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Vestibular signs and facial nerve palsy in dog

Posted by shadowfax1981 
Vestibular signs and facial nerve palsy in dog
January 14, 2016 03:46PM
Please help - sorry about the essay but im in turmoil and all the vets don't seem to have a clue.

My 8 year old neutered female Jack Russell, is otherwise very well. Tendency to be a little overweight even though I don't feed her titbits. Incidentally moulting like never before this winter and drinking lots more but having just started on a dry food instead of wet.
She weighs 5.6kg at the mo.

She was itching her ears and shaking her head a little bit so when she went into the vets for a dental excision I asked if they could clean her ears. They reported nothing in her ears apart from wax.
Tooth was removed and all was ok..

A week or so later one eye started watering (same side as itchy ear), then I noticed it couldn't blink, when she flinched (quite a flinchy dog) her inner eyelid would come up over the eye instead. Blood vessels in her eye were noticeably more inflamed than in the other. Then I noticed her stumbling a bit when she shook her ears and her head was tilting to that same side. Took her to the vets who checked her ears and found nothing. Prescribed a short course of prednisone and gave me some eye drops because she couldn't blink. The wobbliness went away after about 3 days. Her eye now shuts and she has no problems at all but her muscles have obv contracted on that side in her lip because her nose has pulled over to the affected side. This was the first time I realised that her lip/ nose was involved because she had no problem eating or drinking and hadn't drooled.

A few weeks went by and the same eye started watering again and so this time I took her to the vet straight away.. Thinking that maybe it would progress again to "wobbly" stage and trying to intercept. A longer course of prednisone was prescribed as well as a course of antibiotics and an X-ray of the ear was performed which was clear. I don't exactly know the time frame now but that eye, apart from watering and a few more blood vessels, has been ok now for maybe a month, closes and the tilt seemed to have lessened.
In the mean time she had an increase of itching in one ear in particular.. The same ear which had itched more in the beginning and the same side as the tilt. It got quite bad so I took her to the vets again. The vet looked in her ear and said there was a plug of wax in front of her ear drum and so she couldn't see if the drum was damaged but gave me some cleaning solution (no meds) and told me to clean her ears every day for a week and to stop immediately at onset of any neurological signs. I asked at that point about doing blood tests as no one had mentioned bloods. They were taken and came back clear. I asked about hypothyroid and the vet said definitely not as facial paralysis is not seen in hypothyroid. I had read differently but she insisted no need for a thyroid panel. T3 (I think was taken.. Or is it T4) as part of the bloods and was in "normal" range. Amylase was slightly low but otherwise all normal.
Ear itching improved a lot after cleaning.

Fast forward to last week.
Exactly the same happened in the same order to the opposite eye and side of face.
Watering noticed first, then paralysis of eye. Lip slightly droopy but eating fine. Took her to the vet who put her straight on prednisone and antibiotic. This time though She has been given two weeks worth at 2.5mg twice daily as opposed to 1mg twice daily as before. Not sure why as same symptoms as before??
I was booked to have my dog undergo a neurological exam yesterday but I cancelled it for the moment. I'm sure it's a very good idea and wonder why we haven't my done it sooner but she gets extremely stressed going to the vets.. Has done since the day she had her teeth removed and ears cleaned and I couldn't bare to do it to her again just yet.
I have seen 7 vets at the same practice now (not intentionally) and we are starting to go round in circles (excuse the pun!)

My questions really are..
1. Could an inner ear infection possibly affect the nerves on the other side of the face if left long enough?
2. Do you think the eye that was affected first would have improved like it has if it was caused by a tumour (as one vet thinks it is)? She has also put on weight as I've not walked her as much so I thought cancer was unlikely?
3. I'm at the point where I hope this is just an episode of vestibular sorts and that it will pass like the last time with hopefully not many lasting nerve problems but surely an inner ear infection is most likely?
4. Why would she now be prescribed more than double the dose of steroids for more than double the length of time if she has exactly the same symptoms as before just on the opposite side?
5. Would any bacteria be present in the outer ear if the problem is behind the eardrum? Ie is there any point in doing cytology on the wax?
6. How best do I get that wax out? Are some cleaners better than others? Surely that could be the cause of all of this.
7. Would a long course of antibiotics harm her if im wrong about inner ear infection?

THANK YOU!!!!
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