Mabel needs your help

As many of you know, Mabel had her second surgery for sleep apnea/seizures on March 13. She has had her soft palette shortened, her tonsils out and her laryngeal saccules removed. We can't think of anything left to obstruct her breathing, but she starting to have sleep apnea again. She hasn't gone into a seizure since her surgery, but fear it is coming since she stops breathing in her sleep like she did before the surgery. She'll gag and wretch or crawl a little and point her nose to the ceiling and gasp for air. This can happen as often as every 10 minutes when she sleeps. The sound she makes when she does this is heartbreaking. We've tried phenobarbitol, but it made her sleep more...leading to more episodes. We are out of ideas. Has anyone seen anything like this?
We shaved her down because she was hot and panting after her episodes and it seemed to help keep her cooler. She is fine when she is awake. This only happens when she is sleeping. We appreciate any help we can get. We can't watch her suffer like this much longer.
Karin

Bless her little heart. That video made me tear up and I want to cuddle her. I'm sorry I don't have any advice for you. Too bad they can't make CPAP machines for doggies. My boyfriend has sleep apnea and that machine has made a world of difference for him.

I hope some other folks on the board will be able to help you. Mabel will be in our thoughts and prayers.

That breaks my heart to see, could you show your vet that video?
I really hopes she will be ok.
judy

I seriously think that you should contact--or have your vet contact--Tufts University in Grafton, Mass., about Mabel's symptoms, in case someone there has a clue. Having a video, to accompany the verbal descriptions, would be a huge help.

I'm so sorry to hear that it seems as though this surgery hasn't done the trick.

Oh my.....I'm sobbing watching that...I can only imagine how it must break your heart. Oh poor baby!! Dear Lord...I hope you find an answer soon....that just looks and sounds so awful. Prayers that you can find out what in the world is going on!!

oh Karin I'm so sorry, this must be very distressing for you and for Mabel.

I have no experience to offer you - only to let you know that we're thinking of you, and as the others have suggested, I really think you should be seeing a specialist centre - it would be helpful for them to see the video too.

I hope they manage to come up with a solution for you - I presume you've tried putting a pillow under Mabel's neck to raise her chin?


I've just been doing a search...

Dogs do indeed suffer many sleep disorders.
Recent research at Stanford U Medical Center has
isolated the gene responsible for narcolepsy, dog's with narcolepsy were used for this fantastic discovery!
You might have your vet see if your dog has any
enlarged throat tissue that might be closing the airway.
http://www.sleepnet.com/forum5/messages/449.html

Might be worth asking your vet to contact Stanford?

Oh that is really distressing. Poor little mite.

Mabel's Mom said:

We've tried phenobarbitol, but it made her sleep more...leading to more episodes.

Click to expand...

I don't mean to be an alarmist but I can not understand why a vet would give phenobarb to a dog that is already having trouble breathing. Phenobarb is a known respiratory suppressant and is now rarely used in humans because people would forget to breath while they were asleep and die.

It is still used by vets in the treatment of epilepsy. In fact our Scarlett is on it & doing reasonably well, but it is an extremely dangerous drug.

If I've missed something here, I apologise but this just rang big danger bells to me. I'm going to see if I can dig up some info on phenobarbitol for you. I'll be back if I can get some blurb on it.

Okay, I am back. This information came out of Medical Director, a medical prescribing software package used by doctors here in Australia.

Phenobarb

Adverse Reactions

The most frequent adverse effect following administration of phenobarbitone is sedation which often becomes less marked with continued administration. Phenobarbitone may produce mood changes and impairment of cognition and memory. Continued use of barbiturates even in therapeutic doses may result in psychological or physical dependence. Abrupt withdrawal may lead to a series of neurological symptoms culminating in seizures and delirium (see Precautions regarding withdrawal symptoms). Tolerance to the hypnotic effects may develop. Refer to the Overdosage section for the effects of excessive doses.

The following adverse reactions have been reported with the use of phenobarbitone.

Neurological.

Common: drowsiness, sedation (appears to lessen with use), lethargy, `hangover', disorientation, mental confusion, dizziness, depression, excitement, confusion, irritability, hyperexcitability, restlessness, tolerance and dependence, psychic or physical dependence.

Less frequent to rare: profound shock, lowered body temperature, prolonged coma, depressed or absent reflexes, ataxia, nystagmus.

Haematological.

Uncommon: folate deficiency.

Less frequent to rare: megaloblastic anaemia, thrombocytopenia, agranulocytosis.

Cardiovascular.

Uncommon: hypotension, syncope, bradycardia, vasodilatation.

Less frequent to rare: peripheral vascular collapse, feeble heart beat, circulatory failure.

Respiratory.

Uncommon: significant respiratory depression, bronchospasm or laryngospasm (especially if given IV).

Less frequent to rare: apnoea.

Click to expand...

OMG, that is so heartbreaking to watch-how brave you are with Mabel, it must hurt you so much. I have no answers for you, how I wish I did. Does it help to increase humidity for her? Maybe elevating her head while sleeping would keep things anatomically correct. She must be so tired. My son has severe sleep apnea and when he can't use his CPAP( ex. mask has a problem) he is so tired the next day. Babies used to be put into oxygen tents to help their oxygen levels, I wonder if something on that order would help her. I don't know, it's hard not to cry for her and for you. God bless.

Poor Mabel, I hope there's an answer out there sweet girl :flwr:

Poor Mabel, what a dreadful situation for both of you.

Are you close to a Veterinary School at a major University??

If not, maybe you could phone and get some sort of advice over the phone.

It would be worth paying for a phone consultation, if it's not possible to take her there....but make sure they watch the video beforehand.

My thoughts and prayers go out to both you and Mabel. :flwr: :flwr:

Oh Karin...I can't imagine what you are going through. That video was just heartbreaking. Was that taken since last weeks surgery? My husband who studied medicine but did not become a physician watched the video and said that humans having seizures are commonly treated with dilantin, and phenobarb as Caraline said, is used as a respiratory suppressant most commonly used to calm someone down and slow down respiration. He also said that being overweight can cause sleep apnea and difficulty breathing, which I beleive Karlin had mentioned in a previous post. I'm sure you have already discussed all of this with your Vet and I am by no means giving medical advice. I just wanted to mention this. Please let us know what the Vet says as soon as you find out anything. You and your family and little Mabel are in our thoughts and prayers.

I'm so sorry she is still having these problems.

I would talk to a university vet school gto see if they have any othger ideas. Unfortunately it may be that she is extremely affected by problems that can beset short-nosed breeds and you may have done most of what can be done. I am sure you have read through all the possibilities here: http://cavalierhealth.org/brachycephalic.htm

The only thing I can suggest is to really work to get her down to a lean weight. Weight is one of the biggest contributers to breathing problems. When my dog Lily came from the pound she was grossly obese and has now lost a third of her body weight. But initially she gasped and snored and snorted constantly and her snoring was so loud -- for a really small cavalier -- that I had to keep her in a separate room at night, two doors away -- and I could STILL hear her. Once she lost the weight, the breathing problems completely stopped.

On a related note my father had sleep apnea so severely that he slept for some time with a breathing apparatus each night. At the time he was stout. He has since lost all the extra weight and is very lean. He no longer has the apparatus or any need of it as the sleep apnea disappeared as soon as the weight was shed.

If I were you, I would put Mabel on a very strict diet (with approval of your vet) -- HALVE her food and no treats but fruit or veg.

I believe strongly that because of the potential problems the breed already has with its very short nose that are worsened by extra weight, and because of the extra work more weight puts on heart valves, keeping all cavaliers at good lean weight is of real benefit to their overall health and their chances for a long life. :flwr:

Oh dear the poor darling she is so stressed.

Personally I don't know as much about Cavaliers as some board members but personally this is what I would do if I had a dog suffering as Mabel does. Don't know if any of it will help at all. I think you are doing a wonderful wonderful job :flwr:

1. Start a diary keeping note of the time, duration and severity of each episode (grade 1-10) excel spreadsheet is good.
2. Reduce her weight right down to the optimum weight for her size and breed. Continue to keep the diary so that you can see if weight has a direct affect on the breathing.
3. Seek expert advice as recommended above.
4. Change her onto a natural diet, don't use pesticides or cleaners or anything that could trigger an attack or contribute to the attack.
5. Most importantly and this will be hard for you to do. Try not to touch her when she has an attack but give her loads of space to deal with it. Reassure in a clear voice keep it as if nothing is wrong for example "it's all fine Mabel good girl" even though your heart is going out to her. Reason being if she senses that you are stressed you could make it worse for her because she is worring about you too.

My heart goes out to her and you. Thank god she has you to look after and care for her.

Gosh, I wish I had some advice to offer you, but I have no experience with this. But I second the opinion of going to a University or some place like that (large vet hospital), to get a second opinion.