Facial Nerve Paralysis In Dogs

Has your dog suddenly can’t lift one side of its face? developed a lopsided smile? or, one portion of its face seems to be frozen or droopy? Your dog may be suffering from Facial paralysis. This is a condition that is characterized by changes in facial control and a dog’s expression. The dog may look like a canine Harvey Dent.

Facial paralysis is quite common in middle to old age. Facial nerve paralysis is a malfunction of the cranial nerve VII, the facial nerve or of the region where the nerves come together affecting the electrical impulses of the involved nerves. This condition is evidenced by weakness or paralysis of the muscles of the eyelids, ears, nostrils, and lips.

Affected dogs have a tendency to drool uncontrollably, are unable to blink properly and food gets dropped from the side of the mouth. Often, both sides of the face may have the same signs making the changes difficult to identify.

A deep-seated infection of the ear (otitis media/internal) is the second most common cause of facial nerve paralysis. In this case, other signs such as vestibular syndrome (balance loss, head tilted to one side) and/or Horner’s syndrome (third eyelid coming across the eye and decreased pupil size) are frequently seen in addition to facial paralysis. When there is no known cause for paralysis can be found, it is called idiopathic facial nerve paralysis. This condition is similar to Bell’s palsy in humans.

Rarely, canine facial paralysis can be associated with brain disease (infection, inflammation, or tumor) or affecting multiple nerves (polyneuropathy).

• Failure to move the eyelids to close normally or causing problems in the blinking process
• Disproportinate Palpebral fissure (larger on one side)
• Palpebral fissure’s nasal or temporal corners (the lateral or medial) are touched, the eyeball may retract into the orbit and the eyelid may not close due to the immobile upper eyelid frontalis muscle
• Ear carriage is disproportionate and may appear lower or higher on one side than on the other side
• Sloppy eating; Food falling from the side of the mouth
• Excessive drooling
• Discharge of pus from the affected eye
• Nostrils are unsymmetrical; one nostril may deviate toward one side or the other or Collapse the nostrils
• Elevated third eyelid
• Absent or decreased menace response and eyelid reflex
• Deviation of the face toward the affected side
• Facial spasms
• Stupor or Somnolence

• Supportive therapy
• Oral and/or Systemic Antibiotics
• Lubricant ointments and/or antibiotic ointments
• Corticosteroids and Immunosuppressive Agents- Cortisone (dexamethasone, prednisone, prednisolone) and Cyclosporine (Atopica)
• Antihistamines – Chlortrimeton, Benadryl, Atarax, Clemastine, Claritin and Zyrtec

Discuss with a veterinarian any home care specific to your dog’s situation.

This may include dietary changes, exercise, further medications to administer, and future veterinary visits for treatments as needed.

Prevention is not possible for facial paralysis as the causes in dogs is varied.

Facial paralysis due to the hereditary abnormality can be prevented by stopping the breeding of affected dogs so that the risk of passing the condition on to the next generation is averted.

1. Causes:

One-sided facial nerve paralysis:

• Inflammatory – Otitis media-interna: inflammation of the inner ear
• Nasopharyngeal polyps
• Trauma – Injury to the facial nerve, fracture of a bone at the base of the skull
• Iatrogenic – Secondary to the external ear canal surgical flushing
• Metabolic – Hypothyroid
• Cancer
• Idiopathic (unknown cause)

Two-sided facial nerve paralysis:

• Immune-mediated – Inflammation of nerve roots- including myasthenia gravis (muscle weakness), polyneuropathies (multiple nerves are involved); coonhound paralysis, etc
• Pituitary neoplasm
• Toxic – Botulism

Central Nervous System: one-sided paralysis

• Neoplastic – Primary brain tumor; a metastatic tumor
• Inflammatory – Infectious and noninfectious

2. Types:

• Complete facial paralysis: maximum region of the face is affected, and the lack of ability to move the eyelids, lips, nostrils, and ears of the dog
• Partial Facial paralysis: only a part of the face is affected. This is a mild type of facial paralysis. Some movement of the eyelids, lips, nostrils, and/or ears is possible; however, the movement would be limited.

3. Mortality: There is no mortality due to this condition documented yet

4. Diagnosis:

• Complete blood count and a serum chemistry panel
• Skull x-rays
• CT SCAN/MRI

5. Prognosis:

Facial paralysis isn’t a lethal condition; however, it is a permanent problem. Discuss with your vet to figure out the underlying cause. When no underlying problem was found for the nerve damage as in idiopathic causes, then the dog’s prognosis is good. Prognosis is guarded for paralysis due to ear infection depending on the diagnosis and appropriate treatment for cases of ear infection. Infected Dogs due to an underlying medical condition will need follow-up visits to monitor their progress.

Contact your vet right away, if you notice any of the following:

• Failure to move the eyelids to close normally or causing problems in the blinking process
• The palpebral fissure may be larger on one side than the other
• Sloppy eating; Food falling from the side of the mouth

• Minimally processed meat: seafood, organ meat, and poultry; meats should be pasture-raised or grass-fed, whenever possible
• Soups: Broths, chicken soup/stew, fish stew
• Omega-3 oily fishes such as salmon, tuna, cod, etc
• Leafy greens such as spinach, kale, watercress, etc
• Citrus fruits or juices, Sweet potatoes, tomatoes, pumpkin
• Zinc foods such as Pork, tuna, Oysters
• Blueberries, Broccoli, cabbage, carrots, etc

The prognosis for dogs with facial nerve paralysis depends upon the specific diagnosis, as well as the dog’s health condition at the time of diagnosis.

If the underlying cause of paralysis is diagnosed early and the dog is in relatively good health, effective treatment for the underlying illness will result in a good prognosis.