Spinal Cyst Saga: A New Chapter

“Well, he’s not dead.”

That’s the response the Husband received when he spoke to Moses’ surgeon this afternoon.  …Part of me is beginning to think that maybe spinal surgery is a little more risky and complicated than she initially lead us to believe.

I kid, of course.  But having gone into our last consultation with our minds really already made up does mean we had selective hearing with respect to some details.

Moses hydrating this morning - then it was off to the vet

And today was the big day.  We have now entered the period “Moses: AC” (After Cyst).

I don’t really have a lot of surgery details to report right now.  She went in through the top at the shoulders (rather than other surgical procedures, like for a disc problem, where they go in through the bottom) and had to make a large incision to get through all of the muscle in that area on a big dog.  And once she had cut into the vertebrae, apparently there was a lot of spinal fluid that came out, since there was such a blockage due to the cyst.  (Hats off to surgeons everywhere – not a job for just anyone!)

And now Moses is in post-op care; he’ll be their guest for the next couple of days.

The good news is that as soon as he woke up his tail was wagging, he can move his front legs and has already tried to sit up on his own.  (Key word: ‘tried’ – not there yet.)

Will we ever get back to this point:

 

Only time will tell.

But we are very happy that he made it through surgery and it’s now on to the recovery and rehabilitation process.

Thanks to all for your kind words and support throughout this whole thing!

(Video from last spring; Moses accompanies the Husband to work whenever possible – I wish my job had that perk!)

(Also, after uploading the video, it came to my attention that there’s another Newf out there on YouTube named Moses – is it ‘great minds’ or ‘mimicry is the sincerest form of flattery’? Hmm…)

Longer Days Ahead

Though I had alluded to it in my last post, I thought I probably shouldn’t leave my readers and friends hanging when it comes to Moses’ health roller-coaster.

Moses was diagnosed with a spinal cyst.

Last Monday, we had our meeting with the surgeon.  I can’t say we went there completely objective and undecided; in the days leading up to the appointment we’d pretty much decided we’d be going forward with surgery if we got the reassurances we were looking for.

We did.

The studies I had found on my own were accurate representations of a prognosis: short-term outcome (up to 2 years post-surgery) has very good odds (93%), and long-term outcome has decent odds (70%) – which actually is considered quite positive when it’s a neurological condition.  And Moses’ overall health otherwise, age, and our relatively early diagnosis all work in his favour.  Not to mention the surgeon has experience with these cysts and the procedure and is confident herself.

The other side of the conversation is that without surgery, Moses will not get better.  Medical management may slow progression, but he won’t gain any motion back and will certainly continue to get worse.

So Moses goes in for surgery on Monday.

He will probably be in the vet’s care for a couple of days and will need a lot of help getting around, and some physio appointments.

The Husband has already started thinking about how to put together a wheelchair to assist in the rehab process, similar to the one to the left.

And the long-term hope is that Moses returns to a happy, healthy, moderately active dog at the end of it all.

No more carting, no extraneous hikes in the mountains, but we’d like to see him able to play and swim again, go back to hour-long daily walks, and just generally accompany us everywhere, just like before.

There’s a certain amount of anxiety about how things will go on Monday, but we’re staying positive.

And no, going forward with surgery wasn’t the cheapest decision – but he’s worth it.

Fingers crossed.

That Summer ‘Do

It is hot in Calgary today.  HOT.  My pale ginger self is hiding inside in front of the A/C as I type, and I am probably still at risk for sunburn.

According to the always-trusty The Weather Network, it is currently 28°C, with a “feels like” of 34°C.  That’s 93°F for our friends south of the border.

Pre-cyst, we used to take Moses for a nice long swim to cool down. We hope to resume that activity post-cyst.

As the hot summer days go by, advice abounds about how to help our pets cope with the heat.

There are the obvious precautions:

– DO NOT leave your pets in a hot vehicle for any length of time

– Ensure your pets stay well-hydrated and have constant access to fresh, clean drinking water

– Be careful about over-exercising your pet on hot days, and if necessary, plan walks for early morning or late evening when it’s not so warm.

– Learn the signs and symptoms of heat stroke so you are able to monitor your pet

– Consider the summer-time uses of Musher’s Secret and help protect your dog’s pads from hot pavement

There are lots of options to consider for keeping your pet cool and comfortable in the summer.  And there are lots of things to be cognizant of to keep them out of potential danger.

But there is one trend I cannot get on board with.

Quite some time ago – last summer or perhaps even the summer before – I came across a female Great Pyrenees throughout the normal course of a warm Saturday in June.   I don’t remember the dog’s name, but I will never forget the encounter for two reasons:

1.  The dog was overweight.  I mean, extremely overweight.  I’m guessing she could’ve easily shed 30+ excess pounds.  But that’s a soapbox for another day.  My main concern today is…

2.  The dog was shaved.   Fully and completely shaved.  Head to toe.

She looked kind of like this... only fat.

So I naturally (and mistakenly) asked the owner if the dog had some sort of medical condition that elicited the shave.  After all, there are lots of legitimate reasons for shaving a double-coated dog, including a skin condition or a surgical procedure.

Moses himself is sporting a bit of a shave job these days.

And there are lots of legitimate reasons for shaving and cutting the fur on several breeds of dogs – because it’s not fur at all.

Breeds such as the Poodle, Bouvier, Bichon Frise, Schnauzers, and Portuguese Water Dogs (among others) are single-coat breeds that actually have hair, not fur.  They’re sometimes called non-shedding or hypoallergenic dogs, but that is a bit of a misnomer because they actually shed hair as much as you or I would.  (Well, maybe you.  I actually shed quite a bit and have been the sole demise of more than one vacuum.)  Though they do have less dander than fur-shedding dog breeds.

These dogs require regular haircuts to keep all that hair under control.

Umm... no comment. (Photo credit: http://www.pics24h.com)

But to my original inquiry about the Great Pyrenees, the owner simply explained it was her “summer haircut”.

And it took every fibre of my being to restrain myself.  Because it’s not polite to lecture complete strangers.

I suppose some people conclude that because some dogs get haircuts, their furry dog must be in need of a summer shave to help keep them cool.

And to that I say:  WRONG.

Yes, double-coated breeds such as the Great Pyrenees and the Newfoundland do have a lot of fur.  But they should absolutely NOT be shaved (barring an extreme matting situation or one of the legitimate reasons noted above), and nothing would make me cringe more than coming across an intentionally shaved Newfoundland.

OH THE HUMANITY. (Photo credit: Flickr - 2-Dog-Farm)

So I suppose the ridiculousness of shaving these dogs kind of speaks for itself, doesn’t it?  I mean look at that guy.  Can’t you just feel his shame?

But what many don’t realize is that you are actually doing your double-coated dog a huge disservice by shaving them in the summer.  And any groomer worth their salt will do their best to talk you out of it.

The Groomer, out of Ottawa, Ontario, lays out the very important reasons not to shave your dog on their website (on the main page, no less), advising that just like your dog’s fur insulates them from the cold in the winter, it also helps keep them cool in the summer: insulation from the heat and sun is also provided by the double coat.

It is important to remember that dogs do not sweat like you or I.  They sweat from the pads of their feet, period.  So while you and I may want to shed layers to help air out our perspiring bodies, that is not the case for dogs; they will be cooler with their natural summer coat.  Even a black Newfoundland like Moses.

Precious Paws Grooming from Guelf, Ontario, also addresses this issue, including the added concerns:

– a shaved double coat can sometimes grow in thicker than it was before (kind of defeats the summer time purpose, doesn’t it?)

– sometimes it doesn’t grow back properly or evenly (or even the same colour), and if the undercoat grows back faster than the outer “guard” coat, the undercoat is more likely to mat and create need for another shave – a vicious cycle – since it is the guard coat that prevents matting (that last part is credit to The Groomer).

– you are now putting your dog at risk for a sunburn (aloe vera, anyone?)

– their thick coat also protected them from biting flies and mosquitos, a defence they would no longer have if shaved (the Edmonton Humane Society has a safe-for-dogs, homemade bug repellant recipe here.)

– not used to being shaved, they can sometimes scratch excessively, irritating the skin or creating hot spots

– behavioural changes in dogs not used to being shaved have been reported, and anecdotes I found online seem to report resulting in increased insecurity in some dogs (however, whether or not that should be attributed to a bad grooming experience is probably a discussion to be had)

What can happen when you shave a double coated dog, in this case, a Pomeranian. Having been repeatedly over-groomed, this poor guy developed alopecia (uneven growth/bald spots). (Credit: http://www.thoughtfulpawsgrooming.com)

And if you’re shaving to reduce shedding, The Groomer advises that even with the shorter ‘do, the shedding will continue – it will just be shorter fur on your clothes and couch.  And since you have interrupted their natural shedding cycle, you may actually cause more shedding.

And lastly, for those water dogs such as the Newfoundland – that rely on their oily coats for increased buoyancy – shaving them can impact swimming.  Heck, some say they’re not even supposed to swim for a couple weeks after a bath until those natural oils come back to aid their swimming abilities.

Instead, to keep your double-coated dog cool and comfortable in the summer, keep their fur clean and brushed.  Brush regularly to take out the excessively thick or dead undercoat, but don’t shave it off.   You can even take them to the groomer in the early summer for a thorough bath, blow-dry, and brush-out to get rid of as much dead and excess undercoat as possible.

And remember that mats WILL result in a hot and uncomfortable dog.

But that should be your only grooming concern, so save your money.  Otherwise, keep them out of the heat by using the usually recommended techniques like keeping them out of the direct sun and well-hydrated.

Not sure if your dog has a double coat?  Check before you do anything drastic!  Commonly known breeds with double coats are, according to this source:

– Newfoundlands and other long-haired mastiff-types such as the Great Pyrenees and Tibetan Mastiff

– some herding breeds, such as the German Shepherd or rough-coated Collie

– Spitz-type dogs like the Siberian Husky, Malamute, Akita, Samoyed, and Pomeranian

– some terriers, even though their outer or “guard” coat may be quite wiry – examples include the Tibetan Terrier and Cairn Terrier (I should note the source includes Wheaten Terrier in their list, and I think that’s incorrect)

– some sporting dogs, such as retrievers (both the Golden and the Labrador varieties)

So please, stop the madness.  Back away from the razor.

And if you thought an inappropriately shaved DOG was pitiful... (Photo credit: whyevolutionistrue.wordpress.com)

BtC: Breed-Specific Rescue

It’s that time again!

I’m even going to do you guys a favour by switching it up and not blogging about Actions Speak Louder (Calgary).  But don’t get too excited; I’m not straying too far from that sentiment.

When advocating for the end of retail pet sales, a surprisingly common question that gets asked is “well, then where will people get pets?”  The answer is simple: rescue or reputable breeders.

But the problem with that answer is that it seems to divide animals – or dogs specifically – into two separate categories: mixed breed mutts (rescue) or purebred companions (breeders).

What I think often gets forgotten is that you can rescue a purebred dog.

Purebred dogs, or purebred-type dogs (in other words, non-registerable), often wind up in your large, local, well-known rescue organizations that such as your local pound, SPCA, Humane Society, or other similar organization.

They also are often taken in by your lesser-known or smaller rescue operations.  Take, for example, Pound Rescue, out of Okotoks, Alberta: their Facebook page recently released a photo of Sophie, a purebred Bloodhound now in their care and up for adoption.

Sophie - Pound Rescue

And if the idea of routinely sorting through your local rescues in the hopes a dog the breed you’re looking for happens to come up for adoption, there’s always Pet Finder.com, which does the work for you.  Just plunk in your location and the breed you’re looking for and voila!  Dozens, if not hundreds, of results – all dogs available for adoption through rescue agencies.

But another approach, and what seems (to me) to get less visibility than any of the above options, is to look for a local breed-specific rescue.

Take Calgary and area, for example.  I lived here for a long time as a member of “Joe Public” before I became involved in the pet community and I had no idea the multitude of local rescue agencies that exist outside of the Humane Society (both breed-specific and not).

Looking for a little dog, but flexible on breed?  Then check out Little Mutts Rescue – they have lots!

Interested in a beagle?  Beagle Paws can help you out.

Maybe you’d like a bulldog?  Alberta Bulldog Rescue are the folks to contact.

In the market for something bigger? Say, Great Dane?  For the Love of Danes Rescue Society will be happy to help.

Bubba is a successful adoption tale from For the Love of Danes Rescue Society

Looking for a loveable pitbull?  Pitbulls for Life are run out of Spruce Grove, Alberta.

Keera is currently up for adoption through Pitbulls For Life

My point?

For nearly every breed, there is a breed-specific rescue somewhere. Canadogs.com has an extensive list here of breed-specific rescues around the country.

Gitta is up for adoption through Southern Alberta Rottweiler Rescue. http://www.albertarottweilers.com/index.html

And coming back to that familiar tune: I beg you to tell me how these options are not better than a pet store purchase.  Seriously.

Not sure where your rescue dog comes from or who the parents were?  You don’t know that with a pet store purchase either.

Nor can you guarantee that the pet store will have the exact cockeryorkapoowhatchamacallit you want any more than a rescue can meet your exact parameters.

Not to mention rescuing a dog from a nonprofit (where adoption fees just cover care, admin, vet bills, and spay/neuter) is significantly different than emptying that spot in the store window just so another commercially bred puppy can fill it.

Shadrach is up for adoption through the Bernese Mountain Dog Club of Canada. http://www.bmdcc.ca/dogs_for_adoption.htm

To sum up: the change I’m blogging and would like to see is more visibility and preference for breed-specific rescue organizations.

Thanks for the readership and see you all in October for the next Blog the Change for Animals!

To read how others are blogging the change, find the official July Blog Hop here.

Rocket here is currently looking for a home through Calgary Basset Rescue. http://www.bassetrescuecalgary.com/

A note for full disclosure: aside from a fleeting reference or two, reputable breeders have been left out of this post because that it not what it’s about. The intent here is to draw attention to a lesser-known adoption option.  Period.  My own dog is purebred and did come from a reputable breeder; and I would do it again. I am not one of those to call an end to all dog breeding or the CKC.

Learning About Cysts

My dog is one in a million.  Probably more.

My Dog

And I say this both in the way that most pet owners do about their pets, but also to allude to what has turned out to be an extremely rare condition that is causing us all a lot of stress and sorrow – Moses more so than the rest of us, of course.

The diagnosis is in, and it’s a c-word, but not the one we were previously worried about for a bit there.  Moses has been diagnosed with a subarachnoid cyst.  One vet pointed out the silver lining by noting that hey, at least a cyst is probably benign.  Touché.

In the usual course, I immediately started looking for good resources on these cysts.  Because they definitely weren’t on my radar before.

The most useful resource I found was a retrospective study from the Journal of the American Animal Hospital Association.  This study looks at spinal arachnoid cysts in 17 dogs between 1987-2001 at North Carolina State University’s Veterinary Teaching Hospital.

Brace yourself for some medical jargon.

These types of cysts (though most sources take a moment to point out that they’re not technically a “cyst” because they don’t have an epithelial lining – yes there will be a quiz on this later) are broken into two groups: cervical arachnoid cysts and thoracolumbar cysts.

Moses qualifies for the first group: cervical arachnoid cyst.  Our report back made the distinction of “subarachnoid”, but I’m given to understand the added prefix doesn’t change anything; arachnoid cysts typically occur in the dorsal subarachnoid space in the cervical vertebrae.  And I can actually say I know what that means.  To see for yourself, see this diagram of the spinal cord.

These cervical arachnoid cysts, according to the study, are typical found in young, large breed dogs, and are found higher up on the spine in the neck/shoulders (in Moses’ case, the C5-C6 vertebrae).  The other kind of cyst is more commonly found in older, small breed dogs, and is found much lower on the spine – the thoracic vertebrae.

The listed symptoms are exactly what we noticed in Moses: progressive ataxia (wobbliness), reduced range of motion, scraping knuckles, but no pain.  The cysts enlarge over time, and cause nerve pinching.

In the study, surgery was performed on 15 of the 17 dogs (with both kinds of cysts), and according to this study and the other resources I came across, surgery appears to be the favoured treatment, and very little (if anything) is written about medical management options or success, or alternative/unconventional options (though our report back quickly noted hyperbaric oxygen treatment as a potential novel option).

Of the 15 dogs in the study who underwent surgery, 14 had good short term results.  12 of those dogs were followed up with, and 8 of the 12 had good long term results (67%).

6 of the 15 dogs who underwent surgery were large breed dogs with the same type of cyst we’re faced with.  The short-term post-surgery results were good in all.  The long term results were good in four of the six (67% again).  The other two dogs experienced a recurrence of the symptoms 18-26 months after surgery.

Moses' post-myelogram bald spot.

So that’s what we’re faced with: a spinal cyst that requires surgical removal in order to give Moses any real shot at going back to healthy and active (noting that carting and long day hikes are indefinitely out of the question regardless).

And odds at long-term recovery are estimated at 67% based on the study I’ve discussed, or bumped up to 70% based on the expert report we got for Moses.

The reports and our vets all note that factors influencing a good outcome are: age (3 years or younger, and Moses is 3 years and 3 months old right now), length of time symptoms are noted (4 months or less, and we’re right about at the 4 month point now), lack of other medical conditions that could impact recovery (none here), and the surgical method used (out of our hands, but our gal is the best).

So, in an ideal world, Moses would recover reasonably well and have a good shot at long term success with surgery.  And I’ve done my best to quantify “good”.

On the other hand, I can’t help but think about how long it has taken him to recover from the CT scan and myelogram from last week – it was several days before he could get up on his own and the tile floor is still a challenge.

Moses also has a bald spot on his rump from having to try the myelogram from the other direction - it's kind of like a canine tramp stamp. And, sadly, it's not growing back nearly as fast as the other one.

And although it may seem foolish to consider success rates based on one retrospective study from 2003, that brings me back to how our dog is one in a million; these cysts are very rare, and the study comments that spinal arachnoid cysts have been reported in only 28 dogs and 3 cats since 1968.

Understandably, and unfortunately, the small number of dogs studied has also meant there is no firm conclusion about the cause of these cysts.  Based on the occurrence younger dogs, they expect a congenial condition.  Another study that looked at 11 dogs with spinal arachnoid cysts hypothesized a genetic predisposition related to the dog’s confirmation (they suggest weight of the head being a possible influencing factor) noting that 6 of those 11 dogs were Rottweilers.

Moses

So that’s the situation we’re faced with.

And no, surgery is not cheap.  We will definitely max out our annual policy limit and then some (though I am pleased to report that so far insurance has paid out for our significant diagnostic costs without fuss), and it’s a question about putting Moses through an extensive procedure with long recovery and rehabilitation time, and without any real guarantee for success.

We have until next Monday to weigh all the variables in advance of another discussion with the vet.

And after all of this research and reading I’ve been doing lately on each possible diagnosis, I figure I’m probably in line for at least an honorary DVM by now.

One Long Day

Well the much anticipated Fourth of July has come (and is nearly over).

Not anticipated because I live south of the border and love me some fireworks (though that last part may still be true), but because Moses’ long awaited appointment with the specialist was today to determine exactly what it is that is causing his clumsiness and drastically reduced range of motion – and hopefully fix it.

Moses

We previously had two (great) vets independently come to the conclusion that Moses probably had Wobbler’s, and so our specialist appointment for a consultation, CT Scan, and hopefully surgery was made.

That was today, and unfortunately there is no good news to report.

The worst news?  Ironically that it’s not Wobbler’s.  Definitively not.

That’s the bad news because not only did all of the signs and symptoms point to Wobbler’s, but also because we were basically mentally (and emotionally) braced for that diagnosis and what to expect.  And boy were those expectations shattered.

At the outset, even the specialist put Wobbler’s on the top of her list of likely causes, based on the way he walks, drags his feet, and his hypersensitive reflexes in his back legs.  Definite nerve pinching is happening, restricting the movement in his front legs, and Wobbler’s and disc lesions are the most common causes.  Both of these are vertebral issues.

So in Moses went for a CT Scan to confirm that strong hypothesis.

And they got this:

Moses' spine - C6

Which is bad, because it’s supposed to look like this:

Moses' spine - C4

If it were Wobbler’s or a disc lesion, deformations would be found on the white part – the vertebrae.

Instead, what we see is that central circle is much larger at Moses’ C6 than in the second image (at C4), and pushed to the top left.

So that explains the nerve pinching, because there is definite swelling/inflammation, but instead the swelling is in and around the spinal cord itself.

Apologies to the specialist, veterinarians in general, and anyone else who better understands and can explain this issue; my humanities degrees grossly under qualifies me in anything medical, and I’m still trying to make sense of these issues myself.  Maybe this photo helps.

Moses’ diagnostic also included a myelogram, where dye was injected into his spinal column.  This allows the spinal column to show up well on X-rays, so any sort of pinching or blocking can easily be seen.

When they injected Moses at the top of the neck in the usual course, the dye stopped right about at C6 and would no longer move further down, so they had to inject him again in the lower back so the dye would travel upward to the other side of the blockage and they could get a full picture.

Moses' myelogram results.

I’m no expert, but even I can see the circled swelling.

Another view - that's C6 circled.

So if it’s not Wobbler’s, then what?

Well, good question.  And that’s the worst part – it’s still very much up in the air.  We’re waiting for a report back, and some fluid test results, but a new possibility is cancer.

Which just plain sucks and there’s no other way to put it using clean language.

I want to wait for the more definitive diagnosis before thinking too hard about treatment possibilities, but cancer is an entirely different bag of awful than Wobbler’s, so it’s been a terribly long day.

Perhaps the worst part is that Moses had to stay overnight at the vet.  The dye used in the myelogram has side effects (seizures are common due to caused hyperactivity in the brain) and they wanted to keep him overnight for observation while the dye dissipated from his system.

This is good, because when we got an update on the big guy earlier this evening they informed us that he had a seizure about half hour prior to our call.  They administered valium to combat seizures until the dye is out of his system.  So if our day has felt long, I can only imagine how Moses is feeling.

It’s pretty odd and very sad without Moses at home with us, but it’s important that he’s being cared for.  And we’re dog sitting our favourite pitbull, Hooch, this week so at least the house isn’t totally dog-free tonight.

We’re looking forward to picking up Moses tomorrow and finding out more about what exactly his condition is, though it might be as long as a week before we have certain results.

A long day for all of us.

(My regrets for the depressing post….)