6 replies
    • neuropetvet
      neuropetvet says:

      No treatment other than supportive care…Depending on severity, I often will give a Cerenia (maropitant) injection and send home oral meclizine.

        • neuropetvet
          neuropetvet says:

          It’s anecdotal and size dependent. For dogs, I usually give 12.5 to 50 mg once daily. Very small dogs get 12.5mg, small to medium size dogs get 25mg, large to giant breed dogs get 50mg. For most cats I give 12.5mg once daily. I give half that dose for very small cats. It’s fairly non-sedating, but I have owners give at night just in case it causes sedation so that it occurs when the patient is supposed to be asleep anyway.

  1. tjkelman
    tjkelman says:

    Love these so much – many thanks for taking the time to produce them! For this one, I’m having a hard time seeing that the horizontal nystagmus is positional – seems consistently horizontal from resting through neck extension. Is the nystagmus truly positional or was that a typo? Thanks again!

    • neuropetvet
      neuropetvet says:

      Hello, tjkelman. You are correct that this dog’s nystagmus is consistently horizontal with the fast phase to the left. The video only shows the nystagmus clearly when the head is lifted and I’m holding the eyelids open, but you can also see it (admittedly, not easily) in the video when the head is in a neutral position. Resting nystagmus is the term used to indicate abnormal pathologic nystagmus noted when the dog’s head is in a normal, resting, neutral position (i.e., head parallel to the ground with the dog looking ahead), while positional nystagmus refers to nystagmus noted when the head is in any other position (e.g., patient lying on its side, head extended as in the video, patient lying on its back). The nystagmus needs to be described in several ways: (1) resting or positional or both, (2) direction of fast phase which is usually away from the side of the lesion, and (3) whether it’s horizontal, rotary, or vertical. Truly vertical nystagmus is usually central, but can occur with peripheral dysfunction. Horizontal occurs more often with a peripheral lesion, but can occasionally be central. Rotary nystagmus can be either central or peripheral. A central lesion is also more likely if the fast phase changes direction, such as resting nystagmus with fast phase left but positional nystagmus with a fast phase right. When I was a student, I was taught that the presence of positional nystagmus when there’s no resting nystagmus indicates the lesion is central, but if you watch a lot of vestibular patients, the resting nystagmus often improves/resolves first and the positional nystagmus takes a bit longer so you really cannot use this to determine central vs. peripheral. Hope this helps! Thanks for your question!

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