fourleg.com

I cross posted this to the VetRehab site but only got one post suggesting DM. I thought of that too but the progression is so fast for that. I am considering a tumor but X-rays were non diagnostic. She is currently using a cart out in the yard and is still continent. Below is YouTube video and the X-rays I hope. The text will have to be in a a separate post because I lost my original post because I can not copy and paste the vet rehab post and the youtube video at the same time. So if you are interested, also look at the second post describing the case. Too complicated to tell you why the YouTube is in the first post!! Thanks!!



https://www.youtube.com/watch?v=YW5Qu2lDPG0

Carole Nicholson DVM, CCRT, CVSMT

This is the details of the case , one X-ray attachment did not work it was a VD of her hips and lumbar spine. She has terrible hip OA but I don't think that is why she is ataxic. She is not even very painful considering how bad the rads look!!


Hope someone can help folks-

I saw this dog on Sept 6 for ataxia of 2 days duration. She was slightly weak on the rear end, CP deficit on right rear foot, normal patellar reflexes- could urinate and defecate on her own by holding position, not walking while doing it!! Ortho exam normal except slight pain on right hip extension. No pain on spinal palpation - no other deficits seen . I ran a chem/cbc ( 4Dx test was negative in August- she is a regular client- I have taken care of this dog since she was a puppy)- treated her with IV dex, acupuncture and laser- prescribed pred and cefa ( I always remember Steve Steinberg talk about spondyltis years ago and since she could not be immediately radiographed- what the heck?)

Blood work normal (she was Lyme positive years ago BTW)

Rechecked on 9-22 and the ataxia was much worse- now CP deficits on both back legs- I videoed -I do house calls so I watched her for several minutes over uneven terrain
I did acupuncture and laser again and added in gabapentin

Another follow-up on 9-26- no better - more crossing behind, could still hold position to poop and pee- recommended X-rays - did electroacupuncture and added in previcox( she had been on it periodically for mobility issues)

Owner told me she is not walking at all now- can still poop and pee when held up with a harness

I was really worried about a tumor with the rapid progression but…

the rads are not diagnostic to me, maybe someone sees what I am missing!!

1) hips are horrible - these changes are clearly not recent and she is really not very painful with extension and manipulation- this current scenario is about a month now and progressing rapidly- it really looks neuro to me and I know bilateral cruciates can appear neuro but there is no medial buttress, no crepitus felt in stifles, no thrust or drawer

2) bridging change at L2-L3? I can't imagine this would cause such serious signs!!

3) cervical- poor X-ray quality here- It looks blurred and dark to me-the clinic near me is nice enough to do rads for me without charging them an exam and office call- for some reason, one of the vets told her that I would know exactly what was wrong as soon as I looked at the neck x-ray! ha? Now I know they have their viewer which may show more detail especially with the 3d stuff you can do with digital X-rays- I can not tell anything from this view!! I may need to go in there and look on their viewer

Anyway, nothing has helped this dog - IVDD usually responds to any combo of drugs, AP, laser etc

Ortho ( if hips are an issue) should respond to NSAIDS, AP, laser

I am flummoxed!

When I ran this case past Dr Gallagher at VOSM a week ago, his differential was about what mine was (is) - a tumor- I am not sure they will go for an MRI-

I wonder still about ticks- I reran her 4dx and it was negative again- I wonder if I should do a complete tick panel at NC State- i know tick stuff can be bizarre!!

Rads are below- my Youtube video is below- I hate the sound of my voice and am embarrassed for you all to hear it!!

Owner tells me today her attitude, appetite still good. Front end still working fine. If anyone out there exclaims- how could she miss this? I am ok if I have missed something obvious on the rads or the video - I am not too proud! Thanks

Carole Nicholson DVM, CCRT, CVSMT

I would agree that the speed at which this came on is crazy.
There does seem to be some compression or fusion at C4-6. Have to tried mobilizing? What does it feel like?
But still, I think it would be worthwhile to do the tick panel and the DM test is cheap.
Yes tumour is a possibility, but they are usually slower in showing up (the ones I've seen).

(And I like your video and Moses parting the red sea comment! I smiled listening to you!)

Cheers,
Laurie