

A brief update on our two Chihuahuas, Jake and our recent arrival, Mickey. That’s Jake above, in his favorite bed in his favorite place, the kitchen.

You may recall that Jake had developed a nasal tumor a couple of years ago, and I had taken him to a veterinary radiation oncologist in Connecticut for two weeks of radiation therapy. At the time, the oncologist thought we might get an extra year at most after treatment. (The radiation is what turned his face white and left his nose skin a little dry and crusty.)

About every three months, we repeated CT scans of his head and nose, and each time there was no sign of the tumor coming back. A year had passed, and he was still good! In February I took Jake to see a new veterinary radiation oncologist at Angell Animal Hospital in Boston, and another CT scan there still showed no re-growth. Nor had it spread anywhere else in his body.

In June, I drove him down to Boston again for another scheduled scan. This time, the reviewing radiologist said that if anything, the remnants of the original tumor might have shrunk a little. Jake had now passed the two-year mark since his radiation treatment! To say the least, this is extremely rare and we are feeling so fortunate. The oncologist was so delighted with the latest results that she said we didn’t need to repeat the CT scan for another six months now.

As for Mickey, you can tell from that photo above that he has a bit of a head tilt. A couple of weeks ago, Mickey suddenly developed a pronounced head tilt, began having balance issues, and struggled to walk in a straight line. We were able to get him into our local primary care vet right away. After doing X-rays and running bloodwork, they could not find a ready explanation — there was no sign of a disc or cartilage issue. The vet thought it was in his brain, rather than in his spine, and recommended seeing a specialist.

So that afternoon, a Wednesday, after talking with the vet, I called our veterinary neurologist at BEVS in Burlington to book an appointment for a consultation and MRI. The soonest they had open was the following Monday, so we took it and held our breath.

Early the next morning I picked Mickey up from his bed in the living room to take him outside, and noticed his head tilt was even more severe and his body was now curled sideways. He was still able to walk, but barely.

I called BEVS, explained the situation, and asked if there was any way we could get Mickey in sooner. About 15 minutes later the neurologist nurse called and I explained to her what was going on. After briefing the neurologist, she called us back to say, “If you can get here by noon, the doctor can fit him in.” I looked at the clock … it was 9:30 a.m., and Burlington was 2.5 hours away. I told her we’d be on the way!

While I got Mickey squared away in the vehicle, Alayne got ready, and in just a few minutes she was barreling down the road headed for BEVS.

The good news is that the MRI showed no signs of a tumor or lesion, and a spinal tap analysis later came back negative, too. It turns out Mickey was suffering from idiopathic vestibular syndrome. Here’s the neurologist’s summary of the findings:

Mickey’s neurologic exam is consistent with a problem affecting his vestibular system. The vestibular system controls balance and equilibrium and orients the body in space (upside down vs. right side up etc). The system is divided into central and peripheral components. Central vestibular disease infers a disorder with the brain and peripheral vestibular disease indicates a disorder of the inner ear or its components.

Clinical signs common with vestibular disease include a head tilt, circling to one side, falling over/rolling, abnormal movement of the eyes (nystagmus), abnormal position of the eyes (strabismus), weakness of the body one side and vomiting. Depending on the cause of the disorder, the clinical signs can be extremely variable in terms of severity and number of clinical signs.

An MRI was performed of the brain for further evaluation. On preliminary review, no abnormalities were noted. We have submitted the study to our radiologist for further review as well as have submitted spinal fluid for analysis. The results of these tests are currently pending. We should have those results early next week and will contact you when obtained. In the meantime, these preliminary findings are most consistent with idiopathic (geriatric) vestibular disease.

Idiopathic vestibular disease is a commonly diagnosed condition of unknown cause in older dogs and in cats of any age. Symptoms are most common in dogs older than 10 years of age. Judging from the appearance of his brain on MRI, I do suspect his age is older than the estimated 8 years old. This condition typically comes on very suddenly with severe symptoms. Symptoms may worsen over the first 12-24 hours, but continued progression after 24 hours has not been reported. As discussed, the cause is unknown, and there is no medication that will improve the degree or speed of recovery. Treatment is aimed at minimizing nausea and stimulating appetite. Improvement is usually seen without treatment within 1-2 weeks. Recurrence is uncommon but may occur. Please also note that in some cases, there may be a residual (permanent) head tilt.

Within a couple of days, Mickey started to improve, and pretty soon he was back to his old self. Well, probably 80% of his old self. Yes, he still does have a head tilt, but nothing like we saw originally. (The tilt was so extreme that he couldn’t even eat on his own, and Alayne would have to hand him tiny balls of food that he could grab with his mouth.)

Honestly, we had suspected the worst — a tumor in his brain or spinal column — and so we were obviously very relieved at the actual diagnosis.

So both Chihuahuas are doing well!