A 10-year-old female spayed German Shepherd dog
was presented to the neurology service at the Cornell
University Hospital for Animals (CUHA) for
evaluation of progressive neurologic signs in the
previous 3 months. The dog had suffered from
recurrent infections in the left ear for one year,
which were managed by the referring veterinarian
with numerous antibiotics and corticosteroids. Three
months before presentation to CUHA, the owner
had noted reduced barking and pain when the
mouth was opened. These clinical signs responded
partially to amoxicillin therapy. The dog then developed
neurogenic keratoconjunctivitis sicca (KCS) of
the left eye, followed by a left head tilt, disorientation,
and difficulty walking and navigating stairs.