Dear Dr. John,

Last night, my almost 15-year-old Retriever X started having a sort of seizure with twitching in the eyes. He had a similar episode about a month and has had a head tilt ever since. He has high kidney values, high calcium, and high phosphorous. He is on multiple medications.

I could not transport him so easily, so I called my vet who was going to come over to administer a sedative. I informed the vet that I had some Diazepam, and I was instructed to give the dog 10 mg. When the vet arrived, I was instructed to give 10 mg more and then go to the local pharmacy for Meclizine. I gave 25 mg as told. Early this morning I gave another 20 mg of Diazepam, and my dog is now calm. He also ate a lot of food! What might be going on and is the end near? L.N.

Dear L.N.,

Given the information you have shared, I suspect that your old dog has several things going on. The head tilt suggests vestibular disease or a problem with his inner ear. It could also be the cause of the eye movements you observed. The bloodwork suggests chronic renal failure and a high calcium level may suggest the possibility of a tumor of some sort in his body. I’m sure that your veterinarian has been advising you properly all along.

If your dog has had a seizure, a stroke, or anything triggering the acute nystagmus of the eyes, there still may be an underlying condition that has not been addressed or any of his multiple issues or a combination of them may have triggered what you observed last night. Full neurological evaluation including a CT or MRI may be worthwhile but, at an advanced age, there is probably little that can be done if a more serious condition is found.

Diazepam was probably the best drug that your dog could have been given based on what you shared. The Meclizine helped with the nystagmus and the motion sickness and nausea that occurs as a result. The drugs given last night stopped the abnormal muscular issues while also helping his appetite. You will need to see how things evolve over the next few days to know what steps will be next. Stay in touch with your veterinarian to make a decision at the right time. Good luck!

Dr. John de Jong owns and operates the Boston Mobile Veterinary Clinic. He can be reached at 781-899-9994.