|Barked: Wed Oct 20, '10 8:43am PST |
|It sounds like you and your vet are working well together to try and figure out this disease process. I have a couple questions to see if I can give you any more info about what might be going on. Please bear with me and try to give me thes best info you have. Hopefully, I will be able to give you some feedback on possible outcomes or testing that you may not have concidered if I can.
1) Do you know what type of test he had to diagnose the lyme diseae? Was it a snap test or a C6? Where other tick borne diseases tested for? Did your vet mention somthing call a tick titer?
2) You originally presented to vet with a limp...how long had you noted the limp for? IE how long did it take you to get to the vet once the limp was noted? Did he arrive to you with the limp? What (if any) other symptoms where noted at this time? Did the vet do a full exam and illicit pain in any part of the leg? If so what parts where painful? Was he painful in any other area of the body?
3) You report they noted a spinal lesion on xrays o 10-14-10. Was this their exact wording? A lesion refers to any injury or issue with any organ or body system. Lesions can be gross (visable with the eye) or microscopic. Spinal lesions can be the result of numerous things. It could be as simple as a pinched nerve or disc causing IVDD type symptoms. (IVDD-Cervical and IVDD-Thoracolumbar) IVDD refers usually to a compressed disc in the vertabral column causing severe pain or paralysis. It can be corrected medically (with excercise restriction and NSAIDs/Muscle relaxers/pain control) or Surgically. Neither option is 100%. Other spinal lesions can be from things like cancer (nerve sheath tumors and spinal cord blastomas are common near the spine where as osteosarcoma, fibrosarcoma,haemangiosarcoma, multiple myeloma, and chondrosarcoma are common in the bone of the spine.), Cervical Spondylomyelopathy (also refered to as Wobblers disease), degenerative myelopathy (very common in GSD's and other large breeds but usually onset is later in life - 10+yrs - a blood test can show if your pet carries the gene for this disease BUT having a + test does not guarantee your pet will suffer from the disease - however a symptomatic dog with a + test definetly is suffering from DM - it has not cure - its about management - Degenerative Myelopathy) and Spinal Cord Infarcts are a few of the more common leasions that you will see.
Have you had myelogram performed? This is a specific test in which they inject a radioactive dye into the spinal cord to help visualize the lesion and determine what it might be. This test requires the pet to be fully anesthitized.
4)Since the 14th he has deteriorated. He stopped walking on his own and stopped eating and drinking. However recently he has started walking again with moderate ataxia after being on doxycycline, steriods and an additional antibiotic (name?). Are they using additional opiod pain meds at the vet? You also note his proprioception is off (for those not familiar with this it is one's sense of the orientation of one's limbs in space - example is when police officers test people they pull over and suspect are drunk. Without proprioception, we'd need to consciously watch our feet to make sure that we stay upright while walking) and he lists to the right side as well has has trouble with his R front leg knuckling (bending under). Although now I see you are reporting that the ER tooks rads that DID NOT note any lesions. Have you had a consult with a board certified neurologist? This is sounding more neurological as you are describing symptoms. A neurologist would be a good person to help you advance diagnostic or treatment options.
5) A CSF tap (spinal tap) will very rarely show lyme disease. The test usually results in a false negative. Do you know exactly what testing they performed on the CSF fluid? I know they said everything was normal but I would like to know the specific tests in case I can think of something they missed. What is a CSF tap?
6) I don't think excessive force during radiographing would have caused any of these issues you are seeing.
7) There are infectious diseases that we stil don't know about or have no idea how to diagnose. Keep in mind that we are very advanced in our knowledge of vet medicine but infectious diseases often adapt and grow making it difficult for us in the vet world to keep up with everything. This dog was on the streets, exposed to numerous things, most likely malnurished and with a weakened immune system. The amount of diseases he could be exposed to are innumerous and possibly undiagnosible.
8) Vestibular disease - The basic symptoms of vestibular disease are head tilt, ataxia and nystagmus (eyes darting back and forth). This dog has obvious neurological deficits (knuckling and poor proprioception) so honestly in my experience this means it is likely not vestibular in nature. Here is more info on this disease process --> Vestibular Disease
9) Some other way out there diagnosis' I am thinking of include
--> Demyelation Disorders which may or may not show up in the CSF but most definetly would show up with lesions on brain seen in MRI.
Brachial Plexus Avulsion - This is nerve damage to a limb (usually a front limb) that results in inability to use limb,bear weight on limb or loss of senstation to the lower part of limb. There is no treatment except time for this - in some cases it gets better over time in others amputation is suggested especially if the dog becomes self mutalative towards the limb.
Nerve issues - sometimes surgical departments have electrical stimulation machines that help by placing a probe on the limb/leg and send small electrical shocks through muscles and nerves to see if the passage ways are still working. Nerve damage is most likely irreversible.
If you are truly interested in researching and gaining more knowledge in this area to help assist in your doctors quest for a diagnosis you can try using these websites to research and develop ideas.
10) As far as physical therapy goes I would research your local area for a good animal physical therapist to help you even if you just go for an initial consult they will be able to give you some good at home excercises.
Excercises like walking over small pole on ground, walking over wobbly or unevenground (you can think of things like wobble tables or even like a waterbed). Also it is amazing how well animals with these types of issues benefit from massage and range of motion excercises.
I hope this info at least helps you somewhat - I will continue to mull this info over...
|my posts | my page | msg me | my family's posts | gift me | become pals|| [notify]|