No one likes to think their dog is sick. Sometimes, you just ignore the little things. The didn't finish all their breakfast. The didn't play fetch yesterday, but did today. The reluctance to jump on the bed. But sometimes these 'little things' can add up to be big things. As a veterinarian, when my dogs don't seem right for a second, I tend to over-react and bring them in. Sadly, my motto is 'If you look hard enough, you'll find something!' Unfortunately, that 'something' might not be a small thing. If a problem persists, it's always best to have your pet looked at by a trusted veterinarian. Sometimes it really is nothing. Sometimes it is something. Something big. The following is a story of something little turning into something big. Something devastating. |
Sasha was adopted in 2011 at the age of 9-1/2 years. She was healthy, vibrant, and overall an amazing dog! She blended into our family with no issues! Sasha loves to play and bounce! She doesn't like to tug, but instead likes to be chased. She is truly the sweetest, most innocent dog I have ever met or owned! Sasha had always been the text book picture of health.
In June 2015, Sasha (now age 13-1/2 years) came to work with me. I let my dogs out at noon, like usual. Everyone was good; everyone was normal. At 5 PM, I went to let them out again so we could go home. This is when I noted Sasha was no longer normal. She had a right sided head tilt, her eyes were darting back and forth (nystagmus), and she was attempting to circle to the right when walking. My heart sank. Just 1 year prior I had lost my 15 year old mini schnauzer, Cori, to a brain tumor. Cori developed these same signs, but it took weeks to come into full force. Sasha had become a vestibular dog after only 5 hours. Lab work and radiographs showed no abnormalities. I cross my fingers, and hope that it was only Old Dog Vestibular Disease. If so, it should be gone within days. Sasha never stopped eating. She kept her bright attitude. The only meds she received were for motion sickness. Within 4 days, Sasha was normal. Whew! What a relief! Old Dog Vestibular Disease is a disease process that hits fast and hard, but goes away after a matter of days to possibly weeks. Check this article out for more info on Vestibular Disease. The cause of simple Vestibular Disease is usually never found, but self resolves, and likely never comes back.
In June 2015, Sasha (now age 13-1/2 years) came to work with me. I let my dogs out at noon, like usual. Everyone was good; everyone was normal. At 5 PM, I went to let them out again so we could go home. This is when I noted Sasha was no longer normal. She had a right sided head tilt, her eyes were darting back and forth (nystagmus), and she was attempting to circle to the right when walking. My heart sank. Just 1 year prior I had lost my 15 year old mini schnauzer, Cori, to a brain tumor. Cori developed these same signs, but it took weeks to come into full force. Sasha had become a vestibular dog after only 5 hours. Lab work and radiographs showed no abnormalities. I cross my fingers, and hope that it was only Old Dog Vestibular Disease. If so, it should be gone within days. Sasha never stopped eating. She kept her bright attitude. The only meds she received were for motion sickness. Within 4 days, Sasha was normal. Whew! What a relief! Old Dog Vestibular Disease is a disease process that hits fast and hard, but goes away after a matter of days to possibly weeks. Check this article out for more info on Vestibular Disease. The cause of simple Vestibular Disease is usually never found, but self resolves, and likely never comes back.
We went about our life. Sasha continued to be an amazing, happy girl! She loves summer! She loves investigating the fence line and looking under bushes. Playing in the yard is her favorite thing, next to car rides! Then in mid-July, Sasha woke up with a head tilt to the right. She had no other neurological signs. I thought 'Well, this is weird.' It didn't slow her down in any form! She never tripped. She never stopped loving life. When I examined her, I was concerned for an inner ear infection with possible ruptured ear drum. I began treatment for the infection, which was 2 weeks of oral antibiotics. No improvement. 'Ok,' I thought, 'what is going on?' She wasn't bothered by it. I decided to proceed with her scheduled dental and wart removal. I flushed out her ears really well while she was under. Once she woke, the head tilt was worse for a few days. Another week or two went by, and I started to worry. I started to remember Cori, and her presumed brain tumor. Cori had been too unstable with heart disease to undergo the definitive diagnosis of an MRI, which requires general anesthesia for dogs. Since Cori kept getting worse, and not better, we were 110% certain she had a brain tumor, and with her deafness, blindness, dementia, chronic diarrhea, and severe heart disease, we made the heartbreaking decision to let her go. Her quality of life was no longer quality; it was quantity.
My husband and I knew that if there was something we could do to 'fix' or help Sasha, we would do it. We decided that we NEEDED to know what was wrong with our Sasha Bear. Although she is not 'sick' and dying, we knew she wasn't right. A dog doesn't just have a head tilt. Unfortunately, the only definitive way to find an issue in the brain is through an MRI. We knew we'd either find something and need to address it, or we'd find nothing and be content with our crooked headed dog. On Wednesday, August 12th, 2015, Sasha went to Blue Pearl-Eden Prairie for a neurology consult. The neurologist was surprised to find that Sasha was actually extremely normal, except for the head tilt. This may mean that there's nothing on her brain. She may be safe. I dropped Sasha off for her procedure. Dr. Wolf called me in a few hours. Sasha was still under anesthesia, but they had found something. I knew by the tone of her voice, and her initial questions 'How are you? Is this a good time? Can you talk?' I've used those terms myself when I call a client with bad news. And then there was the beginning of her sentence 'Sasha is doing well. Um.' The 'um'. The necessary pause before you give news that will crush someones world. The pause because you don't know how to break the bad news. The pause because you don't want to tell them. The pause that I knew my world was about to change. Dr. Wolf proceeds to say something, but what I hear is, 'Sasha has a tumor. On her brain stem. It can't be removed. Life expectancy is months. We can try radiation. We can try prednisone. But she is healthy and happy.'
I was driving. I held it together until I got off the phone with her, and I was home. Devastated does not begin to explain the feelings I am going through. World shattering. Life changing. I see in my head Sasha progressing. I see seizures that can't be controlled. I see her mind leaving her. I see her not being able to stand. I see her painful. Oh, so painful. Months, she said. Months. My girl only has months. Radiation is an option. But where? And how much? And is it worth it? These are all questions I am working on finding answers to.
The tumor is called a meningioma. It does not spread. It does not cause cancer. But it grows, and it compresses the structure it is on. The brain cavity is enclosed in bone, therefore it has very limited ability to have its interior structures expand. When the tumor grows, it compresses and damages the structures near it. The brain stem specifically has several functions, such as controlling respiration, swallowing, and heart rate. Surgery is not advised for brain stem tumors, as you can cause deficits with these extremely important functions. Check out this article for more information on meningiomas.
My husband and I knew that if there was something we could do to 'fix' or help Sasha, we would do it. We decided that we NEEDED to know what was wrong with our Sasha Bear. Although she is not 'sick' and dying, we knew she wasn't right. A dog doesn't just have a head tilt. Unfortunately, the only definitive way to find an issue in the brain is through an MRI. We knew we'd either find something and need to address it, or we'd find nothing and be content with our crooked headed dog. On Wednesday, August 12th, 2015, Sasha went to Blue Pearl-Eden Prairie for a neurology consult. The neurologist was surprised to find that Sasha was actually extremely normal, except for the head tilt. This may mean that there's nothing on her brain. She may be safe. I dropped Sasha off for her procedure. Dr. Wolf called me in a few hours. Sasha was still under anesthesia, but they had found something. I knew by the tone of her voice, and her initial questions 'How are you? Is this a good time? Can you talk?' I've used those terms myself when I call a client with bad news. And then there was the beginning of her sentence 'Sasha is doing well. Um.' The 'um'. The necessary pause before you give news that will crush someones world. The pause because you don't know how to break the bad news. The pause because you don't want to tell them. The pause that I knew my world was about to change. Dr. Wolf proceeds to say something, but what I hear is, 'Sasha has a tumor. On her brain stem. It can't be removed. Life expectancy is months. We can try radiation. We can try prednisone. But she is healthy and happy.'
I was driving. I held it together until I got off the phone with her, and I was home. Devastated does not begin to explain the feelings I am going through. World shattering. Life changing. I see in my head Sasha progressing. I see seizures that can't be controlled. I see her mind leaving her. I see her not being able to stand. I see her painful. Oh, so painful. Months, she said. Months. My girl only has months. Radiation is an option. But where? And how much? And is it worth it? These are all questions I am working on finding answers to.
The tumor is called a meningioma. It does not spread. It does not cause cancer. But it grows, and it compresses the structure it is on. The brain cavity is enclosed in bone, therefore it has very limited ability to have its interior structures expand. When the tumor grows, it compresses and damages the structures near it. The brain stem specifically has several functions, such as controlling respiration, swallowing, and heart rate. Surgery is not advised for brain stem tumors, as you can cause deficits with these extremely important functions. Check out this article for more information on meningiomas.
Now what? That's exactly what we're asking ourselves. We have no idea. I have began the process of contacting specialists - a veterinary brain surgeon and 2 different veterinary oncologists. We need to know what is best for our little dog who doesn't know there's something wrong with her! She still plays. She still 'dances'. She still pounces. She's still Sasha. At this point, the tumor is small, but it will grow. At this stage, it might be easier to radiate or suppress. We don't know. We do not have unlimited funds, but we want to give her her best shot for a happy life. Yes, we have only had her for 4 years. But she is our dog. She is our family. She is our child. She is our responsibility. When we took her in, we promised her we would take the best care of her that we could, and we will try our best. To us, our dogs are not just dogs, they are our children. |
I hope this blog has provided useful information on a disease process that is very rarely ever definitively diagnosed (definitely presumed a lot). It is a horrible disease. If surgery were an option for our Sasha, we have no doubt that we would do it. I understand that an MRI or brain surgery isn't an option for everyone, and not doing so does NOT make you a bad owner or pet parent. There is a very small percentage of the population that can get a definitive diagnosis for a brain lesion or tumor. With us, we needed closure. I needed closure, in part, for Cori. I needed to know that this was likely what she had. I knew that I would always wonder, after Sasha was gone, if there was anything more I could do. Now I will know that. I will know that I did, without a doubt, everything possible for her. No, this will not make life easier. But, in a small way, deep in my heart, I will be at peace once she is gone, knowing that we had an answer and I did everything I could to save her. There is nothing worse, as a veterinarian, than not being able to save your own babies or wondering afterward if you did everything possible to try to save them.
When that fire in her eyes and the smile on her face fades away, and her pain is too much for her, we will make the decision to say good-bye. For now, we will keep Sasha as happy as possible!
When that fire in her eyes and the smile on her face fades away, and her pain is too much for her, we will make the decision to say good-bye. For now, we will keep Sasha as happy as possible!
***None of the dogs in this blog posting are available for adoption!