Most of the time, I trust my clients when they tell me it is time to say goodbye. After all, pet owners are the ones most familiar with their companion’s attitude and quality of life at home. And quality of life includes much more than the metrics I check on physical exam and diagnostics – things like what your pet loves to do, and how they interact with you and the other members of the household. A Border Collie who lives for playing ball will have a more significant decline in quality of life when they develop arthritis than a Boston Terrier who lives for snuggling on the couch. Even if those dogs look similar on physical exam and bloodwork, I factor in the input and assessment of the owners when we are considering euthanasia.
However, there is one situation that often deceives dog owners. It is a strange condition that we do not understand – I can’t predict when or whether it will occur, but it happens often enough and is consistent enough that I can usually diagnose it before even seeing the pet. This is Old Dog Vestibular Syndrome, also known as Idiopathic Vestibular Syndrome. As the name says, it happens in senior dogs. It is acute onset, and can be severe. These dogs have vertigo – their head tilts to one side, their eyes swing back and forth rapidly, and they have difficulty walking or walk in circles. If very severe, some patients roll on the floor until they hit an obstacle. They may vomit, and most don’t eat, either from nausea or due to difficulty accurately picking up food. Their world spins, and their people fear the worst.
Most often vestibular syndrome is described by owners as a stroke. Often the dog was already showing signs of advancing age, and the sudden appearance of vestibular syndrome results in their owner calling to schedule a euthanasia appointment. This is one of the rare instances where I will question that decision, because these dogs get better. They get better within days, usually go back to being normal, and do it without treatment. We give them supportive care such as anti-nausea medications for their sea-sickness, and otherwise just keep them safe from falls until they recover. Usually this discussion is met with relief, although I have had an owner who didn’t believe me, until the next day when her dog was back on his feet and started eating again. The only thing better than being able to tell dog owners that we don’t have to say goodbye today, would be if I could spare them the panic and heartbreak they experience before they get to the appointment.
– Dr Ema Thigpin