Things are back under control after a long run of spam attacks in the comments of the Vet Blog. I have blocked a number of IP addresses. I have flagged a number of words, including “acai” and “weblog” (spammers often pump acai berry products; the second word is favored by non-English-speaking spammers). I have flagged dozens of comments as spam, and the WordPress spam filter seems to have done the rest. I apologize to anyone whose legitimate comment was inadvertently thrown into moderation during this period.

Speaking of legitimate comments, Carrie left a question in the comments section of my article about old dog vestibular syndrome.

HI, I have a 13 year old lab/golden/chow mix doghe had a stroke a day agothe vet said most dogs recover from thisand his prognosis is good.but when I saw him today, he looked the same.one eye has this constant twitch and the other eye has this upward movementslight, but constant.he wont stand up at all so hes peeing where he is in the cage at the vetshe wont eat, but can drink water when I gave it to himhe can hold his head up..Im bringing him home tomorrow and see how he does over the weekendif things dont improve and his quality of life is diminished, then I will have to let him go.how do you care for dogs that cant stand up.Ive used towel to make a sling to hold them up with my other old dog.and I bought a package of wee wee pads to put it under him..

First, some semantics. Carrie, your dog probably did not have a stroke. It is more likely that he is suffering from old dog vestibular syndrome (ODVS, which soon may be renamed to a more politically correct canine geriatric vestibular disease). The cause of ODVS is not known. The syndrome is marked by sudden onset of dizziness, head tilt, disorientation, eye twitching, and possibly inability to walk. Many dogs with ODVS suffer from nausea due to perceived motion sickness.

Although ODVS usually comes on in a very dramatic fashion, one feature of the syndrome must not be forgotten: almost all dogs recover from it. ODVS carries a good prognosis.

The key to treating ODVS is nursing care. I recommend hospitalizing pets who are too dizzy and nauseated to eat, drink, and walk. However, pets who can eat and drink may be cared for at home with proper nursing care.

Carrie, since your dog can’t walk to the water and food bowls, you should offer water and palatable, easily swallowed food to your dog every 4 hours at least. Make sure he doesn’t eat and drink too fast when he is unable to stand; this can lead to accidental aspiration of oral contents into the lungs. Talk to your vet about medications such as Cerenia that can decrease motion sickness.

Help your dog to stand up, and attempt to walk him, every four hours. A rolled up towel can serve as a makeshift sling for his hind end. Take him to his litter area and encourage him to urinate and defecate. Talk to your veterinarian if he does not produce normal amounts of urine and feces.

If your dog does soil himself, clean and dry him immediately. Urine and feces can scald the skin and lead to severe infections. Make sure that his skin is dry at all times.

Attempt to turn your dog every four hours in order to reduce the likelihood of pressure sores (bed sores). In other words, turn him from his right side to his left side. Never roll a dog over on his back. Instead, help him to stand up, then to lie down on the other side. Be aware that some dogs with ODVS will refuse to lie on one side. Don’t force him if he won’t willingly switch sides, but keep encouraging him to switch every four hours.

Be sure that your dog rests on plenty of soft, dry bedding. This helps prevent pressure sores. Bedding also can absorb urine when it is initially produced. That helps to prevent it from contacting the skin. Be prepared to change and wash the bedding several times each day. Never allow your dog to lie on soiled bedding.

Finally, be patient. Most dogs with ODVS improve within 48 hours, but I’ve known several that took up to a week to come around. Don’t give up on your dog until he’s had an honest chance to get better.