Question Details
Walking Backwards In A Dog
by LJH - August 31, 2017    View Case Report
Hi Steve,
I've seen a 6yr M(N) Lab x Pitbull who has been having neurologic issues for several months starting this spring.In January/17 seemed "sad", less energetic, soft wheezing, putting on weight. Hx of allergic dermatitis controlled with Vanectyl P, showing papules and a few collarettes and hyperpigmentation ventrally , mild or no pruritis, with alopecia ventral chest and abdomen, medial and caudal thighs and dorsal tail, dry skin and hair. Omega 3 supplement seemed to help dryness but hair did not regrow. T4 was slightly low at the time but later testing showed nomal T4 but elevated Alk. Phos ( 1399) and markedly lipemic serum. Neurologic issue started a couple of weeks later with dog veering to the left when he walked, followed by a slight head tilt to the left and left sided facial paralysis, drooping lip, lower eyelid and ear. No nystagmus or strabismus. Then began walking backwards leaning to the left down stairs and in the hallway. Has a history of waxy ears and otits externa and when seen by rDVM had erythema and exudate ( R ear >L ) and was unable to assess if tympanic membrane was intact. DDX otitis media/interna, other neurologic issue/neoplasia, trauma, hypothyroid. Negative for tick born dz.Treated with Baytril systemic and otic. There had been no scratching at the ears or head shaking. Dog has had a few episodes of coughing through summer, esp. when excited, often ending in a gagging retch. Heat intolerant. Good appetite and no apparent difficulty eating. Not a thirsty dog. Has had 4 rounds of antibiotics and ear cleaning/ ointments etc.About a month ago the dog's neurologic signs changed over to the Right side. When I saw him he had a mild head tilt to the right, right side facial paralysis with drooping lip, lower eyelid and ear. Normal pupillary,menace and palpebral reflexes. Vision appears normal. No deafness apparent.Ears clean and not reddened. tympanic membranes appear intact though maybe a bit cloudy. Mild bilateral mucoid ocular discharge. Dog continues to walk backwards down the hallway. Similar flooring through most of the house and he will walk forward elsewhere most of the time. When I saw him at home he would also occasionally tip to the right side/ stumble esp. when he turned. Normal knuckling responses all 4 feet. Feet and ears cool to the touch. Owner says he dreams a lot and snores a lot. Some flatulence and eructation, better with change to fish from chicken.Very nervous of loud noises. No seizures. Tongue was pale pink, wet and a bit flabby. Pulse was very variable in strength, sometimes very weak , but most often deep, a bit thin and wiry. Improved with massage of GB-20,34 and BL-40. He was a bit sensitive on palpation of GB-20, 21, Bl-10, 11 and GV-14 and a bit resistant to fully extend his neck and flex laterally R>L.Neck muscles not spasmed but tight. Periferal vestibular issues with facial nerve paralysis I see Blood deficiency, Damp/ Damp Heat and probably Shao Yang imbalance. Doesn't have the pulse for CHJLGMLT so wondered about XCHT ( too upward dispersing?) with BXBZTMT or a blood tonifier. like DGSYS with the hypothyroid concern, or BGT with the tight neck muscles and hairloss. Maybe even SMS +/- Dang gui with the history of otitis externa/ media/ interna ? and the elevated Alk Phos. Prolonged Damp Heat having damaged blood, though again no slippery pulse. Have suggested chiro assessment, xrays to try and assess bulla repeat bloodwork. Owners can't afford referral to a neurologist and MRI. I'm sorry for the very lengthy post but would appreciate any thoughts you might have about this dog. Many thanks again for your input.
Replies
by naturevet
September 5, 2017
Hi Llewanda,

I agree that Xiao Chai Hu Tang seems the way to go, along with probably some chiropractic to the neck. It wouldn't surprise me if there are substantial fixations, including in the atlanto-occipital joint.

You can modify the XCHT by adding 12g Gui Zhi and 15g Bai Shao, to give it more of an influence on the neck and help relax the neck musculature. The walking backwards is probably just learned behaviour for certain areas of the house, because of prior aggravations walking forwards in that area. For example, dogs with the above chiropractic fixation will do much worse descending the stairs, perhaps to the point that they orient themselves as though going up the stairs, to lessen the tension on their neck.

The underlying Dampness will probably have to be handled later

Hope that helps!

Steve
Reply to this question.
You must be logged in to reply