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Urgent Advice Sought Please


Pheebs
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Tess has either had a stroke or has a tumour on the right part of her frontal lobe as her pupil is somewhat fixed and her left aide is affected. I've left her there to see the neurologist who will most likely recommend an MRI to the lovely tune of $1500 (apparently needs an anesthetic in order to do this) so I have nfi what to do :laugh:

You poor thing!

Personally I wouldn't bother with the MRI. They are unlikely to be able operate in that region anyway. My dog had a similar thing when she was 12 years old and when we saw the neurologist at the uni, she said there is no way she would recommend an MRI- too risky (the dogs are not closely monitored, ie a nurse/vet is not in the room with them, when they are having the MRI. They can be monitored by machines by vets in another room though) and although it may give us a more definitive diagnosis, it was unlikely we would be able to treat.

This neurologist was very good, and obvoiusly had the dogs welfare in mind, unlike another vet we consulted who wanted to do a CT myelogram! (not even a specialist!). The neurologist said this causes some dogs to become worse after the procedure, so it was lucky we didn't take that advice.

Our dog lived for approximately a year after seeing the neurologist.

Thinking of you guys :thumbsup:

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Love and best wishes to the dear girl.xxxxxx

I've lost a dog to stroke and one to a brain tumour and both times it was very easy to diagnose, even for me before we got to the vet. BOth times one side of the body was heavily affected and with the tumour there was wasting of muscle tissue around the tumour site, of course this can vary between dogs. One was 12 and one 15.

Hopefully it may be something else. She sounds like a wonderful girl who is very very loved. Love and hugs.xxxxxx

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Hi Pheebs....hope you're a little more relaxed than last night.

I agree with the others. At her age putting her under anesthetic is dangerous. I would have thought that with a mass you would have seen minor indications prior to now not just straight for the biggie....Let her go a few days while you think about it - if it is a mass it isn't going anywhere and you will see more problems. If it isn't you should see an improvement.

Take care and give her a hug for me.

Edited to say that strokes can leave a person with those remaining signs for a few days - or even for ever........

Edited by AmandaJ
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I too agree about wait and see for the MRI. I was under the impression that with both stroke and a brain tumour there is really only a 'make life as comfortable and painfree as poss.' treatment, esp with an elderly dog. Or course things may have changed in the last few years, but putting a sick dog through such a lot needs very careful thinking. I think I'd ask what the treament options would be before the MRI (if it turns out to be stroke or tumour) and what quality of life you could expect. If there is not a lot that could be done or if it is too invasive, (and if it were my dog) I'd prefer the rest of our time together to be spent with painkillers, hugs, kisses and lots and lots of time together.

with strokes, often the dog can improve with a bit of time too.

I really feel for you, :) ;) xxxxx

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Hi all,

Appreciate your thoughts so much. I will keep it brief as I've just discovered that my grandfather passed away this morning so as you might imagine its a pretty crappy time all round really.

Just spoke with the neurologist - ruled out vestibular syndrome and ivermectin allergy, although she has says there us a REMOTE possibility that the ivermectin was a trigger if she had a blood barrier problem to begin with (ie there was a tumor there to begin with which I'd impairing her ability to process it properly). Either way I feel like I've just about killed my dog.

They're doing bloodwork now to eliminate any major things like liver and kidney, and pending the outcome of that will do thyroid tests which I'll have to find the money for.

I agree, I think the MRI unnecessary as it's really only going to tell me two things - stroke or tumours and we wont be putting the poor old chook through any more than is necessary.

Eta. Theres been nothing to indicate any problem thus far - last night was the first sign if anything going on :)

Thanks again everyone and I'll keep you updated. Sorry for any typos or predictive text errors as I'm on my phone.

Edited by Pheebs
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I just caught up on this thread and wanted to firstly send you my condolences on the loss of your Grandfather. I can only imagine how stressful things are for you at the moment. I hope perhaps some good news will come through the blood test that show something treatable but if not please dont feel you have killed your dog by doing the responsible thing and heartworming and as the vet said it was a remote possiblity it was connected.

Sending all my best wishes your way that things come good really soon. :)

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If they want to do Thyroid - DON'T have them interpreted in Australia - get them sent to the US and have Dr Dodds do it! If you are going to pay for it you may as well have it done properly.

Thyroid testing can be done properly here in Australia.

Pheebs, why thyroid testing?

I'm so sorry you are going through all this, and I hope Tess is feeling ok.

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Pheebs condolences on the loss of your Grandfather. You are not a bad Mum and were doing the responsible thing trying to prevent heartworm. You giving the tablet and Tess becoming unwell were most likely a coincidence so please don't blame yourself. Sending healing vibes for Tess and hugs for you. Hope you get some better news after the blood tests.

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If they want to do Thyroid - DON'T have them interpreted in Australia - get them sent to the US and have Dr Dodds do it! If you are going to pay for it you may as well have it done properly.

Thyroid testing can be done properly here in Australia.

Our laboratories do not have the facilities to conduct a full blood panel test. Gribbles confirmed this with me a few years ago and told me that the likelihood of them ever developing the facilities to conduct the full blood panel test was pretty much Buckleys and None because the dog population in Australia requiring this more thorough testing was not enough. Last time I queried this (with a Vet who was insisting Australia can do it) it turned out that the Vets sometimes send the bloods to OS as well - they often have a contract with someone over there to do the testing. (I don't know if they send OS routinely.) I think I'd prefer and be more confident with the testing and the results analysis from Dr Jean Dodds too.

Edited by Erny
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Pheebs, why thyroid testing?

I honestly can't remember. Isn't that terrible ;)

I've just been trying to absorb a lot of Ifs and or buts :)

Over or under active thyroid glands is one thing that can be the cause of ischemic stroke (which is a sudden stop of blood flow feed to the brain).

Edited by Erny
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Hi all,

Just got back from the vet. Still no formal diagnosis... basically if she improves with steroids, then she has a brain tumour... if she doesn't improve, then i'll need to make some tough calls.

The vets seem to think she's improved during the day but I personally don't see it :confused:

Assessment is as follows:

Clinical and Neurological Examination

Neurological exmination showed compulsive circling to the right side. Tess had no head tilt or turn when examined. She had proprioceptive defecits in her left foreleg, but her left hindleg was normal. She had a tendency to learn to the left when examined. There was decreased left sided facial sensation. These findings were most consistent with a problem in the right forebrain (prosencephalon).

Diagnostic Tests

We discussed the option of performing blood tests - in particular looking at free T4 and TSH to rule out hypothyroidism (as a cause of vascular disease). MRI is the next diagnostic option, which would involve a general anaesthetic. Full blood tests revealed an ALT of 179 (5-80), and an ALP of 136 (10-120). These were considered to be out of questionable significance although without further investigation, hepatic disese cannot be completely ruled out.

Diagnosis

Right sided compulsive circling with left sided body weaknes. This indicates a problem in the right prosencephalon. Differentiuals include infarct (ischaemic versus haemorrhagic), neoplasia, inflammation/infection.

Medication and Further Management

We have decided to pursue conservative management based on Tess's age. Possible underlying causes of her signs include an infarct based on the acute onset of signs. Approximately 50 - 60% of infarcts in dogs have an underlying disease process such as anti-thrombin 3 deficit from a protein losing nephropathy/enteropathy, or diseases resulting in a hypercoagulopathic state such as diabetes or cushing's disease. Cardiac disease and vascular conditions (eg artherosclerosis) are extremely rare as a cause in dogs.

At this stage we have no indication for a cause of Cerebrocascular siease, although we have not excluded all possibilities. The majority of Cerebrovascular disease in dogs improves significantly with time, and if no identifiable underlying cause is found, the prognosis for recovery is good and recurrence is very unusual. The timing of her signs in conjunction with the ivermectin is intriguing. Potentially if impairment of the blood brain barrier was present at the time of administration, ivermectin toxicity could occur, although Tess' signs are not classic for this. We would like Tess to start steroids which would potentially treat oedema surrounding a tumour, and inflammatory brain disease if present - these being the only treatable conditions that we have not ruled out.

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Pheebs please take Tess to a good animal chiropractor in your area. Its worth a phone call at least. Mine has some testimonials on his website that you might find some comfort in..you just never know...some of these people were told euthanasia was the only option for them, that their dog needed MRI's, xrays, spinal ops, cruc ligament ops and many other drastic measures but were returned to good health when they were in alignment after 2-3 treatments. Best of luck, I feel for you.....my old dog was completely paralysed, I was just lucky to stumble across this guy 3 years ago and my now 10yr old boy is in great health. Stay positive and know you're doing all you can.

http://www.######.com/testimonials_2_24.html

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No real improvement here this morning (I know, it's early days still :grouphug: ) she's got the shakes a little

Bit when she lies down... Im guessing this is normal?

I have to go to Sydney on Monday for the funeral... The other two girls have been VERY intrigued with Tess, Lucy even licking and smelling the right front part of her head??!!!

Should I be separating them do you think? I don't want to make her an easy target to be ganged up on and I have my reservations about leaving her with Maggie, and Lucys an energetic twit who will likely bowl her over. Problem is Lucy screams whenever they're separated...

Any suggestions?

Eta. Theres the remote possibility OH can take her to work but this is not ideal and he's a mechanic

so I dont want the loud noises and strange environment to distress her..

Edited by Pheebs
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