Friday, October 20, 2017

Nerving Neurology

His cries pierced the calm, quiet night.  What started as a whimper turned into a ceaseless moan that tore my heart into a million pieces.  I knew that our time together was rapidly growing shorter.
I knelt by his side and tried to comfort him. 

I covered his tiny body in the warmest blanket that I could find.  My hand gently stroked his long, tan fur.  The words I spoke were soft, calm and full of love.  My feeble attempts were failing miserably and we were losing time.

Throwing on the first outfit I could find, my husband and I loaded Theo into the car and raced to Hawthorne Animal Hospital.  Matt turned on the radio partially trying to provide background noise and partially to drown out Theo’s mournful cries.  My tears flowed like a river down my non-make-upped face.

We had called ahead, so the nurse was waiting for us by the emergency door when we arrived.  I tried to remain calm as I explained to the vet technician what had taken place.  Theo had been squinting his right eye for the past two days.  His veterinarian had examined him the day before and diagnosed him with glaucoma in his right eye. 



Theo wearing his Muffin's Halo.




He had had glaucoma in the left eye before losing vision in that eye.  We had been giving him his prescription eye drops daily and were instructed to now administer the drops to both eyes. His crying spree began at 11:00 p.m. that night and would not stop.  Not even for his favorite treat:  Blue Buffalo Sizzlers.

The veterinarian determined that the glaucoma was causing the pressure in his right eye to shoot up to an incredible 80.  We were told that this pressure could be giving Theo a doggy migraine.  The hospital staff was great.  They began to administer the eye drops every five minutes in an attempt to lower the pressure quickly.  After 30 minutes, the pressure was down to 60.  Not great, but definitely better than 80. 

Theo was also given some numbing drops in order to reduce the pain and (hopefully) allow him to sleep before his ophthalmology appointment the next day.  We thanked the staff and headed home.  Theo cried the entire way.  Our car was almost home when I made Matt pull over in a nearby Target parking lot and call the hospital back asking what we should do.  We were told to give the injection and numbing drops more time to work.

At 3:30 a.m., we were heading back to Hawthorne.  My tears began anew and I was screaming at my husband to drive faster, desperately seeking a miracle.  Theo was then admitted to Hawthorne where he would be given an IV medication in an attempt to bring the pressure in his eye down further.  If this could not be done, the eye would have to be removed.

Theo is 14 years old.  That is 72 in human years.  I was beyond afraid of him having to be under anesthesia.  I was praying that the medications would work.

I received a call later that morning from the veterinarian.  She said that the pressure was back down to a normal level and Theo was doing great.  He had even inhaled his breakfast for the vet tech.  When we picked Theo up, I could tell something wasn’t right.  He kept trying to climb over my shoulders and leap out of my arms.  The staff assured me that he was healthy enough to be released.

Theo cried the entire way to the ophthalmologist.  Once the doctor appeared, his crying stopped.  My mom and I were amazed.  The doctor spoke softly and gently looked into Theo’s eye.  His diagnosis was devastating.

“The eye is not causing him any issues.  I believe this is something neurological.”
He told us to allow more time for the medications to leave Theo’s system before seeking any additional treatment.  Theo’s cries picked up again the minute we got in the car.  Mom tried to convince me that everything was going to be fine.  My gut continued to tell me that something still wasn’t right.

I made a call to my veterinarian’s office.  One of my favorite receptionists answered.  My heart sank when she told me that Theo’s vet was booked for the day.  She then asked what was going on.  After I explained all that Theo had been through, she spoke with the doc and got us squeezed in.

Since my mom had an appointment, my dad graciously drove us to the appointment.  The vet also agreed with the ophthalmologist’s assessment.  She was concerned that Theo was exhibiting an extreme head tilt.  He was also taking a while to respond to having his feet picked up one by one.  She suggested that we see a neurologist at Veterinary Specialty Services in St. Louis, MO.  The vet called ahead so that Theo could be seen on an emergent basis.

Dad did a fantastic job getting us to VSS.  I was surprised to see that the lobby was packed.  We were soon taken to a room and Theo was whisked away to ICU.  My only comfort was knowing that Theo had slept the entire way to VSS.  At least he appeared to be getting some relief.

The ER doctor returned and said that something neurological was definitely going on.  Her main concerns: cancer, a brain tumor or a stroke.  Theo would need to be admitted for several days and monitored closely.  We were told that they may need to do an MRI and spinal tap if his condition worsened. 

I left feeling completely numb.  I had literally spent 24 hours trying to get answers and was walking away with something worse: fear.  What if Theo had cancer?  If there was a tumor, could Theo handle surgery? 

We received daily calls with an update on Theo and his condition.  The doctor called the next day and said that Theo was eating great and had just gone out for a walk.  My hopes began to soar.  He was still walking!  We decided to visit him that day to see the miracle recovery for ourselves.  Bad idea.  The moment that Theo smelled us, he began to whine…like he had on Thursday night.  We ended our visit quickly and asked the vet tech if our presence was causing him distress.  She said that when a pet smells his/her humans and then realizes that they are not at home, they can become confused and upset.

I left feeling horrible.  My intention was not to cause Theo more stress.  I was very happy that we at least got to take him outside for a short walk and I got a few sweet kisses.

Monday I received a call stating that Theo was going to be released.  The doctor stated that they believe he had a “vascular accident,” a.k.a. stroke.  It had also been determined by the ophthalmologist that he was now blind in the right eye.  Thankfully, we already had been using a Muffin’s Halo when he lost vision in the left eye.

Theo was so happy to be home!  Matt and I made it a priority to learn all of the signs of a stroke in dogs.  Per Petmd.com, these signs include:

·         Inability to walk or walking with an uncoordinated gait
·         Head tilt
·         Abnormal eye movements, side to side or rotary (nystagmus)
·         Abnormal eye positioning (strabismus)
·         Loss of consciousness
·         Abnormal behavior
·         Falling to one side
·         Blindness
·         Abnormal behavior
·         Rapid onset of symptoms

September was a fabulous month.  Theo was nicely adjusting to being blind.  Just like Hope, he quickly learned where the water bowl was.  His walking was even improving.

Then, October came.  I had been eagerly awaiting the Picture Book Summit online writing conference.  The day-long event was to take place on October 7th.  I was an hour and a half into the conference when my husband and I noticed that Theo was walking in circles and had a slight head tilt.  He then took several steps and pooped out a large portion of blood.

As I ran to get paper towels, Matt called Theo’s new veterinarian.  She told us to bring Theo in ASAP.  He was not happy about having to leave the house.  And then he began crying again.
I had a feeling I knew what was in store.  Sure enough, the vet said that his blood pressure was 195.  She wanted us to get to VSS as quickly as possible.  My husband and I were thinking the same thing:  another stroke.

We arrived at VSS to find the lobby full to capacity.  One of the receptionists looked at me and said, “Are you from Davis Animal Hospital?”  I told her that we were.  She picked up one of the FRS’s and said, “Theo is here from Davis.”

Before I knew what was happening, a vet tech (with blood stains on his arms) came running out, grabbed Theo towel and all and raced back to neurology.  I felt sick to my stomach.  He hadn’t been acting that unusual.  Could something horrible be happening and we are totally clueless?

Thankfully, the same veterinarian that saw Theo the first time was also on duty that day.  She said that the pressure in his right eye was fine.  He did very well on the neurology examination, but she wanted to do some lab work and chest x-rays to see if he possibly had cancer in the chest or abdomen that could be causing swelling in the brain.  Theo was admitted once again.

We got the call later that night that Theo’s labs came back better than before.  The x-rays were also clear, no signs of cancer!  We were able to pick him up that Sunday with the caveat that we bring him back the following Thursday for a neurology appointment.

I counted down the days until his appointment.  I was bound and determined to get answers.  We had to know what was happening to our furry pack leader.  To our surprise, the lobby was completely empty.  We had come prepared with a large blanket for Theo and electronics for us.  And I remembered to pack my phone charger!

We had the sweetest woman who is completing her fellowship at VSS in the neurology department.  She said that Theo did great during his exam.  However, she was concerned that he may have cancer or a tumor.  Theo was to undergo an MRI and spinal tap immediately.  She also thought that he might have an infection of the inner ear, so she wanted to also perform a myringotomy.  This involves making a tiny incision into the eardrum to release the pressure caused from backed up fluid.  She would then send the fluid off for culture samples.

The procedures would take two hours.  Matt and I tried to be proactive by staying in the area and getting some much-needed shopping done.  Thankfully, there was a Petco right around the corner.  We headed back to VSS around 2:00 p.m.  My husband offered to go in and inquire about Theo’s status. 

Suddenly, my cell phone rang.  It was Matt telling me to come inside to room 9.  I raced into the building and saw the doctor sitting across from Matt.  “Don’t worry, we didn’t start without you,” she smiled.  She said that we had perfect timing because she was just getting ready to call us.
The veterinarian said that Theo did a great job and was still waking up from the anesthesia.  His MRI came back completely normal!  She said that there weren’t even any signs of a stroke!  And he didn’t even have to have the myringotomy.  The spinal tap labs would not be available
Theo was then diagnosed with Idiopathic Geriatric Vestibular Syndrome. Per VCA Animal Hospitals, “vestibular disease is a sudden, non-progressive disturbance of balance.”  This is also known as “old dog disease” and is typically seen in older dogs.



Theo's shaved spot where the spinal tap was performed.


She explained that the Theo may have reoccurring episodes or he may never have another episode again.  His symptoms just need to be monitored.  I was so excited that I hugged her.  Theo was not dying!  My best friend was coming home with a clean bill of health.

His follow up appointment at the ophthalmologist revealed that he has chronic corneal calcification.  This means that the cornea of his right eye is calcifying.  We were assured that this process may cause discomfort, but not pain.  The eye ointment seems to be working wonderfully.  In two weeks, the cornea should be completely calcified and no longer be an issue.

My purpose in sharing Theo’s story is to help pet parents of aging or senior dogs.  Witnessing your fur baby walking in circles and stumbling around the house can be terrifying.  Especially when they begin crying out for no reason.  While we are sure that Theo’s eye played a key role in raising his blood pressure during both episodes, we are very happy to know that this condition will not cause him pain or stop him from living an amazing life.



We are so thankful to have Theo at home!





I love looking at his smile!



If you live in southern Illinois or around the St. Louis, MO area, I would highly recommend Veterinary Specialty Services for all of your emergent pet care needs.  The staff is compassionate and friendly and treats everyone like family.  To learn more about the services offered, please visit:  http://www.vssstl.com/.


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