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HELP! Has anyone had a dog with these symptoms??

This forum is for dog lovers seeking everyday advice and suggestions on health-related issues. Remember, however, that advice on a public forum simply can't be a substitute for proper medical attention. Only your vet can say assuredly what is best for your dog.

  
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Bruce

1160199
 
 
Barked: Tue Oct 19, '10 3:01pm PST 
Quick background: I found this dog about 3 weeks ago along the side of the road. I have no idea what he has been through before this. He had no external injuries when I found him but he was limping.
When I took him to the vet for the first time he tested positive for lyme disease and we got him started on antibiotics and pain killers (doxycycline and deramaxx). His limp improved but he was still walking funny so I opted to take him in to get an x-ray to see if something was wrong. They found a spinal lesion (Thursday 10-14-10) and said he should take it easy for a few days (They also prescribed him Deramaxx, methocarbamol, and tramadol along with doxycycline). The next day his condition started to deteriorate and by Saturday (10-16-10) he wasn't walking at all and quit eating or drinking. I rushed him to the vet and they sent me to the ER. He's been there ever since (10-19-10). He has been on an IV and all of his meds while at the hospital. Yesterday they started him on corticosteroids and another antibiotic and he has started walking, drinking, and eating again. They did x-rays which showed possible HOD but the vet said it would not cause so much pain (touching his paws made him whine on Saturday). They just got spinal tap results back (in case of infection in spinal/brain region) and these also came back negative. Since he is responding to treatments and I am a college student (poor), the vet said to continue with these treatments and hope he improves. The issue is he is better than when he wasn't walking but he has poor propioception and falls to his right side a lot. He bends his right paw under and walks on his lower arm. They have done x-rays of his arm and spine and found nothing that would result in these symptoms (no spinal lesion as the other place found). They suggested a CT scan but as I noted above I am in college and I am digging into my savings to help this dog which I am supposed to be giving away (although highly unlikely now since I have spent more than 2000 dollars on him thus far). A CT scan would only show what was wrong anyways and the vet said there are very few things that would show up on a CT scan that are operable. In closing, I just want to see if anyone has had a dog with these issues or has any idea what may be wrong so I can consult my vet when I speak with him tomorrow.

I will greatly appreciate any input!

Sam
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Ty

976505
 
 
Barked: Tue Oct 19, '10 4:03pm PST 
I have no advice to give you. But i just want to say that my prayers are with both of you and I hope things start to get better.
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Harlow

st. francis of- asses
 
 
Barked: Tue Oct 19, '10 4:08pm PST 
Hopefully Leah will come on here and give you some advice, she is very helpful with health issues.
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Bruce

1160199
 
 
Barked: Tue Oct 19, '10 4:34pm PST 
Thanks! I've been doing some research on it but it seems like it usually effects older dogs but Bruce is a year old or less. If he gets to come home tomorrow I am going to work on doing some rehabilitation exercises with him (if I can find any). At least then maybe we can work on his balance and get him to walk more normally. I am just worried that whatever it is will relapse and I don't want him to go through with that again. frown
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Ch. Luke, in memory.

Luke--- the dog talking
 
 
Barked: Tue Oct 19, '10 4:44pm PST 
Luke was a Frenchie with some spinal issues in the neck area. Whenever it happened (somehow he would injure this area), he would hold his front leg right out to the side and scream bloody murder if you even brushed against his leg or toes. He was always treated immediately with steroids, tramidol and muscle relaxants (and crate rest.) As he was recovering in the first few days he definitely seemed to have no feeling in that leg and would roll his foot under as well as well as fall over on that side. Within a week or so he would be back to normal. It happened three times over his life of 9 years. My vet felt it was a disk issue but we never xrayed... we always said we would do it the next time it happened.
I suppose your guy could have been hit by a car or something like that??
Hey, good luck with him... you have done a GREAT thing!!!
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Bruce

1160199
 
 
Barked: Tue Oct 19, '10 4:58pm PST 
The thing I don't understand is how/why it progressed so quickly. Unless they did something to him during his x-ray to irritate the issue, I can't think of any incidence that might have catalyzed him to his current condition. I also found it irritating that the Banfield (Petsmart) vet claimed they saw a cervical lesion but never transferred those x-rays to the ER. And although I asked several times if it was possibly "the lesion" causing these symptoms, they dismissed it saying their x-rays showed no signs of a lesion. Although PetSmart may not have the most competent vets (not that I am judging, they have been great to me), I feel like they wouldn't make such a serious issue up. You know? Seems ridiculous especially since they aren't making a profit from it. I wonder if I could get a copy of his x-rays. I don't see why not. At least then I could look at them and I could show them to the vet so they would see exactly what the other vets saw. It might make me feel better anyway. smile Which reminds me. If anyone knows of any physical therapist type exercises for dogs with ataxia, let me know!
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Snickers

Momma is the- center of the- universe...
 
 
Barked: Tue Oct 19, '10 5:08pm PST 
A few years back I was able to do a search on these symptoms and come up with "Late stage Lyme disease".

When the Lyme spirochettes pass the blood/brain barrier it can cause nuerological problems.

It can infect humans as well. My cousin was an active health woman. But due to an undetected tick bite she developed "late stage lyme".
She has headaches and still can't walk without some help.
The antibiotic treatment my cousine recieved was not nearly long enough. It may take months to years to kill spirochettes that are in the brain.
Killing them is no picnic. As they die and decompose, they become toxic to the host and cause further, nasty symptoms.

Your good to try. I hope it goes well. I wouldn't fault you if you gave up and put the poor baby down to avoid his having to suffer.
wisheshug
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Bruce

1160199
 
 
Barked: Tue Oct 19, '10 5:44pm PST 
Hmm it very well could be. Would Lyme disease show up on a spinal tap? He said it "didn't tell us anything" but I am not sure if he was only checking for meningitis or for a number of things. Like I said, I have no idea how long he had the Lyme disease before I found him... it could have been months.

I've been looking at vestibular disease since it fits most of the symptoms... "The major causes of central vestibular disease are inflammatory/infectious diseases or neoplasia. Organophosphate intoxication, liver disease (with metabolic brainstem degeneration) and thiamine deficiency can occasionally result in central vestibular disease (depending upon the species of animal), but these causes are far less than the inflammatory or neoplastic causes. In dogs, canine distemper virus, granulomatous meningoencephalitis, toxoplasmosis, neosporidiosis, aspergillosis, cryptococcosis, steroid-responsive meningoencephalitis, Lyme's disease, Rocky Mountain spotted fever and ehrlichiosis are the most common inflammatory and infectious diseases recognized."

I'm not planning on putting him down. I don't think I could bring myself to do it. Plus, I already spent about 2500 dollars on him so I plan on following through and he seems not to be in pain at all any more... It just makes me sad seeing him struggle so much to walk and I hate not having an answer as to why it is happening. My philosophy is that if I can educate myself on something I can come up with a solution or at least find someone else who can. wink
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Leah, CGC

All the Beauty- with none of the- Brains
 
 
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.
Petplace

Merck Manual

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...
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Bruce

1160199
 
 
Barked: Wed Oct 20, '10 4:56pm PST 
I've answered all that I could think of below.

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?

I am not sure what kind of test it was exactly. I do know this particular test only checked to see if he had ever had lyme disease not whether it was actively affecting him. According to my discharge sheet they did a lyme 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?
He had the limp when we found him on the side of the road Friday and I took him to the vet the following Monday. I did run to the vet on saturday morning to get worm and flea medication since both were present. Other than the limp he had a slight head tilt. I noticed that he was in some pain on Sunday. When I took him in the vet put pressure on his left leg (the injured one) a few times and once in a while he would yelp but if she touched that spot again it didn't seem to phase him much. I think she may have said it was "transient pain" or something like that. The only other time he would yelp was if I was walking him and tugged on his leash. He would pull away and whine. It wasn't very severe when I first found him but it worsened.
3) You report they noted a spinal lesion on xrays o 10-14-10. Was this their exact wording?

They said lesion and the vet explained to me that it was either due to a ligament that was too elastic leading to vertebrae shift or an intervertebral disc that wasn't firm enough to prevent spinal compression. They suggested a myelogram but when I went to the ER they dismissed this as a possibility based on the amount of pain he was experiencing in all of his limbs. They took some x-rays just to make sure and they only found possible HOD in his front leg (subtle double lucency distal radius). They did opt to do a CT scan though. I showed the vet the x-rays from Banfield today and he didn't see anything significant. I have both sets of x-rays on CDs if you'd be interested in seeing them. I was going to take another look when I got home but I have a mac and the images won't open.

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? 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.

They have him on Clindamycin and Prednisone. I am not sure about additional pain pills other than the ones I listed. I have under IV set-up Propofol, atropinem and butrphanol. I am not sure what any of those are but maybe it'll help you. The closest neurologist is in Charlotte and they suggested I take him there for an MRI which would run around 2500 dollars. If he doesn't improve in the next week or so I might consider it. The vet seems to think he will be nearly back to how he was initially by Monday. I just don't want him to relapse, it's hard enough watching him recover now frown

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?

In my billing statement it says CSF analysis using cytology-Antech (company maybe?)
I forgot to ask specifically what it was testing for but I can find out tomorrow.

6) I don't think excessive force during radiographing would have caused any of these issues you are seeing.

Well that's good, I just thought it was weird that right after that he started getting progressively worse.. coincidence I suppose.

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.

Yea... I actually found him in an area surrounded by swamps in SC and I can only imagine the number of things he came in contact with.

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

Yes I looked it up and asked the vet. Bruce doesn't have the eye darting and balance issues are likely stemming from some problem in the brain stem (according to the vet).

Thanks so much for your help! I really appreciate it smile He is walking a little better today but he's still really unstable, especially on slick surfaces. It makes me nervous.
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