Looking for answers: FCE, myelomalacia, pts

Neurological Disorders Resources. Treatment and care for pets having pain or trouble walking or standing due to spinal injuries or neurological disorders like IVDD, FCE and DM.
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MartaS
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Joined: Thu Jul 23, 2020 6:27 am

Looking for answers: FCE, myelomalacia, pts

Post by MartaS »

Hi everyone,
I'm really glad that at last I've run into a forum like this. Maybe some of you will be able to help me in my desperate need of getting to the bottom of this. On New Year's Day I lost my dog to a neurological disease that made him paralyzed in the hind legs (yeah, there couldn't have been a worse beginning of the year). Since then, I've been beside myself with grief, guilt, despair. I think I've read all the articles and research papers that there possibly are on the Internet, just to find the answers, but I'm still full of doubts. I'm pretty sure the vets that treated Boris did the best they could do for him, but they hadn't really prepared me for what was to come.
Boris lost mobility literally overnight and two days later, after heading to another city to run some more tests, it was indicated via neurological examination that he had lost his deep pain sensation as well. Myelography was performed which excluded IVDD or any physical compression of the cord, but apparently there was clearly something blocking bloodflow in the spinal cord. The vet pointed to either FCE or haemorrhage, totally unoperative condition, and we were told to do some light rehab exercises at home, given medications and 5 days to see if any improvement came.
After regaining counsciousness from the test, Boris was rather normal, a bit sleepy, but alert - there were no signs of altered mentation. But the next day, the nightmare came back. In the afternoon, the first seizure struck which looked like a typical epilepsy attack with all the characterstic phases and symptoms. Then small seizures followed - it was impossible to touch Boris because every move would cause him to seize (imagine not being able to hold your pup to comfort him). Also it seemed that he was in great pain despite the medication that he was given that day. He also tried to snap when trying to touch him - we had to nuzzle him when moving him around or expressing his bladder. One thing to note is that he had been in pain as well on the night before myelography was made, a night I will never forget. He then bit me really hard in my hands - I've had scars since then.
I was there with my parents and we were totally lost and helpless, having no idea how to help him, with no emergency vet unit in town to leave him there for the night. We got some antiepileptics from a local vet to calm him down a bit but he wasn't really responding. Finally, I decided that I didn't want him to suffer like that any longer and I made the toughest decision that I had ever had to make.
I'm not even sure what I'm asking of you right now? Advice? Guidance? Support? Has anybody's dog experienced such extreme symptoms like my Boris? Was it possible to help him? Was it myelomalacia that took him in the end (I only learnt about it after doing research online; no vet mentioned the "m" word to me)? I'm finding it really hard to cope, even though it's been more than 6 months.
Thanks in advance for any information whatsoever.
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CarolC
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Re: Looking for answers: FCE, myelomalacia, pts

Post by CarolC »

MartaS wrote: Thu Jul 23, 2020 7:17 am Myelography was performed which excluded IVDD or any physical compression of the cord, but apparently there was clearly something blocking bloodflow in the spinal cord.*skip* After regaining counsciousness from the test, Boris was rather normal, a bit sleepy, but alert - there were no signs of altered mentation. But the next day, the nightmare came back. In the afternoon, the first seizure struck which looked like a typical epilepsy attack with all the characterstic phases and symptoms. Then small seizures followed - it was impossible to touch Boris because every move would cause him to seize (imagine not being able to hold your pup to comfort him).
Dear MartaS,

What a sad thing for you and your dog. I am so sorry for all of this. There will probably always be some lingering questions.

You mentioned that your dog had a myelogram as part of the testing. Myelograms were once considered the gold standard for diagnosing a spinal condition. They give very good images for the vet to look at to make a diagnosis. As far as I know, they were the best thing available before MRI and CT became more common. They give much better views than x-rays.

In recent years, MRI and CT scans gradually became more available for veterinary hospitals. For quite a few years they had MRI for humans before they had it for pets. Now MRI and CT are more common in veterinary hospitals, but not every facility has them. MRI gives very good images and is considered pretty risk free. Myelograms are still done because they also give good images, are cheaper, may be available where MRI is not, and are usually considered low risk, but not entirely risk free.

There is a slight risk of seizures with a myelogram, and I am not a vet or radiologist and am not a good person to explain it. What I say may not be precisely right but I hope it will be generally right. When performing a myelogram, the hospital injects some dye into the spinal area that helps the spinal cord show up better on imaging. There are several different kinds of dyes that may be used. I believe the risk has to do with the dye, and I have read the risk is greater with larger dogs, and also there may be a difference in risk depending on which area of the spine they put the dye into, and how much dye is used.

I thought or assumed the vet would normally discuss the risk with the owner before a myelogram, or ask the owner to sign a consent form, but I'm not sure of that, it was only my assumption. There are so many different vets with their own policies and procedures, and office procedures right now may be irregular with the pandemic, I don't know.

Here is some general information about myelograms, and a link to a study about risks in different dogs.

https://www.vetmed.ucdavis.edu/hospital ... /myelogram

https://onlinelibrary.wiley.com/doi/ful ... 09.00479.x

If you have a vet that you have a good relationship with, you might ask the vet if they think the myelogram could have caused the seizures. If your dog did have seizures as a result of the myelogram (which there is no way to know) it does not necessarily mean anyone did anything wrong at the hospital. I think it just happens sometimes, with an individual dog, and they probably feel terrible about it, too.

It is hard to say what the biting was about. Some dogs do something called fly-biting or fly-snapping as part of seizure activity. If your dog had an FCE, that can be painful for the first day or two, and he could have been reacting to that. Some dogs will begin fear-biting when they are suddenly disabled, even biting those that are trying to help them. Supposedly dogs become scared because there is a pack mentality in dogs where if one dog is sick or weak, the pack may turn on him, so some dogs become nervous and frightened when they are suddenly disabled, and you are having to handle them in ways they are not used to. I do not know if that is really true, or if it is just folk wisdom that people say.

I am not sure of any of this, but it is very sad for your dog and his family. I really do not know what else you could do if he had uncontrollable seizures that were not responding to antiepileptics. Maybe if you search the internet, you will get a better feeling for how likely any of this is or is not. I only know that you did everything you could for him, and he was a lucky dog to have someone who loved him that much and would do anything to help him. Sometimes even though we do our very best, from the bottom of our hearts, the rest of it is just out of our hands. I am so very sorry for your loss. :cry:
MartaS
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Joined: Thu Jul 23, 2020 6:27 am

Re: Looking for answers: FCE, myelomalacia, pts

Post by MartaS »

Hi CarolC,
I really appreciate your reply. I know there are a lot of experienced dog owners here so every comment is and will be valuable, especially in this difficult time of trying to understand what had happened to my boy.
I was aware of the procedure of myelography and the risks it entails, but at that time I'd sign anything that would help diagnose my dog. And frankly there was no alternative, as despite the fact that it was a renowned clinic, it wasn't (and isn't) equipped with na MRI. If there had been such an option, I would have definitely gone for this one, as I knew it would be less invasive. I was also told by the vet that after a myloegraphy a dog may experience some twitches that look like tiny seizures but that they usually subside within a couple of hours. That in fact was the case with Boris, but later when he recovered from anaesthesia, he was rather his usual self. I also read during these 6 months that if any seizures happen due to a myelogram, they usually happen within 24 hrs. Boris's seizures developed after these 24 hours passed and they kept getting worse. And these were not only seizures, also his mentation was altered, he was getting more anxious, he couldn't keep himself in sternal recumbency, he seemed so very weak as if he was drifting somewhere else:(
Of course, I can't deny that this is only my perception of his condition. Probably if Boris had been under thorough medical supervision, we would have gotten some more objective information, but there was just nowhere where we could put him in (I was at my parents' who live in a smaller town). Driving him 100 km back to the clinic wasn't an option in his state. I can't help the feeling of making a too rushed decision, I really can't. I only know that my options were limited and I just couldn't stand my dog suffering any longer.
I guess I will have to carry on with the 'what if's' for the rest of my life...
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critters
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Re: Looking for answers: FCE, myelomalacia, pts

Post by critters »

I'm sorry for your loss. :(
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