Hello I am Dr. Joey. Thanks for trusting me to help you and your pet today. I am a licensed veterinarian with over 15 years of experience. I look forward to working with you.
I apologize that no expert has jumped on to answer your question until now. This is a tough question. It sounds like he has significant evidence of traumatic brain injury between the unresponsive pupils (lack of visual processing which signal brain issues) and the lethargy/unreponsivness. This trauma to the brain can occur if whatever attacked him was larger and perhaps shook him and this lead to brain swelling or a contusion on the brain (brain bleed). Or if a puncture went through his skull and into his brain (this is very unlikely...he probably would not have survived had this been the case). It is very unlikely to be spread of bacteria to the brain so quickly to have cause this.
Your veterinarian is correct that there is no test we can do aside from an MRI to confirm brain trauma. That being said, doing an MRI may not change how we approach treatment (brain surgery is usually not an option for these small guys). I assume your veterinarian has been treating him for brain swelling. If the brain swelling is quite severe or there is a significant bleed, then all we can do is wait and give him time to see if he improves. I would expect within 3 to 4 days he should start to show some improvement, at least in attitude. He may never be able to see again, though. It is possible that the trauma to the brain was so severe that he may not improve and in that situation you and your vet must together decide how long you let him be supported with in-hospital therapy. Take into consideration, however, that it takes a long time for the swelling and bleeding to resolve.
It is important to remember that the compensatory ability of the brain is high. Most patients that survive the initial 24 hrs will recover, although some may have residual deficits.
We often use what is called a Modified Glasgow Coma Scale to try to determine prognosis (you can ask your veterinarian to calculate a score on this scale).
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