PDA

View Full Version : Last stages of SM????



Shay
29th June 2012, 07:07 PM
Hi everyone,

I have not posted in a while, but I am beside myself, and need answers from anyone who can help me.

Just a little background, my Cavalier, Lily, who was diagnosed with a mild form of SM when she was three, has taken a drastic turn for the worse. She was showing symptoms of SM at three months, but was officially diagnosed at three years, along with PSOM, she will turn six, this August.

She has mild symptoms, face rubbing, scratching, a few times a day, but never did the bunny hop, or had weakness in her limbs. When she was diagnosed, she was put on gabapentin, and omneprozal. She has done very well, and was a normal happy, healthy, agile, and very active dog.

Just a few days ago, I noticed that she tripped a few times coming up the stairs, but didít think too much about it, because she always goes full speed running up or down the stairs. There were no other indications of limb weakness. Yesterday, when she got up, she could not walk, when she tried, her front and back legs on her right side, would just spread out to the side, and she would lose her balance, and she tried to jump on the sofa and couldn't. I put her up on the sofa, and she just lay there starring up at me. I walked toward the kitchen, and she tried to jump off the sofa, and fell flat on her face. She was very confused, and couldn'tíunderstand what was going on. I called her vet, who said she would call the neuro at Auburn Vet School, where she was diagnosed, but in the mean time, I brought her to the vet. She was worse by the time I got to the vet, and her little body was tuned in complete C shape. The vet had not yet heard back from the neuro, but she thought it was either her SM, or possibly the PSOM, with perhaps an inflamed ear pressing on a nerve. She started her on prednisone for inflammation, and tramadol or pain, and said to continue her on her gabapentin.

This morning she seemed a little better, ate well, and even wanted me to throw her ball, but now, she is back to where she was yesterday. This dog has gone from a happy, healthy, and VERY active dog, which I can't stress enough, to a shell of herself, almost overnight. I canít believe she could have gone down this quickly, with no other signs.

My questions are, is his the end stages of this horrible disease? Would she have gone this far down overnight? Could it be the PSOM, or does this sound more like SM? And what do we do now? She can't even go out side to potty, because of the stairs, she has to be carried, and can't even balance herself well to potty, and keeps falling over. Has anyone had this happen, and then with the prednisone, they get better? I am beside myself and can't imagine why this happened so quickly. Any information anyone can give me of similar experiences and outcomes would be greatly appreciated. I love this dog more than life, and it is killing me to see her like this. It's like I went to bed with a happy, vital dog, and woke up with another dog. Her life has changed overnight. Is it normal for this to happen this quickly, and will she get better, or when these symptoms appear, do they stay, and even get worse?

Thanks in advance for any info you can give me. As of this morning, my vet hasn't heard back from the neuro.

Margaret C
29th June 2012, 07:28 PM
Unfortunately it does seem that SM can break through with these sudden painful symptoms but don't despair too soon and don't panic until you have had specialist advice from the neurologist.

There are a variety of drugs that may help if this is a deterioration of her SM.

Sydneys Mom
29th June 2012, 07:30 PM
Sharon, I am so, so sorry that this is happening to Lily. I'm sure both of you are frightened and confused with what is happening. I wish I could give you advice, but I have no experience with SM. I will keep you both in my prayers. :hug:

sins
29th June 2012, 07:56 PM
My Daisy developed hepatic encephalopathy,where the liver function fails.Sometimes it can happen over time that the liver tolerates the medications less well and that's why vets order periodic blood tests on cavaliers who are being medicated for SM.The symptoms are ataxia and collapse,with lack of control over limbs and disorientation.
If it's a neurological issue,your specialist will be able to advise the best way forward.Hopefully you'll be able to find the cause of her symptoms quickly.
I certainly wouldn't give up hope yet.

Sins

Emkaybee
29th June 2012, 08:25 PM
IMO you should take her directly to a neuro for an exam, and not wait to hear through your vet. The symptoms are severe enough to warrant pushing on this. Good luck! Hope she returns to normal and this isn't something serious.

Brian M
29th June 2012, 08:52 PM
Hi

I am so sorry for Lily and you an do so hope you find a solution quickly .I can only say what others have said a
visit as urgent as you can to your Neuro .

DZee
29th June 2012, 09:22 PM
Sharon, I am so, so sorry that this is happening to Lily. I'm sure both of you are frightened and confused with what is happening. I wish I could give you advice, but I have no experience with SM. I will keep you both in my prayers. :hug:

I second this. Will be praying for Lilly ( and you*) as well!

tupup
29th June 2012, 09:28 PM
just to say you are in our thoughts & prayers, please do keep us posted when you can:hug:

Love my Cavaliers
29th June 2012, 09:59 PM
It almost sounds like something is damaging her vestibular system - or maybe a syrinx is putting pressure on it. Riley's SM damaged her vestibular system and a lot of symptoms are similar to Lily's. Prednisone is the only drug that worked for her and it has been a miracle drug for her. She had to start on a pretty high dose - 10 mg for a time before we could cut her down to 5 mg a day and we have just cut her back to 2.5 mg a day, but she has been on it for over 4 years now. She still has days in which her balance is terrible - she has to lean against walls to walk, she has seizure like activity in which he head whips backward and her whole body goes into a backward C and she has nystagmus of the eyes, she can't jump, sometimes one step up into the house is hard, her back legs are weak and she sometimes falls over, Sometimes she can't sit up, etc.

i will echo everyone else's advice. Call the neuro directly. This is not something to fool around with. Please let us know how she's doing.

Shay
30th June 2012, 12:45 AM
Thanks for the kind and informative replies. My vet did hear back from the neuro this afternoon. He is familiar with Lily, and saw her two years ago, when he increased her gabapentin, and when she was having vestibular episodes, which he said was from her PSOM. She only had two episodes and has not had one in two years. He was located in my city then, but is now back at Auburn Vet School, so we have no local neuro in my city now, and Auburn is two hours away. The neuro, Dr. Shore, who initially diagnosed Lily is now at the U of Mississippi vet school, and was an excellent neuro. At that time, he told me Lily was borderline for surgery, so we opted to treat her with medication. I will not do surgery on her now, because I have heard of too many cavs, one done at Auburn, who still deteriorated after the surgery, and have since died. I won't put her through that now, to have the same outcome.

She does have blood work drawn twice a year to check the affects of the gabapentin on her organs, and to check her gabapentin levels. She just had this done in April, and all her blood work was excellent, so it is not her liver, but I appreciate the info Sins.

Bev, when she had the vestibular episodes, it was similar to this, but they only lasted about an hour each, and she vomited both times. This seems to be somewhat different, in that it has not gone away, no vomiting, and is much worse than the vestibular episodes. But, my vet is not convinced this is not in some way a vestibular incident associated with her PSOM in addition to the SM. I do see her little leg shake when she tries to stand, so that leads me to think it is muscle weakness, and not a vestibular episode. But I guess it could be both.

Anyway, the neuro said that my vet is doing exactly what he would do, the prednisone and the tramidol, and there is nothing else he would recommend at this time. He also said that he believes it is a progression of her SM. He said we should finish this course of treatment, and see how she is, and go from there. My vet is not convinced the her PSOM is not involved in some way, because when she tried to look in Lily's ears, she freaked out and screamed, and then the muscle weakness immediately got worse and she collapsed on the table. She thinks the plug could be pressing on a nerve causing the limb weakness. It is so hard to tell with a dog that has SM and PSOM. I will bring her back to Auburn, if she is not better after this round of treatment, but if her SM has progressed, after another MRI, we can only treat the symptoms.

I am not giving up, and pray that this is just a flair up, or that she can regain her quality of life with prednisone, but as it stands today, she has no quality of life. All she does is lay here and look up at me, as if to say "what is wrong with me, help me". She has tried to do her normal things today, but her little body, just won't allow it. When my husband got home, and I heard the garage door open, I said "there's daddy", which I have done almost every day of her life. Her routine when I say that is to jump up on the couch, run to the end and jump up, so she can see him come up the stairs from the garage. She was laying next to me on the couch when I said that, and I never dreamed she would do her normal thing, since she has barely gotten off the couch today. Like a light, before I could grab her, she tried it and went right over the arm off the sofa onto the floor....it was heartbreaking. She seemed to be ok, but just looked confused. She has tried to bring me toys, but just drops them on her way, and just plops down. She looks very depressed, and there is no light in her eyes. She is a different dog, literally overnight. I am hoping some of what I see in her eyes, and the lethargy is from the tramadol.

Please keep Lily in your prayers, and again thank you for the kind words and encouragement.

Shay
30th June 2012, 01:07 AM
It almost sounds like something is damaging her vestibular system - or maybe a syrinx is putting pressure on it. Riley's SM damaged her vestibular system and a lot of symptoms are similar to Lily's. Prednisone is the only drug that worked for her and it has been a miracle drug for her. She had to start on a pretty high dose - 10 mg for a time before we could cut her down to 5 mg a day and we have just cut her back to 2.5 mg a day, but she has been on it for over 4 years now. She still has days in which her balance is terrible - she has to lean against walls to walk, she has seizure like activity in which he head whips backward and her whole body goes into a backward C and she has nystagmus of the eyes, she can't jump, sometimes one step up into the house is hard, her back legs are weak and she sometimes falls over, Sometimes she can't sit up, etc


Bev, this sounds encouraging. She is on 5 mil pred 2 x per day for 7 days, and then one per day until gone. The neuro said we will take it from there when the medication is complete. Thanks for the info!

DZee
30th June 2012, 01:16 AM
Awe Sharon...reading this make my heart hurt for you..and for your Lilly. Please know..> like I said above<...will surely be praying. Those are powerful drugs ...so be assured some of what you are seeing is from that.
http://img.photobucket.com/albums/v205/jabateman1/Signatures/KN_Puppy_Hugs.gif

sunshinekisses
30th June 2012, 03:15 PM
I am so sorry for you and Lily....must be a terrible thing to watch your beautiful pet suffer and not be able to help. I hope your neuro knows how to help and Lily bounces back.

Charlifarley
30th June 2012, 11:52 PM
So sorry to read this and I hope that Lily starts to feel better soon. XX

Shay
1st July 2012, 12:07 AM
Thank you for the kind words

I have been on line today trying to find some things to make her life easier. I ordered some little socks that have no skid surfaces on the bottom for the hardwoods. She does much better on the rugs, but the hardwoods is where she is having the most difficulty. I also orderd a harness for invaldid dogs which has a handle so I can help her down the stairs. Carrying her is a nightmare, becasue she doesn't want to be carried and wiggles and tries to jump out of my arms. I have 18 steps down from the deck into the back yard, and last night I thought we were both going down head first. I wish she would use pee pads, but she refuses to use them, and she would burst before using a pee pad. Today, I put her puppia on, and attached a leash to it and I held the length very short as we are going down and that has helped tremendously until I get the other harness in. Poor baby, when I got out her leash she thought we were going walkie, and she went crazy like she always does for her walks. It brought me to tears. But everything she is trying to do is bringing me to tears, becasue she has not yet realized she can't do the same things right now, and it breaks my heart. She is about the same today, I haven't seen any improvement, but I don't know how long it takes for the prednisone to work, if it's going to, but I am still hoping for improvement.

ashleighelizabeth
1st July 2012, 01:05 AM
I'm so sorry. This makes my heart hurt. Keeping you guys in my prayers. :hug:

lovecavaliers
1st July 2012, 04:26 AM
Heartbreaking to read this. I can only imagine how you feel watching your baby go through all of this. Please know we are all praying for Lily to get through this difficult time. Please keep us posted on how Lily is doing.

Lots of hugs being sent your way

mommytoClaire
3rd July 2012, 02:39 AM
I just wanted you to know I'm holding you very close in prayer.....let us know how things progress. I do wonder if you could ask to be put on a high dose of the pred for now, and see if it makes the difference.

Shay
3rd July 2012, 07:15 AM
I just wanted you to know I'm holding you very close in prayer.....let us know how things progress. I do wonder if you could ask to be put on a high dose of the pred for now, and see if it makes the difference.

Thanks so much for the prayers, I appreciate all the prayers we can get, and everyone who is praying for her. She is on a high dose of pred, 10mg per day, at least I think it is a high dose, but this is the first time she has ever been on it, so I'm not sure. Actually, today, she is a tad bit better, so I am cautiously optimistic. Her mood was better, and she didn't seem to be as depressed, and a little happier, and a little bit more like her old self. She is a barker, and today was the first day she barked since this happened. And I got a hug this morning for the first time since it happened too. I can't tell you how happy that made me. She is still wobbly, and her legs are still slipping, but it doesn't seem to be as bad. Today, is the first day I have seen a slight improvement, so maybe the prednisone is starting to kick in. I still hear her back leg toe nails clicking on the floor when she is walking on the hardwoods, so she is still dragging that leg, but it is not completely turned in it like it was.

I did notice that when she eats her treats now, some of the food comes out of the side of her mouth, which has never happened before, and when the pieces drop on the floor, she seems to have a little difficulty finding the dropped pieces. Also, I usually drop her treats from holding them above her head, and she snaps them in mid air, just a little game we play, and she has never let one hit the floor before. She now misses them when trying to grab them. I don't know if her eye sight is affected, or it's facial paralysis, or both, but this just happened when the limb weakness started. It's odd though, that the food is falling out of the opposite side of her mouth, from the weak limbs. It is all very confusing. It is almost like she had a stroke, but I know it is very rare for dogs to have strokes. But her symptoms mimic that of a human who has had a stroke. If I didn't know she has SM, I would have thought she had a stroke.

I hate this disease. I felt so blessed that she was diagnosed with a mild case, and had been so well for so long. It just goes to show, a mild case can have, or progress to severe symptoms, and dogs with a more severe diagnoses can show very few symptoms. It is a very perplexing disease. I guess I was lulled into a false sense of security because she was so well for so long, and I honestly thought she was always just going to have the light scratching and face rubbing episodes. I never dreamed I would wake up one moring to this, with no warning.

Hopeful4now
3rd July 2012, 12:58 PM
Oh Sharon, I'm so sorry for what you and your girl are going through. Reading your posts brought tears to my eyes because I'm scared for my own dog Dagny who was diagnosed with CM/SM at 4 months. Things are good now, but like you said, you had no warning and overnight things seemed to have deteriorated. I'm so, so sorry and I truly hope things will start looking up.

You said your vet looked in her ear and she yelped. Is there any way to figure out if the PSOM procedure might help her? I'm not too educated on the topic, but I know they do a procedure to clear out the plug. Would that even help?

I hope she's not in pain today and that she's just having mild weakness and that every day she gets better and better...
You're a good mom and she's so lucky to have you!
xo from France

Shay
10th July 2012, 04:35 AM
Hi guys,

Just wanted to give you an update on sweet Lily Rose.

She is doing so much better. She has come a long way, but is still not back to where she was. She is still dragging her back leg, and her front leg is still week, but she is not falling like she was. The socks I bought didn't work, and made her slip more, because they keep turning around to where the non skid surface turns to the front instead of under her paw, where it is supposed to be, so we scraped that. She is able to go up and down the stairs again, but still trips coming up a little, but no where near as bad as it was. I'd say from 1-10 she is about a 6 as to being back to where she was. She has 4 pills left, and tomorrow she starts with one every other day. When she is done, we will reevaluate whether she needs to continue on the meds for a while longer.

This may be as good as we get. I am just concerned if she is going to go back to where she was, when we stop the prednisone. If she stays where she is now, I will be thrilled. She is no longer dribbling food from one side of her mouth, and her reflexes, and eye coordination is better. Her personality has come back almost to normal. She is barking again, and acting more like the dog she was. The first week, she was a zombie. The best I can describe it is like a human stroke patient, she couldn't bark, or wouldn't, and her face was pulled a little to one side. That seems to have cleared up considerably.

Thanks for all the good wishes and prayers, I am convinced they helped. Please continue to keep her in your prayers, that we don't get a re-lapse when we stop the meds.

Lani
10th July 2012, 01:59 PM
Keeping you & Lily in my thoughts and prayers. I am so relieved for you that she seems to have turned a corner and is doing better.

Love my Cavaliers
10th July 2012, 07:02 PM
I'm so glad Lily is doing better. Personally I would see about keeping her on the prednisone. I know it has serious side effects, but for Riley it has kept her alive and functioning for the past four years and for that I will take the side effects. Maybe Lily will do remarkably well on every other day though. I hope so. I'm just glad she's doing so much better.

linderbelle
11th July 2012, 06:33 PM
Sharon: I'm glad she's doing better. I saw the post in regards to a dog with surgery and is now dead. I don't know if you are referring to me/Abbey but if it is me then I wanted to say something. If you weren't referring to me then please ignore this. Abbey was misdiagnosed for 3 years and had neuro damage that was irrepairable as you know. I truly feel we wouldn't have had those 3 years without Abbey having surgery. She did wonderful for 2.5 years after and then started declining and in 6 months after the start of decline we put her down. I'm not pushing surgery but for Abbey it gave us alot more time I believe and so does Dr. Shores.

Holly
14th July 2012, 01:06 PM
Hi Sharon! Sorry to hear about Lily. Have you thought about trying Lyrica? Many people have had good success with it. The patent is up on in Oct so hopefully prices will start to go down on it and the generic will become available. Just a thought!