Bassett hound neck pain, etc.
Breed: Basset Hound
Age: 5-8 years
Our dog Lola came to us as a stray about 3 yrs ago. She is about 7 years old and has been spayed for 2 years. Early last month my husband and I came home from lunch to find our dog Lola laying on her bed in our room. I called her and she walked to me with her head low to the ground. Later that night she was sitting on the couch with her neck extended and she was drooling. She had no fever, 84 heart rate, no other symptoms. She was obviously uncomfortable but finally settle down to sleep that night but on the floor on the other side of the bed which I had never seen her do before. I took her to vet #1 in the morning. He had her walk for him, he did an exam, asked about the drooling, took some xrays of her and did a heartworm test. She was positive for heartworms but showing no symtoms yet. The xrays showed that she had two calcified disks in her back (one near the back end and one cervical)and also a slightly enlarged heart and pancreas. Despite the calcified disks he diagnosed he with gastoritis and gave her Pepcid, Prednisone, an anti-biotic and 2 Heartguards. (We plan to treat the Heartworms when we get this other issue resolved.) She went from a Prednisone everyday to every otherday. She seemed fine on the Prednisone. But everytime she missed that day she would get bad again. So I took her to another vet. I told him the whole story and he took more xrays. His conclusion was that it was from the cervical disk. His Rx Prednisone every other day and Cyclobenzapine daily. A week later I found her in my office, sloppering like crazy and she had thrown up yellow bile. She threw up some more and was slobbering so badly that I took her back to the vet. He asked me about the slobbering and I told him she does it everytime she is not on Prednisone. He told me that it could be from pain but remarked that she wasnt crying. (Otherthan the first few days she doesn't even move gingerly. She has always been a very active dog. Loved to run and play. Never sinced anything was ever wrong.) He added Rimadol to her meds every 12 hours and told me to try keeping her crated. He explained to me that she might have to have a specialist do surgery on her cervical disk. That was three days ago and she has stopped slobbering on her off Prednisone day. However this morning she got up and I let her out of the crate to poddy and noticed that her eyes were swollen and kind of sagging with her third eyelid 1/2 coming over. But she acts fine like nothing hurts. Very little drooling now. I'm just not sure what is going on with this dog. Blood work and urinalisis were good. White count a little elevated but he thought it may be from the heartworms. I'm not sure. My grandmother had Bells Palsy and it kind of looks like that. Or maybe something else. Wouldn't she show other signs of pain if it was from a cervical disk? Any suggestions?
Dr. Marie replied:
Oh, poor Lola! It sounds like you and Lola have been through a lot. It is very frustrating when you don't know what is going on.
This is a tough question to answer without seeing Lola, but I will give you some of my thoughts.
It does definitely sound like there is some neck pain affecting her. But, neck pain and drooling are not usually connected. With that being said, it is possible that the pain is causing her to be nauseous and this could cause the drooling.
Swollen eyes with elevated third eyelids can be a sign of an allergic reaction. While most allergic reactions that cause facial swelling are caused by an insect sting, it is possible this is a reaction to one of her medications.
I do have some concern with her being on both Prednisone and Rimadyl. Usually we do not use these two medicines together. You may want to ask your vet just to be sure, whether you are supposed to be using both of them.
Another possible reason for a third eyelid to be elevated is something called horner's syndrome. This is kind of complicated to explain, but sometimes a neck or upper back problem can cause damage to the nerves that affect the eyes. However, we usually only see a problem with one eye, so if both are affected then this is unlikely.
It's also possible that she has something called uveitis which is inflammation in the eyes. Uveitis can cause both third eyelids to be elevated. Usually if a dog has uveitis it is a sign that the immune system is fighting something else. The heartworms could potentially be the cause of the uveitis.
If the eye swelling is new, I would highly recommend that you have your vet take a look at Lola tomorrow. If they suspect uveitis they can prescribe medication to help the eyes. If they suspect an allergic reaction then they will give medicine for this as well.
If the symptoms are getting much worse tonight (increase in swelling or problems with breathing) then she may need an emergency visit.
In cases like this where we have complicated symptoms and the vets can't figure it out, sometimes vets will refer you to an internal medicine specialist. This may seem a little expensive, but these specialized vets are often very good at diagnosing the "unusual" things.
Unfortunately I am heading offline now (bed time for me). Feel free to reply though and I will check in in the morning.
I really hope Lola is ok!
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I am sorry, its Tramadol that she is on. This is her third day on this med (6th dose) first time I have seen the eye thing. Its funny because one minute she will be fine and the next shes drooling. However, she has NEVER lost her appitite. In fact she is in the cat food anytime she can get away with it. I would think that she would have lost her appitite if her tummy was feeling bad. And she has only vomited that one day.
She is no longer acting like the neck is bothering her. Even on the days she has been drooling. She hasn't acted like the neck was an issue for about 2 weeks now.
Dr. Marie replied:
Ah, OK. Tramadol and Prednisone are ok together.
It definitely is possible that she is having a reaction to the Tramadol. But, I can't say that I have seen that before...and I would expect it to have happened sooner than 3 days into treatment.
Regarding the drooling, it may be helpful to have a thorough mouth exam done under some sedation or even an anesthetic. It may be that she has a tooth infection or even something stuck in her mouth or throat. Often these things can be hard to see in an awake animal.
It sounds to me like the drooling is the only constant here...and you are right that if the drooling was due to nausea we would expect her to not want to eat.
It's probably a good idea to call your vet and mention that the drooling is still happening and ask if they can think of what else may be causing it.
I hope she is feeling better soon!