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Paralisis and facial change

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Thanks rod,

So much information you have. I will see what the neurologist says tomorrow.

Tania, there are so many issues that

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Sorry. I hate to assume it is something without having other things looked at. Thank you

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I asked ellas neurologist to look at previous mri images for psom and he responded that her right ear has image consitant with psom or an ear infection. So more questions of what next

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I've spoken to vets and a neurologist about maxiliary myositis before and they say it is always an early onset condition in cavaliers-- so would seem highly unlikely as an option with Ella.

Anne, the problem is that you probably cannot tell what the source is of this -- but surely most likely it is SM or PSOM. The options are pretty limited then in what you can do -- PSOM requires a GA, an ear procedure that can actually cause facial paralysis itself as a side effect, and almost always has to be repeated several more times. If SM, I think you would probably be looking at only redoing the surgery as an option for what might halt it. Both are serious and invasive procedures with risks -- in order to achieve what aim here? If it is not bothering her, and given that you already are aware she has been through a lot and is on limited time, I would just make her as comfortable as possible and watch for signs that her quality of life is deteriorating to the point where it may be time to let her go.

I feel for you; dealing myself with one with serious SM, and Lucy in what vets say are likely her final days or weeks with MVD. I think you need to be clear in your mind about what constitutes a decent quality of life if things are progressing, so you have this in mind as I find that helps me, and maybe rereading the good essays and links pinned in the health library section may help.
 
anniemac said:
I asked ellas neurologist to look at previous mri images for psom and he responded that her right ear has image consitant with psom or an ear infection.
Click to expand...

I'm confused about that statement because I was with neurologist Simon Platt this afternoon reviewing an MRI (I'll write more about that later - it's been a very, very long day - four hours on the road and seven hours in the waiting room) and he explained exactly what PSOM would look like and what an ear infection would look like - and there is no question differentiating between the two. It is very obvious so I'm not sure why your neurologist wouldn't be able to definitely identify one versus the other.

Pat
 
Yes was thinking same... PSOM is easy to see, it is a murky whitish spot in the ear area.
 
Karlin said:
Yes was thinking same... PSOM is easy to see, it is a murky whitish spot in the ear area.
Click to expand...

That is correct. Dr. Platt showed me one ear that had a large solid black middle circular area - it is black because there is nothing there that shows up on MRI. He said that if PSOM was present, that solid black area would be all white - the entire area. Then he showed me the other ear and there were some thin white lines outlining the inner ear, but still black in the center - and he said that this was the beginning of an ear infection or a current ear infection and I should monitor that ear. It was all pretty fascinating.

I can't say enough good things about Simon Platt! I had a prejudice toward Auburn and Dr. Andy Shores after attending his AVMA session, but I'm now a big fan of Dr. Platt and I suspect their approaches to SM are different.

Pat
 
I emailed images to rod but he wants to see her for further valuation. He knew I was in tears and asking about PSOM and given my emotional state, it is something he may want to talk face to face.



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Not much changed in size like I thought.
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Anne, I just wanted to say that I am thinking about you, and keeping you and your dear sweet Ella in my prayers.

You are such a caring 'momma' to Ella. I'm hoping for some glimmer of decent news in the middle of all this.

Hugs,

Cindy and Claire
 
Anne, none of us here are medical professionals. You need to be talking directly with your neurologist about this. It is not a good idea to have people without any background in the area try to make a diagnosis from small, low resolution versions of MRIs posted to a discussion board. Some have made wild guesses in other places and IMHO it is insane to be trying to get adequate or accurate medical advice this way.

As I said, you really need to consider first whether the paralysis is affecting her in any kind of problematical way. Unless it is interfering with her ability to eat or swallow, I really don't think this is something that you need to be concerned about right now *but you need to talk to your neurologist* (y). The second consideration is–what are you planning to do about this if it turns out this is due to PSOM or SM? Would you wish to put your dog through further procedures at this point?

I will wager that a neurologist will say that this side effect is almost certainly another symptom of the condition she already has. That's again, why it is best for you to go make a decision about this after a conversation/appointment with your neurologist and an evaluation of whether whatever you are seeing actually has any effect on her quality of life. This has been worrying you for a month now so you really do need to go see a professional with Ella. It isn't fair to her to keep asking for guesses from all of us when it sounds like she needs a medical evaluation.

So I am going to ask you to please first have a discussion with a professional on this issue now. Once you get a response and informed medical recommendations perhaps you will want to return here to ask people for a response. But I really do not want this same conversation running in a loop as it has been for a while now, because I think it is risky for you to be taking decisions without any direct professional advice, and I also think it increases overall anxiety and distress because you are getting so many/too many different opinions here and elsewhere, as you've asked this on several forums. It sounds like other issues bother her a lot more and she is having more pain -- that sounds like maybe it needs re-assessment from your neurologist even more.

I am going to close this thread for now and when you have an informed response from Ella's neurologist, you will be able to start a fresh thread based on an actual diagnosis. (y)
 
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