Goldie with progressive neurological signs

Re: Goldie with progressive neurological signs

Martin Atkinson — Thu, 04 Dec 2014 10:48:31 GMT

[quote user="Anthony Todd"]

[quote user="Martin Atkinson"]I would have suggested 'never putting anything to sleep without the benefit of the 'roids' [/quote]

Geez, next I'll be told that the world is flat......

[/quote]N.B. This logic is for when all else has failed Anthony and the alternative is that dog is going to go tits up otherwise so side effects are the least of your worries. NOT as an irrational treatment protocol without a proper diagnosis.

Re: Goldie with progressive neurological signs

Anthony Todd — Tue, 02 Dec 2014 19:29:07 GMT

[quote user="Martin Atkinson"]I would have suggested 'never putting anything to sleep without the benefit of the 'roids' [/quote]

Geez, next I'll be told that the world is flat......

Re: Goldie with progressive neurological signs

Martin Atkinson — Tue, 02 Dec 2014 19:21:03 GMT

[quote user="Anthony Dennison"]Perhaps some sort of inflammation was set off and that's where the progression came from.[/quote]You may have a point. A friend of ours was showing severe symptoms due to a brain tumour and the medics put him on mega doses of corticosteroids. The symptoms were almost totally resolved probably because of the anti-inflammatory effect rather than any chemotherapeutic action. Of course the benefit was only temporary but it gave him a few months of relatively normal life to say goodbye and sort his affairs.

I would have suggested 'never putting anything to sleep without the benefit of the 'roids' in this case but it was taken out of my hands and PTS at the referral centre.

Re: Goldie with progressive neurological signs

Anthony Dennison — Mon, 01 Dec 2014 13:01:26 GMT

Weird. Perhaps some sort of inflammation was set off and that's where the progression came from. At least an answer was found; not a good outcome but the mystery was solved

Re: Goldie with progressive neurological signs

Martin Atkinson — Mon, 01 Dec 2014 10:09:24 GMT

[quote user="Anthony Dennison"]How normal was normal though? There could have been subtle changes going on for some time before this episode. For examply, the aggressive nature of the dog?[/quote]The dog only became aggressive after the onset of symptoms, up to that point it had been perfectly amenable. The owner noticed it was tired/weak after a walk, fearful of someone approaching its head and cried when their other dog bumped into it 2 days before first consultation. There may have been very subtle changes before that they hadn't picked up on but I would say they are amongst my most sensible and observant owners.

Re: Goldie with progressive neurological signs

Anthony Dennison — Mon, 01 Dec 2014 09:51:20 GMT

[quote user="Martin Atkinson"]What's striking about this is the speed of onset of symptoms from apparently normal to nearly unable to walk or eat and incontinence in the space of 5 days. [/quote]

How normal was normal though? There could have been subtle changes going on for some time before this episode. For examply, the aggressive nature of the dog?

Re: Goldie with progressive neurological signs

Martin Atkinson — Fri, 28 Nov 2014 19:44:32 GMT

Final Report: MRI scan showed brain tumour and dog was euthanased today as he had deteriorated significantly.

What's striking about this is the speed of onset of symptoms from apparently normal to nearly unable to walk or eat and incontinence in the space of 5 days.

Re: Goldie with progressive neurological signs

Richard Carter — Fri, 28 Nov 2014 09:24:25 GMT

Has brought back memories of an enthusiastic intern (now a prominent professor in the USA) doing a spinal tap on a later confirmed rabies case in my final year rotations. Quite a few people needed post exposure treatment but in his defence, it wasn't the typical drooling, aggressive case.

Re: Goldie with progressive neurological signs

John Flynn — Thu, 27 Nov 2014 19:20:10 GMT

[quote user="Martin Atkinson"]I'll keep you all posted.[/quote]

Thanks. Always interesting to hear a case outcome

Re: Goldie with progressive neurological signs

Martin Atkinson — Thu, 27 Nov 2014 18:43:55 GMT

[quote user="mariette asselbergs"]

+1 from me. Drooling? Voice change? Contact with bats?

Mariette

[/quote]No, no and don't know. Bat Lyssavirus is endemic in the UK but AFAIA there's never been any reported cases of transmission to dogs just the odd unfortunate bat enthusiast.

Meanwhile: Been to neurologist this afternoon, still baffling so is having MRI tomorrow on his brain and spinal tap if nothing diagnostic on that. Plus there is progression of the hind leg weakness and urinary incontinence. Rabies has not been mentioned in the list of differentials. From our end CK was normal and there was a mild mature neutrophilia with a number of basophils on the differential smear.

I'll keep you all posted.

Re: Goldie with progressive neurological signs

mariette asselbergs — Thu, 27 Nov 2014 17:35:33 GMT

+1 from me. Drooling? Voice change? Contact with bats?

Mariette

Re: Goldie with progressive neurological signs

Martin Atkinson — Thu, 27 Nov 2014 12:53:00 GMT

[quote user="Richard Carter"]

dog been to Europe would be my first question having graduated in South Africa where dogs showing a developing aggression are referred to the freezer and their brains sent for rabies check

[/quote]Well its not been abroad but given the number of illegal puppy imports from eastern Europe around here, never say never.

Re: Goldie with progressive neurological signs

Richard Carter — Thu, 27 Nov 2014 12:51:35 GMT

along with a progressive deterioration, difficulty swallowing, hind leg paresis - all not good signs

Re: Goldie with progressive neurological signs

Richard Carter — Thu, 27 Nov 2014 12:49:32 GMT

dog been to Europe would be my first question having graduated in South Africa where dogs showing a developing aggression are referred to the freezer and their brains sent for rabies check

Re: Goldie with progressive neurological signs

Anthony Dennison — Thu, 27 Nov 2014 11:58:35 GMT

I think if you were considering neurological referral beforehand it was best not to sedate, so at the referral appointment the dog is not affected in anyway that may alter the neurological exam. Given the rate of onset of signs, best getting this seen by a specialist for further work up sooner rather than later, which you have done.

Will be interesting to hear the report, please keep us updated.

Re: Goldie with progressive neurological signs

Martin Atkinson — Thu, 27 Nov 2014 11:46:38 GMT

[quote user="Thomas Johnson"]

The last 2 dogs I've seen with pain on opening mouth have had retrobulbar abscesses. Neither had any obvious protrusion of the eye but both were painful on palpation of the eye. One I anaesthetised to examine and could see the abscess bulging caudal to the last upper molar, lanced and flushed and treated with appropriate antibiotics and it made a full recovery. The other declined any treatment other than systemic antibiotics and NSAIDs, got much worse, ended up at Vets Now out of hours who sent it to the RVC for a CT scan.

With the other signs you've got it does sound neurological, but they could be due to systemic spread of an infection.

[/quote]No pain on facial examination eyes look normal plus dog chewed a Dentastik but then had difficulty swallowing and tried to regurgitate. Sluggish PLR this morning but menace reflex intact and even more wary of being approached until muzzled then happy for examination but too flighty for meaningful neuro examination. Managed to get a thermometer in his rectum with a fight (why doesn't everyone have a bioThermo chip?) temperature normal. Biochemistry normal except mild hyperglycaemia 6.3mmol/l presumed stress response. borderline granulocytosis - awaiting differential count and CK.

I might be missing a trick by not sedating and having a look in the mouth but I suspect there is a lot more to this and have managed to get a referral to local neurologist Simon Wheeler this afternoon so don't want to miss the opportunity and will give progress report later.

Re: Goldie with progressive neurological signs

Thomas Johnson — Thu, 27 Nov 2014 10:46:57 GMT

With the other signs you've got it does sound neurological, but they could be due to systemic spread of an infection.

Re: Goldie with progressive neurological signs

Martin Atkinson — Thu, 27 Nov 2014 09:26:44 GMT

The menace response is it tries to get away from any approach to the head but there is no apparent visual disturbance. Seeing the patient shortly so will give an update, but your reply just reinforces my inclination to ship this off to a neurologist.

Re: Goldie with progressive neurological signs

Anthony Dennison — Thu, 27 Nov 2014 09:19:19 GMT

Did you manage to do a PLR or check menace response (probably very hard in this case I guess). Has the dog always been aggressive or has that been a recent development, any change in demeanour?

Trying to figure out if this is central or peripheral (neuromuscular junction) is the tough part. I'd possibly be concerned about maybe a central lesion; forebrain or brainstem?