HandicappedPets.Net

Found this

https://web.archive.org/web/20150803071013/https://www.fortheloveofmiabella.com/ wrote: Clinical signs may be more severe with an intact dens, as a normal but dorsally deviated dens causes a greater degree of spinal compression.

In Pip's case the dens is missing, and that is often congenital in chihuahuas.

I've never heard of "dens," beyond the obvious, of course!

I found an example in human medicine of dyspnea and dysphagia related to C1-C2 compression, not to the brain stem as in a previous article I quoted. Pip has both (trouble breathing and trouble swallowing).

https://www.e-neurospine.org/journal/view.php?number=384 wrote: we experienced a case of dyspnea and dysphagia after posterior C1-C2 fusion. [skip] So we did C1 posterior arch decompression and extended fusion to the occiput with neck extension position. Dyspnea and dysphagia gradually improved after the surgery and complete recovery was observed within a month.

Pip had a CT yesterday. He has more compression than expected. He did OK with the anaesthesia, except he regurgitated twice. The first time he was still intubated so that should be OK, but the second time was when they were removing the tube, so the neurologist called in Clavamox to prevent aspiration pneumonia.

The imaging report says

A dens type structure is present but appears dysplastic (abnormally shaped); this could be secondary to a congenital malformation or trauma.

He's a most interesting fella, I have to say!

I noticed he was constipated after his neurology appointment May 16, and thought maybe it was the prednisone. Then he was constipated again after the May 23 appointment, and by then he was on less prednisone (tapering). In each case he had to be fasted before the appointment, so that might have thrown his system off. Trying to stimulate him is hit-or-miss (more miss than hit) so I've been trying lactulose for him. I gave him 0.5 ml the first time and it worked the next day. But I thought I'd try getting him on it daily to see if we could get him regular. I started with 0.2, 0.25, 0.3, and yesterday was 0.35. At 0.25 and 0.3 he went in his bed after breakfast, which does not usually happen. This morning he went before breakfast (yay!) after getting 0.35 yesterday. Would love it if we could get him predictable. Tried 0.35 again. We'll see.

I also wonder if being backed up from the first appointment had anything to do with the regurgitation at the CT appointment. I think the appointments made him tense.

I'd certainly think stress could make him pukey.

Pip had surgery to stabilize his atlantoaxial joint at 4PM Wednesday, June 7. He was high risk for anaesthesia but did well. He came home yesterday. His incision is under his neck where his throat is. He has screws, pins, and bone cement. He is on tramadol, gabapentin, prednisone, and an antibiotic, Simplicef. The meds seem to be working well. He had cold pack treatments on his incision for 3 days and today he starts hot pack treatments. He is eating well. He can drink soy milk. He can bark. He has bladder control. He can get himself sternal. He seems more normal than I would have expected on his 3rd day. He is constipated but I started him on lactulose this morning. The surgeon said the surgery went about as well as possible and he is "rock solid" now. She said the bone in his dens was good and strong. She thinks it is highly unlikely he'll break his implants. She said he had a lot of scar tissue. He is on crate rest for 8 weeks. He'll have another neurology appointment after 8 weeks. Here is what the neurology report said after his CT/MRI 2 weeks ago.

Pip's CT/MRI study revealed severe spinal cord compression up to 90% at the Atlantoaxial joint (C1-2). This is the cause of Pip's paralysis.

The surgeon says it is wide open now.

At 3:45 pm today he sprang himself and did a back flip out of his bed and rolled. He's fine. 5 days after surgery. I guess the meds are not eliminating the spasticity like I thought. He'd just had his next dose of Tramadol and gabapentin at 3 pm.

Any idea what caused it? Glad he's OK!!!

Nuh-uh, I never know what causes it. I always compare it to a human quadriplegic flipping himself out of his wheelchair. It seems to just be spasticity?

Today is day 7. I put him on his potty towel before breakfast and when I came back he had gone four feet away. He was lying on his "wrong" side. He must have got up and run a couple of steps, but I didn't see it. He didn't merely kick himself over there because he was on his other side... He's OK...

Morning of day 8, he flipped or rolled backward out of his bed again and got stuck between a blanket roll (put there to prevent this) and the wires of Millie's crate. I put him back in bed and he then licked his cat food plate clean like nothing had happened. Normally in the past he'd flip out of his bed about once every 5-7 days. Wasn't expecting it so soon again.

Yesterday he twice got himself into a mostly sternal position but with his body curved slightly and his head turned to the right, and it was uncomfortable for him and he couldn't get out of it apparently. I was in the other room and heard a steady Yip....Yip....Yip....Yip and came and found him that way. It's something new. He never used to get in that position before and he doesn't seem to like it now. Not sure what that is about, but next time I hear that Yip-Yip I'll know.

His neck still pops. I guess that is the ligament damage. We'll probably be able to strengthen his neck muscles once he has really recovered.

Something exciting happened last night. I was feeding him dinner and he coughed. You might think, "Big deal", but I've had him 23 months and he has never done more than a little "heh-heh" sound like when he aspirated water. I don't want him swallowing wrong (of course), but this is the first time he's ever got enough air or diaphragm control or whatever, to manage a genuine cough. He's been able to bark (high pitched) the whole 2 years, so it seems like he could inhale air well enough. Not sure what is different between barking and coughing, but he has never, ever managed a real cough till last night.

Human quads, in particular, DO spasm themselves not only out of a wheelchair but they can throw the wheelchair on top of themselves.

Coughing is a good thing!!