Presenter – Pip Boydell CertVOphthal MRCVS, Co-founder and Senior Clinician (Neurology and ophthalmology) at Animal Medical Centre Referral Services (AMCRS)
Vestibular disease in human medicine is a massive topic with more than 126 textbooks dedicated to the condition available on Amazon. Yet on the veterinary side, according to Pip Boydell who led last week’s veterinary webinar covering vestibular disease in small animals, there are no veterinary books specifically covering this condition. With this in mind, a refresher on this relatively commonly encountered condition could only be of benefit and yet again, ‘The Webinar Vet’ stepped up and organised an informative and practical webinar.
Pip Boydell works at the Animal Medical Centre Referral Services and clearly has a passion for anything neurological and ophthalmological, making him an obvious choice to lead a talk on vestibular disease. Nystagmus is the stand out clinical sign associated with vestibular disease and is a natural reflex where the eye moves in response to the head moving (even with the eyes closed) and nystagmus which is present when the head is still in a normal position is considered abnormal.
Pip was really keen to stress that nystagmus can easily be missed if checking for the sign just by looking with the naked eye. He explained an ophthalmoscopic examination was always necessary when assessing a neurological or ophthamological condition as sometimes subtle movements associated with abnormal nystagmus can only be observed by looking at the back of the eye.
Vestibular disease is divided into two categories, peripheral and central disease and in the majority of cases a horizontal nystagmus is associated with peripheral disease and a vertical nystagmus is associated with central disease. Proprioceptor deficits are also associated with central disease and not seen with peripheral disease. Central vestibilar disease is generally associated with cerebellar and hindbrain disease and peripheral vestibular disease is seen in inner and middle ear disease.
Idiopathic vestibular disease in dogs is a condition we will have all encountered in practice and patients present with peripheral vestibular signs. Some vets refer to this condition with the word ‘stroke’ but this often paints a picture to the client which is worse than the reality of this condition. Pip explained these cases will more often than not get better after a few days by just giving supportive care such as anti emetics. Pip also advised in his experience these cases tend to be seasonal often seen in the months of August and September and the condition is thought to be viral in origin.
I have covered some of the take home messages from this veterinary webinar but Pip discusses the disease in greater depth in his own very entertaining style and even covers the effects of alcohol on the human vestibular system. So to make up from the lack of textbooks covering this topic in comparison to our medical friends I can recommend taking an hour of your time to log into ‘The Webinar Vet’ and watch this webinar.
The Stethoscope (MRCVS)