Treatment and Prognosis of Strokes in Dogs
Goals of Treating a Stroke
Dogs suffering from a stroke need immediate veterinarian attention. The goals of therapy are to minimize brain swelling (reduce intracranial pressure) and associated tissue damage, maximize oxygen delivery to the brain, treat any identifiable cause of the stroke and rehabilitate the dog physically. Once the cause of the stroke is determined, the treatment protocol can be determined as well. Early diagnosis and treatment dramatically enhance the outlook for a full recovery.
The most important form of treatment for a dog that has had a stroke is supportive, inpatient nursing care. The dog will be carefully and slowly rehydrated with appropriate intravenous fluids, if necessary. Recumbent patients will be kept warm and dry with soft, absorbent bedding that is changed frequently; their heads should not be placed below body level. They also will need to be turned regularly to prevent pressure sores, pulmonary (lung) congestion and urine scalding. Physical therapy is often recommended as well, and may include therapeutic massage. If the stroke was caused by an underlying systemic disease such as diabetes mellitus or Cushing’s (hyperadrenocorticism), that condition must be treated.
A variety of drugs are available to help dogs suffering from a stroke, including sedatives (to address disorientation and ataxia), antiemetics (to address nausea and vomiting), anti-inflammatories (corticosteroids or nonsteroidal anti-inflammatory drugs [NSAIDs], to control swelling), anticonvulsants (to control seizures) and antibiotics (when infection cannot be ruled out).
Normally, dietary restrictions are unnecessary. Clinical signs usually improve within 48 to 72 hours of treatment, starting first with resolution of vomiting and restoration of mobility and coordination. Most patients return to normal within several weeks. Recurrence is rare, but it can happen. Unfortunately, permanent disabilities can happen as well.
Most dogs that survive the first few days following a stroke have a good prognosis for full or nearly-full recovery. The long-term outlook depends upon identifying, eliminating or at least controlling the underlying cause of the condition. If a dog displays signs of stroke, he should be taken to his veterinarian or to a nearby veterinary emergency clinic immediately.