Partial Facial Paralysis

Did you know that dogs can experience facial paralysis much like Bell's Palsy in humans?  I didn't.  Not until I came home one Monday evening and noticed that Sammy's face looked weird.  It had been a long Monday with a crazy week ahead.  I came home from work as usual and Sam was bouncing around with her newest Bark Box toy so I started playing.  Then I saw it and thought...hmmm...her jowl looks weird.

The more I looked at her the more I could see it.  Her left jowl was hanging and her left ear was flat and didn't perk up when I said milk bone.  I put my finger near her eye and no blinking.  OMG, what happened to my dog!?  I immediately text the emergency number for my vet.  I was thinking stroke.  The vet told me that if she was acting like herself, eating, playing, running, going to the bathroom then I didn't need the emergency vet I needed to monitor her and bring her in the morning.  And so we did.

The vet checked her out.  What are they looking for?  Well, the facial paralysis can be caused by lots of things; ear infection, hypothyroidism, injury, and cancer to name a few.  Sam's vet said they could find no cause of the paralysis which isn't uncommon.  They call it idiopathic.  Interesting that a word used commonly by very smart people starts almost the same as the word idiot.  I did not feel this about any of the veterinarians we saw, but I definitely feel this about the partial facial paralysis.  I want to know what's wrong with my dog!

Sam's regular vet recommended that we watch her closely, that we treat her left eye (which she can't blink) with drops to avoid eye ulcers (what!!!??), and if we wanted another opinion we could take her to a neurologist.

Starting with the eye ulcers, they are common in many breeds of dogs and they are caused by eye irritants or injury.   I am thinking if you can't blink your eye, it makes perfect sense that your eye could get random junk in it causing irritation; especially if you are a dog and like to roll in the grass (or dirt or mud).  Secondly, yes there are vet specialists.  Yes, we went and saw the vet neurologist and yes, it was expensive.  Sammy made sure of that.

We were in the neurologist's office and the doctor was in the process of telling me that Sam's results were all normal from her neurological exam.  At this point she had used no huge fancy equipment on my dog, so I asked exactly what came with a neurological exam.  They check the ears for infection (they cannot see far into the inner ear during this type of exam), they check her facial and neck nerves for response to stimulus (to confirm the paralysis is localized), they check her for equal gait and make sure she isn't leaning to one side.  She had passed all these tests with flying colors.

As the doctor was recommending continued monitoring, Sammy had a seizure.  Holy, what the what!?  Scariest vet moment in a long time.  The vet ran, actual running, to get a med to calm her down.  After that, the vet did recommend some scans.  I left Sam in the vet's capable hands and headed home in frightful tears.  I had never seen my dog have a seizure before.

After a partial day of work I went to meet with the vet and get my dog.  The vet did a doggie MRI (hello, expensive...I wish I had pet insurance) and a spinal tap.  The MRI revealed no abnormal growth or swelling in the brain.  The spinal tap revealed no infection that could be cause for swelling by the facial nerve (the big culprit they were looking for was meningitis).  So 3 very expensive haircuts later...

we are back to idiopathic facial paralysis.  Facial paralysis is an idiot.  And what about the seizure you ask?  Oh, well it's idiopathic too, but I do have an expert opinion telling me that combined with the facial paralysis and the super high level of stress Sam feels in vet offices could have caused her seizure; helped a tiny bit along by her recent dose of Trifexis.  Yes, I had heard warnings about Trifexis.  I had even talked to my vet about it.  What we had settled on was that as long as your dog was not already prone to seizures that it was safe.  The neurologist said that the drug can increase seizure chances in dogs prone to seizure.  Sammy will no longer be taking Trifexis and if she has another seizure the vet will evaluate her for a seizure med.

So on we go with our rock star buzz cut...

...eye drops, and messy eating.  The chances of her regaining full facial movement is 40%.  The other 60% makes up chances of partial or no recovery at all.  Am I upset I spent so much to find out that there is nothing scary wrong with my dog?  No.  I am thankful to be in a position that I could.  Am I happy about it?  Well, no.  I would have rather put it in my savings account, but that's okay, because my sweet girl is happy and healthy.

Thank goodness.