The Crash

AP here:
The ER at CVRC is a busy place but it is the best place for Tonka when he is in distress. Most all of his specialists are there and everyone knows him. So when he had the multiple instances of diarrhea and was weak and dehydrated it was the place for him to get the best care.

We arrived around 5:00pm on Monday June 3rd and he would not be leaving till Tuesday June 4th at 7:00pm. They had taken him back and started him on IV's and his Aunt Gina came to sit with me and make sure he was OK. She also came to make me go get dinner with her since she knew that I would be spending the night there and would not eat otherwise. They put my boy in one of the nice large condos with lots of comfy bedding.

In the Condo

This is where I would also be spending part of my night and most of the next day. It was a little surreal being there again overnight as it was just a month earlier I had been there for 2 nights when he had his surgery.

Sleeping with Me

The next morning his care was transferred from the ER staff to the Internal Med./Oncology staff.
Diana who had helped me carry him in the night before was kind enough to bring me coffee and a muffin for breakfast when she came in to work. Since it was Tuesday morning it was also his usual therapy day so all his therapists were there and came by several times to pet him throughout the day as well as his Aunt Gina and his surgeon Dr. Roa.

I went back to sit with him whenever they would let me and I stayed cuddled in the condo with him for a good part of the 20 some hours we were there. At lunch his therapist Chris went out and got me a sandwich and sat with him while I went out front to eat it. Everyone was super about taking care of him and me and giving him lots of love. It is both a blessing and a curse that he is so well known there by everyone. We are fortunate that we have the resources locally for the kind of support and medical attention he needs.


In the afternoon his oncologist Dr. Peterson talked to me about his blood work which was pretty normal and wanted to do an ultrasound to see if they could come up with anything else that could have caused this. Since the last chemo dose had been Friday and he tanked early Monday the theory was it was not the meds that had upset him. The chemo meds are supposed to clear the body within 48 hours.  I agreed to the ultrasound and when it was done it also looked normal the only thing was a little thickening of the intestinal wall in a spot but after consulting with Dr. Roa it was agreed that was from he surgery. Tonka may be a big boy but he is a very sensitive guy when it comes to meds and this had not gone well. Part of the medicine protocol was Metoclopramide which helps move food through the system. I had given Tonka his heartworm meds Sunday morning which consists of two squares that look like treats (heart guard) and the smaller one had passed through completely intact. I think perhaps the medicine worked a little too well.....

It was now past 24 hours of being on fluids non stop and both of us were ready to go. They wanted to keep him overnight again but I said no and promised to keep him hydrated. Now that he was no longer in distress the best place for him was home.

Going Home

I had wrapped up his tail with an ace bandage after his third bout of diarrhea as I was out of vet wrap and Caitlin had bought some with her and re wrapped it for me. Once home I kept his tail wrapped for a few more days just in case.

Home

He could not seem to get comfortable and would puff his cheeks out and sigh as well as twitching and jerking a bit. He was still hating to lie down on his left side and his breathing was not getting any better. I was hesitant to put him back on his meds for his allergy/sinus problem so I waited a few days to make sure he was OK and eating well. I kept him on Flagyl for the diarrhea for next seven days. On that seventh day we went to see Dr. Philips for acupuncture, we had tried it before for his lameness but now I wanted to see if it would stimulate his appetite and perhaps make him relax. I showed Dr. Phillips how he had an issue laying on his one side and how he was jumpy around his ribcage. She agreed that something was definitely off and that he was not his normal happy self. We discussed maybe having a full MRI done to figure out
1. does he have a tumor in his nose and it is not allergies or sinus 
2. is something broken and making him uncomfortable
That night he had a full blown seizure. It had been two years since he had one and it caught me off guard. It was 11:30 at night and I called the ER and spoke to one of the Dr.s that had seen him the week before. We agreed that since it was only one and under 5 minutes long we would wait to see if he had another one before rushing him in. Running down his list of meds the only one that could have possibly been a cause was the Flagyl. He was postictal for about 20 minutes and during that phase he knows nothing not even his name. He kept trying to stand and walk which completely broke my heart. I had to keep repositioning him to stay down and he was flailing frantically.  When he did come back to being fully himself he was very hungry and thirsty. I had been sleeping on the floor with him for only 1/2 of the night but after the seizure I went back to sleeping with him all night.

He was very jumpy and snoring a lot and then one night I could not wake him up. His face was contorted in a horrible grimace and his breathing was very labored. He stayed like that for almost an hour and then sat up like nothing had happened. I got him some water and he then laid down and slept normally the rest of the night.

This became a nightly occurrence so I took a video and sent it to someone who could maybe tell me what this was. The answer came back perhaps a different form of seizure. Every vet I talked to about this felt that perhaps his breathing and strange activity was being caused by a tumor in his nose that was now pressing up into the brain. It was time to decide a course of action

Underwater Treadmill and Muscle Memory

AP here:
Seems that every Friday night about 5 hours after his underwater treadmill therapy Tonka wants to try and go for a walk. As this is becoming a pattern we are upping his treadmill workouts to twice a week to see what transpires. He sees Chris and Diana on Tuesdays for manual and laser therapy and then Diana works with him in the treadmill usually only on Fridays. The addition of Wednesdays will work as long as he does not getting too fatigued.

This week was our first double session week and he did great. We went on Wednesday afternoon and Chris came by to watch him in the treadmill and analyze his gait in the water. She was pleased with how he was doing and pointed out that each leg is a separate issue and is moving differently. Once I got him home, blew him dry and combed him out he slept most of the afternoon. He didn't try to walk that night but did get himself into a sitting position twice but just could not get his feet right under him. He also slept through the night which he hadn't done in months and  sometime in the night he had rolled himself to his other side .

Thursday he rolled himself over several times during the day and attempted to get up for breakfast and for dinner but again just could not get the feet right to push. Friday though was a different story....
I have set the cameras up to record during the day because he has been wandering out of range of the camera that is setup where his cage used to be. One minute he is there sleeping and the next I cant find him till I switch to a different camera. He could be just scooting along but he could be also getting up and attempting to walk...

This was Friday around 1:30pm and yes he is trying to walk....

After the big attempt to get up and go to the other room I arrived home to take him to his treadmill appointment.

Canine Fitness Center

UGH Water

Keeping his head up

Rest Time

It seems that walking on the treadmill is helping him to:
A. Get Stronger
B. Invoking some muscle memory of what his legs should be doing


Three weeks ago it was thought that he would
never walk again but we are on a mission to
prove that statement completely wrong.

He is getting much stronger and wants to try and pull away from me and walk every time I stand him up. Today his feet were moving as they carried him to get rinsed off after the treadmill and he tried to walk away when he was being toweled off.
Diana and I keep saying we expect him to just get up one day and start trucking on his own - he defiantly has the will to do it.

Tonka Tonus Clonus!

I have taken to calling Tonka by his new name- Tonka Tonus Clonus.

If you follow the blog you know that he has an outstanding issue left over from whatever happened to him 8 months ago. The lack of a diagnosis or prognosis has left me with trying to understand his symptoms and controlling those. This is essentially what his therapists Chris and Diana work on every week. I have added acupuncture back in the mix with Dr. Philips and everyone is on the same page.

I wrote an article for Dogster about Tonka and someone (who does not know Tonka, does not know me, and I am assuming is not a Veterinary Neurologist) commented to the fact that if I loved Tonka I would have euthanized him so he did not go through all this misery. In order to be very clear to everyone I am going to try and explain what is going on with Tonka symptom wise so that you can understand that he is not in any pain, nor is he miserable.

First a picture of Tonka at the park NOT BEING MISERABLE

 

Tonka has something going on called Clonus which refers to repetitive, rhythmic contractions of a muscle when attempting to hold it in a stretched state. If you have ever had your eye twitch you will understand the feeling, not painful just annoying. It is a common sign in neurological conditions and is usually a sign of damage to the nerve tracts above the place where it is initiated. Tonka suffers from clonus and what is known as hypertonicity in his hind leg.

Every muscle has tone which refers to the amount of neurological input the muscle receives. Hypertonicity refers to the neurological system sending too many signals or a signal that is too strong to the muscle which makes it rigid. The inverse of that would be hypotonic or not enough signal and a “loose or floppy” muscle. In Tonka’s case we have a muscle with too much tone creating a joint that does not bend or straighten smoothly.  This also means he does not lift enough to always clear his toes off the ground and so he scuffs.

We created a little video to show you what I mean. Notice he is not in any pain even when he goes to sit and lie down; he just has to maneuver a bit.

 

The other leg had these exact same symptoms and disorders and they were resolved with therapy. I have faith that this leg will do the same.

The Meaning of Nothing

AP here:
Pondering the meaning of nothing.
I am not a big believer in nothing. I believe in cause and effect in which an action or event will produce a certain response to the action in the form of another event.
If you have ever studied philosophy or know anything about Karma you have heard of cause and effect - action and reaction.
In science this is one of Newtons Laws for every action there is an equal and opposite reaction, -something happens and something caused it .
In management cause and effect is used to predict outcomes and to locate potential problems within a process.there are even diagrams and charts to help narrow things down.
So what happens when you have an effect with no cause?

Something is causing Tonka's problems, something is having an effect on his ability to walk and balance correctly. I have spent 8 months now dealing first hand with this  "Somethings"   effects and am no closer to knowing what the cause is. Multiple Orthopedic Doctors,  Multiple Neurologists, many, many tests of different types and we have a big fat "Nothing" as the Cause.

The last place to look - his head and neck - was scanned using an MRI on Thursday evening.
His Canine Rehab Specialist (physical therapist) Chris came by to check on him and get the results first hand. She went over the results with Dr. McDonnell before I did and was with Tonka when they called me back. I could see her in the back on the floor with Tonka and was looking at her to see if I could get a read on whether I should be bracing myself for the worst. Dr. McDonnell then proceeded to tell me that Tonka has a beautiful head and neck and there is nothing visible that could be causing his symptoms.
Now I had joked with several people that this was my worst fear and you were going to have to pick me up off the floor if that was the verdict and here it was- a diagnosis of nothing.
I am sure my real reaction would have been puzzling to anyone not knowing the full story or the past 8 months.
I had just been told that there is nothing nasty lurking in his head and most people would be ecstatic and jumping for joy instead I was just dumbfounded. this was the last place to look - the answer was supposed to be here - good or bad we would know something.
Nope - nothing there - nothing to fix - no cause to his effect...

So what is the meaning of nothing? and just what do you do with nothing?

Chris and Dr. McDonnell had the only answer I can hold on to at the moment which is to "keep doing what we are doing". He has come a long way in 8 months so that is what we will do..

Riddle me this

Riddle me this Batman? If you watched the TV show with Adam West then you remember the Riddler would always have a riddle and the Batman would always have an answer. Sometimes it took Batman a little while to figure it out but he always did. Well tonight we should finally have an answer to the riddle that is Tonka's neurological issue. Tonight we MRI his ginormous head!

It was 8 months ago this week that my big goof started displaying odd symptoms and behavior. He has since been poked and prodded, scanned and tested with no concrete answer as to what is causing his neurological deficits. We have been to therapy every week and tried different medications with some success. his therapy seems to have worked the best. It gave him back his mobility in the left leg but he is now having issues with his right so it is time to look in the only place left - his head. I am a mixture of emotions about the MRI that will take place today. I want to know the answer but I also do not want to know if it is something devastating. Knowledge is power so knowing what we are fighting will help everyone involved and let us know how to prepare for the future.  His therapist Chris is going to be there and is also very interested in finding an answer. In researching neurological issues in canines over the past 8 months I have learned a great deal and I know what I do not want it to be. The problem is he displays symptoms at different times that correlate to many different things making it very hard to pinpoint what it is. The last MRI was of his Thoracic and Lumbar area and showed nothing of significance so this truly is the last place to look.

Therapy Rocks

AP here:
It has was a horrible weekend and a terrible start to the week. Tonka has been falling, crossing his back feet and just dragging his foot. We had therapy yesterday and this morning was still not great but this afternoon is a totally different Tonka.
Watch this video from the weekend.

Then watch this one from tonight.

Once again  Chris Fritsch and Diana Huey at CVSS have worked their magic.

New Years Day 2012

AP here:
2011 was a horrid year for Tonka with all his medical problems so we were happy to see it go. This morning we got up around 5:00 and at 6:00 I was sitting having my coffee and he was laying next to the chair. All of a sudden he rolled onto his back and belly'd up for just a few seconds. Now you may be thinking "big deal" but it is - IT IS A HUGE DEAL! Tonka used to belly up every night to be brushed and he has not physically been able to do that for the past 2 months.
Granted it was just for a brief instant but I am thrilled.
The whole day has been great.

This was the beginning of our morning walk today. It did not last long before it became a drag and a scuff but he was actually lifting his foot.

This afternoon we picked up Carol and Nala and went to the park and he did really well. His knee seems to be floating a bit because his foot twists outward and his hip is not quite right but it was a real walk and lift not a drag and knuckle. He has not been this good since a month ago. I don't want to jinx it because a month ago we were here and then slid backwards but this is at least going back in the right direction. They tried some new things at Physical Therapy last week and I believe it really made a difference.

Add this to the fact that he has not had to wear the belly band for a week and that my friends is PROGRESS! He has lost 5 pounds in a week and some of that is definitely muscle mass but I think once we get the cart and get back to being able to go further he will build the muscle back up.

Happy 2012 :)