Bilateral Cranial Cruciate Ligament Tear Discovery

Below is a journaled account of how we discovered Whiskey’s bilateral CCL tear. As with just about everything else our pack members acquire, it is never presented in textbook fashion, and always a puzzle to figure out!

January 8th 

Whiskey took a walk with Jägermeister. Nothing out of the ordinary was noted during the walk, and she was completely fine afterwards. About an hour later her hind end collapsed and she could not stand back up. This lasted only a few seconds and then she was walking normally…well…normally for Whiskey… Those of you who have been following along for a while now or who have met her in person know that she has a “wonky” gait due to a broken shoulder and broken growth plate – both acquired before she was rescued by Pointer Rescue Organization as our foster dog, “Wish.” We thought maybe she just tripped or lost her balance but to be sure, we put her on crate rest into the next day. She seemed fine and resumed normal activity…playing, walking, running, jumping up/down on the couch, etc. She continued to show absolutely no symptoms for the next week. 


January 16

Whiskey and I took a walk with a friend and her dog. Whiskey was absolutely fine throughout the entire walk. It was a nice day so after the walk was over, I sat down to eat lunch with my friend and Whiskey remained her usual busy self for approximately 40 minutes, walking around and keeping an eye on the geese in the nearby lake – and then all of the sudden once again – her hind end collapsed. She got right back up and seemed fine – absolutely no limping. We had a 25 minute ride home. When we arrived to our house,  Whiskey could not support her hind end at all, and was not recovering. Luckily, our primary vet, Dr. Campbell, got us right in for an appointment.  When we arrived, Whiskey still could not support her hind end. An exam was performed and an X-ray of her spine was taken. No significant findings were observed. Dr. Campbell gave Whiskey a steroid shot and sent her home with Prednisone. Dr. Campbell suggested that we see a neurologist.

Radiographs:

Lateral TL spine (T4-Sacrum): Spondylosis at LS. No other significant findings.


Note “weird” right leg movement at about the 16 second mark.

January 17

Whiskey was able to walk and was not limping.


Jan 19: Neurological Exam

Whiskey was still displaying no symptoms at this time. Porter and Whiskey’s neurologist, Dr. Eagleson at BluePearl Pet Hospital, performed a neurological exam on Whiskey.

Physical Exam:

  • General – BAR, appropriate, ambulatory
  • ENT – No significant findings
  • H/L – No murmur ausculted, lungs clear, strong synchronous pulses
  • ABD – Soft non-painful, no masses palpated
  • lUG – WNL
  • PLN – WNL
  • INTEG – Clean hair coat
  • MS – BCS ~ 6/9, thickened right shoulder joint

Neurologic Exam:

  • Mentation – Alert and appropriate
  • Gait – Normal
  • Reflexes – Normal withdrawal in all limbs; normal patella bilaterally; normal perineal reflex
  • Postural Reactions – Normal
  • Cutaneous trunci – Normal
  • Cranial nerves – Normal
  • Sensory – No pain on CTL palpation or neck ROM
  • (NEUROANATOMIC LOCALIZATION – Normal exam

Diagnostics:

  • Bloodwork
    • CBC: NSF
    • Vetscreen: NSF

Release Notes from Dr. Eagleson:

Whiskey’s neurologic exam was normal. In the video, it appears that she is having trouble/difficulty supporting weight in her back legs. This is causing her to shift her weight forward onto her thoracic limbs and she walks with her back arched. She would be taking on this posture either due to weakness or discomfort when bearing weight. I did not find any source of pain on her exam and her stifles and hips palpated normally. We performed bloodwork which was normal (including her muscle enzymes). A lack of blood flow to the back legs could cause weakness; however, she has no evidence of this (she has great femoral pulses). To further rule out a spinal cord problem an MRI is recommended. This is scheduled for next Tuesday (1/24/23). In the meantime, we are going to wean her off of the prednisone. If she has another episode, I would like you to try to evaluate her reflexes if possible.


January 20

Whiskey began limping again, but this time only what appeared to be on her right side. 

Holding her right leg up while drinking
Rear-view of Whiskey trotting away – note right leg not moving properly
Slo-mo of previous video – Rear-view of Whiskey trotting away – note right leg not moving properly

January 24: MRI appointment 

Whiskey was still limping predominately on her right side. Prior to our appointment, I had sent all videos I had taken to Dr. Eagleson. I took Whiskey to her MRI appointment and when Dr. Eagleson examined her upon her arrival, he suggested that we hold off on the MRI when he saw that she was now presenting in a different fashion.  He suspected that Whiskey torn her right CCL. Dr. Eagleson had the Surgical Team look at Whiskey and noted that if Whiskey were to continue to have episodes of hindlimb weakness after correcting her knee(s), we will pursue the originally planned MRI.

Dr. Deahl, a surgeon at Blue Pearl viewed all the videos and examined Whiskey. Dr. Deahl determined that Whiskey has a bilateral CCL tear after palpating her knees….a complete tear on the right, and a partial on the left. It was suggested to surgically repair the right side and then reevaluate the left side once the right is healed. It is suspected that the left will have to be repaired as well. An appointment to sit down and speak with Dr. Deahl has been set for January 30th. It is also quite possible that Dr. Deahl will perform surgery on Whiskey’s right CCL that same day.

Release Notes from Dr. Eagleson:

On exam today Whiskey had a consistent right pelvic limb lameness. On physical exam it was found that he had a torn right cruciate ligament. An orthopedic consult was performed which confirmed the right cruciate ligament tear as well as evidence of a partial tear/chronic remodeling in the left knee. I showed the videos to the surgery service who agreed that the way Whiskey was holding the right leg up is peculiar for a CCL tear. It’s also a bit strange that she wouldn’t bear weight in both limbs as episodes and then recovered. However, since there is evidence of the left knee not being completely normal, then it’s possible that she was just sore in both knees on those days (since it happened after longer walks). Although it’s possible two issues could be going on, I feel it’s more likely the cruciate tears presenting in a slightly atypical fashion. We discussed either performing MRI first to rule out a possible neurologic issue versus correcting the knee first. I feel that a 5 year old Pointer will need to have the knee fixed in order to remain highly active. The only reason not to correct the knee would be if there was something seriously bad going on in the nervous system (e.g. tumor), which I do not feel there is a high likelihood of. If Whiskey were to continue have episodes of hindlimb weakness after correcting the knee, we would always pursue MRI at a later date. At this time you have decided to follow up with the surgery service.

CCL Tears and How a TPLO Surgery Works:

More Great Resources That Were Shared With Me to Help Explain CCL Injuries:

FaceBook Groups:

Abdominal Ultrasound Re-Check

January 20, 2023

Today Lager had his abdominal ultrasound re-check that was suggested at his oncology visit.

We are pleased to share that no significant abnormalities or changes were noted in the recheck interim! The small nodule on the left adrenal gland
was deemed to be consistent with an incidental adenoma (these growths usually don’t pose a health threat or require treatment). There is a faint nodule on the liver, however this was considered to be consistent with a benign hyperplastic nodule (also benign).

We are beyond thrilled for this boy!

Ultrasound Results:

80 Days Post Surgery

The only way to guarantee failure is by quitting. NEVER…GIVE…UP!

Lager lets NOTHING get him down! He is 80 days out from surgery and playing ball like a boss! He can grip the ball, run with the ball, and even shake his head around… all without dropping the ball! Lager has not skipped a beat! He can hold his tongue inside his mouth but it does hang out only when he’s tired or excited. Such an amazingly resilient boy!

Croft Farm; Cherry Hill, NJ

Another couple of miles in the books with Team Salty Paws ! Yesterday afternoon Whiskey and I met Heather and Ellie🐾 at Croft Farm for a hike followed by a picnic lunch.

Croft Farm is on both the NJ and National registers of historical places and the farm house that is still standing dates back to the 1700’s.…Another beautiful trail system nearby that I never knew existed!

Hooch’s Perianal Adenoma

December 19, 2022

Discovered a mass at the base of Hooch’s tail, on the underside – at the outer part of his anus.

December 22, 2022

An exam and fine needle aspirate performed by our primary veterinarian determined that the growth needed to be removed and biopsied to determine clean margins and tumor type.

The mass is suspected to be a perianal adenoma, a benign type of hepatoid gland tumor. These types of tumors can also be malignant (adenocarcinomas) and borderline malignant (epitheliomas). We are extremely hopeful due to the following statistics:

  • (1) 80% of hepatoid gland tumors are found to be perianal adenomas (benign)
  • (2) adenocarcinomas (malignant) are uncommon
  • (3) epitheliomas (borderline malignant) are rare

January 10, 2023: Mass Removal

Surgery was performed at our primary veterinarian’s office and a the mass was send to pathology.

January 17, 2023: Pathology Report

Pathology report showed that the mass was a hepatoid gland tumor. There are Luckily Hooch’s was a perianal adenoma which is benign! These tumors occur most commonly in intact (unneutered) dogs or male dogs who have been left intact until a later age.

Cancer Checks Should Be Done At Least Once A Month

I know there are certain areas of a dog that are difficult or unpleasant to examine (like the anus), but please remember that checking your dog thoroughly at least once a month can truly be a life-saver.

Not sure how to examine your dog? I’ve included a complete guide below on how to do a Canine Cancer Check from Chase Away Canine Cancer below for your reference:

Crows Woods Nature Preserve: Haddonfield, NJ

A spontaneous last minute decision to today with Team Salty Paws resulted in such a great day!

We chose Crows Woods Nature Preserve which is approximately fifty acres of fairly undeveloped forest with some ball fields and mowed lawn areas bordering the preserve.

 

We had such a nice time with our friend and team handler Heather and her pups Kayla and Ellie! Lillet Blanc came along for this hike. She’s doing so well on her pain medication and supplements for hips and is able to take longer walks now!

She also did a great job walking on lead at a safe distance (and closely monitored) alongside Kayla and Ellie of Team Salty Paws. (Lilly can be extremely selective).

The park has a pavilion where we stopped after the hike to enjoy lunch.

Brendan T. Byrne State Forest (Pakim Pond Area): NJ Pine Barrens

2023 began with a sunny 60°F day… so we decided to do a New Years Day hike in the Brendan T. Byrne State Forest which is made up of 38,000 acres, and is located in the Pine Barrens of New Jersey.

Whiskey and Porter did very well on this hike!

5 Years

Happy 5th Birthday to our little Tennessee Whiskey (aka Wish and Wish the Fish ) You have matured such a great deal in the last year, but your BIG personality is still one of the most stubborn and vibrant I’ve ever seen. Your quirks and shenanigans bring a smile to others and your ability to entertain a crowd at a dock diving event without ever jumping in the water is an extraordinary skill! Thank you for challenging us on a daily basis to improve ourselves and for always making us laugh!

This is 5!
Breakfast: Pancake puffs (made with a cast iron Aebleskiver Pan) & sausage with a side of mixed berries
Dinner: Beef & veggie casserole (lean ground beef, peas, carrots, green beans, brown rice, shredded cheddar) and a side of applesauce
Dessert: PB & Apple crunch pup cakes

PB & Apple PUPcakes

Ingredients

  • 2 cups water
  • ¼ cups organic unsweetened apple sauce
  • ¼ tsp vanilla extract
  • 1 organic egg
  • 4 Tbsp organic honey
  • 1/2 cup organic all-natural peanut butter (no salt / no sugar added) – room temperature
  • 4 cups organic whole wheat flour
  • 1 Tbsp baking powder
  • 1 cup peeled organic apple (about 1 large apple apple) chopped into small cubes

Icing ingredients

  • Organic organic all-natural peanut butter (no salt / no sugar added) – room temperature
  • Organic Greek yogurt – plain (fat free or low fat)

Instructions

  1. Preheat oven to 350 degrees F.
  2. In a large bowl mix water, apple sauce, vanilla, egg, and honey together with a whisk.
  3. Mix in peanut butter.
  4. Combine whole wheat flour and baking powder, then stir into wet ingredients.
  5. Fold in chopped apples.
  6. Spoon mixture into greased muffin tins.
  7. Bake for 35 minutes

Icing Instructions

Use two parts yogurt to 1 part peanut butter. Mix well then spoon into an icing piping bag.

47 Days Post-Surgery

This boy… once again bringing me to tears… 47 days post rostral mandibulectomy surgery and Lager grabbed every size and shape bumper and Wubba we tried in the water with no assistance needed…He’s amazing! I can’t wait to see him competing in his first post-surgery event! Take THAT cancer! Thank you Chrissy and 4 Paws Adrift !

6 Years Old

Happy 6th (ish) birthday to this sweet, brave warrior! Your kind and gentle soul is filling the hearts of so many with love and happiness. It is a miracle that you are still here with us after all you have been through. We are so grateful for our time with you. Keep shining bright buddy… We love you Po Po POtato!

This is 6!
Breakfast: blueberry pancakes and breakfast sausage
Dinner: chickpea pasta with peas and carrots with a side of cantaloupe and kiwi

Peanut Butter Banana Cake Pops

Ingredients

  • 1 cup organic whole wheat flour
  • 1 teaspoon baking soda
  • 1 organic egg
  • 1/2 cup organic whole milk
  • 2 ripe organic bananas
  • 1/4 cup organic all natural peanut butter (no salt/no sugar added)
  • 1/8 cup organic honey
  • 1/2 cup (1 stick) unsalted butter, softened
  • Organic coconut oil non stick spray for cake pop pan

Icing

  • Unsweetened Carob chips (melted)
  • Unsalted organic peanuts (crushed)
  • Organic whole milk

Instructions

Cake

  • Preheat oven to 350°F .
  • Spray silicone cake pop pan with organic non-stick coconut oil spray
  • In a medium bowl mix whole wheat flour and baking soda and set aside.
  • In a large bowl mash bananas with a potato masher. Then mix in the egg, milk, peanut butter, honey and butter.
  • Once well combined, begin to add the flour mixture to the peanut butter mixture and stir until mixed.
  • Spoon batter into the cake pop pan.
  • Bake for 20 to 30 minutes, or until a toothpick inserted in the middle comes out clean.
  • Remove cake pops from pan and place on a wire rack to cool completely

“Chocolate” Icing

  • Using a small pan over very low heat, begin to melt carob chips, adding the milk until you have a creamy “melted chocolate” consistency
  • Dip cake pops in the melted carob, then roll in crushed peanuts, and lay the coated cake pops on wax paper. Let sit until firm. You can place them in the refrigerator to speed up this process.

Feed sparingly. When serving to my pups, I split a cake pop in half and give a half to each dog as an occasional treat.

Ain’t Nothin’ Gonna Break My Stride

Is someone chopping onions or are my eyes just sweating? This boy right here is my hero!
Lager… 35 days post-surgery (rostral mandibulectomy) … and he’s able to knock the bumper down, pick it up off the ground, and grasp it in his mouth while running!!

Unstoppable!

🇺🇸Truly 𝙐𝙉𝙎𝙏𝙊𝙋𝙋𝘼𝘽𝙇𝙀! Look who learned to eat on his own after he healed from his rostral mandibulectomy! This did not however come without much practice and some failed attempts and experimenting. Thanks to the support of Lager’s oral surgeon, Dr. Jennings, we were able to assist Lager in overcoming his obstacles in re-learning how to eat independently!

Lager eats independently for the first time since surgery!

… Next step: Over the upcoming weeks I will begin land drills with a dock diving bumper to see how Lager does with grabbing the it from the air and out of a baby pool filled with water…stay tuned!

Giving Thanks with a Grateful Heart

Suture Removal

November 17, 2022

For those of you who are crazy lucky enough to share your life with a German Shorthaired Pointer, I’m sure you are quite familiar with the “oh sh*t” feeling when a veterinarian tells you that you have to somehow do the impossible….restrict your GSP’s activity. Even at 10 years old Lager does NOT act his age. He’s still got that insane-in-the-membrane-never-ending-crazy-high GSP energy. Along with praying that somehow we are miraculously teleported to the “all clear from restrictions” date our veterinarian gives us, my usual go-to for a restricted activity period is stuffed West Paw brand Topl or Qwizl, lickimats, puzzle toys, and snuffle mats. In Lager’s case, however, we could not do any of that due to his simultaneous recovery from his rostral mandibulectomy. Lager’s jaw and chest surgery were on October 31st. He was due to get his chest sutures out on November 11th. However, when his body bandage was removed, there were signs of an infection. Restricted activity and suture removal date was then extended to November 17th while Lager completed a round of antibiotics. Once the bandage was off, Lager began to try and lick the area, so he continued to wear a Suitical Recovery Suit until his chest could be reevaluated. At his appointment on November 17th, the surgical team at Blue Pearl decided that the chest sutures could be removed, Lager’s jaw was healed enough that we could remove the E-collar, AND Lager could have all restrictions lifted …giving some MAJOR thanks for this!

Sutures are out, but incisions still need time to heal
Lager runs free for the first time since having his surgeries on 10/31/22
Enjoying being “naked” …no sutures, no Suitical, no cone and no E-collar!

Once home, even with the sutures having been removed, Lager began to lick the area, making the healing incisions redden. We still have him wearing the Suitical Recovery Suit until this area is fully healed in order to try to avoid an infection, giving him a break from wearing it only when we can watch him closely.

Lager does not need to have a follow-up appointment with Dr. Jennings (Dentistry Team) or the Surgical Team in the future unless a problem arises. However, there was a nodule observed on his adrenal gland during his abdominal ultrasound. It was suggested that we may consider reevaluating the suspected growth in 3-4 months, so I will be discussing this with Lager’s medical team to determine if they believe that repeating the ultrasound would be appropriate for him.

“We often take for granted the very things that most deserve our gratitude.”

~ Cynthia Ozick

Eight dogs, sixteen feedings per day, and each meal was prepared and presented to our dogs without realizing I should be grateful for the whole process….not only for being blessed with the food itself, but for the fact that all of our dogs could eat on their own. I never thought about how I should be grateful for that…it’s just something dogs do, right?! I took for granted that I put food in front of our dogs, and voilà…They ate it…UNTIL…Brian and I were hand-feeding Lager after his surgery. It was then that I realized I needed to take a step back and direct more focus on being grateful for the daily routines that are in fact blessings as well.

Lager had been doing wonderfully with being hand-fed “meatballs,” (made from a mixture of his regular kibble ground to a fine powder using a food processor wet food, pure pumpkin purée, and grizzly salmon oil) however, he was having a difficult time learning how to pick up food without us having to place it in his mouth. We tried meatballs in a bowl, meatballs on a flat dish, dry kibble that had been put through the food processor, soaked kibble, regular kibble…you name it, Lager had not been able to pick up any of the food. However, Lager’s never give up attitude paid off…It is with an extremely grateful heart that I share the progress Lager had during breakfast on November 20th: Lager was able to pick up meatballs and eat it all by himself! The meatball still needs to placed on a flat dish at an elevated angle, but picking up the meatball on his own is a huge accomplishment! We are so proud of Lager and his motivation to improvise, adapt, and overcome!

Lager picks up a “meatball” on his own for the first time since his rostral mandibulectomy!

Lager has also been doing a phenomenal job picking up soft stuffed toys! He has been enjoying all the toys that he received as gifts!

No One Fights Alone

I added some oral cancer awareness bling to Lager’s collar this week! Canine Acanthomatous Ameloblastoma (CAA) luckily is not known to metastasize if clean margins are achieved during surgery (which was the case for Lager). Even though we are celebrating what we hope and pray is the end of Lager’s CAA Journey, he will still have some challenges to face as he continues to adapt to doing daily activities differently with his mouth. We want to be sure to continue to bring awareness to this type of canine cancer, and do our best to support other families that one day may find themselves on this same journey with their pup.

Oral cancer awareness ribbon charm for Lager’s collar bling
No one fights alone charms… Half for me to wear as a necklace and the other half will be added to Lager’s collar bling

We have many reasons this year to give thanks with a grateful heart. This week, in addition to the more obvious “bigger things,” I will be focussed on recognizing and mindfully appreciating the smaller blessings in our daily life as well.

May this Thanksgiving be filled with peace, love and happiness for you and your family.

Three Week Check-Up

November 18, 2022

It was has been three weeks since Porter began taking the Thyro-Tabs for his hypothyroidism. Porter saw his primary veterinarian, Dr. Campbell, for a physical exam and blood work to re-test his Total T4. Total T4 (Thyroxine) measurement is a screening test for diagnosing hypothyroidism in dogs. 

The lab results brought us good news! On October 25th, Porter’s Total T4 was 0.8 . His blood test on November 27th showed that his Total T4 has now risen to 2.1! (Normal therapeutic range is from 1-4).

This result proves that the Thyro-Tabs are in fact doing their job. Porter’s hair has not begun to grow back yet, so that will continue to be monitored. Porter will see Dr. Campbell again in 4 weeks for an exam and another Total T4 test.

Post Surgery Check-Up And New Diagnosis

Pathology Reports

November 8, 2022

Now that the pathology report from both the chest masses as well as the jaw sample has returned, we have a new diagnosis, but still much to be thankful for!

  • Chest masses
    • pathology result: follicular cysts
      • Follicular cysts are large bumps, or nodules, on a dog’s skin that originate in the hair follicle. The hair follicle becomes dilated and fills with a dark brown substance that looks similar to a blackhead. These cysts are prone to becoming infected. Lager’s follicular cysts should not grow back now that they have been removed.
  • Oral Mass
    • The mass originally deemed Oral Papillary Squamous Cell Carcinoma was reevaluated as Canine Acanthomatous Ameloblastoma (CAA)
      • The tumor diagnosis can sometimes change as a better sample is acquired during the removal of the “heart” of the mass. This type of tumor has “layers” and the superficial part of the mass is made up of similar squamous-type cells which often produces an inaccurate diagnosis. During Lager’s first surgery, only the superficial part of the mass could be removed and sampled.
      • About Canine Acanthomatous Ameloblastoma (CAA)
        • Acanthomatous Ameloblastoma is a locally aggressive tumor that originates from the epithelial cells of the dog’s jaw.  Acanthomatous Ameloblastoma forms a large red mass on the gums. Beneath the visible portion of the mass, there is usually considerable bone destruction. These tumors have not been documented to spread to other areas of the body. As Lager’s tumor was removed with clean margins, it is not expected that there should be any recurrence. Without treatment, this type of tumor will continue to grow and destroy the jaw bone, becoming life-threatening for the dog.

Post Surgery Oral Exam and Check-Up

November 11, 2022: BluePearl Pet Hospital

Dr. Jennings said that Lager looks great! Dr. Jennings is pleased with the surgery site and healing process. Any remaining oral sutures will fall out and/or dissolve on their own over the coming few weeks. During today’s appointment Dr. Jennings answered all of my questions in detail. The following was covered in today’s appointment:

  • We have observed some teeth chattering. Dr. Jennings said this should subside as the mouth continues to heal
  • Lager may begin return to a normal diet. Over the next week, we will work on transitioning from wet food meatballs to soaked kibble to regular kibble as we monitor Lager’s progress in re-learning how to eat on his own.
  • We can begin brushing Lager’s teeth immediately. Dr. Jennings also recommended that we continue to use products to help reduce plaque and tartar. We currently use a water additive called Vetradent, which is included in products that have earned the VOHC Accepted Seal , so we will continue to use this.
  • Lager is cleared to compete in dock diving once we start up again in the Spring, and is cleared to train and condition throughout the fall and winter once his jaw and chest is completely healed!
  • As long as no issues arise, Lager does not need to have further follow-up visits with Dr. Jennings. Dr. Jennings recommends that we have Dr. Campbell monitor Lager’s oral health at his regular check-ups. If we happen to notice any bad breath or dental buildup/inflammation of the gums, Dr. Jennings instructed me to have Lager evaluated by Dr. Campbell or himself.
  • Lager can begin to have soft toys within the next week. We experimented today during the appointment with an Extreme Vertical/Speed Retrieve bumper. Upon sight of the bumper, Lager grabbed it up! After dropping the bumper on the floor, in less than 30 seconds Lager had learned to pick it up on his own! He is truly amazing and an inspiration! There was some minimal dilute blood on the bumper which Dr. Jennings said was normal at this point. In about 5-7 days when Lager is closer to being completely healed, we will try giving him some soft stuffie toys.
Lager holding a dock diving bumper

Dr. Michael Jennings and his nurse, Ashley McCullough, provided outstanding care and surgical excellence for Lager. Confidence in a medical team and their abilities was imperative to us.  Beyond the medical aspect, Dr. Jennings and Ashley displayed such care and compassion not only for Lager, but also for me as I broke down in tears (at every single appointment)! They not only patiently answered my notebook full (literally) of questions, but also took the time to explain everything in detail. I will never forget the personal touch and willingness they spent making sure I felt comfortable with all of the information being presented to me, and comforting me during a terrifying time to ensure me that Lager was going to pull through this procedure just fine. Dr. Jennings and Ashley’s love and passion for animals is remarkable, and shines bright for all to see. We are blessed to have been lucky enough for Lager to have this the dedicated, thoughtful, and compassionate surgical team.   

Chest Suture Removal

November 11, 2022

The Surgical staff at Blue Pearl was also wonderful! Their attention to detail on Lager’s chest surgery and kindness towards me was beyond appreciated. Today Michael Pawenski evaluated Lager’s chest incisions. After removal of Lager’s cross-your-heart bandage, Dr. Pawenski noted that the incision is healing well, but there are two small areas of dehiscence and a small amount of discharge that may be due to an early surgical site infection. As a result, the sutures cannot be removed, and Lager will be required to take antibiotics. This also means that his activity restrictions will still need to be in place. The bandage was not reapplied but Lager will have to wear a tee-shirt or Suitical Recovery Suit to prevent rubbing or scratching of the incision. Lager will return to Blue Pearl on Thursday November 17th for an exam with the Surgical Team, and and hopefully suture removal.

We Don’t Know Them All, But We Owe Them All

Lager’s check-up fell on Veterans Day 2022. Blue Pearl Hospital is located on Veterans Highway with a Veterans Memorial 0.2 mile down the road from the hospital parking lot exit. with Lager being a Veteran himself, I knew we had to stop at the memorial. It was raining pretty steadily, but we stopped anyway, and I’m so glad we did. Lager got a break from his cone and was able to take a small, slow walk around the beautiful memorial.

With respect, honor, and gratitude, Cello’s Corner would like to thank all who have served and continue to serve our country. Your bravery and the sacrifices you have made to protect our freedom will never be forgotten. Thank you to all veterans – you are our heroes! 

Things That Make You Go MMM…

…A vanilla McDonalds milkshake! Lager had a few licks of the milkshake as a treat on his way home.

Ba da ba ba ba …I’m lovin’ it!

Keep on Keepin’ On

Over the next week, we will continue Lager’s restricted routine while working on transitioning his diet back to his regular kibble. I will post another update after Lager’s appointment on November 17th. Thank you ALL for your continued prayers, positive thoughts and good vibes for Lager and for your support for Lager’s PAWrents!

National Epilepsy Awareness Month 2022

November is National Epilepsy Awareness Month. During this month, the goal is to educate and raise awareness about one of the least understood of all neurological diseases.

Our fellow EpilepsyWarrior and IG friend, Rosie the Labradoodle ‘s Mom, published a great journal for PAWrents of dogs with epilepsy. This journal is an efficient way to document your epilepsy warrior’s information, log seizure activity, track medications, triggers, appointments and medical history. The journal measures 7×10 inches and makes traveling with your epileptic pet easier in the event of an emergency trip to the vet by having all of your pet’s medical history in one convenient place. Over 125 epileptic canine warriors are pictured throughout… including OUR very own warriors, Porter and Jägermeister (can yo spot them on the page below?! This journal can be purchased on Amazon.

Epilepsy? What’s That?

“Epilepsy” is a general term for neurological disorders that are characterized by recurrent seizures. In some cases, the seizures are caused by trauma, a toxin, a brain tumor, an infection, or an issue with your dog’s blood, kidneys, or other organs. At other times, the epilepsy is referred to as “idiopathic,” which simply means that there is no identifiable, underlying cause.

Seizures commonly fall into two categories: generalized (grand mal) or partial (focal). Generalized seizures commonly appear as involuntary jerking or twitching movements of all four limbs with loss of consciousness. Partial seizures may involve one limb, side of the body, or face. Partial seizures may progress to generalized seizures. Seizures may also result in abnormal behavior, vocalization, salivation, chomping/chewing, and involuntary urination and defecation.

Dogs with idiopathic epilepsy typically have their first seizures between the ages of 6 months to 6 years. Though idiopathic epilepsy can occur in any breed, it is considered an inheritable disease in many breeds and in some breeds a genetic basis has been identified. Therefore, dogs diagnosed with idiopathic epilepsy should not be used for breeding. Commonly affected breeds include:

  • Labrador retrievers
  • Golden retrievers
  • Poodles
  • Keeshonds
  • Beagles
  • German shepherds
  • Dachshunds
  • Irish setters
  • Cocker spaniels

Is a seizure painful or dangerous to the dog?

Despite the dramatic and violent appearance of a seizure, seizures are not painful, although the dog may feel confusion and perhaps panic. Contrary to popular belief, dogs do not swallow their tongues during a seizure. If you put your fingers or an object into its mouth, you will not help your pet and you run a high risk of being bitten very badly or of injuring your dog. The important thing is to keep the dog from falling or hurting itself by knocking objects onto itself. As long as it is on the floor or ground, there is little chance of harm occurring.

A single seizure is rarely dangerous to the dog. However, if the dog has multiple seizures within a short period of time (cluster seizures), or if a seizure continues for longer than a few minutes, the body temperature begins to rise. If hyperthermia (elevated body temperature) develops secondary to a seizure, another set of problems need to be addressed.

Symptoms

Prolonged seizures lasting more than 5 minutes or two or more consecutive seizures without full recovery are referred to as status epilepticus. This is a true emergency and you should seek immediate veterinary care for your pet. Two or more seizures in 24 hours are referred to as cluster seizures and are an indication for beginning anti-seizure medication.

In dogs, seizures often occur in three distinct phases:

  • The first is called the aural phase and the most common signs are behavioral changes. These changes may be subtle and include restlessness, attention seeking or anxious behavior. 
  • The second phase, called the ictal phase, is when the seizure itself takes place. A seizure can last from just a few seconds to several minutes.
  • The final phase is called the postictal phase, which occurs after the seizure. During this phase, your dog may seem restless, uncoordinated and/or disoriented. Occasionally, temporary blindness, deafness or other neurologic abnormalities may occur.

It may be difficult to watch your pet have a seizure but most are of short duration and cause no permanent harm. Avoid being bitten by keeping your hands away from your pet’s mouth during a seizure. If it can be done safely, provide padding and move your pet away from stairs to prevent injury.

Diagnosis

Your veterinarian will take a complete history and perform a thorough physical and neurological exam to determine if there is an identifiable, underlying cause of your dog’s seizure.

In order to do so, the following tests may be recommended:

  • Chemistry tests to evaluate kidney, liver, and pancreatic function, as well as sugar levels and electrolytes
  • A complete blood count to screen for infection, inflammation, anemia, and other blood-related conditions
  • Urinalysis
  • PCR testing and/or serology to evaluate for infectious diseases that may cause seizures
  • Referral to a neurologist for advanced testing including MRI and cerebrospinal fluid analysis
  • Cultures, PCR testing, and other specialized tests that can identify if specific parasites or diseases could be the cause

Treatment 

Epilepsy cannot be cured, but it can usually be controlled with anticonvulsant drugs. If your veterinarian determines that your dog’s epilepsy is idiopathic, one or more of the following medications may be prescribed:

  • Phenobarbital helps reduce the frequency of your dog’s seizures and is the most prescribed medication for dogs with idiopathic epilepsy. It is generally a well-tolerated drug.
  • Potassium bromide is another seizure medication that may be added to your dog’s treatment, if she does not respond well to phenobarbital alone.
  • Levetiracetam (Keppra)

With these medications, as with all drugs, some patients experience side effects. In order to make sure an adequate dose is being given, and to monitor for side effects, it is important that blood levels of each medication as well as complete blood counts and blood chemistry profiles be monitored periodically. Liver function tests may also be indicated. Your veterinarian will advise what monitoring needs to be done and how often. Medication dosages should not be changed without talking to your veterinarian.

Dogs diagnosed with idiopathic epilepsy may require treatment for life, and sometimes more than one drug is needed for adequate seizure control. And while many dogs are well controlled, some are not despite multiple medications. In addition, adequate seizure control does not necessarily guarantee that a dog will be entirely seizure free. The degree of seizure control may need to be balanced against potential side effects of the medications. 

Management


Besides medication, there are many ways for you, yourself, to help manage your pet’s epilepsy:

  • Maintain a seizure log that lists date, time, length and severity of seizures as well as videotape and share this with your veterinarian
  • Do not change or discontinue medications without consulting your veterinarian
  • Have blood work and other lab work done when recommended by your veterinarian
  • Consult your veterinarian whenever you notice a change in your pet’s condition
  • Put a medical alert tag on your pet’s collar so that if he becomes lost, whoever finds him will be aware of their seizure disorder and need for medication.

Several treatments are available for pets with epilepsy. By working closely with your veterinarian, you can maximize the chances of controlling the disorder and giving your pet a long, happy, and comfortable life.


This above information is reposted from: http://www.pethealthnetwork.com/dog-health/dog-diseases-conditions-a-z/canine-epilepsy and https://vcahospitals.com/know-your-pet/seizures-general-for-dogs


Would You Recognize a Seizure if You Saw One?

As a pet owner, seeing your dog have a seizure can be one of the most frightening experiences you’ll have. Seizures are often sudden, seemingly occur without reason and leave you feeling helpless as the owner.

There are a variety of different types of seizures found in dogs. However, one very important type of dog seizure to be aware of is cluster seizures.

What are the types of seizures in dogs?

Unfortunately, there are actually several different types of seizures found in dogs, and they can vary greatly in severity. It’s valuable to be able to differentiate the different types of dog seizures so you can have an idea of what type of treatment and outcome to expect.

Epilepsy in Dogs

Believe it or not, epilepsy itself is actually NOT a type of seizure, rather a condition that often causes repeated bouts of seizures. The term “epilepsy” refers to recurrent seizures that originate in the brain. There are different forms of canine epilepsy as well, but again, these are not types of seizures themselves.

Grand Mal Seizures

In a generalized seizure, the dog will fall, lose consciousness, and extend his limbs out rigidly. The dog may also have sudden apnea, meaning he will briefly stop breathing. This will generally last for around 10 to 30 seconds. Afterwards, the dog will begin paddling his limbs or start chewing. He may also have dilated pupils, salivate, urinate or defecate.

Mild Seizure

A mild seizure begins the same way as a grand mal seizure but will typically not involve the extension of the limbs or paddling. The dog usually will not lose consciousness. Mild and grand mal seizures are most often associated with epilepsy.

Petit Mal Seizure

Also known as an absence seizure, petit mal seizures are very rarely recognized in dogs. These seizures are very brief, lasting just seconds, and can manifest as a brief period of unconsciousness, loss of muscle tone, blank stare, or possibly even an upward rotation of the eyes.

Partial Seizure

During a partial seizure, the associated movements will only be seen in one area of the body. This can be the movement of one limb, a muscle jerking, a turning of the head or bending the trunk to one side or even facial twitches. Partial seizures can progress to generalized seizures and are associated with secondary epilepsy.

Complex Partial Seizures

These seizures are notable for the strange or complex behaviors that they repeatedly cause. In humans, complex partial seizures cause us to distort our thought perception, and certain emotions, like fear.

When they happen to dogs, they might be displayed as lip-smacking, chewing, fly biting, aggression, vocalization, frightened running, covering or hiding. Dogs may also experience vomiting, diarrhea, salivation, blindness, unusual thirst or appetite or biting.

These can last minutes or even hours, and can be followed by or progress to a generalized seizure. Like partial seizures, complex partial seizures are also closely associated with secondary epilepsy.

Status Epilepticus

Colloquially known as simply “status,” this type of dog seizure can occur either as a series of multiple seizures within a short timeframe with no periods of normal consciousness in between, or as one continuous seizure that can last up to 30 minutes.

Although closely related to primary and secondary epilepsy, status can sometimes occur suddenly in dogs that have no history of seizures or brain injury. Status can often be difficult to differentiate from cluster seizures. These seizures are considered life-threatening emergencies.

Cluster Seizures

Cluster seizures in dogs occur when a dog experiences multiple seizures within a short period of time, generally considered within a 24-hour window. Like status epilepticus, cluster seizures should be considered life threatening. These seizures are typically brief and isolated, but can also be more serious. Large breed dogs tend to be the most susceptible to cluster seizures.

When a dog experiences cluster seizures, he will usually have one, seem to recover, and then have another a few hours later. However, the dog never fully recovers from the first seizure before the second strikes. This can continue on and on until the dog is in critical condition. With the aforementioned status epilepticus, these seizures won’t be spread out, but will be one long seizure that doesn’t stop. Both are true emergencies.

Cluster seizures can be managed with medication, but the cause of the seizures must first be established before any medication can be prescribed.

What causes cluster seizures in dogs?

Cluster seizures in dogs are often caused by a problem in the dog’s brain, such as a tumor that interferes with the communication between parts of the brain. They can also stem from a lack of oxygen in the brain, low glucose level in the blood, known as hypoglycemia, or hypothyroidism, which is a deficit of thyroid hormone production.

If the seizures seem to happen for no apparent reason, then idiopathic epilepsy may be the cause. This type of epilepsy is difficult to detect because it leaves no lesions or lasting damage on the brain. Genetics can also be a factor in dogs having seizures, but this is not yet absolutely proven.

What dogs have cluster seizures?

Any dog of any age and breed can experience cluster seizures, but they are most often seen in middle-aged dogs. Breeds like Border Collies, Cocker Spaniels, Dachshunds, German Shepherds, and Boxers are known to be susceptible. Research has actually shown that male dogs are more prone to cluster seizures than females.

What are the symptoms of seizures in dogs?

It’s important to note that most seizures are brief, and that your dog can live a normal life when given the proper dog seizure treatment. However, cluster seizures are much more serious, and can cause serious brain damage, or worse.

A dog experiencing a seizure will most often suddenly collapse, exhibit abnormal movement in its limbs, excessive drooling and uncontrollable jaw movement, as well as incontinence. The dog will usually be unconscious and unresponsive, and have no control over its spasms.

In cluster seizures, the dog will seem to recover between seizures, although he will be very tired and lethargic, potentially even staggering, as seizures are exhausting events.

Though their demeanor will otherwise seem fine, they do not fully recover in between seizures and can get progressively worse. If they don’t regain consciousness at all, or seem to have a prolonged seizure lasting up to 30 minutes, this is not a cluster seizure, but status epilepticus, which is extremely dangerous to your dog and can be life threatening.

How are cluster seizures diagnosed?

Dogs that have encountered cluster seizures should be brought into the veterinarian immediately. Once there, your vet will give your dog a glucose test. Often, your vet will also test to see if your dog has ingested poison.

A lot of the diagnosis will come down to what you are able to report to your vet when you bring your dog in. Pay attention to the symptoms your dog displayed during, before, and after a seizure. If you suspect cluster seizures, tell your veterinarian why and that will help them make a proper diagnosis.

Your vet may also conduct a CT scan or an MRI to see if there are any brain tumors or lesions. Since cluster seizures are so serious, you can expect a full round of testing.

How to Treat Cluster Seizures in Dogs

Medication will be prescribed by your veterinarian in order to treat a dog that is experiencing cluster seizures, but there are also a few things you can do at home to help care for your pet.

If you happen to notice your dog having a seizure, you can spring into action if necessary. Make sure your dog isn’t near anything sharp or close to stairs. Note your dog’s behavior during the seizure and, if possible, try to pinpoint the trigger. Comfort your dog after the seizure and see your vet immediately, especially if another seizure occurs.

If your dog has had cluster seizures, you should also be sure to monitor his other bodily functions. Things you’ll want to monitor include:

  • Mental status and level of consciousness
  • Breathing irregularities
  • Heart rate and blood pressure
  • Body temperature
  • Salivation and fluid intake
  • Muscle damage

Sources:

  1. Yin, Sophia, “Vet Advice: Seizures in Dogs and Canine Epilepsy.” The Bark, 3 Feb. 2015, Accessed 1 April 2017. thebark.com/content/vet-advice-seizures-dogs-and-canine-epilepsy.
  2. “Cluster Seizures in Dogs.” VetInfo, Accessed 1 April 2017. www.vetinfo.com/cluster-seizures-dogs.html.
  3. “Epilepsy in Dogs.” The Kennel Club, Accessed 1 April 2017. www.thekennelclub.org.uk/health/for-owners/epilepsy/.
  4. Packer, R, “Risk Factors for Cluster Seizures in Canine Idiopathic Epilepsy.” Current Neurology and Neuroscience Reports, Apr. 2016, Accessed 1 April 2017. www.ncbi.nlm.nih.gov/pubmed/27033922.
  5. “Seizures and Convulsions in Dogs.” PetMD, Accessed 1 April 2017. www.petmd.com/dog/conditions/neurological/c_dg_seizures_convulsions.

***The above information is reposted from: https://canna-pet.com/cluster-seizures-dogs/

Annual Neurological Exam 2022

Porter being a ridiculous attention hog as usual while the Tech takes notes for Dr. Eagleson

Summary of The Last Year

Porter has not had any seizure activity for the past year (440 days to be exact)! However, added to his laundry of health issues, Porter was diagnosed with Atypical Addison’s disease this past year. Most recently, he was also diagnosed with hypothyroidism in October. Once Porter was started on prednisone following his Addison’s disease diagnosis, he became a lot more alert and coordinated and his daily “twitching” (which was thought to be focal seizure activity) also subsided.

Neurological Exam Summary

Porter’s neurologist, Dr. Eagleson, thought Porter looked great and is pleased with his current seizure control. Dr. Eagleson would like us to try reducing the CBD to once a day. In regards to his anti-epileptic drugs, Dr. Eagleson said that since his seizure control has been so good, it may be worth trying to reduce some of his daily drugs. That being said, Porter seems to be tolerating all of the medication well. Dr. Eagleson also said he would be ok if we did not want to tempt fate. Since Porter has just begun the thyroid medication, Dr. Eagleson recommended that we wait about three months before making a decision about reducing any anti-epileptic medication. If it is decided to reduce meds, then we would likely start with tapering his Topiramate.

Next Exam

If Porter continues to do well, he will have his next neurological exam in one year.

That’s a Wrap!

Today Lager had an appointment for his re-check for the sutures on his chest and a re-wrap of his body bandage. I was relieved that he had an appointment today, as his body wrap was a hot mess after just four days!

The surgical team said both his chest and his oral surgery site look great! They re-wrapped him in red (YAY!).. and said the stitches on his chest will come out on November 11th when he has his re-check with Dr. Jennings, the oral surgeon.

New red body wrap, who dis?!
Lager is ready for tonight’s World Series game… GO PHILS!

We put a Suitical over Lager’s body wrap in hopes to make it last until his re-check on November 11th. If needed, we will drive Lager back to get a new wrap prior to his appointment.

What a difference five days can make! The huge red bubble of swelling is almost gone !

I continue to be in awe of Lager’s resilience. He proceeds to act as if nothing happened. He’s getting better at eating his “meatballs” and his tail has not stopped wagging since we brought him home! He has also been THE best patient ever… he has not tried to chew his body wrap, he has not bothered with his cone, he lets us check his oral surgical sight, and when we hold up his E-collar, he pokes his head through the hole of the cone and waits for us to secure it. This boy is truly AMAZING!

Continued Appreciation

Lager is definitely feeling all of the prayers, love, and positive thoughts that are sent to him daily! I read each and every comment that is posted – and the kind words bring me to tears. The private messages and check-ins have warmed my heart and have given me strength. Thank you for everything. This week one of our wonderful neighbors gifted Lager this awesome toy for when his restrictions are lifted … a CVS receipt that unravels into the real-life ridiculous long length of CVS coupons ! Hilarious!