Trying to look through my dog's new eyes on the world.
July 21, 2010 5:22 PM Subscribe
My dog had a stroke. Her head is now tilted to one side and one of her eyes is sort of bulgy. I'm trying to understand what the world is like for her now. How does the world look after a stroke to the stroke victim?
She is only 5 years old and she recently had IMHA. After thousands of dollars of treatment, she has survived. It's been four weeks now. However the stickiness of her blood led to a blood clot in her brain which caused her to collapse to one side. Now her head is at a permanent tilt and she seems to favour one side when viewing something closely. She has lost her crazy Vizsla spark but she is otherwise mostly normal. Very lucky to be alive. I would just like to know how her world appears to her now. Why does she look at things with a tilted head and a favoring of one eye? Also is there anything that can be done to correct this? Thanks.
She is only 5 years old and she recently had IMHA. After thousands of dollars of treatment, she has survived. It's been four weeks now. However the stickiness of her blood led to a blood clot in her brain which caused her to collapse to one side. Now her head is at a permanent tilt and she seems to favour one side when viewing something closely. She has lost her crazy Vizsla spark but she is otherwise mostly normal. Very lucky to be alive. I would just like to know how her world appears to her now. Why does she look at things with a tilted head and a favoring of one eye? Also is there anything that can be done to correct this? Thanks.
i would second that. she also has a book.
posted by ambulance blues at 5:49 PM on July 21, 2010 [1 favorite]
posted by ambulance blues at 5:49 PM on July 21, 2010 [1 favorite]
With regards to the lost spark, my mother's dog was the same way after having a stroke, but after a few weeks she had adjusted to the situation and was much more like her old self and lived perfectly happily for several more years. And over the course of the next few months, the head tilt even grew much less pronounced as she adjusted to her new vision.
posted by Blue Jello Elf at 6:07 PM on July 21, 2010 [1 favorite]
posted by Blue Jello Elf at 6:07 PM on July 21, 2010 [1 favorite]
Consciousness of a dog, a healthy dog, is a vastly different experience than human consciousness.
I think it might be worth your while to investigate the healthy dog mind - that might help you understand the mind of a canine stroke victim.
A great book is Dog Body, Dog Mind.
posted by Flood at 6:12 PM on July 21, 2010 [1 favorite]
I think it might be worth your while to investigate the healthy dog mind - that might help you understand the mind of a canine stroke victim.
A great book is Dog Body, Dog Mind.
posted by Flood at 6:12 PM on July 21, 2010 [1 favorite]
Best answer: Although I don't know exactly where the clot disrupted her brain,* I can give you a general overview of what dogs with unilateral brain insults tend to do. Your dog looks at things with a tilted head and favors one eye (though in actuality she's favoring one field of vision and one set of eye muscles because one side of her brain--is damaged. She is using the more intact side to perceive the world, as whatever sensory information the damaged side is getting scrambled in processing or transit, if it's able to be processed at all. Her sense of balance has changed--the information traveling from her inner ear to her impaired brain is no longer being processed as efficiently. She probably feels dizzy/seasick some of the time, but especially if she's not vomiting repeatedly, it's not painful or extremely distressing...just a bit uncomfortable and different while she adapts.
Her motor control on the side contralateral (opposite) to the brain injury will be weaker-to-nonexistent, and because she cannot use the muscles as effectively, there will be asymmetrical atrophy, and this will reinforce her preference for her 'good' side.** She is probably on or slooowly being weaned off of pred, and the steroid will also be facilitating muscular atrophy. (However, IIR the last Emergency/Critical Care lecture I attended correctly, pred is still one of the gold standard treatments for IMHA, and the side effects of pred are far better than those of untreated IMHA.)
Her personality--like that of a human stroke survivor--may be altered, and she may not remember commands or she may have behavioral disinhibitions that she did not before--though the usual manifestations of irritability, increased food-stealing/pushiness, and changes in house-breaking are also affected by pred--which causes irritability, increased hunger and thirst, and increased urination--so you may not have a sense of what the permanent changes are for quite some time.
From what we know, your dog is probably occasionally anxious or confused when things that are familiar are experienced differently. She does not understand why, nor is she necessarily aware of what has changed, partly due to being a dog and partly because brain injuries change function and the ability to perceive that there is a lack of function. The comfort of being home and in a familiar environment will keep helping any anxiety, as will time and adjusting to her limitations. She probably still enjoys a good chew toy or bone. She probably can't judge stairs or navigate obstacles or changing terrain as easily, because she's getting different feedback from her limbs, vision, and inner ear about where she is in space. She will learn and improve. Her head tilt may or may not improve with time--but what you saw the first few weeks is probably the worst that will get, assuming she doesn't have another insult to her nervous system. In fact, if her neurological function worsens acutely, that's often a sign that something else is going on, other than or in addition to the initial injury.
One of the most amazing things to me about veterinary neurology is how much damage animals can 'walk away' from. (Or, hobble and teeter to one side away from, and still have very happy, comfortable lives.)
*knowing or understanding where the clot caused damage makes a difference in this explanation, because in its simplest form, one site entails a loss of one field of vision in both eyes, and the other would entail loss of vision in one eye. Of course there are all kinds of variations on this.
**some of this can be rehabilitated to varying extents--I am not a veterinary neurologist, nor a vet, and even then I haven't seen your particular animal, so I can't give you an idea of that. But it is not a DIY project. I'm not saying you necessarily need to go to a specialist in rehabilitation, but perhaps your regular veterinarian could make some recommendations. Walking in warm water/underwater treadmills (the latter is obviously specialty rehab equipment) can be helpful with balance issues.
posted by Uniformitarianism Now! at 6:34 PM on July 21, 2010 [11 favorites]
Her motor control on the side contralateral (opposite) to the brain injury will be weaker-to-nonexistent, and because she cannot use the muscles as effectively, there will be asymmetrical atrophy, and this will reinforce her preference for her 'good' side.** She is probably on or slooowly being weaned off of pred, and the steroid will also be facilitating muscular atrophy. (However, IIR the last Emergency/Critical Care lecture I attended correctly, pred is still one of the gold standard treatments for IMHA, and the side effects of pred are far better than those of untreated IMHA.)
Her personality--like that of a human stroke survivor--may be altered, and she may not remember commands or she may have behavioral disinhibitions that she did not before--though the usual manifestations of irritability, increased food-stealing/pushiness, and changes in house-breaking are also affected by pred--which causes irritability, increased hunger and thirst, and increased urination--so you may not have a sense of what the permanent changes are for quite some time.
From what we know, your dog is probably occasionally anxious or confused when things that are familiar are experienced differently. She does not understand why, nor is she necessarily aware of what has changed, partly due to being a dog and partly because brain injuries change function and the ability to perceive that there is a lack of function. The comfort of being home and in a familiar environment will keep helping any anxiety, as will time and adjusting to her limitations. She probably still enjoys a good chew toy or bone. She probably can't judge stairs or navigate obstacles or changing terrain as easily, because she's getting different feedback from her limbs, vision, and inner ear about where she is in space. She will learn and improve. Her head tilt may or may not improve with time--but what you saw the first few weeks is probably the worst that will get, assuming she doesn't have another insult to her nervous system. In fact, if her neurological function worsens acutely, that's often a sign that something else is going on, other than or in addition to the initial injury.
One of the most amazing things to me about veterinary neurology is how much damage animals can 'walk away' from. (Or, hobble and teeter to one side away from, and still have very happy, comfortable lives.)
*knowing or understanding where the clot caused damage makes a difference in this explanation, because in its simplest form, one site entails a loss of one field of vision in both eyes, and the other would entail loss of vision in one eye. Of course there are all kinds of variations on this.
**some of this can be rehabilitated to varying extents--I am not a veterinary neurologist, nor a vet, and even then I haven't seen your particular animal, so I can't give you an idea of that. But it is not a DIY project. I'm not saying you necessarily need to go to a specialist in rehabilitation, but perhaps your regular veterinarian could make some recommendations. Walking in warm water/underwater treadmills (the latter is obviously specialty rehab equipment) can be helpful with balance issues.
posted by Uniformitarianism Now! at 6:34 PM on July 21, 2010 [11 favorites]
Also, feel free to MeMail me if you're interested in academic resources or articles. I started a search for some reading on the subject of neurology and rehabilitation, but I realized it'd be kind of rude to link-dump a pile of JAVMA/JVIM articles in the thread if you won't be able to access them.
Cornell, North Carolina State, Minnesota-Twin Cities, and Penn have well-known veterinary neurology programs and research, and their websites--and probably especially Cornell, since the man who literally wrote the standard book on veterinary neuroanatomy and neurology is there--might have good resources for the lay person.
posted by Uniformitarianism Now! at 6:49 PM on July 21, 2010
Cornell, North Carolina State, Minnesota-Twin Cities, and Penn have well-known veterinary neurology programs and research, and their websites--and probably especially Cornell, since the man who literally wrote the standard book on veterinary neuroanatomy and neurology is there--might have good resources for the lay person.
posted by Uniformitarianism Now! at 6:49 PM on July 21, 2010
Our dog (a lab-husky cross) had a stroke a couple of months ago. She's 14 years old. Same symptoms: tilted head, could only walk in one direction, seemed to lose the ability to bark, had a goofy look on her face, was very unsteady on her feet. We did nothing to treat and by a couple of weeks later, she was 99% back to normal and has stayed that way.
Don't know how she perceives the world. She had quite a few standing-still-looking-like-she was-wondering-how-she-got-there spells. Went off her food completely. Drank a ton of water. The way she related to us did not change. She's back to her old tricks: she still thinks she can catch birds and squirrels; goes in and out the side door 4 times within 5 minutes, etc. Our vet said this recovery is not uncommon. In fact he predicted it the very first night we brought her in.
posted by feelinggood at 8:12 PM on July 21, 2010 [1 favorite]
Don't know how she perceives the world. She had quite a few standing-still-looking-like-she was-wondering-how-she-got-there spells. Went off her food completely. Drank a ton of water. The way she related to us did not change. She's back to her old tricks: she still thinks she can catch birds and squirrels; goes in and out the side door 4 times within 5 minutes, etc. Our vet said this recovery is not uncommon. In fact he predicted it the very first night we brought her in.
posted by feelinggood at 8:12 PM on July 21, 2010 [1 favorite]
feelinggood, was it a known vascular incident, or was it 'old dog vestibular'? What you're describing--especially with the rapid, near-complete recovery and age--sounds more like vestibular disease.
OP, I apologize--I forgot about the marvista site.
posted by Uniformitarianism Now! at 8:44 PM on July 21, 2010
OP, I apologize--I forgot about the marvista site.
posted by Uniformitarianism Now! at 8:44 PM on July 21, 2010
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posted by caek at 5:46 PM on July 21, 2010 [4 favorites]