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Unilateral Facial Palsy in Two Dogs-A Report: The Indian Veterinary Journal December 2018

This document summarizes a report on unilateral facial palsy in two dogs. Both dogs presented with drooling of saliva and drooping of the lips and ear on one side of the face. One dog had a history of otitis externa treatment and was found to have enlarged tympanic bulla, indicating otitis media. Both dogs were treated with oral prednisolone and other medications for 15 days, with one also receiving cephalexin. Both dogs showed signs of recovery within the first week of treatment. The report discusses idiopathic and otitis-induced facial nerve palsy and successful management with corticosteroids and antibiotics.

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56 views

Unilateral Facial Palsy in Two Dogs-A Report: The Indian Veterinary Journal December 2018

This document summarizes a report on unilateral facial palsy in two dogs. Both dogs presented with drooling of saliva and drooping of the lips and ear on one side of the face. One dog had a history of otitis externa treatment and was found to have enlarged tympanic bulla, indicating otitis media. Both dogs were treated with oral prednisolone and other medications for 15 days, with one also receiving cephalexin. Both dogs showed signs of recovery within the first week of treatment. The report discusses idiopathic and otitis-induced facial nerve palsy and successful management with corticosteroids and antibiotics.

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Unilateral Facial Palsy in Two Dogs-A Report

Article  in  The Indian veterinary journal · December 2018

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Indian Vet. J., December 2018, 95 (12) : 60 - 61

Unilateral Facial Palsy in Two Dogs – A Report


M. Ranjithkumar1, D. Chandrasekaran, A. Gopalakrishnan, P. Pothiappan and M.G. Jayathangaraj
Department of Clinical Medicine, Madras Veterinary College, TANUAS, Chennai – 600007, Tamil Nadu.

(Received : May, 2018 153/18 Accepted : June, 2018)

Abstract 1987). Idiopathic facial nerve paralysis usually


Two dogs aged 4 and 6 years were presented occurs acute in onset, generally unilateral and is
with the history of drooling of saliva, lacrimation not associated with any identiable underlying
and dyschezia. One dog was treated for otitis cause (Penderis, 2003).
externa 6 months back. On physical examina- Case History and Observations
tion, there was unilateral facial muscle palsy,
loss of menace and palpebral reex and drooping Case No. 1: A six old Labrador Retriever male
of lips and ear on the affected side. Radiographic dog was referred to the Outpatient unit of
examination conrmed the enlarged tymphanic Madras Veterinary College Teaching hospital
bulla of otitis media in one dog. Both animals with the history drooling of saliva, lacrimation
were treated with predinisolone @ 1mg/kg for 15 and unable to swallow for past 4 days. On clini-
days along with other neuroprotective agents. cal examination, the animal had paralysis of
Both dogs started showing signs of recovery from facial muscles on left side, drooping of lips (Fig.
rst week onwards. In addition oral cephalexin 1) and ear with absence of menace and palpebral
was administered in otitis case and advised for reex. Radiological examination revealed that
surgical correction also. Idiopathic and otitis the animal had normal tymphanic bulla and
induced facial nerve palsy and its successful inner ear.
management is reported here. Case No. 2: A 6 year old Pug male dog was
Key words: Unilateral facial palsy, Predniso- presented with the history of anorexic and
lone, Dogs occasional shaking of head for 3 days. Clini-
cal examination revealed that the animal had
Facial paresis and paralysis result in drooping of lips and ear on the left side, drool-
facial muscle dysfunction from cranial nerve ing of saliva (Fig 2) and absence of menace and
diseases and injuries (Kim et al., 2011). Clini- palpebral reex. Radiographic examination
cal signs are most obvious as drooping of the lip conrmed the presence of enlarged tymphanic
on the affected side, frequently leading to food bulla. The animal neither had peripheral
being dropped from the mouth, and impaired vestibular signs nor Horner’s syndrome. Both
blinking, accompanied by a paretic or absent the animals were negative for blood protozoans
palpebral reex (Smith et al., 2012). Parasym- in molecular analysis. Neurological, ophthalmic
pathetic denervation to the lacrimal pathway of and boichemical examinations conrmed facial
the facial nerve can also result in loss of tear nerve paralysis in both cases
production which can cause keratoconjuncti-
vitis (Kim et al., loc cit). Lesions causing facial Treatment and Discussion
neuropathy include those that affect the facial
Facial nerve paralysis has been recorded in
nerve itself, the brainstem nuclei from which
the nerve arises, and the various adjacent struc- several domestic animals (Jeong et al., 2001),
tures through which it courses, in particular the and is associated and suspected with multiple
tympanic bulla. Infectious diseases – especially etiologies (Kern and Erb 1987; Penderis, loc cit).
otitis media – are a well-recognised cause, as However, the aetiology is usually not yet clearly
are neoplasia, trauma, surgery and inamma- understood. Although facial nerve paralysis
tory diseases of the brainstem (Kern and Erb, may be improved by treating underlying causes,
the prognosis is poor (Jeong et al., loc cit). Oral
1
Corresponding author : Email : [email protected] prednisolone @ 1 mg/kg was used in both the
60 The Indian Veterinary Journal (December, 2018)
M. Ranjithkumar et al.

Fig 1. Drooping of left lips and ear and drooling of saliva Fig 2. Drooling of saliva and dropping of lips and ear

cases for a period of 15 days and then it was saliva with absence of menace and palpebral
tapered gradually. Two dogs with idiopathic reex. Both the animals were treated with oral
facial paralysis cases have been earlier reported prednisolone @ 1mg/kg once daily for about 15
to be managed with oral prednisolone @ 1 mg/ days. One animal with otitis media was also
kg for about 10 days (Motta et al., 2011). Facial treated with cephalexin @ 30 mg/kg, bid for
paralysis due to otitis media cases have been about 15 days. There was signicant recovery
successfully reported to be managed with after a month.
prolonged course of cephalexin @ 20-30 mg/kg,
bid for 3 to 6 weeks (Penderis, loc cit). In our References
study, otitis media case was treated with oral Jeffery, N., (2004) Neurological abnormalities of the head
prednisolone and cephaexin and advised for and face, In: BSAVA Manual of Canine and Feline Neurology,
ventral bulla osteotomy immediately after clini- Third edition, (Eds) Platt, S.R. and N.J. Olby, British Small
Animal Veterinary Association, Gloucester, U.K. pp. 186-187.
cal improvement. There is no effective treatment
for the underlying disease but supportive treat- Jeong, S. M., Kim, H-Y., Lee, C-H., Kweon, O-K., and Nam,
ment includes addressing exposure keratitis in
T-C., (2001) Use of acupuncture for the treatment of idiopathic
facial nerve paralysis in a dog. Vet Rec., 148: 632-633
those dog breeds at risk due to eye conforma-
tion, and keeping the paralysed lip clean to
Kern, T.J., and Erb, H.N., (1987) Facial neuropathy in dogs
and cats: 95 cases (1975-1985). J. Vet. Med. Assoc., 191:
avoid lipfold dermatitis (Penderis, loc cit). In 1604-1609.
both the cases, affected eyes were lubricated
with hydroxyl methylcellulose. The prognosis
Kim, J., Jung, D., Kang, B., Kang, M., and Park, H., (2011) Uni-
lateral facial paresis secondary to a suspected brainstem arach-
for idiopathic facial palsy varies, many animals noid cyst in a Maltese dog. J. Vet. Med. Sci. 73(4): 459–462.
make a gradual recovery (weeks to months) Motta, L., Altay, U. M., and Skerritt, G.C., (2011) Bell’s palsy
but some will be left with permanent decits. with concomitant idiopathic cranial nerve polyneuropathy in
These decits may progress to produce muscle seven dogs. J. Small Anim Pract. 52(7): 397.
contracture and deform the facial expression Penderis, J., (2003) Common cranial nerve disorders in dogs
permanently (Jeffery, 2004). Uneventful recov- and cats 2. CN V and CN VIIl. In Pract. 25: 256-263
ery was noticed after one month of treatment. Smith, P.M., Gonçalves, R., and McConnell, J.F. (2012) Sensi-
tivity and specificity of MRI for detecting facial nerve abnormali-
Summary
ties in dogs with facial neuropathy. Vet. Rec. 171: 349 – 353.
Unilateral facial palsy was conrmed by neuro-
logical, ophthalmic and biochemical examina-
tion. Affected animals had the signs of dropping
of lips and ears on the affected side, drooling of
The Indian Veterinary Journal (December, 2018) 61

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