Cornell Visit
Re: Cornell Visit
How cool, davet...isn't it a small world?
JMM -- JaMi Maltese -- Dust Mops with Drive
Re: Cornell Visit
Cornell Visit #2 Last Week:
Exam - ok, lost a little weight.
U/S - ok, his normal changes to kidneys and liver same as usual (a little small, a little speckly)
Verdict - Tweak his Dexamethasone dose, leave Carafate and MTDZ the same. They were suppose to call with a dose of Simethicone to try before his meals to see if maybe he is gassy and hurting from that. Later this week I'm suppose to reduce his kibble intake and replace that with something low fat to overall reduce the amount of fat he gets. I'll probably do couscous or else tofu.
The weekend before we left, he was walking a little funny, kind of stiff in the rear and not fully extending his back legs. He bunny hopped when running. He also did not really want to stand if you asked him to. He'd tuck his bum and sit. His internist here said crate rest for a week or so. We also got in for acupuncture which seemed to relax him. We assumed he pulled a muscle in his back from standing hunched. His spine that we got on his abdominal radiographs looked just fine. No back pain either.
Well, he is still walking funny and bunny hopping. He is not unwilling to stand now, but his rear legs tremble if he's standing still. That might just be a more intense version of his normal tremors which have always concentrated in his rear legs. It was kind of assumed since it wasn't HE that he probably had hydrocephalus or something. We didn't bother to work it up since he's done it forever and no real issues other than it being odd.
So, if he's not all better by tomorrow (and we're still on crate rest for another 10 days), his internist wants him to see one of the neurologists at her practice. I really don't want him in and out of the vet again so soon, but an exam won't hurt and better safe than sorry. We have an appt for Thurs hoping we can cancel.
Clinically, his GI symptoms of vomiting and diarrhea are improved overall. His stool was good for about a week and then started getting soft, but did not progress to diarrhea! His vomiting is still about twice a week which is great. His appetite is up with the steroids. The main problem is continued nausea and discomfort after eating and throughout the day. He'll feel good usually in the am before he eats. He eats 4 small meals a day and is nauseous off an on and usually most uncomfortable at night after his last meal.
Exam - ok, lost a little weight.
U/S - ok, his normal changes to kidneys and liver same as usual (a little small, a little speckly)
Verdict - Tweak his Dexamethasone dose, leave Carafate and MTDZ the same. They were suppose to call with a dose of Simethicone to try before his meals to see if maybe he is gassy and hurting from that. Later this week I'm suppose to reduce his kibble intake and replace that with something low fat to overall reduce the amount of fat he gets. I'll probably do couscous or else tofu.
The weekend before we left, he was walking a little funny, kind of stiff in the rear and not fully extending his back legs. He bunny hopped when running. He also did not really want to stand if you asked him to. He'd tuck his bum and sit. His internist here said crate rest for a week or so. We also got in for acupuncture which seemed to relax him. We assumed he pulled a muscle in his back from standing hunched. His spine that we got on his abdominal radiographs looked just fine. No back pain either.
Well, he is still walking funny and bunny hopping. He is not unwilling to stand now, but his rear legs tremble if he's standing still. That might just be a more intense version of his normal tremors which have always concentrated in his rear legs. It was kind of assumed since it wasn't HE that he probably had hydrocephalus or something. We didn't bother to work it up since he's done it forever and no real issues other than it being odd.
So, if he's not all better by tomorrow (and we're still on crate rest for another 10 days), his internist wants him to see one of the neurologists at her practice. I really don't want him in and out of the vet again so soon, but an exam won't hurt and better safe than sorry. We have an appt for Thurs hoping we can cancel.
Clinically, his GI symptoms of vomiting and diarrhea are improved overall. His stool was good for about a week and then started getting soft, but did not progress to diarrhea! His vomiting is still about twice a week which is great. His appetite is up with the steroids. The main problem is continued nausea and discomfort after eating and throughout the day. He'll feel good usually in the am before he eats. He eats 4 small meals a day and is nauseous off an on and usually most uncomfortable at night after his last meal.
JMM -- JaMi Maltese -- Dust Mops with Drive
Re: Cornell Visit
JMM, how is Mikey doing now?
The reluctance to stand on the rear legs may be due to pain, whether it is abdominal or other, hard to say but would certainly discuss a potential pain aspect with your internist....did you see them on Thursday?
I'm starting to wonder if Mikey is developing multiple conditions, secondary. One thought, excess acid (nausea, vomiting, painful abdomen)...despite the carafate, he could still have an excess. Am also wondering if megaesophagus was ever ruled out....
The reluctance to stand on the rear legs may be due to pain, whether it is abdominal or other, hard to say but would certainly discuss a potential pain aspect with your internist....did you see them on Thursday?
I'm starting to wonder if Mikey is developing multiple conditions, secondary. One thought, excess acid (nausea, vomiting, painful abdomen)...despite the carafate, he could still have an excess. Am also wondering if megaesophagus was ever ruled out....
..........Traci
Re: Cornell Visit
He did see the neurologist on Thursday. He has some weakness and minor defecits in his hind limbs as well as a clear gait change (bunny-hopping when running and waddling at a walk and trot). She also had one of the orthopedists (the one who did M's knee surgery) give him the once over. No pain anywhere. They took hip rads which are fine. She suspects time with either resolve or advance the symptoms. One idea is early signs of metronidazole toxicity. He could also have a lesion somewhere, but his signs are so vague right now she did not feel like scanning him would be appropriate at this point (and boy is my credit card pleased at that). For now I'll just monitor him and he can have normal activity. I'm watching for changes in his gait after his just gotten up vs. after exercise and such. I just have to be careful as he is a little weak in the rear so I'm keeping him away from stairs and ledges.
He just had whole body rads the other week with no abnormalities. They were reviewed by a radiologist and his internist.
Mikey is doing okay right now. He has maintained his good stools and decrease in fequency of vomiting. His nausea episodes are still the same. No improvement with the simethicone. We call with an update next week so will see what they think. He was really lethargic and didn't eat last night and this morning, but is perky this afternoon so probably just felt bad.
He just had whole body rads the other week with no abnormalities. They were reviewed by a radiologist and his internist.
Mikey is doing okay right now. He has maintained his good stools and decrease in fequency of vomiting. His nausea episodes are still the same. No improvement with the simethicone. We call with an update next week so will see what they think. He was really lethargic and didn't eat last night and this morning, but is perky this afternoon so probably just felt bad.
JMM -- JaMi Maltese -- Dust Mops with Drive