Cassie is in trouble
 

Hello all,
I am posting this in hopes that someone will have some words of wisdom to guide me. Recently I had to take Cassie to the dentist because my doctors felt a couple of teeth needed to be extracted, as she was getting constant upper respiratory infections. The surgery went well and she seemed to be doing okay when she all of a sudden came down with pneumonia, I think it was aspiration pneumonia. She was in the ER for a week and we didn't think she was going to make it. Thank god she did make it, but I had to take her back several times for a recheck and during the X-rays and observations the doctors presented me with the following: They think she may have hydrocephalous, they say she has a very small liver and may have liver shunt (small possibility) or micro displasia ? something which may or may not cause her trouble over the years, and then they had a surgeon speak with me about AA instability? It seems her neck and spine are deformed and that is why she hops around instead of walks. They say she could die if she hit her head the wrong way, but the surgery to correct it is very risky. She is only 2lbs and 5 years old. I am waiting to talk with my wholistic vet about all this, but in the meantime I am very worried and feel very much alone. She hasn't called me back yet for a consult, an appointment or t/w the ER doc about the findings yet. I am afraid for her to shake her head, to hop jump like she does or for her to get too excited. I'm so upset, I don't know which thing to address first. They think by far the most dangerous thing is the AA instability, and that if she does have hydrocephalus, it is mild. Also they can't see a liver shunt on the tests, but she was not really holding still for them. They think there might be something with the liver, but probably not as much to worry about as the AA thing. I'm sick with worry. I'm terrified of doing the surgery, and terrified of not doing it. Any words of wisdom would be welcome.
TIA Shellie:confused:

I can only imagine how devastated and in shock you are about this news....OMG!! after the first couple of things they gave you, your mind just sort of goes numb.....If it was me, I would be fleeing to the nearest vet school for a work up and consultation....I would take all the findings, reports, xrays, etc these vets have given you, and run!!!!

AAI Priority
 

Your vet is right. AAI is very dangerous if left untreated. I lost an 18 month old with this problem and never knew he had it until an emergency and then it was too late for the surgery. The surgery can be very successful if done in time. If not, death is imminent. Run to the nearest vet hospital.

I can't stop crying
 

I am crying night and day. I am shaking. I am sick deep into my soul. I am going to call my holistic vet yet again. I know she is busy, but this is an emergency. I'm finding it difficult to breathe. I am in such a panic.

Hi. Sorry to hear this news... Hugs to you...

The Hydrocephalus is very much caused by the AAI. Meds can also control it, but the AAI may require at least casting or surgery.

She's 5 Years old? These are congenital problems, so she's had them since birth. For the Liver, you can feed her a low protein diet, Hill's prescription L/D is highly recommended. Denamarin will help her liver to function a bit better too. Were her Liver enzymes okay on the pre op bloodwork? No trouble coming out of the anesthesia? These would be signs of Liver Shunt. Has she had any recurring UTIs? Also a symptom.

I recommend getting her to a teaching hospital asap. What state do you live in?

Never mind... California... are you near UC Davis?

If not, a Board Certified Orthopedic specialist would be the next best thing.

Calm down... she's had this for a while... no need to panic. Easier said than done... I know. But she needs you to keep yourself together so she can get treated asap. Take some deep breaths, sit down. We need to find a vet for her... we here can help. Going to look now.

California. I've been to the VSH in Sorrento Valley in San Diego with Muffin. Yes she is five years old, so the surgeon says she has been living with this for a long time and has compensated for it, so far. They are not sure about the liver shunt, as the the doctor did not see a shunt during the tests, but Cassie was not holding still for them. Her numbers were elevated on the tests they did, before and after, but...the doctor says they were quite low even though they were elevated and she has never had a problem recovering from anesthesia, so the doctor is not very sure about the liver shunt. She might have some other lesser condition with the liver, I forget the name, micro something or other, but they really can't tell anything without a liver biopsy. She has been through so much already. I am so very sad for her. The thing is she is just soooooo tiny. So very tiny. I keep thinking surgery oon such a tiny thing is certain death. I just can't stop crying.

I would go to a vet school and let them do a work up on her. I have a foster who has AAI along with multiple other neurological issues and his is not operable. He is older and has managed for many, many years.

AAI is a surgical condition BUT not always. It depends on the pup and what else is going on. You would need a specialist to make that call. I like the vet school clinics because they look at the whole dog and they have the best "toys" (diagnostic tools) in most cases.

I took Sammy (my foster) to Texas A&M and after all of the testing, they recommended no surgery since he had too many things and was way too high risk.

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

No, not certain death... if they can do a dental on her she should do fine.... if it's even necessary. I wouldn't worry yet so much about the liver, the AAI is more important to have evaluated first.

I would not do a dental on her until she is seen by a neurologist! They have to turn them around quite a bit during dentals and it is very risky with AAI. When Sammy was at A&M recently because he had an issue with his hernia, I spoke with the vets and they felt that a dental was extremely risky for him.

I hope the doctors are able to help your baby. I understand why you are feeling so panicked, and I am so sorry that Cassie isn't doing well. My prayers are with you and your little girl.

VSH looks good they have a Neurosugical Department and Emergency Dept (24/7) there, and the Vets are DACVIM.

Veterinary Specialty Hospital San Diego - Veterinary Specialists and Services

Do you have someone to go with you?

They already did a dental... she did fine.

I see that now...but I was responding to your post....it threw me off when you said she should be ok getting one.

Thankfully, it was not a problem. :) Dentals are very risky in AAI pups.

Get well soon Cassie. I have no words of wisdom as I am new to Yorkies.

Hi Ladyjane,

In 2009 Cassie had to have dental surgery and they removed 15 teeth from her. A couple of weeks ago she again had to have dental surgery before I knew about the AAI and four more teeth (canines and 2 other little ones) were removed. 19 teeth in all. No problems recovering from surgery at all. I am shocked she was able to withstand this. Plus all the grooming stuff which can pull on the hair on the neck, the hair on her head etc. What do you make of all this? I mean when I think of everything she has been through and all the wear and tear on her neck, I am in awe that she is still here....... (THANK GOD)! She is only about 2 lbs, but MIGHTY in spirit!!!!!!

She could be like the foster I have. He had a dental last year and also two hernia operations. We knew about the AAI and took the chance because he was such a mess.
He just had surgery again a couple of weeks ago because the hernia is still there and the bladder got trapped....the surgeons were very concerned about doing the surgery, but Sammy once again showed how tough he is! There is nothing we can do for his AAI because he has way too many other issues and they are afraid of a snowball effect. I talked with them about another dental as he is in need again; but they are not thrilled about it...and it does frighten me.
BUT...he might do just fine. He has been like your Cassie...very tough! :)
Oh, and Sammy is probably double Cassie's age, so he has lived a very long time with all of these things. Even the neurologist was shocked when they did all of the tests and found all of the things that are wrong with him. I asked her how he lived this long and she said they had been talking about that all day. So...you just never know.

Well, kjc, not really. I mean technically my 89 yo father goes with me usually everywhere, as he doesn't drive anymore, and has some vascular dementia, plus he loves the girls so much. But he is not really a support, and usually ends up getting mad and impatient if he has to wait a long time, and ends up needing more help and support than he could ever give. But there is no one else near bye, so I have to handle both the girls and my dad alone. But I'm grateful to have them all.

Just looked at the Veterinary Specialty Hospital San Diego - Veterinary Specialists and Services, they have forms you can download now and fill out... you will need a referral from your vet for the Neurology dept.


Better yet, this can be considered an emergency... no referral needed...
Veterinary Specialty Hospital - In Case of Emergency

They do like you to call first. I'd do that, then from there they'll get her into Neurology. I think sometimes appts may be a week or two out... you do not want to wait that long.

I hope and pray Cassie has the strength and will to make it to Sammy's age. WOW!!! Double Cassie's age, and he's still hanging in there! What a trooper!!! I hope hope hope Cassie will make it to at least 10 or more years!!! You have given me hope!!!!THANK YOU!!!!!

I hope it happens for her, too! :) You definitely should get a total work up done though so that you can be in a better position to make a decision.

I went to a specialty hospital first and they wanted to operate without doing an MRI. I just was not totally comfortable; so I went for a second opinion at Texas A&M and they did a lot of testing...and then the MRI and it was then that all of the other things were found and they felt he was way too high risk for surgery. If I had let the first place operate on him, he most likely would not be here.

Anyone that could meet you there? Just didn't think you should go alone... I know how upset you must be... How far from your house?

Did you call them yet?

I wish there were. My only sister died in 2005, my mom died in 2009. I have no one near by, and no one near the hospital. My real friends are far far away, so are my kids. You are right, I would love to go with some support, but I think I am in it alone. Most people, if they are not really dog people, do not understand the intense connection between us and our little fur babies. No one could ever know not only the physical connection, but the soul connection, the spiritual connection, the love energy that passes between us and our fur babies.

No I have not called them yet. I called my wholistic vet, who drives the care for both Muffin and Cassie, she is the captain of the ship, and has saved their lives many times over, so I trust her completely. She is also a traditionally trained vet as well, so she is brilliant and amazing. She will be talking with the ER doc who did all the tests and then she will call me today and we will discuss a plan. Also I called Dr. Feinberg, the vet she recommended for the dentistry, who is also fabulous and amazing, who got Cassie through two difficult dentistry surgeries, and I am also going to talk to him and ask him for a second opinion. He is not a wholistic vet, but is a wonderful traditional vet that I would go to with my girls, in a heart beat for many traditional things that Tamera does not do, if he were only closer to me. As it is he is at least an hour away, but totally worth it if you are doing something risky like dental work on a tiny yorkie. So I'm waiting to hear from both my Vets and possibly even the ER that Cassie was in. I don't want to rush into anything until all the docs have conferred.

I'm soo sorry Cassie is going through this, I can only imagine your heartache. My thoughts and prayers go out to you and your family. I'm sorry i have nothing to add to the wonderful advice that has been given from the more experienced here. Cassie is really a teeeny one...My baby is now 5lbs and I thought she was tiny...I honestly cant imagine 2lbs. Hang in there and try and remain calm until you have some answers.

I am reading you as a bit calmer? That is good. Sounds like a plan...

in the meantime... don't let her jump on or off of anything, including stairs, etc. just as a precaution.

Also maybe elevate her feed and water bowl a smidge, ( she could benefit by not having to lower her head to eat and drink)(I don't know how tall she is, maybe a folded towel under her bowls would help).

If she's crate trained, I'd set her up in there when you're not right there with her. Basically, China Doll treatment...

Praying for a good update after the conference...

Thank you and UPDATES
 

Dear kjc,

Thank you so much for your support. I cannot tell you what it means to me to have you and everyone else here writing me and taking time out of your busy schedules to comfort and support me. You are so much appreciated, I don't know what I can do to thank you and show you how much you all mean to me. There just are no words----I'm all choked up!! Thank you, thank you all, for all your love and support. You are grounding me, keeping me sane, and warming my heart and soul.

Here is an update:

I spoke with Dr. Feinberg at the Governor Animal Clinic, the Vet who did her dentistry. He states he is surprised at the findings. He is having an expert come in on Wednesday and wants her to look at the X-rays. He's says, if he had known about the AAI would would be hesitant to even put her under anesthesia much less do the dentistry. He says, they are very very gentle, but any test including ultra sound, X-rays, and certainly dental surgery requires a good about of moving and neck manipulation-he is puzzled and surprised she did so well, not only in surgery but recovering from the anesthesia after surgery. He says he will get back to me on Friday with the results of the consult. I talked to him about her head bobbing up and down and her leaning her nose on or between my fingers when I hold her. He says she must be compensating for the AAI, but still wants his expert to see the X-rays. So I am waiting....he says at this point, he does not think it is an emergency-given everything she has been through, but there needs to be a plan of action very soon. I am still waiting to hear from Tamera, my wholistic Vet.

By the way, that is a great idea about elevating her bowl with a towel. I didn't think of that. Before I even knew about the AAI I tried to get an elevated bowel for the girls, but all the raised food dishes were just too tall for them. But a towel, I never thought of that. That is one great genius idea, and so simple too. I'm going to try it immediately. Thank you!!!

She does usually get the china doll treatment, but she hop jumps into and out of her beds, some are fluffy pillow types, some are soft cosy ones with a soft side, but she does not WALK into any of them. She kind of hops up onto them. There is only one bed that I can think of that she does not need to hop onto, a long rectangle bed with no sides, I think I will switch her bed, even though I think the others are more comfortable. We have no stairs, and I never leave her up on a bed or couch unless I am there with her...
Thanks for the GREAT ideas!
Shellie :-)
Blessings to you all!!

Praying for Cassie.

Praying for a good update on Cassie.