From Diagnosis to Recovery: Navigating Vestibular Disease in Your Dog
Vestibular disease can be a perplexing issue for dog owners. In this episode, our dedicated veterinarian breaks down the complexities of this condition, providing insights into its recurrence, potential causes, and available treatments. Our veterinarian shares personal experiences, success stories, and practical tips for pet owners navigating the challenges of canine vestibular issues.
What You’ll Learn:
Recognizing Symptoms:
Identify signs of vestibular disease in dogs, such as sudden loss of balance, head tilt, and abnormal eye movements
Understand that these symptoms can be distressing for both dogs and their owners, requiring attention
When to Seek Veterinary Care:
Learn that veterinary attention is crucial when observing severe or sudden onset vestibular symptoms
Understand the importance of ruling out potential causes for symptoms, such as strokes, inner ear infections, or brain tumors
Distinguishing Vestibular Disease:
Explore how veterinarians differentiate idiopathic vestibular disease from more serious conditions through physical examinations and diagnostic tests
Home Care vs. Neurology Consultation:
Gain insights into the decision-making process between opting for supportive home care and pursuing a neurology consultation or diagnostic imaging like an MRI
Understand that some cases may show significant improvement with supportive care, while others may require further investigation
Ideas Worth Sharing:
"For those pets who are back to normal in about two to three weeks, the most common question I get after they've left the office is, will this happen again? Unfortunately, it is definitely possible for this to happen again." - Dr. Tyler Sugerman-McGiffin
"It's basically like doing physical therapy at home, and a lot of these older dogs are going to become more stiff and lose muscle mass if we don't help them move around and keep up their strength." - Dr. Tyler Sugerman-McGiffin
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Read The Transcript:
Dr. Sugerman: [00:00:00] Alright, so we had this really cute little Shiba Inu named Lucy that came in to see me last week. She was super sweet, even despite just everything that was going on with her. Her parents came in to me because they came home and found that she was alligator rolling on the floor. Unable to stand up.
And if you know what I mean by that, or if you don't know what I mean by that, it's basically where if you imagine you taught a dog how to roll over and over and over again, and they just did it constantly, and they can't sit still, that's what an alligator rolling is literally an alligator that rolls in the water.
So anyways, they rushed little Lucy right in because they were actually worried that she might have had a broken neck and they were just besides themselves because they had even left her alone.
So I looked into her eyes and I told them that that's likely not what happened, that she most likely did not break her neck and they didn't have to really feel bad about leaving her alone because this was going to happen regardless of whether she was alone or she was with them.
So what is it that I told them then? What [00:01:00] did I see in Lucy's eyes that without even feeling her neck to tell you that she likely did not have a broken neck and instead something else was going on. So keep listening to find out about what this neurological mystery is that was affecting poor little Lucy.
Hi, and welcome to Vetsplanation. I'm your veterinary host, Dr. Sugerman, and I'm going to teach you about veterinary medicine. In this podcast, we can dive deeper into the understanding of what our pets are going through and break down medical terms into easier to understand chunks of information. Just a quick disclaimer, this podcast is for informational purposes only.
This is not meant to be a diagnosis for your pet. If you have questions about diagnostics or treatment options, please talk to your veterinarian about those things. Remember, we are all practicing veterinary medicine and medicine is not an exact science. Your veterinarian may have different treatment options and different opinions.
The information I provide here is to help pet parents have a better understanding about their pets. [00:02:00] If you like our podcast, please consider sharing this podcast with at least one friend or just somebody else who has pets as well. Now, let's jump into this week's episode.
All right. Welcome back to Vetsplanation this week. As always, I am your veterinary host, Dr. Sugerman. So let's continue on about Lucy's story. So what I saw in Lucy's eyes was something called nystagmus. This is where the eyes just dart back and forth in a rapid motion, sometimes in a slower motion, but most of the time it's in a very quick motion.
They can either go up and down, which is called vertical nystagmus, or they can go side to side, which is called horizontal nystagmus. Or the third kind of nystagmus is going to be where it goes like kind of in a semicircle. And that's called rotary nystagmus.
So this is one of the classic signs of something we call vestibular disease. So we're gonna talk a little bit of anatomy and physiology here so you have an understanding about what I'm talking about. The vestibular system is what helps your body [00:03:00] balance so that you can find or keep your whole body in equilibrium.
So it stands straight, you know where up is, you know where down is, you know where side to side is. Now there are multiple portions to the vestibular system. For the vestibular system, we are usually talking about the inner ear. So you have the outer ear, so that's like the part you can put your finger into the canal, right?
The middle ear is basically where your eardrum is, which is also called the tympanic membrane. And the inner ear is where these vital organs are housed that kind of help us sort out when we're hearing things and also helps with our balance. In the inner ear, there's this tiny little bone that has this fluid in it that helps you to kind of like know again where you are in space.
Those are called the semicircular canals, but it's this tiny little bone that just helps you figure out where you are. So like I said, it tells you kind of like whether you're upright, if you're laying down, if you're upside down, that's, that's how your body actually knows. And it's the biggest reason, like, when you get [00:04:00] off of a roller coaster, or let's say you go on the teacups at Disneyland, or you go on like that spinny thing that's at the fairs, right?
The tilt a wheel, that's what it's called, the tilt a wheels. If you go on all of those, there's this fluid that kind of touches all those little hairs in that little semicircle, circular canal. And it tells you, that you're, that it's just like spinning in circles.
So that fluid when it touches the hairs, it also goes up to another part of the vestibular system. And that other part is called cranial nerve 8, or also known as vestibular cochlear nerve, to the brain to tell you that there's something wrong. Like you're not upright, you're not standing still.
The cranial nerve just means that it's a nerve in the head and vestibular cochlear refers to the vestibular system, but also the cochlea, which is another bone in the body and specifically in that inner ear that helps you with auditory or basically hearing. There are [00:05:00] multiple parts of the brain that are part of this system as well, the vestibular system.
So we're not really going to talk about each individual portion. We're just going to lump it into just the brain. Just for, simplicity's sake. So essentially, we said there's three parts, three main parts that make up our vestibular system.
So you have the inner ear portion of it, the nerve portion of it, and the brain portion of it. Now, when there's something really awry with the vestibular system, then we start seeing some weird signs. These all come on very suddenly. Think about when you get off that rollercoaster, you've gotten off the rollercoaster and immediately you're just moving around, right?
You can't really like get your balance right away. And that tilt a wheel thing. That's how quick it is when all this happens in our pets as well. It's a very sudden thing. Usually our pets are falling over to one side. You might see like their eyes darting back and forth, like we talked about earlier, called nystagmus.
You might see their head tilt over to the same way that they fall over. And [00:06:00] then you might also notice them being very nauseous, so like drooling excessively, or licking their lips, smacking their tongue basically. Sometimes even vomiting, or not really wanting to eat.
And that's because like their brain is continuously on this rollercoaster while this is going on with them. So it makes it very difficult for them to be able to do these things. They also might have difficulty walking because their head being tipped over to one side.
And these are all like pretty classic signs for this vestibular syndrome. You might also see them alligator rolling like we talked about with Lucy. And then you may even see them having a problem with like their feet. They may not be able to feel where their feet are or know that where their feet are in context where their brain is.
Those are called CP deficits, which I'll get into later on. But these are all really scary signs, right? So let's talk about the possible causes of what vestibular syndrome is. The first thing that we usually look at as a clinician is whether the pet has vertical nystagmus. So going up and down, or if [00:07:00] they have horizontal nystagmus.
Meaning those eyes are flickering sideways, if they're going sideways, then we're more likely thinking that this is something to do with either the inner ear or the nerve. If the nystagmus or that eyes flickering is going up and down, then I'm a lot more worried about a bigger problem with the brain.
When the nystagmus is rotary, remember it's like the semi circle one, that really doesn't help us, unfortunately, like that can happen in any of those cases. So let's break these down then. So if the eyes are flickering back and forth, so we're going horizontal nystagmus, then the most common cause is actually what we call idiopathic vestibular disease, or old dog vestibular disease is the other common name for this.
Idiopathic is just like a medical way of saying we don't really know what's causing this, it just happens, unfortunately. So if this idiopathic or old dog vestibular is the case, then most of those patients actually start to improve pretty quickly over about two to three days [00:08:00] and are usually back to normal within about one to two weeks.
The other common thing that we see with the horizontal nystagmus is something called otitis media or otitis interna. You guys are learning a lot of terms today. That just basically means that they have an inner ear infection. A middle ear infection or an inner ear infection or some sort of inflammation of those areas.
And that can happen from having an ear infection that's from the outside that spreads inwards and can cause a lot of inflammation even spreading inwards. It can happen from having an eardrum rupture and then that infection getting deep inside or inflammation just being deep inside there.
And if that's the case, this needs to be treated with medication that's very specific for these types of ear infections. This is not something that you can just use any over the counter ear medication for. Because unfortunately, if you put those ear medications in and that eardrum is ruptured, it could cause permanent damage.
So we don't want to do that. So if for some reason you are already [00:09:00] giving medications in the ear and we worry about a ruptured eardrum, definitely tell the doctor what medication you've been using so that they know, but also stop using any of those medications. If you start seeing those signs, a lot of people are like, oh, they have an ear infection.
So they start using drops from over the counter, but we don't want to do that. Because like I said, that could actually make things worse. If this is a ruptured eardrum and we have to use a medication for that, a lot of times we're going to be doing one that's by mouth, called orally by mouth, and they take it over a long period of time.
It's six to eight weeks of medication. There are certain medications that you can use if there is a ruptured eardrum, but it's a very, very short list, so usually the veterinarians need to prescribe that if that's the case. It also really depends on what kind of ear infection that is too. There are different types of ear infections because there are different types of infections.
So we need to know exactly which one it is, again, to know how to clear that up. But like I said, it's a pretty long 6 to 8 weeks of medication when we do that. [00:10:00] But after that ear infection is cleared up, most of them go back to normal after that. If it's not treated, then they will stay the same or get worse.
So now let's talk about when that nystagmus or eye flickering goes up and down. Now I'm more worried about something bigger. Something in the brain. So did you notice like what these signs sound like in people? So if I describe some of these things like walking as if they're drunk, falling over to the side, maybe slurring our words, dogs can't really slur their barks. But we can slur our words.
So one big differential for these guys is what we call an ischemic stroke, meaning that there was a blood clot or something that occurred that stopped oxygen from getting into the brain correctly. Sounds very much like a stroke in people, right? So most of these patients, they will usually improve within hours to weeks, even without any treatment at all.
Just like our patients with our old dog vestibular disease or idiopathic vestibular disease, whatever you'd like to call it. [00:11:00] Most of those will get better without doing any treatment. They don't need antibiotics or anything. Usually we're giving them medications. We'll talk about that a little bit later. Now, the last big cause of this is going to be something we call neoplasia.
Basically, some cancer is also common. This can be a cancer that started in the head or it can be the vestibular cochlear nerves, the nerve we talked about in the face, facial nerve. You could have a mass that's in the nerve that could be causing this.
This can also be cancer that started somewhere else and then has metastasized or basically moved into the brain. With this type, the symptoms will stay the same or just get slowly worse. If it's a slow growing tumor, or if it's a more faster growing tumor, then it just progressively gets worse without any treatment or without any medications for them.
Now there are a number of other less common causes that [00:12:00] can cause these things such as things like hypothyroidism, meaning they have low thyroid, certain toxins can do this, certain medications like high doses of metronidazole, which is a common medication that veterinaries put pets on for having diarrhea, or something called meningioencephalitis, which I have covered in the meningitis episode before.
So like those kind of things can cause this vestibular syndrome as well. So what kind of diagnostics do we do then to try to figure out what the cause is? The first test is basically looking into the dog's ears with a scope we call an otoscope. Oto just means the ears, by the way. But we're looking to see if the tympanic membrane, remember that eardrum, is ruptured.
That is our first clue as to whether there's an inner ear infection. Even if everything looks clean, and the eardrum looks closed, there could still be an inner ear infection that we just may not be able to see. It's a rare thing, but you can get infections just through the [00:13:00] bloodstream that can go to the inner ear.
A ruptured eardrum, now that is like a really good indication this is probably an ear problem that's causing this. Now most clinicians from there will probably talk about, if all that looks normal, they're gonna start talking about doing like blood work or checking their blood pressure.
The bloodwork is not going to show if Lucy had a stroke or brain tumor, unfortunately bloodwork doesn't do that. But it does show if there's some sort of other underlying cause as to why that patient might have had a stroke. So about 50 percent of strokes in dogs are caused by some sort of underlying cause, such as things like high blood pressure, kidney disease, low thyroid, that hypothyroidism, cushing's disease, which Dr. Z covered, so you should definitely listen to that one again. Or a problem with proteins in their body, and it could be a problem with like blood clotting along with a lot of other things as well. So blood work and blood pressure are important to rule those things out to see if those could have been the cause of [00:14:00] a stroke, so we can get those figured out before the pet has another stroke.
Next, if all of those things come back normal, we have to start talking about advanced imaging at that point. A CT is great for looking at things like the middle ear. You can see signs of inflammation or a mass that's in there. But unfortunately, it's not the best for looking at things like brain tumors or signs of a stroke.
An MRI is actually going to be the best tool for that.
And that is usually done at some sort of specialty hospital, so if you're not at a specialty hospital already, usually it means either transferring them to a specialty hospital, or they go home, and then you make an appointment to go see a neurologist, who then does the MRI, or whoever runs the MRI, there are many different specialties that do that, but pretty typically, it's going to be the neurologist that do that.
So MRIs, I do usually tell people like they can be really expensive. If you're going to do an MRI or if you're considering doing an MRI, I always suggest like calling the hospital first and asking to see like how much the MRI would be. Or [00:15:00] if it's a transfer, asking the doctor who's transferring if they could ask how much the MRI is going to be. Just so you have some sort of understanding as to how much it's going to be and how much you're going to have to pay upfront and whether that's a doable thing.
I usually tell people though, if, if you would go through brain surgery for your dog, then a hundred percent, absolutely go do that MRI because you could potentially, save their life by doing this brain surgery. If they found some sort of tumor that was in there, if they found a stroke, there's nothing you're going to be able to do about that, but at least you'd have an answer and know that you don't have to go to surgery.
If you couldn't do brain surgery or didn't want to do brain surgery, then that's your choice. You don't have to do that. And otherwise, if you did the MRI, really, you'd just be finding out an answer, but not doing anything about it. And unfortunately, there are some that are inoperable tumors.
There's no way they're going to be able to operate, even if they did do surgery. But if you would do surgery, then I would say just [00:16:00] prepare for that, that you would go to do that MRI. And ideally, that would be great, right? If everybody could do the MRI, that'd be fantastic, but some people can't afford that.
And you don't have to feel bad about that. There are other places, too, that you can also look into. A lot of times there's besides the specialty hospitals, you can always look into going to the vet schools. There are a lot of vet schools that have MRIs and are able to do that, and they can do it for much less because it's students who are learning those things. So that's another option as well. You can always ask about the nearby vet schools and see if they will do them.
So in Lucy's case, I did look at her ears, which were very clean. They were immaculate.
We looked at her blood work, her blood pressure, and those were amazing as well, especially for her age. I talked to Lucy's mom who like clearly loves Lucy a lot, but she only discussed the options of doing a CT or an MRI versus just giving her supportive care at home for two weeks to see if she would improve.
Remember [00:17:00] that for an old dog, vestibular or strokes, they will either get better or they're just going to stay the same. So it could be possible that she does get better from this. If she has a brain tumor, she's likely going to get worse. So over that two week time period, we would know.
We did talk about how I was concerned about her having a brain tumor, especially with the way that she was alligator rolling, that really concerned me for that. Her mom was not able to afford an MRI, but she was willing to give her that supportive care for the next two weeks to see if she did improve.
And so by supportive care, what do I mean? I mean that usually is giving her medication just to help her with her nausea. We're not going to make the vestibular syndrome go away. There's no medication for that. It's really just, her brain has to fix itself at that point. But also just helping her get around at home.
So when mom is gone, it means keeping her food and water pretty close by and putting potty pads down so that she's in a nice comfortable area and she doesn't have to go very far and hurt herself when she's moving around. But when mom is [00:18:00] home, really that means that we need to get her to move around more.
Think about people who have strokes. We want their brain to figure out how to function again, how to move again, how to talk again, how to respond to where their limbs are again. So it's very similar for our dogs. We want her to be able to get help in trying to learn how to walk in a straight line again, and then starting to move around objects again, like chairs and furniture.
It's basically like doing physical therapy at home and a lot of these older dogs are going to become more stiff and they're going to lose muscle mass if we don't help them move around and keep up their strength, which means that they have so much more to overcome if we have to, get over the vestibular syndrome and then start getting our muscle back again.
So we got to make sure that when these guys go home that, they are being worked with at home to try to do some of those physical therapy things to help keep them up. We're actually going to be talking to Ken in a couple of weeks, who specializes in physical therapy. So I bet he's going to have some really great ideas for us as [00:19:00] well, on what we can do at home for these guys.
Once their brain and the vestibular system kind of normalizes, then most dogs will go back to normal within about two weeks. Some have a slight head tilt, but the majority of people don't really notice that.
Really, it's just like their parents that notice they have a tiny head tilt. Or when they come into the office to see me, I'm like, do you notice that your dog has a small head tilt? And they're like, oh yeah, they had this problem, a couple of years ago. So most people don't notice it though.
Now, for those pets who are back to normal in about two to three week time span, the most common question I get after they've left the office because it's so overwhelming when this first all happens, but they will usually email me then and ask, will this happen again? Unfortunately, it is definitely possible for this to happen again, just like how people can have multiple strokes, with old dog vestibular disease or idiopathic disease, we call it, it can happen again in a matter of months or more. And they more or less have kind of [00:20:00] the same recovery time each time.
With strokes, this can happen again in days to weeks even, or more. It could still be months after that, but it still can happen pretty quickly right afterwards. Again, just like with people. So what about for those patients that don't improve in two weeks, or they just get worse? So those are the ones that we worry more so that this is some sort of brain tumor or a severe stroke.
So I would say the majority of these patients are typically humanely euthanized. It's a really difficult decision to make, but it's just not fair for them to become worse and not have a good quality of life. A few will go to the neurologist after that two weeks and perform an MRI, and then decide from there.
And that's okay, too. You can try treating them for two weeks, and if they don't improve, see the neurologist. I usually tell people if you're going to go that route, call to get an appointment, as soon as this happens. So that way, you can get an appointment within two weeks or so. And if they've improved, then great.
You can cancel that appointment at that time. But if they [00:21:00] haven't improved, then you have that already set up. Even though you've given them that two week time period. But it can be really hard to get in, and so you want to have that all set up and ready to go.
Dr. Sugerman: Alright, so let's get back to Lucy.
So what happened to little Lucy? Like I said, I had the discussion with her mom, she could either be referred for an MRI, or she could take her home for just supportive care, and we wouldn't have an answer, but, we'd be able to see if she does improve. And mom decided to take her home with some instructions about what to do and how to care for her.
A few days later, I actually got an email from Lucy's mom stating that Lucy did not seem to be improving and she wanted more information about like where she could see a neurologist and get a neurology consultation. She still really wasn't sure about an MRI and just really didn't think she could afford it, but she at least wanted to talk to a neurologist.
So I did give her that information about where she could like, find local neurologists and then she said she was going to call them and figure out from there what she was going to do. But about a [00:22:00] week later, I actually got an another email from Lucy's mom and I assumed it was going to be about the neurology appointment or that she was doing worse but she actually informed me that Lucy was doing fantastic, that she was doing great.
She was up and walking. She had a minor head tilt but mostly she felt like she had most of her personality back at that point. She didn't go to see the neurologist after all because she had greatly improved. And so she just canceled her appointment. I was really happy to hear that news for little Lucy, because she was such a nice dog, with such a nice mom. But I thought, for sure, she was going to get worse and she was going to be a brain tumor. So, I was really happy when I was wrong. If Lucy's mom happens to be listening to this, you can give her pet for me.
Alright, we're going to talk about our fun animal fact for today. So imagine this. You decided to take a vacation from the snow, right? Snow and ice all around us. So you decided to go to southern Florida.
You're hanging out all day at the beach, because it's highs of 70s today, so in Florida they're [00:23:00] like, ah, that's so cold. But for everybody who's in the snow, they're like, oh my gosh, this is amazing. But it starts to rain there and then there's a chance of thunderstorms later. So, you know time to hit the highway in your fancy convertible that you rented because you're feeling pretty relaxed. Suddenly you notice all these cars in front of you just swerving and slowing down and then there's suddenly things moving across the highway. So as you get closer and closer, you realize it's not just something It's... it's actually some things instead.
These things look like they're kind of like swimming across the highway. So if you get even closer, you slow down, and that there's actually like a group of fish walking. Yes, I said walking. There's a group of fish walking across the highway. If you've ever seen this in Florida, or if you are in Florida or have seen it, you please tell me if you've seen this. Just comment and let me know. But I'm talking about walking catfish. So when you think of a fish, I'm sure you imagine fish in [00:24:00] water, swimming around, blowing little bubbles out.
No, no, my first thought is not about a fish walking across the highway. But these walking fish are actually native to Southeast Asia and they're a really important food source there. So they're great for selling because they can survive out of water for quite a while. And therefore, when the buyers buy them like they're really fresh still.
So they can pretty much just take them home and eat them very fresh, but they've become a really invasive species in places like eastern India, Pakistan, the Philippines. And of course, we have lots of weird animals that invaded Florida. So real quick. I do want to point out that. An invasive species, it actually means that they do do harm to the environment and do not originally belong there.
So it's not just like they're a non native species and they don't really do harm. So they are an invasive species, meaning that they do harm to the environment. They're actually illegal to have in many countries, [00:25:00] including the U.S., the reason why is because they can invade areas very, very quickly. For instance in Florida, they were well documented to have been there by the 1960s near the pretty much just the Palm Beach area.
The species spread over 20 counties in 10 years though. One researcher had stated that there had been as many as 3,000 pounds per acre of these fish, which is just astonishing. They usually thrive in lakes and rivers. But lots of fish do there, right? So they're really actually known for surviving in really, really murky waters where there's not a lot of oxygen and things like ponds and canals, ditches and swamps, and even flooded prairies.
They have really tiny eyes, so they really don't need to see their food. Plus they really don't care much about what they're eating. They're really not picky at all. They'll eat kind of anything, any eggs, bugs, anything that they can pretty much fit in their mouth. Other fish. And [00:26:00] so the really cool thing about them though, is their ability to walk on land, right?
Like how many fish can walk on land? So how do they do this? They have little spikes, so like spines is what they call them towards the back and bottom of their body so that they can move them back and forth, like almost as if their feet. So the kind of like moving back and forth so that they are walking across the freeway.
They can use their front flippers as well to kind of like move as well, right? But the back, the back you would think it's more like a snake, but it's like a slithering thing. They actually use those little spikes to be able to walk. Alright, so they figured out how to walk now.
What about the fact that they are still out of water, right? Fish cannot breathe out of water, because fish need to use their gills, move water through their gills in order to be able to breathe, which I probably should do like an episode on because I think it's a super, super cool thing on how fish actually breathe.
Anyways, these catfish have their own unique breathing apparatus. It's called a suprabranchial [00:27:00] arborescent organ. So luckily, if you know a little bit of Latin, you can kind of like figure it a little bit out and break it down. But supra means above. Branchial means gills. And then arborescent, I'm wondering if my wife knows what this one is, because she listens to a very specific podcast about this. Arborescent means tree, because the little organ has like these branching appearances that kind of make it look like a small tree. So the little suprabranchial arborescent organ is basically like a lung that allows the catfish to breathe atmospheric air, meaning air that's in our atmosphere, not in the water.
So these two unique features, it allows these catfish to move from one murky pond to a ditch or somewhere else really easily. So they can live a few hours out of water if needed. But there are some rare instances of them surviving out of water for even up to 18 hours. So they can like move from one place to another because if [00:28:00] all of their food supply is gone or the water is, let's say the water is all, dried up from heat. They can move to other areas if they need to.
So they don't sound too bad, right? I mean like, they're not very cute by any means. But, they do like to live in areas where a lot of oxygen isn't available. They like to eat all these weird bugs. They live in places that other fish don't really want to, you know, live in.
So what makes them so invasive? For one thing, because they can cross the road, there have been reports of hordes of catfish walking across these roads and being run over. And they're very slimy, which then makes the roads extremely slick and have had numerous accidents caused because of this.
Another thing is that they can easily invade the commercial aquaculture facilities. So that's where like the fish are grown rather than being harvested from the wild. And then they just eat huge numbers of stock fish in there and just eat tons [00:29:00] of them. So then they can't breed all of these fish.
And then now you have tons and tons and tons of these catfish in there and not the fish that you're trying to breed. Alright, that is our cool animal fact for the day. Otherwise, I hope you have learned some more stuff about our weird vestibular disease that makes our furry little friends a little crooked.
I'm sure they're not jealous of roller coasters after all of that. So as always if you have any questions, you can always ask me on our website at VetsplanationPodcast.com or I'm most active on Facebook, so you can definitely ask me there as well. If you have a topic that we haven't covered or you want covered, you'll definitely let me know that.
I'm, I'm up for covering pretty much any topic or talking to any specialists that need to be talked to. Otherwise, we really want to keep this podcast going. We can only do that by growing. If you enjoy this podcast, please share this with a fellow animal lover. We really would appreciate that.
The bigger we grow, the more likely we'll be able to keep going with our podcast. Or you can also consider donating on our website or at the link that we'll have on the show notes. And as [00:30:00] always, please remember to keep your pets happy, healthy, and safe. Thank you, everybody.
Thank you guys for listening this week. If you have any questions, comments, suggestions, or you just want to say hi, you can email me at Suggs, S U G G S @ VetsplanationPodcast.com or visit the website at VetsplanationPodcast.com or find us on Facebook, Instagram, or TikTok at Vetsplanation. Thank you all for listening and I'll see you back here next week.