Thursday, December 22, 2011

Wheels?

AP here: Today Tonka and I traveled to Oxford, Maryland to K-9 carts east. It does not appear that Tonka is going to be back to blippity blopping on his own anytime soon. When all this first started people immediately started talking about having Tonka in a stroller or a wheelchair. My initial reaction was "NO WAY" the logistics of a 130lb blind dog in a cart seemed impossible and honestly I felt like even thinking that would be giving up hope that he would return to normal. The reality of the day to day dealing with my boy and his multiple disabilities has reminded me that:
1. there is no such thing as normal
2. if there was a normal he never has nor will he ever fit the criteria
3. he needs to be mobile for his emotional and physical well being.
4. It has been 3 months and several specialists and no one seems to be able to find the problem let alone fix it

So after hours of research on the Internet and talking to several people and companies I still have no clue what will work for him. It is hard to research them because when you think you know something is good about one model another manufacturer goes to great lengths to tell why it is not. It appears to be a very competitive and cut throat market. Since I have no experience with carts and being the type A that I am I need to make sure that he absolutely needs a cart and it is the right cart for him. Unfortunately there is no dog cart store where you can go and test drive different models but there is a company within an 2 hour drive that has been making carts for over 40 years so off to Oxford we went.

The company K-9 carts East  is operated by retired orthopedic veterinary surgeon, Dr. Lincoln Parkes. Each cart is individually made based on specific measurements and the website walks you through how to take them or you can make an appointment to visit and they will take them for you. We met with Dr. Parkes and he watched Tonka limp around and we discussed Tonka's varied medical background. His staff took his measurements and showed me how the carts are made, they did not have any quite his size but I did get an idea of how big it is going to be.

If all goes well we can go back in a week and he can try it out and they will tweak it to meet his needs. I am still not 100% sure how I feel about my boy in a cart and I feel like I have failed him with this problem. This has been the first thing that I have not been able to fix for him and it breaks my heart on a daily basis. Perhaps when he gets mobile again things will turn around.

Thursday, December 8, 2011

It may be all in his head!

AP here with an update:

I took Tonka to see Dr. Jay McDonnell to see if he might be able to shed some light on what has happened with my boy. He went over the MRI with me and he did not see anything different than what Dr. Harris had seen.

The MRI is a device that uses strong magnets that spin around the patient, and picks up the magnetic signals emanating from the cells as they demagnetize. This gives a picture of the inside of the body without having to use surgery and is more precise than X-rays.

In a dog there are 36 pairs of spinal nerves of the 36 spinal segments which are categorized into the 5 spinal cord segments labeled cervical thoracic, lumbar, sacral and caudal

8 cervical; 13 thoracic; 7 lumbar; 3 sacral; & 5 caudal = 36 total

His lumbar and lumbosacral areas of his spine look great so there is nothing to suggest that his problem is due to a disk problem or stenosis which is a narrowing of a spinal area that would put pressure on the spinal cord or nerves.

He does have some intramedullary (within the spinal cord) hyperintensity within the thoracic part of his spinal cord. A hyperintense signal is a "bright spot" on an MRI. In order to eliminate fluid being the cause such as cerebrospinal fluid they use FLAIR "Fluid attenuated inversion recovery" which is a pulse sequence that essentially removes fluids from the picture. This allows any lesions to be visible. It is not known what has caused his bright spots and in order to get a fuller picture of what has happened we would have to MRI his cervical area and his brain. The plan at this time is to do that in January. The brain and spinal cord are surrounded by cerebrospinal fluid (CSF) and this fluid nourishes the nervous system and protects the brain and spinal cord so it directly reflects what is going on inside the nervous system. Dr. Harris checked for CSF problems at the time of his MRI with a spinal tap and it came back normal. It could be that there is too much CSF and perhaps a narrowing that is inhibiting the normal flow and creating elevated intracranial pressure so he is now on Prilosec. Prilosec which is omeprazole relieves heartburn in people but in dogs it reduces the production of cerebrospinal fluid.

We have seen some improvement with the foot drag which is now a lift and stutter until he gets tired and then it is back to a drag. The incontinence seems to come and go – some good days, some bad so we are just going to create as normal an environment and routine as we can. The advice was to “do the things that he likes and that seem to work and avoid the things that make him worse” and we can certainly do that. We will continue with the acupuncture and anything else that helps him physically. Twice a week I will take him to the park and let him “see” his dog friends and once a week we will go visit his human friends and that should keep him emotionally happy.

I cannot say enough great things about Dr. McDonnell and Dr. Harris. I never felt rushed or pressured into any procedure. They both took the time to go over the MRI results with me and the support staffs were and are always extremely professional and helpful. You can tell when people really care and understand what you and your pet are going through and this group does. I hope you and your pet never need a neurologist but if you do Tonka and I would recommend you check in with Veterinary Neurology of the Chesapeake and Dr. Jay McDonnell, DVM, MS, Diplomate ACVIM (Neurology) and Dr. Jeanene Harris, DVM, MS, Diplomate ACVIM (Neurology)

Friday, December 2, 2011

Throw me a Rope

AP here: I have now been dealing with Tonkas gradual decline for almost 2 months with no answers. The poor boy has been poked, shaved, prodded, physically manipulated, lasered and scanned with no definitive answers. Through it all he has been such a good sport and a gentleman and I have no doubt that he will keep on being such a "very good boy". It all seems so unfair since he is such a good boy. He will be 4 soon and he has never growled nor even snarled a lip towards anyone or anything. It is very frustrating that we have no answers and equally as frustrating that it is only about a 1/4 of an inch lift that the foot/leg needs to do in order to not drag or scuff.

We have had good days and then really bad days on good days he sort of lifts the foot with little drag
and on bad he drags and knuckles under. His bad days seem to come after medical consultations with
lots of pushing and prodding. Acupuncture seems to be the only thing that has not caused a bad day yet. I have noticed that lately when he stands at the food bowl his back end starts to sag and his legs bend. When he goes to lay down he starts down and then falls all the way back and then slides his front legs down with his left leg way out to the side in a straight position with very little bend
at the knee.

video


It is very frustrating that this does not seem to have a cause, or fit any particular known problem. If nothing can be done and this is how he is going to stay that is fine but I would like to know what the problem is. I don’t let him do too much because I don’t want to hurt him in any way but if this is it then I would like to get him back into a normal pattern (a new normal of sorts). I will take him to the park and let him see his friends and we will create a schedule for the urinary problem. I just want to him to keep him safe and happy.