Peripheric Vestibular Syndrome Associated to Congenital Hydrocephaly and Occipital Dysplasia: A Clinical Case Report
World Small Animal Veterinary Association World Congress Proceedings, 2005
P.D. Hansel, MVZ, Interno Hospital Veterinario U.N.A.M.; S.P. Bernardo, MVZ, Residente Hospital Veterinario U.N.A.M.; L.D. Socorro, MVZ, Academico del area de Neurologia Hospital Veterinario U.N.A.M.
Veterinary Medical Teacher Hospital of the College of veterinary Medicine at the University of México; Ciudad Universitaria, circuito exterior s/n Coyoacan C.P 04510. Facultad de Medicina Veterinaria y zootecnia. Hospital Veterinario

A 3 months old female beagle arrives to the clinic for a clinical examination with a complete card of vaccination and deworming program. Walks abnormally since it was 1 ½ month old and falls off a side. In the history we found that the parents were brothers, The rest of the puppies had seizures, and all of them died. The signs that the puppies presented were not constant because they were presented just in stressful situations. At the physical examination, we found a clinically normal patient. At the neurological examination it presents vestibular ataxia, head tilted to the right, decreased proprioception and postural reactions in the right thoracic limb, it marches in circles towards the right and it has a decreased right palpebral reflex. All the signs associated to peripheral vestibular syndrome.

Based in our findings at the signalment we thought at the beginning of canine distemper as the causal agent of the neurological signs. The differential diagnosis was vestibular syndrome associated to congenital hydrocephaly, vestibular syndrome associated to trauma, and congenital vestibular syndrome of the beagle. The immunofluorescence test taken for distemper diagnose was negative, there were no abnormalities in the of thalmologic examination. The titters for diagnose of leptospirosis were negative too. We decided to take skull and neck radiographs, in the R20° D Cd-v proyection, we found an ancient lock image at the base of the occipital bone. This is compatible with occipital dysplasia. There were not relevant changes in the other radiographs.

The presumptive diagnose was peripherical vestibular syndrome secondary to congenital hydrocephaly, which is associated to occipital dysplasia. In the magnetic resonance imaging founded minimal ventriculomegaly. We started therapy with prednisone 0.5mg/kg with reducing the dosage, ranitidine 2 mg/kg during 10 days, vitamin E 400 IU PO SID until new advice, and with recommendations of avoiding any stressful situation. After treatment the patient improved considerably.

Discussion: The intracranial neurologic diseases are very difficult to diagnose. It is required a thorough physical exam history and especial diagnostic methods such as magnetic resonance. Even with magnetic resonance sometimes is hard to get a definitive diagnose. The vestibular syndrome in puppies could be associated to many pathologies such a congenital compensated hydrocephaly and occipital dysplasia because of the sporadic clinical sings.

The treatment is based only avoiding stressful situations and NSAIDs whenever the clinical signs are presented.

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P.D. Hansel, MVZ
Interno Hospital Veterinario U.N.A.M.

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