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gentess1
20th November 2009, 01:31 PM
Hello All. My 2 year old Todd had fenestration surgery just over a week ago, and he is not improving. I had him back to the specialist yesterday and he had a further CT scan which showed no further deteriation, but he is still in pain. I was expecting to pick him up today but the specialist is concerned about his mobility, and he is warning me that he is leaning toward recommending Ventral Slot surgery. I have no medical training, but I am not daft enough to think there are no risks of further damage being done.
Has anyone had this procedure done, what sort of recovery timescale does this have. We have 3 other cavaliers and it is difficult keeping them from apart. I was aware that the fenestration was not certain to solve the problem, but what is the pro's of having the ventral slot done.

Sorry for gabbling, but I am trying to guess the questions my wife will ask when I go home without him today

Margaret C
20th November 2009, 06:37 PM
I do hope that someone out there can help you.

If a visitor to the site reads this and has some knowledge to share, perhaps they will contact Karlin, the owner of this site, so she can put them in contact with you.

Pat
20th November 2009, 07:25 PM
There are several red flags here - and way too little information disclosed for anyone to be very helpful. You should carefully read those links I posted in the thread about Bailey, who just had surgery (laminectomy) for a herniated disk. Bailey's only symptom was pain - long term. The first link is to a published veterinary paper. It describes ventral slot surgery and the indications for surgery, recovery, etc. in the same section that describes fenestration. You could print this out and discuss your questions with your vet/s. I hope that this specialist doesn't just expect you to trust him without understanding all of the ramifications just because he is a vet and you are not! Are Todd's symptoms WORSE since the surgery or the same?

It is not at all clear to me that your 2 year old dog has a herniated disk. You repeatedly said that MRI showed "minor disk degeneration" which would not be consistent with the major neurological deficits that you describe (which would correlate more with major disk compression from a herniated disk or perhaps with another neurological condition such as SM). It also not clear to me what kind of a "specialist" is seeing him. Do you know the exact credentials?

Because of these inconsistencies, no one is really going to be able to give you a good answer. Your "specialist" should be giving you these answers, and if you have doubts I would seek a second opinion before doing anything. Carefully check the credentials of these vets and see if you can get vet references. What you are reporting just isn't "adding up."

Best wishes,

Pat

Pat
20th November 2009, 07:41 PM
Also - go back to your original thread - I have all of the same concerns, questions and advice that Karlin posted in that thread.

Pat

gentess1
20th November 2009, 08:50 PM
Hello, I have no reason to doubt the vets credentials, but I a little concerned that he explains everything, even offers suggestions, then leaves us to make a decision. I just put that down to him trying to involve us with the decision process. After the euphoria of getting Todd back, after the first day he went back over. I know the vet has discussed the case with the other senior specialist surgeon.
He is being kept under observation this weekend. It sounds daft, but we have three other cavaliers in the house ( it is little Megs first birthday today and she is missing her friend ), but the house feel soooo quiet without him. My only hope is that he is getting quality rest, and they are able to put a finger on what the problem might be by watching his behaviour pattern. At the moment, all I can do is trust, hope a pray, what are the other options?

Pat
21st November 2009, 12:04 AM
That's what he should do - give you a thorough explanation of the disease, give you treatment options and pros and cons of each option and you should make the decision. If you really trust this clinician, ask him "what would you do if this was your dog?" I don't think you have told us whether this is a certified neurologist or a certified orthopedist or a certified surgeon (who might have a specialty).

Some people are comfortable simply following the recommendation of their vet and others like to do independent research in addition so that they have a better understanding of the decision. I like to make a chart (nothing fancy) as it helps me to reach a decision when I look at something on paper and it helps when I am discussing the decision with the vet or specialist. I write out the possible diagnoses (plural) then the possible treatments and the pros and cons of each treatment along with the success rate of each treatment. Then I figure out if there is an order to follow (try A first and if that doesn't work, try B next and so on).

Pat

gentess1
23rd November 2009, 08:57 AM
Fingers crossed we are going to get Todd later today. He has been in hospital 4 days, his progress is slow, but hopefully enough to not warrent further surgery just yet. I know the whole family has missed him so much, especially our little Ruby Meg. She has been very clingey and quiet. I think the surgeon will recommend the ventral slot procedure, but we have decided to get him home and give him and us more time to decide. I will keep you all informed, and post what happens later tonight, and maybe apicture of him.
Thanks

gentess1
23rd November 2009, 11:53 AM
Got the call from the hospital, they are happy for us to collect Todd. Is is still not right, but will benefit from being at home :fool:
He has his original appointment to got to next Monday, so hopefully he will make a marked improvement by then.

Nicki
23rd November 2009, 06:21 PM
So pleased he is coming home, and that will give you time to think about the options.

I'm sorry this isn't something anyone seems to have had experience with, so I think you need the specialist to explain it very thoroughly.

Sabby
23rd November 2009, 07:53 PM
Got the call from the hospital, they are happy for us to collect Todd. Is is still not right, but will benefit from being at home :fool:
He has his original appointment to got to next Monday, so hopefully he will make a marked improvement by then.

You must be so happy Todd is coming home. I just hope he will improve and won't need anymore surgery. I am so sorry you have to go through this. keep us updated.

gentess1
23rd November 2009, 08:41 PM
Another long car journey, but worth it to get Todd. He is still very out of sorts, but hopefully it is just him getting settled again. The other dogs gave him a big welcome. He is at or local vets tomorrow to get his staples out, then back to the specialists next Monday to work out the next step. Thanks for concern and best wishes

Karlin
23rd November 2009, 10:11 PM
I am going to again very strongly advise you get Todd's MRI read by Clare Rusbridge for a second opinion.

I am just really alarmed that the vet sees NO CM -- this is, and I stress it -- virtually impossible.

As Pat mentioned in an earlier post, the kind of problems you are seeing may have nothing whatsoever to do with what he has had the surgery for and it would also alarm me that they are even considering further surgery without getting a formal neurologist consult. I just don't really understand how a mild disk problem could produce the symptoms you saw before surgery or after and I'd want that explained.

Some of these decisions do sound as if the people involved do not know very much about CM/SM (believe me -- if you had a cavalier with NO CM, the researchers would want to know -- only a couple have been found out of over a thousand MRIs). You are fortunate to have several of the leading neurologists/researchers in this area in the UK -- before you spend more money of any other treatments, I'd get a second opinion. You can get Clare Rusbridge by talking to Stone Lion. At least then you will either have eliminated a major worry that you are not treating for the right condition, or you will find a correct way forward for treatment.

Pat
24th November 2009, 02:36 AM
I wasn't going to post again, but I must say one more time that I strongly agree with Karlin's last post. Again, you've never said what kind of specialist this is - neurologist, orthopedic specialist, surgeon or something else. I sure would want a neurologist to review the MRI and to review this case especially because of all of the inconsistencies between the MRI and his symptoms, the serious nature of the symptoms, and discussion of more surgery that could be harmful if the diagnosis is incorrect.

Pat

gentess1
24th November 2009, 06:06 AM
The surgeon is an orthopedic and soft tissue specialist. I hear gushing praise of Clare, how would I contact her. The hospital we are using is part of a big group, should I call and insist on a second opinion from a neurologist, or should it be a specific type of specialist I need to ask for. I am already over my insurance limit, but I want my little Todd back, and all his puppy like ways.

Thanks, hopefully you will come back to me.

Regards Steve

Sabby
16th December 2009, 12:44 AM
Just wondering if there is any news on little Todd.

Karlin
16th December 2009, 12:54 AM
Sorry Steve, I missed this -- there are a lot of daily threads and posts and I don't get to all of them -- always feel free to PM me if you need a contact. :)

Information on Clare and contacting her are on her website:

http://www.veterinary-neurologist.co.uk/