We have four dogs the youngest,AMBER is a labroder just 6 years old. very healthy and active, until one morning she was unwilling to get out of her bed. She was extremely nervous shaking as would a jelly .Our vet has taken bloods, x rays total visual examination etc etc all to no avail. We also tried a course of antiboitics for inner ear balance issues, again nothing. Instead of a young dog she is as if she were sixteen. We fear brain damage, she is we believe totally blind on her right side and deminished on the left We are unable to afford a ct scan, particularly as it might not confirm a reason or cure. With some reluctance we have agreed to steriods 2x30 twice daily .These do not appear to have helped,our hope was a reduction in inflamation in or around the brain might have corrected a brain misfunction or released the optic nerve. You will gather we are owners who wish only to do the best for her but her quality of life is currently poor. Because of the other dogs she walks on the lead happily and cautioudly around the home. The final point if she suffered a animal stroke, can she be cured, are we keeping her alive for us and not her well being .We understand she has no pain but have no way to be sure.We are now desperate and will be grateful for any advice, good news or otherwise THANK YOU XXXX XXXX . we are in XXX XXXX XXX XXXXX XX XXX mobile XXXXXXXXXXX [email protected]
Questions to consider include: 1. Does she still enjoy doing the things she used to enjoy doing (even if for shorter periods of time) or is she too debilitated or weak to do so? 2. What is her attitude like? Is she lethargic/depressed or is she still upbeat and enjoying interaction with her family and with your other dogs?
3. Has she had difficulty adjusting to her new circumstances? Is she trying to adjust or has she given up?
I find that if you can answer these questions honestly and objectively, then it often helps make this difficult decision about whether or not to let her go.
My personal opinion is that it's best to let our pets go while there's still some dignity to their lives but this is only my personal opinion. For me, quality of life trumps quantity.
I hope this helps although I do realize that this is a very difficult situation for everyone. Deb
I think the follow up questions I raised yesterday may not have reached you so Itry again. Having decribed the investigations that have been undertaken do you feel we have missed anything. It was suggested we should do a blood test for TOXICPLAMOSIS (SPELLING)? Is there any test that could indicate a tumour, or rule out the possibility.I am told dogs do not have a stroke in the human sense but something else??What are the possible causes particularly in such a young dog. Anything you can add suggest or dismiss will be gratefully appreciated.Finally since the steriods she would appear to be loosing weight. Does this help your considered opinion?? THANK YOU TREVOR XXXXXXX
Trevor: I didn't receive your follow up questions so thanks for sending them again. Sometimes the site has issues and I'm at a loss to explain or understand why. Toxoplasmosis is a very uncommonly seen disease in dogs although I see it quite a bit in cats...probably because they hunt and ingest birds and rodents (one of the most typical modes of transmission). This disease can cause a whole host of symptoms ranging from neurologic signs (head tilt, seizures, blindness) to those involving the eyes (uveitis, sensitivity to light, discharge), or respiratory issues (such as coughing, increased respiratory rate), gastrointestinal signs (such as diarrhea, vomiting, abdominal pain), and fever.The tests typically detect antibodies to the organism (and thus exposure) but not active infection.Antibiotics such as Clindamycin are what I dispense when I suspect this condition in the cats that I've seen. If Amber hasn't been prescribed this drug, then this may be something to consider.It doesn't sound like your vet has necessarily missed anything and has run the routine diagnostic tests which I would also have done. As you previously mentioned, an MRI or CT scan might be useful in trying to rule out a stroke or vascular event or mass in the brain but treatment options are extremely limited even if such a diagnosis were to be made.If money were not a consideration, then brain surgery could be considered depending on the location of any mass which might be present. However, this is not something that most of my clients can afford.A consultation with a neurologist might be something to consider if one is available to you in your area even if you can't pursue additional testing.
But having said that, if her symptoms have stabilized and she's no worse, then an ischemic event may be more likely.
If her symptoms are worsening and/or she's developing new signs, then a brain mass or infectious disease may be responsible.You're correct that dogs don't have strokes exactly like humans but they do have what we call vascular or ischemic events. This could involve bleeding in the brain, a blood vessel tumor which interferes with circulation, or an area of inflammation which changes blood flow. The end result is a portion of the brain becomes deprived of oxygen and cells are injured or die; then function is lost depending on the location.The risk factors for this condition are also different for dogs as opposed to humans but might include Diabetes or chronic kidney disease or heartworm disease or use or the drug Phenylpropanolamine (used for urinary incontinence issues primarily in spayed female dogs). However, we often don't have a good explanation as to why most dogs will have vascular or ischemic events.I'm not certain why she would be losing weight if she's otherwise eating well although dogs with Toxoplasmosis can experience weight loss in addition to the other myriad of signs which can be seen.
In cases like this, if no obvious cause for symptoms can be found but my patient is losing weight, I always worry about cancer somewhere in the body; I just may not be able to locate it yet. She is a little on the young side for this, but I have seen it which is why I mention it. And, unfortunately, there are very few specific blood tests which can detect cancer. Depending on the symptoms, ultrasound may be useful but it doesn't sound as if Amber would necessarily benefit from this.
This obviously sounds like a difficult and challenging case but if at all possible, I'd consult with a neurologist who may be able to provide additional rule outs based on a physical exam, test results and response to medications.But, I'd also consider Clindamycin if this is not the drug previously dispensed to her. Regards, Deb
DR DEB Thank you for your response we will digest your comments before responding further.I thought you were a neurlogist and not knowing where you are based i wonder can you reccomend someone and likely fee.We had not proceeded in this direction previously for we belived a consultant would only wish to refer to a CT scan which we know could well be inconclusive and expensive.Are you confident that a consultant could really assist further than her current vet particulary with the negative results to everything that has been tried todate? THANK YOU TREVOR
Trevor: I'm sorry if you were under the impression that I was a neurologist; unfortunately to the best of my knowledge there are no specialists in that discipline who answer questions on this website. There are a few UK-based experts on this site but the majority of us are based in the States so it will be difficult for me to suggest a neurologist in your area. However, I feel certain that your vet should be able to suggest someone.I don't know how close this facility would be to you but this hospital (LINK) is associated with the Royal Veterinary Collage and would, no doubt, have excellent specialists.As to fees, I can tell you that a consultation in the States will run about $150-$200 (approximately 90-120 pounds) but this also very much depends on where you live here since certain areas of the country are much more expensive than others....and fees reflect this.In many cases, I do believe that a specialist can provide additional expertise and information when complicated cases are seen; after all, this is all that they do. If board-certified (typical for most individuals), their knowledge and experience is typically superior to that of a non-specialist. Of course, at this juncture, such an individual may only be able to provide more or less likely rule-outs but I do believe that in most cases, there is value in a consultation with them. Their input may be hampered by lack of an MRI/CT scan but this shouldn't negate their assessment of what may be going on with Amber.Does a consult assure that new information or insights will be provided? No, but at least there may be some comfort in knowing that you did the most you could given your financial circumstances. Deb
DR DEB,Thank you for answers. Unfortunately things have not improved, despite all the efforts her quality of life has further worsened and therefore the decision to end our time with her has been taken and she will be put to sleep tomorrow. If she were able she would thank you for your attention so I thank on her behalf. Obviously the matter is closed and I will not continual with your company regards TREVOR
DEB can you help me. I enrolled with a one week free trial. I believe I have hit the right button but nothing confirms that I have withdrawn. could you kindly notify whoever, similar sites have caused difficulties when we are in different parts of the globe . There is no point in keeping a monthly account when Amber has departed THANKS TREVOR