Dog with head tilt and balance issues treated with progesterone

Abstract

A 2-year-old male Kanni dog was presented to the Veterinary College and Research Institute, Orathanadu with a history of head tilt, unable to balance while walking and with suspicion of traumatic brain injury.   On clinical examination, neurological signs like compulsive walking, head tilt, circling, nystagmus, staggering gait, decreased proprioception and tactile reflexes were observed.    The blood samples were analyzed for hematological and biochemical profile analysis and all parameters were in normal range except mild leukocytosis.  The cerebro-spinal fluid was collected and neuron specific enolase (NSE), a neural biomarker was estimated.  The CSF was red-tinged and had elevated NSE value (41.42 ng/ml). Based on history, clinical signs and NSE values, the case was diagnosed as central vestibular disease. The animal was treated with polyionic fluids – inj. ringers lactate @ 10ml/kg I/V, inj. hydroxyprogesterone caproate @ 2mg/kg, I/M, inj. cefotaxime @ 25 mg/kg I/V and Inj. B Complex vitamins, I/V.  The animal was prescribed with oral micronized progesterone @ 5 mg/kg.  On day 7, only mild head tilt and nystagmus were noticed. On day 14 post therapy, the clinical signs were resolved and NSE value became normal.