Senior sheltie had a stroke :-( Any recovery advice?

@Sharon7 , she had a stroke sometime between 6am and 11:30am on June 19, but the symptoms were relatively mild at that point. I honestly don't know that the average person would have noticed, I just could tell that she wasn't quite right.

Then at 9:45pm, she had a grand mal seizure. That's when I rushed her to the emergency vet, and while in the back with the vet she had another seizure. I don't know if it was a grand mal, they didn't say and I was too upset to think to ask. They prescribed 500mg of Keppra Extended Release, twice daily.

I took her to her regular vet on June 21 for blood work, and all of her numbers were fine. I was concerned that 500mg was high (I read that humans take less!), but he said it was normal and that she would likely be on it for the rest of her life.

Now I'm reading that 20mg per pound is normal in an emergency situation, but a normal sustaining dosage is 30mg /kg:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4858031/

At 25lbs that would be 340mg instead of 500. Pills are 250mg or 500mg, though, and Extended Release can't be split, so I guess my choice is to give her too much or risk giving her too little :-/
 
OK that makes more sense, but it might be worth a recheck with a neurologist to reconfirm drug and dosage? I haven't had a dog with seizure issues so I'm no expert, but if in another week or so you are still concerned about the medication causing too many side effects, it might be worth another vet visit. Hang in there, it's a roller coaster, but honestly if my dog had responded this well after her stroke I would have been so happy.
 
I'm trying to be encouraging with her, but not pushy. She's always been independent, anyway, so (for example) when she wants to climb the stairs by herself, I let her... and I try to not let her see that I'm guarding her little butt the whole time! LOL

The only "pushing" I've done is walking her down the driveway. She really doesn't seem to want to do that very much, honestly, and it's a slow trip! But I think that the steady walk is sort of like physical therapy to retrain her brain to work her lame leg, so I've been pushing her a little.

The only real concern I have at this point is the spontaneous howling.

I mentioned that she howled last night while I was brushing my teeth; the first howl she's done in years, and before they were always just echoing her beagle brother. Last night I was 5' away from her, and she didn't appear to be in pain or anything.

Then today she howled at around 4pm while I was gone and she was home with her mommy. Again, no apparent reason.

Then twice this evening she howled, including just now while she was laying at my feet! I reached down and put my hand on her and she stopped howling; then she walked around for a minute, came back to lay down, and now she's kinda grumbling.

She had her Keppra about 30 minutes ago, she's had a few treats and drank water on her own, and she just went outside to potty about 15 minutes ago. I can't think of any reason at all for the howl!

That scares me, of course. Her body is fine, but now I have to worry that there's a tumor hurting her head and I wouldn't know it :'-(
 
Just a thought or two, Maybe she needs a "job" to turn your walks down your long driveway more fun.. "ex.checking the mailbox for mail or magically getting a small treat from the mailbox." This might give her a purpose for making the walk if she really doesn't like to.
I now Teddy my Sheltie thinks walks are fun so for me it's easy, but treats on the walk do happen for good behavior.
I remember when Dewey was alive,, he would go into full out barking mode if a double engine train would idle on a spur line going to a local factory a half mile away.. When I first moved into my house I could feel a very slight vibration when that happened. Teddy never responds when this happens The reason I mention this is is there something outside that might be triggering her howling? Something that she might hear that hurt her ears that maybe we don't hear or ignore? I always thought Deweys hearing was more responsive than my other Shelties but my others never had the seizures like he did.
 
Good thought, @Ron Atkinson , I'll carry a treat with me today and find out :-) She pants the whole time so I honestly think that her lack of excitement is still from the Keppra, but I'll find out!


The reason I mention this is is there something outside that might be triggering her howling? Something that she might hear that hurt her ears that maybe we don't hear or ignore?

You raise a slightly complicated question.

About a year ago we thought that Katy had lost her hearing entirely! She stopped responding to verbal commands, and there were a few times that she would be outside and not coming when I called (totally unlike her), then I would walk up and touch her back and it would make her jump.

Then in early May we woke up to find the left side of her face totally swollen! We rushed her to the vet and he discovered an abscessed tooth, so we gave her a round of antibiotics and then had the tooth removed.

Then, as you know, on June 19 she had an apparent stroke. Again, on the left side of her brain.

Could there have been inflammation in her jaw that caused hearing loss and then a stroke? I don't know. Now that we have her on Keppra and a round of Prednisone, though, could that be removing inflammation in her inner ears that is restoring her hearing? I don't know, and the vet really can't say either. He said that there's really not a test for hearing, so all we do is wait and see.

Long story short, we've wondered if maybe her hearing is coming back. I've made sounds recently that she reacted to, but I can't be 100% sure that she's not reacting to a smell or vibration.

That first time she howled, I had my electric toothbrush going. It could have a high pitched sound that I don't hear, but bothered her.

The second time, my girlfriend had the hair dryer going. Again, potential irritating sound.

The third time, we were watching TV ("Suits", so far a great show). Nothing unusual happening, just men talking. We've had the TV on 16 hours a day her whole life (usually music playing while we work, and we leave it on when we're gone so that thieves won't know if someone is home), but still it's possible that there was an irritating sound that we couldn't hear.

The fourth time, though, it was very quiet in the house. Mommy was in bed and I was behind the computer with Katy at my feet. I can't swear that she didn't hear (or smell) an animal outside, though.

I'm going to hope that this is the issue, though, and not some type of pain!
 
Giving a quick update, she's doing better every day! Today I let her go down the stairs on her own, with me guarding. She was hesitant, but figured it out pretty quickly. She's not dragging her front right paw as much now, either, although she's still a bit wobbly when going potty. And she's been pretty barky today!

And our trip to the mailbox went much faster today!

I still can't decide if she has any eyesight at all. There have been times that she had to have seen something! Like, I had a sealed bag of pork rinds (one of her favorites) that I picked up to open, and she clearly watched it go from the table to my lap! She couldn't have smelled the change since it was unopened, and she wasn't close enough to feel me move.

I've also seen her duck under the coffee table a few times instead of bumping in to it.

But then I had her go to the living room and sit / stay while I went to get her a carrot, but instead of watching me like usual, she stared off to the side. And a few times I've gone to give her a treat, and she's trying to take it several inches away from where it is.

Other than that, though, she's recovering in leaps and bounds!
 
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