Stroke (Cerebrovascular Accident) in Dogs - Causes, Treatment and Associated Conditions

Key takeaways

A stroke, or cerebrovascular accident in dogs (CVA), is when there is a loss of blood flow to part of the brain, which damages brain tissue.

There are two mechanisms of stroke: obstruction (ischemic) or rupture (hemorrhagic) of the blood vessels of the brain; ischemic events are more common in dogs.
Patients show acute onset of neurological symptoms: abnormal posture, difficulty walking, abnormal eye position/movement, head tilt, and seizures
Symptoms generally stop progressing within 24-72 hours
Potential causes include hyperadrenocorticism (Cushing’s disease), kidney disease, hypertension (high blood pressure), cancer, and infectious diseases
Diagnosis involves a physical and neurological examination, blood work, and imaging (CT, MRI)
There is no specific treatment for stroke; supportive care and physical therapy are standard
Prognosis depends on type, location, and severity of the stroke, and any concurrent conditions

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A closer look: Stroke (Cerebrovascular Accident) in Dogs

Cerebrovascular accidents (CVAs), or strokes, are caused by an event which prevents blood flow to part of the brain. This can happen by an obstruction of the blood vessels (ischemic stroke) or by a rupture of the blood vessels (hemorrhagic stroke).

CVAs are emergencies and treatment should be instituted within 3 hours of onset of symptoms for the best outcome. Signs of stroke are often disturbing for pet parents and may be painful to the affected dog. Symptoms mimic those of vestibular syndrome, which is not life-threatening, and prompt veterinary intervention is needed to differentiate the two.

Risk factors

Symptoms of stroke vary depending on the type, location, and extent of the lesion on the brain. Generally, the larger the area of damaged brain tissue, the more severe the symptoms.

Ischemic strokes are more common in dogs than hemorrhagic, but strokes in general are uncommon in dogs. Certain dog breeds, such as the Cavalier King Charles Spaniel, may be predisposed to CVAs.

Possible causes

Amyloidosis (protein build up within the body) and injury may be a cause of either type of CVA.

Main symptoms

Testing and diagnosis

The first steps for diagnosis when presented with a possible stroke are a full physical exam and complete neurological exam (which might require referral to a specialist), blood work, and urinalysis. Advanced imaging (CT, MRI) may be used to locate and visualize the lesion. Spinal tap with analysis of the cerebrospinal fluid is a possibility.

Steps to Recovery

Treatment is supportive care. This may include IV fluids, feeding tube placement, oxygen supplementation or ventilation, anti-seizure medications, blood pressure medication, medication to normalize intracranial pressure, help with mobility, and physical therapy. In rare cases of hemorrhagic stroke, surgery may be done to remove the hematoma (pocket of blood).

The prognosis varies depending on the severity of the neurological function loss, response to treatment, and the severity of the underlying cause (if identified).

Stroke is an acute event. Expected outcome depends on several factors such as the severity and responsiveness to treatment. Loss of function may be restored with treatment or be permanent. Dogs may require long-term home care.

Prevention

There is no specific prevention for stroke, but keeping dogs healthy with routine veterinary check-ups and screening blood tests can help identify and treat underlying diseases before a CVA happens.