Its been a week, she hasnt really improved at all, and perhaps slightly progressed more. Another disturbing sensation that is more vaguely described by patients with terms such as dizziness and spacey-ness is also heightened by head movement and persists in as many as 60% of all patients. I think it would be a great idea to contact the neurologist in Honolulu and see if telemedicine is an option! WebMyopathy is a muscular disorder and should not be confused with myelopathy, which has to do with nerve damage inside the spinal cord. Accurate diagnosis and appropriate plans of management can be achieved with careful history taking and clinical examination. Usually, the brain can adapt to the altered signals resulting from labyrinthitis or neuritis in a process known as compensation. But not offered any other supportive therapy or testing?? We work with organisations big and small Vestibular function tests-including rotating chair test and videonystagmography. I did no tests he new right away. My doctor recommended Trazodone. Now my 9 yr old lab is having same issues the first episode 2 weeks ago lasted a couple of hours had a couple of more short episodes took her in the vet she didnt really care to hear what I thought was going on after a 400.00 visit labs/stomach xray she said she didnt think it was vestibular problems and sent me home with no answers no treatment prior to the problems she has been having pretty bad allergies her ear was bothering shaking her head drooping one ear her eyes had gunk nose was dripping I explained this and she still didnt really care to listen she said her ears looked clear even though they really couldnt see the middle ear. The SLUMS Exam is a clinician administered examination used to identify persons who have dementia or Mild Neurocognitive Impairment. I will attach links to other articles about how to know when its time to say goodbye. Nausea, anxiety, and a general ill feeling are common due to the distorted balance signals that the brain receives from the inner ear system. No, trip to Honolulu with her would not be feasible, but if the neurologist would do telemedicine, Id be all in! No matter what the cause, I think physical therapy/rehabilitation could be a great addition to what you are already doing at home. Yesterday she was coming out of several days of coughing/sleeping/resting/low activity/off her feed and last night the head tilting, nystagmus, falling, weakness, no appetite, little urine output (carrying her outside she squats a bit, carry her back inside). Many people with chronic neuritis or labyrinthitis have difficulty describing their symptoms, and often become frustrated because although they may look healthy, they dont feel well. 1. You may want to seek out the help of a vet that specializes in rehabilitation. Dear Melissa, Histopathology case of the month: Aminoglycoside ototoxicity. Otology and Neurotology, 22:266268, 2001. Shell fall right back down if we lift her. It would be a good idea to keep in touch with your vet during this healing process and update them on any concerns, symptoms, and progress. Support for the use of exercises to improve physical function in patients with bilateral vestibulopathy was based originally on the result of studies of nonhuman primates (Igarashi et al).19 Evidence now exists in people with BVH that supports the use of specific exercises (adaptation, substitution, balance and gait) to decrease subjective complaints, improve visual acuity during head movement, and improve postural stability during functional activities. It is never a bad idea to get a second opinion or seek the advice of a veterinary neurologist. I am glad you had her evaluated by your vet and they were able to start treatment with steroids. Current and future management of bilateral loss of vestibular sensation an update on the Johns Hopkins Multichannel Vestibular Prosthesis Project. He just goes in and out the garden as Ive tried just to do a very small walk but hes panting alot. The more you practice balance the better it becomes making you more stable. My question is am I doing too much by trying to have him walk a little once a day? . Your dog may still be on medication when you begin, which is perfectly fine, as long as there is definite improvement and the condition is beginning to resolve. Joel. Keep the updates coming! Well, after prayerful consideration, and a dream seeing her running on the other side of the fence, and seeing that shes needing to run again, I believe its time to let her go. But I am slightly suspicious that what you are describing could be seizure activity. Some of the tests that may be used to determine how much hearing or balance function have been lost involve the vestibular autorotation test (VAT), vestibulo-ocular reflex testing equipment (VORTEQ), electronystagmography (ENG), computerized dynamic posturography (CDP), rotary chair (SHAT), head-shaking, electrocochleography (EcoG), auditory brainstem response (ABR), otoacoustic emissions, pure tone audiometry, speech discrimination, and most other tests often used to identify and quantify inner ear problems. I have no doubt he knew how much he was loved and pray his memory will continue to be a blessing to you and your family. I made a sling out of a cloth grocery bag by cutting the sides out. In those patients, the recovery is often slower and incomplete. Its quite likely that your dogs vestibular system responsible for helping maintain balance is not working properly. As far as the Meclizine dosing goes, I am going to refer you back to your vet as I have made it a policy not to give out dosing information on the internet. Thank you again for helping us all. Laryngoscope.1987;97:582. I then proceeded to give her a gentle full body massage for a few minutes. Typically treatment would involve a combination of advice on activity modification and manual treatments to help reset and retrain your vestibular system. For the majority of cases one or two sessions can significantly reduce symptoms or eliminate them altogether. Comment * document.getElementById("comment").setAttribute( "id", "ab4d4a4f377df0238f9905b2b58b1887" );document.getElementById("d52460ca5d").setAttribute( "id", "comment" ); document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); NEW! This is such a scary experience but we do what needs to be done for our fur babies. promptly change bedding if it becomes soiled with urine or feces. Is there anything like this in puppies I have a five month old great Dane Shepherd ive talked to her vet and he told me they were partial seizures and very common in puppies well Ive looked into and read almost everything I can find about partial seizures and a lot of other things and nothing fits quite right with how shes acting I just stumbled upon this and its word for word exactly how I would explain her behavior. When one side is infected, it sends faulty signals. Chinese herbal therapy can also assist with this vestibular disease. Nevada Brief Cognitive Assessment Instrument (NBCAI) & SLUMS. Yearly ophthalmological examinations that include a glaucoma check should become routine. What is known is that when permanent and extensive ototoxicity occurs, the effects can take a terrible toll on a persons ability to function. [11] Other common symptoms include tinnitus, ear ache, and a feeling of fullness in the ear.[12][13]. Otolaryngo Head Neck Surg.2003;128:240. I was told by my vet to put him down today but I am not about to do this. However, we are now May and now her sister developed it. Hi Sherri, These could soak up some urine too (although they may or may not be able to hold the full volume in her bladder). My dog who is 16 1/2 yrs old, she just got diagnosed with Vestibular Disease. [more], NEED HELP? A small room, a crate, or a section of a room partitioned off with stacked pillows or cushions will work. I do think you may be onto something with the car rides acting as a possible trigger. More typically, however, their balance problems become obvious only when they are standing or walking. 1. Patients with bilateral vestibular problems can be expected to return to many activities but will continue to have problems in certain areas. She was an active dog prior to this with walking 3-4 miles a day and having fun with her one year old sister so she is missing these things in her life. Decreased sensation; or b. Sensory nerve deficit (abnormal sensory nerve latency) on electrodiagnostic testing; or. Providers typically do this surgery only after youve lost hearing in your affected ear. Hi Jennifer, Hi Lana, I hope you can find a way to restore your senior pups quality of life and allow her to live her life to the fullest. This way you can make sure that the vet doesnt think it is a short partial seizure, brief episode of pain, or other problem. Boettcher FA and Salvi RJ Salicylate ototoxicity: review and synthesis. American Journal of Otolaryngology, 12:3347, 1991. Ototoxicity: Oto = ear; toxicity = poisoning Ototoxicity is, quite simply, ear poisoning (oto = ear, toxicity = poisoning), which results from exposure to drugs or chemicals that damage the inner ear. Herdman SJ, Blatt PJ, Schubert MC, Tusa RJ. Water therapy can confuse the sensory system and provide too much motion, making it difficult for the dog to control its movement, or can lead to dizziness, nausea, and vomiting. Sorry to hear that your sweet GSD has a potential middle ear infection and is having so much trouble getting up on her own. In the balance. Dateline, NBC-TV, June 19, 2000. In conclusion, A) do you think I am overthinking it and B) have you seen more that two bouts of vestibular disease in dogs? Tracy. Thank you for sharing your experience with us. This evidence includes at least one of the following criteria: The entire October 1993 issue of The Otolaryngologic Clinics of North America is devoted to ototoxicity, as is the entire November 1999 issue of Annals of the New York Academy of Sciences. Text: (843) 781-6430. They were great, and trying also to pinpoint something. She also has episodes of panting. They are all symptoms that can result from a peripheral vestibular disorder (a dysfunction of the balance organs of the inner ear) or central vestibular disorder (a dysfunction of one or more parts of the central nervous system that help process balance and spatial information). In other cases, the symptoms are present upon awakening in the morning. The incidence of the various forms of BVH is also not clear, because it varies depending on the type of clinical practice examined. The treatment approach for patients with complete loss of vestibular function involves the combined use of gaze stabilization exercises and exercises that foster the substitution of visual and somatosensory information to improve postural stability and the development of compensatory strategies that can be used in situations where balance is stressed maximally. This is one reason it is almost impossible to say with confidence how many and which drugs cause ototoxicity and how many or which people are affected by it. I started taking him outside once a day to try to have him go potty and give him some exercise by leashing him and doing small walks with my guidance around the yard. Restoration of 3Dvestibular sensation in rhesus monkeys using a multichannel vestibular prosthesis. Alternatively, you could probably cut a hole for her tail in a pair of Depends (or other similar products made for incontinence in adults) and use that as a diaper for her. Vestibular rehabilitation is concerned with the treatment or a range of conditions that affect the inner ear and your sense of balance, dizziness and nausea. Its great that you are in expert hands! If this is an emergency, please dial 911, A Young Scientist's Journey after a Stroke, Care by the Numbers: Skilled Nursing versus Inpatient Rehabilitation, WSJ: Recognizing Aphasia and Seeking Treatment, Shirley Ryan AbilityLab Ranked No. Vertigo, dizziness, and difficulties with balance, vision, or hearing may result. The more I read here, the more it sounds still like vestibular syndrome, but the fact that its been 4 weeks with only progression and not improvement makes me wonder. Wishing you both the best. Even if he is dizzy, it will help retrain his muscles and nerves and make adjusting to this easier. Viral labyrinthitis may produce the same symptoms, along with tinnitus (ringing or noises in the ear) and/or hearing loss. Psychological Reports 111(3): 939-951. The presence of remaining vestibular function can be used as a guide in predicting the final level of recovery for patients.2,3,7 Patients with incomplete bilateral vestibular loss are often able to return to activities such as driving at night and to some sports. I hope that some of these suggestions are helpful and your pup is on the mend soon!. A clinical review of ototoxicity. Clinical Otolaryngology, 19:38, 1994. Most of the time, the symptoms slowly pass, allowing a person to return to normal activities. Be greatly appreciated. You are doing a wonderful job. Rybak LP. You will be given set tasks to do each day to achieve this. If both dogs had allergies and developed an internal/middle ear infection as a result of the allergies, they could both have vestibular signs, but that is an unlikely scenario. Referred for Social Services/Disability Adjudication: (Brown et al, 2012;n =49; mean age = 43 (11.35)). My point is, do you think a car ride would bring it on (i.e.. similar to humans and motion sickness which often results in vertigo)? I am glad to hear your girl is making steady improvements despite these trembling and panting episodes. I recommend you call your vet as soon as it is possible (Tuesday?). From what you are describing with the head tilt and falling over to one side, I would definitely localize this to be a central issue. They may be able to give her medications to help with the nausea and there are options to help treat the dizziness as well. I understand your concern for Bobo and these worrisome problems he is facing. It does concern me a bit that the symptoms are worsening instead of improving after 4 weeks. Falls in patients with vestibular deficits. The infection originates either in the middle ear or in the cerebrospinal fluid, as a result of bacterial meningitis. Strengthening exercises involve movements with or without resistance which aim to build up strength in the body. Hi, Many people find they must continue the exercises for years in order to maintain optimum inner ear function, while others can stop doing the exercises altogether without experiencing any further problems. I hope your girl will continue to heal and come home soon. At Physio.co.uk we can apply a range of therapy techniques and advice to manage your symptoms and maintain the best possible level of physical ability and independence. He cant walk just yet, so Im unsure how to help him go potty, even with a sling. WebNeurosurgeons may use this approach to reach certain tumors, such as meningiomas, acoustic neuromas (vestibular schwannomas), skull base tumors and metastatic brain tumors. Idiopathic vestibular disease is also called old dog or geriatric vestibular disease because it affects senior dogs. Gave me ear drops Synotic and dosed him up with Autoimmune injections, . Handbook of Sensory Physiology.Berlin: Springer; 1978:755. Do we need to have an MRI of her brain or does it take this long for her to get back to herself? Typically, these patients have been treated with the ototoxic medication because of a serious infection. The SLUMS may be better at detecting mild neurocognitive disorder compared to the MMSE. Do not try to pull the tail to either side, but merely straight back toward you. Physical therapy outcomes for persons with bilateral vestibular loss.Laryngoscope.2001;111:1812. This can be caused directly by a decreased activity level because of the patients fear of falling or because of the increased dizziness that occurs with movement. My 13 year old girl was diagnosed with Idiopathic Vestibular Disease a little over a month ago. The effect of glucocorticoids has been studied, but they have not been found to significantly affect long-term outcome.[26]. . He administered a half dose of Cortisone and Baytril. WebThe trochlear nerve (/ t r k l r /), (lit. I have a 14 year old lab. Vestibular rehabilitation: Useful but not universally so. Increased confidence, particularly in physical ability. Taking Your Dog to the Vet: 15 Tips for Success, 15 Tips to Stop Your Dog Slipping on the Floor, 10 Lifesaving Touches: Dr. Buzby's 5-Minute Tip-to-Tail Dog, A Veterinarian Answers Your TPLO Recovery FAQs. When these hairs are normally bent with sound vibrations or movement, they send electrical signals to the brain about hearing or balance function. In that case, the antibiotics wouldnt change the outcome of the disease. Arch Otolaryngol HeadNeck Surg. You can make a real difference bymaking a donation or becoming a professional member. The DOI No specific tests exist to diagnose vestibular neuritis or labyrinthitis. I waited for the main doctor avoiding the one that has been treating us. My 17 yr old jrt has been diagnosed with old dog vestibular disease. Contact information. During the acute stage, they may feel off balance even when lying or sitting down. We practice exercises to get her to bend her neck to the left, and we take an ever lengthening daily walk. To arrange an appointment please email office@physio.co.uk or call 0330 088 7800. With cochleotoxicity, hearing loss or the start or worsening of tinnitus (ringing in the ears) can occur through damage to the cochlea (the hearing apparatus) or the cochlear branch of the vestibulo-cochlear nerve. The Activity Measure for Post Acute Care (AM-PAC) is an activity limitations instrument which is defined as difficulty in the execution of a task or action by an individual. Herdman SJ, Hall, et al. However, if you feel like you would like to do a thyroid panel or other testing sooner rather than later, it is not wrong to request that testing from your vet now or seek a second opinion for another vet or vet specialist. Hi Yvette, Studies have shown that the worst disability is in part dependent on the number of comorbidities the patient has as well as greater initial intensity of disequilibrium, lower balance confidence, and poor fall risk scores. In 2021, your cash gifts may also favorably impact your taxes, thanks to the extension of many of the charitable provisions in the Coronavirus Aid, Relief and Economic Security (CARES) Act. That way I could place it under her and hold the hand loops to help her walk when she was ready. My concern at this point is that even though she has greatly improved head tilt is gone, doesnt fall like she had been, her hind end is still rather weak. Authors: Charlotte L. Shupert, PhD with contributions from Bridget Kulick, PT and the Vestibular Disorders Association. Is it possible for the symptoms to only last for a few minutes? In the meantime she was also diagnosed with Cushings and started the meds for that the same day vestibular returned. Severe oscillopsia will also impact postural stability because decreased visual acuity will affect the persons ability to use visual cues for stability.11. WebLabyrinthitis is inflammation of the labyrinth a maze of fluid-filled channels in the inner ear.Vestibular neuritis is inflammation of the vestibular nerve the nerve in the inner ear that sends messages related to motion and position to the brain. VeDA is a 501 (c)(3) tax-exempt non-profit organization (Tax ID 93-0914340). Effects on self-motion perception and postural control. Black FO, Gianna-Poulin C, Pesznecker SC. Specifically, exercises that may be prescribed include keeping eyes fixated on a specific target while moving the head, moving the head right to left at two targets at a significant distance apart, walking while keeping eyes fixated on a specific target, and walking while keeping eyes fixated on a specific target while also turning the head in different directions. I am beyond clueless as I am thinking it has to be environmental. Hi Laura, If you arent seeing the progress that would be expected, it might be a good idea to schedule a consult with a veterinary neurologist or an internal medicine specialist. Help a Vestibular Patient This #GivingTuesday. Following are some additional resources you might find helpful: Click here to download the Vestibular Neuritis and Labyrinthitis publication. Limit using drugs to those that are absolutely needed and follow the instructions carefully for those medications that are prescribed for you. I hope that your pup shows some improvement soon, and if not that you are able to get to the bottom of what is going on quickly and easily! Early-stage studies with this device demonstrates that the function of the inner ear balance system can be partially restored through electrostimulation of the vestibular nerve. At present there are no treatments that can reverse the damage. [9] The dizziness sensation that is associated with vertigo is thought to be from the inner ear labyrinth. I just ordered something to help me walk her and support her. Inner ear infections that cause vestibular neuritis or labyrinthitis are usually viral rather than bacterial. Good luck and best wishes as you navigate this new path together. Viral infections of the inner ear are more common than bacterial infections, but less is known about them. My 12 year old lab mix had her 1st attack of vestibular disease a few months ago and it scared me to death.She struggled to get on her feet and they kept slipping out from under her.Then she starts shaking all over.Shaking lasts maybe 5 or 6 minutes before it goes away.This really scares her so I sit with her and comfort her with massages on her chest and wait it out.She used to sleep in my bed but have since moved her to floor for safety sake.Vet never gave her meds to take.This is not going away like I read it is. Did x-rays of whole spine, and not higher than a VD cervical, but probably couldnt see much in skull x-ray (unless calcification? I also brought her up on the couch and let her lay in the direction of her head tilt against the cushions and hand fed her and held her water bowl for her. Whenever euthanasia is brought up as an option, it is never a bad idea to gather as much information and advice as possible. Feel free to leave an update if you have a chance. Decreased deep tendon reflexes. What a great honor and service this page is! She is also on a turmeric/curcumin chew. If the damage is severe, symptoms such as oscillopsia and problems with walking in the dark or with the eyes closed will not diminish with time. In ototoxicity, these hairs can be damaged to the point that they no longer stand up, thus reducing the auditory and/or balance signals sent to the brain. unstable, falling, head tilt, occasional vomiting, sleeping a lot, decreased appetite, walking in circles. Keep in touch and should you decide to switch teams to veterinary medicine Ill cheer you on the whole way! She got better and better & within three weeks, she was close to normal but then it happened again the beginning of August. My question is why so soon and is there anything I can do to help prevent recurring episodes? From what you are describing, it is possible your senior girl is dealing with vestibular disease. Water therapy is amazing for canine arthritis and taking pressure off joints, but when your dog has vestibular disease, it needs joint pressure and the sensation of bearing weight on the ground. Normally an antidepressant used for insomnia in humans. My tripod developed Vestibular in March and after about 2 weeks recovered at home. 3. Schubert MC, Herdman SJ, Tusa RJ. Praying your sweet boy makes a full recovery and his symptoms completely resolve. Vestibular neuritis and labyrinthitis are disorders resulting from an infection that inflames the inner ear or the nerves connecting the inner ear to the brain. You can make a real difference bymaking a donation or becoming a professional member. (which I can find over the counter) and he is so bad of course the right side he has total paralysis. Infection or inflammation must be under control and no longer in an active state when initiating therapy exercises. His vet has put him back on the original medication along with an antibiotic for a potential inner-ear infection. Patients with bilateral vestibular hypofunction are primarily concerned with their balance and gait problems. My vet has also prescribed vivitonin twice a day ? The loop diuretics include: Note: Hydrochlorothiazide (HCTZ) and Maxidediuretics commonly prescribed to people with Mnires disease or other forms of endolymphatic hydropsare not loop diuretics. WebSection 1. He purposely will then sprawl himself out telling me he doesnt want to go. While your dog is in a standing position, use your fingers to tickle the belly. I am suspicious that your dog may be showing signs of dementia/cognitive dysfunction that may or may not be associated with her neurologic episodes. Hi Joel, The mechanisms used to stabilize gaze in the absence of vestibular inputs have been well studied. WebDiplopiaseeing doubleis a symptom with many potential causes, both neurological and ophthalmological. Privacy Policy | Return Policy | Shipping Terms She is a 13 year old heeler. Wondering if any other dogs get similar episodes with this disorder? Your vet is correct that most dogs recover within a few days, but this is not always the case for every dog. It might be a good idea to schedule a consult with a veterinary neurologist. Hi Danielle, Vestibular neuritis is inflammation of the vestibular nerve the nerve in the inner ear that sends messages related to motion and position to the brain. Frustrated. Praying your sweet boy can get some relief and will have a positive outcome. WebNerve trauma Nose and Sinus. Ive increased her insulin accordingly and shes down to blood glucose readings of generally less than 250. Physicians and audiologists will review test results to determine whether permanent damage to hearing has occurred and whether hearing aids may be useful. Should I ask for a refill or ask about getting prescribed a different medication? Also today is the last day of the meds the vet prescribed. 2) You could consider trying a Help Em Up Harness. Protecting proprioception involves taking precautions such as avoiding walking barefooted on any surface that could injure or damage the soles (such as on a macadam road surface), not wearing clothing that restricts circulation to the legs and feet (such as a tight girdle), and taking off excess body weight that can cause knee and hip difficulties. Thus, patients who are bedridden, such as those who develop BVH after receiving a vestibulo-toxic medication such as gentamicin, often do not know they have a balance problem until they get out of bed. Now that you understand more about the causes of vestibular disease in dogs, lets talk about how you know for sure if your dog has vestibular disease. Hate to see him dizzy, but as labs do, his tail is still wagging. Dai C, Fridman GY, Davidovics NS. . Enter your zip code . They curl together to sleep, they are rarely separated and she was so worried when he became ill. Today she was visibly upset when the vet was examining him. It may be the right time to schedule a consult with a veterinary dermatologist. Gentamicin-induced ototoxicity complicating treatment of chronic osteomyelitis. Very disheartening. Feel free to leave an update as you navigate this tough path. We took her to the vet hospital and she was diagnosed with vestibular disease. Thank you for your suggestions! If symptoms of dizziness or imbalance are chronic and persist for several months, vestibular rehabilitation exercises (a form of physical therapy) may be suggested in order to evaluate and retrain the brains ability to adjust to the vestibular imbalance. Rybak LP. This has been demonstrated in patients with unilateral vestibular loss but not in patients with BVL.14,15. I made a mobile doggie gurney to help us get in and out of the house to go potty. (2012). I can see how the addition of a powerful anti-inflammatory like prednisone might help with vestibular disease or other potential causes of these neurologic symptoms. The balance function involves the vestibular organs. We want this girl comfortable, safe, not alone.not sure when is the time to put her down. Its been seven days now and he is making such progress. Start with two to three minutes of standing and progress to five. It increases dramatically when the person is moving. Some of these drugs are more likely to cause hearing loss; others are more likely to cause vestibular loss. Thankfully, it is associated with a good prognosis because it responds well to treatment (including TLC and tincture of time) and often resolves completely within a few days or weeks. Rosaria AM, Casano MS, Johnson DF, Bykhovskaya Y, Torricelli F, Bigozzi M, Fiischel-Ghodsian N. Inherited susceptibility to aminoglycoside ototoxicity: genetic heterogeneity and clinical implications. American Journal of Otolaryngology, 20:151156, 1999. Stay up-to-date with the latest vestibular news. Since I havent examined her myself, it is hard to make specific conclusions and recommendations. Thank you! Learn more. Key Descriptions. Poor physical condition can be a significant problem for patients with BVL. Not nearly as bad and not as scary. These include: Two areas can be damaged or destroyed through ototoxicity: the hair cells within the inner ear, and the vestibulo-cochlear nerve that links the inner ear to the brain. Im waiting for my acupuncture vet to recommend a formula, but I know Bu Yang Huan Wu can help with the disease. I pray your sweet girl can hold on a bit longer. But now when she sees it she has severe anxiety and wont let me help her on it. Typically many dogs with vestibular syndrome tend to make pretty significant improvements after about 72 hours or so, but that can definitely vary a bit depending on the dog. Odkvist LM, Moller C, Thuomas KA. What you thought would be a typical day soon fades into a worrisome and mysterious nightmare as your dog weaves and wobbles while navigating to the dog food dish, bumps into walls, and stumbles and falls just walking across the room all while holding its head with a puzzling tilt while the eyes dart side to side. named Lili who has always been so active and loves her walks. Potentially, an increase in gain may also occur with the use of vestibular adaptation exercises. [6] It can occur as a single attack, a series of attacks, or a persistent condition that diminishes over three to six weeks. I have elevated his water bowl and feeding bowl as this has helped. She seems almost scared to go out for a walk now, so we havent for couple of weeks, and the car did seem to make it worse, along with exertion. The amount of weight placed on the dog should be light in comparison to their body size.

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