Just got home about an hour ago. We meet with the neurologist to go over Bella's MRI and spinal tap. Her spinal tap came back normal but there were many things wrong with her mri. First of all, she has fluid in her brain and some in her spine (where the spine connects to the brain) due to the fluids pushing on the back of the brain. She also has a cyst in her brain and the neuro is hoping it's gme but we're not sure if it is or if it's necrotizing men. He says we won't know for sure until the meds start working or not. He wants Bella to go on prednisolone (for the inflammation) and omeprazole (to decrease the amount of csf production). Hopefully with the omeprazole, the fluids will slow down and some can be absorbed. I'm really hoping this would hope. He said that if it didn't help with the cyst also, Bella would have to have surgery but with her cyst, he said it was a 2 on a 1-10 and normally he'll recommend surgery to someone with a 7.

Let's pray this works.

Are you sure the Omeprazole was prescribed for fluid? That medicine is given to reduce stomach acids. I am thinking he may have done that to prevent a problem with the prednisone which can cause stomach ulcers. I know that sometimes meds can be given for other actions that they can have, so basically I am just asking to learn.

I am glad that you have a diagnosis now...and a plan. I will be praying for little Bella. I hope you will soon see some improvements.

I am praying big time -- contact Pam asap she is awesome - I will link this thread to her in my maltese group too. She is a sweetheart and she is in the medical profession as well. She is going through gme right now and it was tough getting meds right but she has a good neurologist as well and also join the gme forums and the yahoo groups she is on as well as she said they are very helpful and you can get ideas on those meds from them as there is one specialist on this they follow his treatment so you can discuss with neurologist and it may even be what your neurologist is doing as well.

I am so HAPPY you have a firm diagnosis as now she can get better :) Also glad you did not waste your money on all the liver shunt stuff as knew it was not that so that saved you a road you would have went down thus delaying her care further and saved you some money too :)

I am praying real hard this all works and she will be a happy healthy girl again with her meds :) Glad he uses prednisolone too as that is much easier on her liver as they have to use high doses with stuff like this and my dd had alot more side effects on prednisone vs prednisolone and since your baby has mvd i think it is much safer.

Giver her some hugs and kisses from the D gang:)

oh what did he say about the L/D, CLAVAMOX, AND LACTULOSE? Did he say not to use it anymore ?

what doseage of prednisolone did he give you?

Also make sure to give pred mid meal as i give dd 1/2 food then med then 1/2 food that way the food protects the intestines a little and not as harsh on the tummy

Omeprazole (Prilosec®)

and yes the omeprazole is like pepcid ac/famotidine to keep acid down in stomach to prevent ulcers due to steroid use as i am sure he will have her on a very high dose of steroids to get this under control so he is trying to protect the stomach lining from getting ulcers which is good.

Yeah, my husband asked about it since he was taking it awhile back for something else. The neuro said it works to decrease csf production as well in dogs.

That is good to know -- how did you like the neurologist? Did you feel comfortable and did everything go pretty smooth with little stress on her? Just curious as i know you had to drive so far :( Will your vet be able to consult with him for follow up or do you have to drive to him ?

He hasn't given us any meds yet because he was going to call our vet to see if there was a compound pharmacy in town since the omeprazole is 20mg (i think) and we're only suppose to give her 1. He said it would be really hard for us to get it over the counter and spit it for her.

I'm glad you finally found direction, that's a relief on it's own;)
With everything other's (esp DWerten;)) posted it sounds like to me she'll get better. Yippee for you and i hope you can find comfort in knowing this...please keep us updated:p

Take care of yourself now, i recall you were expecting...Congrats:aimeeyork

That is very interesting! Many meds are like that. Mirtazapine which is an anti depressant works really well in dogs for nausea, vomiting and it is also an appetite stimulant.

My client has a compounding pharmacy here if you want his number i am sure he can overnight it for you if you need to let me know if there isn't one there but i would think they would have one there. The meds do not have to be refridgerated so that should be ok and we get our temarilp by the bottle $56 for 100 so maybe your vet can order a bottle for you of the prednisolone to be less costly for you

thanks that was sweet

I worry about you with you being pregnant and the stress of all this you are going through so please take care of yourself as i know this is hard on you but you are on the right path now to get her the best care for this.

I hope you had some fun at the wedding too :)

Thanks all for the help and support. It's great knowing that there's people like you guys to help each other out. I wouldn't know what to do if it wasn't for you all.

The pregnancy is going good. I finally went baby shopping after taking Bella to the neuro. It was a great stress reliever :D.

The neurologist actually found a compounding pharmacy in town for us so hopefully they call so we can pick up the prescription and get her started asap. He said we actually won't see any results til 7-10 days so we'll just have to wait once she gets started on it.

ok fingers and paws crossed she will have a quick relief :)

All paws and fingers crossed!!!
Many, many prayers going up for Bella!:)
Please keep us posted.

My prayers are with you too :)

I continue to pray for Bella. I am glad that you have a diagnosis and can get the proper care. Sometimes the not knowing is the worst.

I'm also sending my prayers for Bella and your family.

Def talk to your vet about her meds. As they were prescribed for a condition that she currently does not have (Lactulose, Clavamox) they will more than likely be stopped. Important to verify this as Lactulose causes the bowel to empty quicker, this may not be ideal situation for the new meds, as they may break down in the bowel and maybe should remain there longer than what taking the Lactulose will allow. As I am not a vet, I cannot tell you to stop giving her those meds, but I can tell you it is very important to talk to your vet about it, so that her new meds can be most effective at this critical time in her treatment. I would also suggest holding onto the Lactulose, as it's a good med to have on hand when you have a pup with liver issues, as I believe her BAT results indicated she has MVD? Lactulose can be stopped with no ill effects (no weening off neccessary), Clavamox too, but your vet may want her to continue with it for a reason I may not be aware of. Most MVD cases are managed with low protein diets alone, and do well. Water can be added to her food to increase her intake if that is still an issue. Be sure to tell your vet about this also, as if she is dehydrated, he could give her fluids to help get her back on track quicker.

Hugs and prayers to you and your family and Miss Bella... this has definitely been a long road to have to travel down... Praying for a speedy recovery...

yeah my dog has higher post numbers and only on low protein diet bc she has worse issues that i have to manage. I would consult the neurologist and ask him to consult with vet as I really do not think those meds are necessary for this problem and this problem is much more critical than the mvd she has so that is a good point about the lactulose pushing the drugs out of the system faster.

My concern is this vet pushing for the ultrasound etc on bats of 49.2 instead of first getting this dog to neurologist with those symptoms so not real sure she is real up on liver issues anyway so i would probably follow the neurologists recommendations over the vet at this point

My vet wanted the ultrasound done to see if there was a single blood vessel or multiples to know if we can do surgery or not. She was thinking the liver issue may cause the neuro problems as well but I'm glad I went straight to see a neuro instead of internal med.

I've actually stopped giving Bella the lactulose and clavamox the night before we were leaving out of town. I didn't want her to have an accident in the car and she's really good about holding it but I would rather not make her hold it for it would have been torture. She's been the same with and without the med so it prob wasn't working anyways since I had her on it for a week. I'll actually double check with the vet though especially since I want to know if I should keep her on l/d or just any low protien diet.

The neuro also sent my vet a copy of what went on and she had called me this morning to check up on Bella as well. She also stated that the neuro wanted us to keep bella on pred for a week then call them so they can tapper it. We'll see how that goes once our meds are ready for pick up...we're still waiting for the pharmacy to hurry up.

yeah check on the L/D as really do not think this was liver related as we know now so you can keep her on 18% or 22% protein diet so what was protein on previous diet? Plus she did not seem to like this food correct? The steroids will make her hungry though so make sure you measure her food or she will PIG OUT and become a porky yorkie :)

Glad you went to neurologist too so you can get her on correct meds and get her well - i hope they hurry up :( as want her to get well fast :)

I was switching her food around as she gets bored of it quick but I fed her california natural, avoderm, and innova.

what was protein percentage on them

Is the cyst in her brain or at the base of her skull ?

it looked like it was in the middle but more on the left side i believe. i remember the neuro saying that could be the reason why she's not seeing on her right side and maybe the meds could help. there was alot of information and i only picked up on a few since i was so shocked. the husband actually picked up on more things. i recall the neuro saying that it could be worst to where the damage is already done and she might not be able to see anymore.

Just reading this makes me so sad....I am sure you were so shocked. I am just so sorry. It is so difficult to have a sick pup.

I hope the medications work quickly to help alleviate some of the symptoms.

Is temarlip the same thing as prednisolone?

We finally got ours today at 5pm and does this sound right or am I getting ripped off?

15ml of prednisolone for $10.75 and 30ml of omeprazole for $45. I'm thinking I'm being way over charged for the omeprazole especially because you can buy it for $30/42 pills except the dosage is too much and it'll be hard for us to cut it exactly into 20 pieces.

I was asking because this is unfortunately a deformity that is seen in other breeds and is appearing now in yorkies. The base of the skull should be curved and in the case of the deformity it is flat. So the cyst forms kind of like a callous where the bones rub together. Depending on where the cyst grows from the rubbing it can push on the brain. Not sure of the correct spelling of this but do a search for kiari syndrome it's almost exactly the same thing and will help you understand more of what's going on with your baby. I had one with this same thing and she lived for 11 yrs. So it's not hopeless. And the meds your vet gave are correct for this problem and should work.

No not the same ... Temaril P has prednisolone in it but probably at a lower dose than what your vet has prescribed. It is not JUST prednisolone!

Does anyone know how compound meds are done? I think we seriously just bought 1.5 pills of omeprazole for $45 (but in liquid form).