Hello all,
Well we are finally home. We have been gone 10 hours and we are all exhausted beyond belief. I will try to give you as much info as I can. Cassie had her MRI. Both Dr. Stephenson and Dr. Lipsitz were present and often work together as they are married and often do surgery together. Results were not great. She does have hydrocephalus which is moderate and the Neuro said it did not concern her and was often seen in small breeds. She is not worried about it. She did very well under anesthesia. Her spine showed a DRAMATIC narrowing of the diameter of her spine where the first vertebra and second meet. The spinal cord makes almost a right angle turn at this location. There is a fluid enlargement just behind this narrowing that is consistent with either arachnoid cyst or syringohydromyelia and evidence of edema inside the spinal cord behind this enlargement. Because of the above her prognosis is a little less certain. There are concerns about manipulating what little tissue she has in this area during a normal surgery which could compromise her ability to move her limbs or breathe after surgery. Also, the cyst above the spinal cord may become a problem once the vertebra are re-aligned. It may not be a problem, in fact it could even improve her condition, but there is no way to know this ahead of time. If I decide to do the surgery, doing it now rather than later if she starts to decline is preferable. The doctor states, in fact, that she may never decline since she has lived with this problem for 5 years with no change in her gait. The main concern is that she might suffer a trauma or injury to her head or neck that could cause the vertebra to move and do more damage to the spinal cord which could cause issues from not being able to ambulate to death, from not being able to breathe. Steroids might help her gait improve. Need to keep her from climbing, falling, rough playing, shaking of toys with head or neck, big dogs, etc. You get the picture. She says if she is kept safe from the above, she believes there is nothing from keeping her from living a normal lifespan. She and Dr. Lipsitz give her 50 to 60 percent for a successful surgery. I was prepared to do this surgery today, until I found out about the cysts.
I couldn't make the decision at the time. I am exhausted and depressed. It is very uncertain, this surgery. Most of the medical people I have spoken to from the surgeon in CVS and also the internist, to my holistic vet, to the two neurosurgeons at VHS say to exercise extreme caution about this surgery. They say if she were a year old, it might be different, but because she is 5, and has compensated so well, they are less certain about doing it, and they say she has an atypical AAI.
So there it is. I have to go lie down now. I'm drained.
Shellie
