Facial Stroke in Dogs: Causes, Signs and Treatment
Can Dogs Have Facial Paralysis? Katie's Story
When the vet said facial stroke is very rare in dogs, and our dog Katie's symptoms could be signs of a brain tumor, I almost fainted. One side of her face was drooping, and she could not blink her right eye or move her right ear.
We first noticed something was wrong with Katie when we saw she had food stuck between her cheek and her teeth on the right side of her face. It was a hot spring day. I cleaned out the food that was stuck in her mouth, but did not really notice anything too obvious, until she went outside and started panting because of the heat. The right side of her mouth was droopy. We freaked out. We also noticed she couldn't blink her right eye or move her right ear.
I immediately called our vet and got an appointment for the next day. But in the meantime, I went online and tried to find out what could possibly be wrong with her. I came up to a conclusion that it was either paralysis from a facial stroke, or much worse, a brain tumor. Both were rare in dogs, but a stroke was the rarer of the two. It was a very long evening until we went to see our vet the next day.
When we got to the vet's, we were hoping she would tell us that it was nothing serious, it would go away on its own, and our dog would be OK. But the news was not encouraging. She told us stroke was something very rare in dogs, so these symptoms could be related to a brain tumor. She said the only way to tell for sure was to have an MRI and CT Scan. For this we needed to see an animal neurologist.
At the time were living in a rural town in Illinois, about five hours away from Chicago. We went home and I found a couple places in Chicago area that did these tests. But they would cost at least $1500. This was in spring 2009; with our small business hit by the economy, we were in no position to afford it. And even if we did and they found out she had a brain tumor, we were then looking at more than $10,000 for this kind of surgery, which would not even guarantee a complete recovery. I was in tears. I felt so hopeless and so terrified, and so guilty that I wasn't in a position to help her get better.
Dogs Get Facial Paralysis; It's "Idiopathic"
Dogs do get facial paralysis, a condition that is called Bell's palsy in humans. Although sometimes there can be an underlying reason such as a brain tumor, most of the time the cause of facial paralysis is unknown, meaning it's an "idiopathic" illness.
A Frightening Time
Our vet told us that if, in fact, these signs were caused by a brain tumor, we would start seeing some other signs soon. For example, she would have changes in behavior; she might become aggressive, or be depressed and hide in a corner avoiding contact with us. She would feel dizzy and nauseated. Or she would walk in circles in one direction, she would lose her balance, she would start having seizures... Very, very scary symptoms.
In the meantime, she prescribed some strong antibiotics for any kind of bacterial infection, and steroids for even worse infections such as meningoencephalitis. She said sometimes things like this occur without any known causes, meaning they are idiopathic, but again, it was so rare.
Needless to say we went home extremely frightened, not knowing how to get through this, but we knew we had to stay strong for Katie, and give her the medication hoping it would help. The steroids made her very weak, but her appetite was good, she wasn't vomiting, and she wasn't acting strange. After two weeks, the pills were done and there was nothing else we could do to help. We never gave up hoping, and we kept believing that it was facial stroke, until one morning, we saw the other side of her face was droopy as well.
Now she wasn't able to blink her eyes at all, nor move her ears or her cheek. We took her back to the vet's, and of course she was telling us to be prepared for the worst. During this time, we massaged Katie's face, ears, and eyes every time we got the chance, just so the muscles on her face and around her head wouldn't grow weaker and start shrinking. The vet said we would soon see a gap on her head, right by her ear, because the muscles would shrink. So we kept giving her massages five or six times a day, for a good 10 or 15 minutes each time. She seemed to enjoy them, actually; she loves the attention.
After a couple of months we started to see some improvement. She was able to move her eyelids halfway down, and her ears responded to us tickling them. Although her face was still droopy, no more food was getting stuck between her teeth and her cheeks. I can't tell you how great it felt. We were now convinced that it was not a brain tumor; it was a rare double-sided stroke, and she was slowly but surely getting over it.
It took probably six or seven months for her to get back to normal, but today she is still alive and doing well. 90% of the symptoms disappeared during this period. There are still some signs, but you need to examine her really closely to notice them. For example, at times she can't blink both her eyes at the same time. When she perks her ears, one moves slightly more than the other. But in the last few weeks, even after two years, things still continue to get better. There are no visible signs left, and I believe our massages were a big help in her improvement.
Signs of Canine Facial Stroke: What You Need to Watch For
- Droopiness on one side of the face (sometimes both sides but it's very rare).
- Inability to blink on one side.
- Inability to move one ear.
- Food getting stuck between the cheek and teeth.
- Tilting the head to one side.
- Lack of coordination; clumsiness.
- Abnormal eye movements; for example, an eye rolling upwards when the dog tries to blink.
- Change in behavior, like looking depressed.
- Loss of appetite.
- Feeling tired.
What to Do? Treatment Options
Take your dog to the vet immediately. Although most of the time a facial stroke, like Bell's palsy, occurs for unknown reasons (idiopathic), sometimes these symptoms are signs of another underlying illness, like infection in the ear canal, meningoencephalitis (which can affect your dog's brain), or canine vestibular syndrome (usually in old dogs). These symptoms might also be due to a brain tumor, as our vet warned us.
Chances are the veterinarian will prescribe antibiotics and steroids for your dog. This is a very typical treatment as it will help get rid of any infections. In the meantime, you need to stay on top of massaging your dog's face. Think of this as like the physical therapy we humans go through after having a stroke. It is very important to keep the muscles active to prevent them from getting weaker and shrinking. The rest is pretty much a "wait and see" process for both you and your dog.
How to Massage Your Dog's Face: Does it Really Work?
This is a slow process: you won't see an improvement in days or sometimes even in weeks. It will take months for your dog to get back to normal, if he or she ever does. But be patient and repeat these steps during the day whenever you get the chance. Try to massage for at least 10 or 15 minutes. Every time your dog sits near you, you can use this time for the massage. They love it!
- Put your fingers on your dog's cheeks and gently massage them in a circular motion.
- Gently press your index fingers horizontally on your dog's eyelids and massage them in a circular motion and up and down, lifting the eyelids up and then down.
- Put your fingers on your dog's head, right above her ears, and gently massage in a circular motion. You can also test if your dog is making an improvement by tickling her ears.
- With the tips of your index fingers, move the corners of your dog's lips up and down, and in a circular motion. This will help with the droopy mouth.
Remember, healing from a stroke is a very slow process. You won't see an improvement in days or weeks. It will take several months.
One thing I made sure I did was give Katie organic vitamins during this process, because antibiotics and steroids were making her weak and killing good bacteria as well as the bad ones. Choose organic foods and dietary supplements for your pets to help prevent other health problems like cancer and allergies.
As you can see in this picture, Katie still has a lazy eye. But it has gotten so much better since the time she had her stroke that now it is barely noticeable.