Sammy has multiple neuro issues....
 

My foster, Sammy, who many of you are familiar with (he is the one who had the two surgeries for perineal hernias) just returned from Texas A&M this evening.

About two weeks ago I had taken him to a local neurologist for evaluation of his neuro signs (very spastic walking, intention tremors and some other things) and she had suggested surgery. We already were aware that he had atlanto-axial subluxation based on xrays that were done by my regular vet when he started having issues with the hernia. I had asked the neurologist about an MRI but she said it was not needed. and it was a cut and dry case. I told her I was unsure about surgery so she gave me prednisone and told me to return in two weeks. I left there with an unsettled feeling and decided that I would take him to A&M for a second opinion. Thank God I did that. I don't want to think what might have happened if that surgery had been attempted.

At A&M yesterday they said that they felt there was more to his problems than the atlanto-axial subluxation. They suggested a complete medical workup including xrays, u/s, blood work....and then a MRI if all of those were ok. They did the MRI today and the results were shocking. Keep in mind that Sammy is probably 10-12 years of age and we are all amazed that he is alive. He was diagnosed with the following conditions:
1. chiari-like malformation
2. chronic atlanto-axial subluxation
3. hydrocephalus
4. syringohydromyelia
5. cervical intervertebral disc disease
6. subarachnoid cyst

He has had much of this all of his life. Sammy is adorable ... loves to eat and loves squeaky toys. Comes to me when I call him and gives kisses! Top it off with the fact that he is food aggressive...and loud as he can be when he wants a treat. The only clue that he is ill is the spastic walking and keeping his head down all of the time.

They gave me omeprazole to help with the fluid...and they want to follow up in four weeks to see if there is any improvement. He does not seem to be in pain...but he has been a mess all of his life and pain may be a normal thing for him. :(

Hopefully this information is going to help someone some day....so much is said about AAI being diagnosed by xray. The one thing that the first neuro said to me that made me think long and hard later on was that holding his head down was not typical for that condition...they usually hold their heads up....And, someone I know has a chiari pup that holds her head down. So...I was just really not comfortable. I know that a lot of people hesitate to do MRIs because of the cost....all I can say is that this MRI saved Sammy's life. I am sure if they had just gone in to operate, he would have been a goner. Always trust your instincts...and also go for second opinions!

Lady Jane,

My Heart goes out to you and Sammy. Shelby developed the syrinx after AAI surgery, it was a difficult time for all of us, she does also have the hydrocephalus, Cardiomegaly, and enlarged esophagus.

It concerns me the statement you made regarding keeping the head down. Shelby does this quite often, rarely she holds the head up. I feel a need to contact her Neurologist after reading your posting. It has always bothered me that she did the head bobbing at the food bowl prior to surgery, and now post surgery with the head held down most of the times.

She is very active, especially with Willow our new girl they enjoy playing and she shows no sign of pain at this time. I consider myself well educated on AAI, but with the development post surgery of the Syrinx - that always bothered me!

I will keep Sammy in my prayers and you for all the wonderful work you do! Bless you

I will be praying for this little guy. The holding the head down is common among Chiari pups as they are trying to relieve the pressure at the base of the skull. As the Omeprizole starts to work he may start to hold his head more uprite again. I am sure that you know how the Omeprizole works but for those who don't, the Omeprizole slows the production of spinal fluid allowing the fluid build up in the brain more time to flow out and the subarachnoid cyst to shrink.
It is the subarachnoid cyst that if allowed to get too large & if in the rite place can press on the optic nerve causing blindness witch usually will rectify itself after treatment begins.

I will be thinking of Sammy and you and praying for both. Hope the new meds work and bring some relief to Sammy.

They told me that he holds his head down due to the skull malformation. That was one of the findings on the neuro exam that set off the alarm that something else was going on besides the AAI.

Interestingly, his vertebrae are malformed and very tiny, and one sits inside the other. They may not have seen the space on xray if not for the position he was in.

Sammy has intention tremors when he goes for the food bowl. He also eats very fast and I have to watch closely because he has a tendency to choke. I was hand feeding him for a while, but that seems to stress him. So now I just put some water in his food (he eats canned food) and watch him closely and pray.

Sounds like he and Shelby have many similarities. She is so lucky to have you!

Poor little Sammy. Bless his little heart. :( He has so much going on. He is in good hands with you. And so lucky you went with your gut feeling to get a different opinion. It really makes you wonder how these pups that you get are able to be so loving and happy with all they have to deal with. Please give Mr. Sammy hugs and kisses.

These pups have an amazing resilience! Honestly Sammy seems very happy! :) I hope he is not in pain....he certainly does not act like he is.

Oh my, Sammy is having a rough life. Hate to think he has lived his life adjusting to pain but hopefully the meds will make him more comfortable. It just seems so unfair that so many of these little guys have such pain in their lives but I guess life isn't fair and we all must do our best to improve the lives we can.

Little Sammy seems to be in the best hands right now. So glad that you got a second opinion. I pray that the little guy starts feeling better. It's amazing how happy and loving they can be, even with all the mess they have on the inside. Please keep us posted on his status.

What a tough little fighter. Basil and caper just made a donation.

I am not saying I understand all of Sammy's health issues, but can say that you both are in my thoughts and prayers.

Poor Sammy! I will keep you guys in my prayers!

poor little sammy, he has been through so much. you are truly an angel to him and all of your darling little ones. he's so lucky to have you and if he didn't, well we wouldn't even want to think about that!!! bless you and sweet sammy. i will say prayers for you both!

Sammy seems to be doing better on the Omeprazole! When he walks, he is now holding his head up! :)