Cassie is in trouble

[4Scrappy]

The vets at those specialty vet places can work wonders. They operate on tiny kittens and puppies and are experienced in their specialty. She's strong and full of life. That is reason to be optimistic. Please let us know what happens. I feel so bad for you and totally understand all your feelings. I hope to hear soon how it went and what's next for little Cassie. Stay strong for her. She looks to you for her mood and if you panic, she will sense it. I pray pray pray she is OK.

[Perrella]

Checking in on Cassie...continuing prayers for this little one.

[broodizt]

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

[ladyjane]

I am sorry ... I know this must have really floored you. If you have not yet, please do read Sammy's story.
Here is a list of the neurological things wrong with him (he also has a couple of other medical issues) .. but Sammy is a happy boy :

1. chiari-like malformation
2. chronic atlanto-axial subluxation
3. hydrocephalus
4. syringohydromyelia
5. cervical intervertebral disc disease
6. subarachnoid cyst

It sounds like Cassie is very similar to Sammy....and let me remind you that he is much older than she is.

No one can tell you what to do....all I hope is that you can see from the above that it is possible for these pups to live with these conditions. Ultimately you are the one who must decide whether to try surgery or not. In Sammy's case the vets at Texas A&M felt that surgery would just open up a can of worms so to speak...they did not recommend it at all.

I will keep Cassie and you in my thoughts and prayers.

[kjc]

Well, it's hysterical that the two neuros are married! And even better that they work together... major plus.

What a horrible dilema... I'm going to have to sleep on this one before I say anything else. I will be praying for you and your baby. Maybe after you get some rest and have had time to digest everything a decision will become clear.... Hugs, Kathy

[yorkietalkjilly]

Good grief. That is a lot of not good information. I know you must be depleted of all that is necessary to even sit up, let alone function tonight. And little Cassie has been through a big trip & lots of stresses, too. Hope you can both rest well tonight. In a situation like this, so fraught with problems of one kind or another either way, you can't decide without some time & thought & prayer. As long as she can live a quiet life and protected as much as possible, odds might be better for her without that dangerous surgery but if having it could keep her safe longer & the surgery is strongly advised by all the vets and she would be safer having it, that would be wonderful. This is one of the hardest parts of being a dog owner - making these types of decisions for those little ones. Whatever you decide, I'm sure everyone here will be lined up behind you, offering what love and support we can through words and prayers.

[broodizt]

Hello all again,

Thank you all so much again for your positive energy and love. I've needed it badly. Today I am a little more rested, although Cassie kept barking and waking me up during the night, to hold her. She was whimpering yesterday, but seems better today. I am struggling with many issues, such as what is quality of life if I have to keep Cassie away from Muffin all the time in separate rooms. Is this realistic, or even desirable? They each know the other is in the house and know when I am with one or the other, and they are both so lonely and unhappy. I am so torn going back and forth to each room to give them the time each of them needs. Maybe it would be worth it to take the risk and give Cassie a shot at a normal life and give her the surgery. Or maybe the risk would be leaving them together and only keeping them apart when we go out of the house. We've done okay so far, and Muffin is not aggressive, although she is playful and barks at Cassie to play with her. She can probably be a little rough with Cassie, given Cassie is half her size, but they have lived together so far with no problems, so maybe THIS is the risk worth taking. I don't know, I'm so confused. But this arrangement where they are separated from each other at all times feels wrong to me. So I am contemplating either the surgery, or leaving them together as before except when we go out. What do you guys think?

[lisaly]

My heart breaks for you. It's so difficult to know what is best for Cassie, but I agree with you about the quality of life issue. If we were talking about a short-term confinement that would affect her long-term health, that would be one thing, but whatever you decide affects her long-term. I didn't hear what the doctor said about how risky the surgery is, so it's difficult for me to say. I don't think I'd want to keep Cassie away from her sister, and I would live in fear about injury, so I probably would lean toward the surgery unless the surgeons didn't recommend it. I worry about my little girl all of the time, and I do whatever I can to minimize risks with her, but I also want her to run, play, and enjoy her life. I wish you didn't need to make this decision, and only you know what's right for your little girl. You and Cassie remain in my thoughts and prayers.

[kjc]

There is no answer. Any of our dogs can pass on at any moment, just now you have some 'insider information' about yours. And no matter when or why it happens, you will feel bad and be second guessing any decision you make.

If I were you, and this were my dog, I would call the neuros back and ask them, point blank, "If this was your dog, what would you do?".

Either way, you have to put it in God's Hands. He will take her when it is her time, and not until.

So a 'Yes' to surgery means you choose to give her a chance for a more normal life, at the risk of no life, should it be unsuccessful.

A 'No' to surgery means you choose to give her the life she is accustomed to, however long or short that may be.

Either decision can result in a long or short life for your baby. But what will be, will be, and it's not going to be a result of any decision you do make.

Similar situation with our Tinkerbell, although a different medical problem. She did survive her surgery and the recovery, although the surgery was unsuccessful, so she is still at risk from her disease. Every day I wake up to see if she's still with us... or not. I just try to enjoy the time I do have left with her.

I hope this has helped, and I will keep on praying for you both and your Dad too.

[ladyjane]

I opted to let Sammy be with the other pups. I was told he should live by himself in a separate room or be crated and should be handled like a china doll. I did that for about two weeks and then decided it was just not good for him. While he never played with the other pups, he still would always come around them when it was time to eat. I figured he had lived this way for so long and if it was going to go bad now, then so be it.

I do put him in a crate when I am not at home.

I am not saying you should do this...just telling you what worked for me...and for Sammy. So far, he is doing ok. I know he would not survive the surgery....and if something happens to him now, then it was just going to happen. I cannot make him live in a bubble. That would not be a life imo.

I am sorry you are faced with such a difficult decision...kind of like damned if you do and damned if you don't. You just will have to make a decision at some point...and trust yourself and always remember there is no right or wrong decision....just YOUR decision.

[Perrella]

My heart goes out to you...so sorry for the news and it does sound like there are numerous issues going on. Sending prayers for you and your girl.

[107barney]

I'm sorry to hear this news. I don't know what I would do. I'm a big fan of erring on the side of veterinary care -- when the benefits outweigh the risks and there is a good likelihood of success. I can't say I'd be jumping to surgery with those low odds of success. On the other hand, I think I join with LadyJane and others' opinion in not wishing for my dogs to live in a bubble. I have had to confine my Barney ALOT the past 5 months for leg surgery and it has been sad to see him unable to romp with the others and just be a dog. I know you will do what you feel in your heart is best for Cassie and for your family.

[yorkietalkjilly]

I honestly don't know what I would do but if she's made it this long playing with the other dog, isn't everything the same as before you knew, with no greater risk now? Unless she's destabilized it or had an injury I missed in the posts you've made, I think I'd be tempted to let her live as she has lived until you found out there was a problem. If that surgery could further put her at risk due to the coexisting condition, it seems a bit of an excessive risk to subject her to in an already risky procedure. But of course only you know what you are going to be able to live with and deal with most effectively and you know your dogs and how they can best live their best lives. There doesn't seem to be one single right answer to the problem.

[broodizt]

Thank you all so much for your feedback. It helps me so very much, you have no idea how grateful I am. Thank you all a million times-THANKS

First I would like to address ladyjane's question about asking the neuro what she would do if she were me. Actually, I did ask her that. I asked, "would YOU do the surgery, if it were you?" Her answer......"probably not!" She said " I'm not telling you NOT to do the surgery, but I don't think I would take the risk given the fact that she is 5 years old and managed to compensate quite well for it all this time. If she were one year old, and we didn't know what her body would do, it might be different."

So I'm starting to think about this somewhat philosophically. Who among us on this earth lives without any risk? I guess we all incur SOME risks, albeit most of the time they are calculated and hopefully the odds are in our favor. With Cassie she says the odds for surgery are about 50/50 or MAYBE 60/40.
I'm not sure what the odds would be about letting the girls be together-as before.

I still have some soul searching to do, because if Cassie can live a normal life, and not have to be handled like a china doll, but could experience the FULL experience of being a dog, well that is very attractive to me.


I still am struggling because she did say Cassie's chances could possibly be better than 50/50.

But as a lot of you have said, I could go back to the way things used to be before I knew any of this, and take my chances...another kind of risk. This is so trying............

[lillymae]

My heart goes out to you & Cassie & honestly can't even say what I would do in your situation. I have to say though, I would have a hard time separating her from her friends. As ladyjane has said about Sammy, she chose to let him socialize & I would do the same as above all else I believe their life should be as full as it can be no matter how long or short that may be. After all, the reality is that no matter how you view her , she is a dog & should be allowed to act like one if she so chooses,IMHO. I will continue to Pray for you both.