Need insight: Sprite dx with hydrocephalus

[kmarla]

Thank you ladyjane and 107barney for the links. Little Sammy was such a precious angel with so many challenges but he was a fighter. I think the human description for COM Syndrome is Chiari Type 1, which it seems Sammy had also. I loved the video's. Little Sprite walks off balance like that just before and after her seizures. Normally she is quite coordinated, but sometimes she walks with the strangest little gait, like she is competing in a dressage competition. She lifts her little front legs high up one at a time like prancing. It was uplifting to read about the little chihuahua. Our neurologist seemed very confident about doing the surgery, but yes, this is a very specialized clinic that sees complex cases so it makes sense that regular clinics probably wouldn't come across this often. We have to imagine what life will be like for Sprite because we don't know anyone else whose pet has had this procedure. He also told us there are risks involved, mainly infection and blockage developing in the shunt, and of course the surgery itself. I'm feeling more optimistic today about Sprite's chances.

[107barney]

Originally Posted by kmarla

Thank you ladyjane and 107barney for the links. Little Sammy was such a precious angel with so many challenges but he was a fighter. I think the human description for COM Syndrome is Chiari Type 1, which it seems Sammy had also. I loved the video's. Little Sprite walks off balance like that just before and after her seizures. Normally she is quite coordinated, but sometimes she walks with the strangest little gait, like she is competing in a dressage competition. She lifts her little front legs high up one at a time like prancing. It was uplifting to read about the little chihuahua. Our neurologist seemed very confident about doing the surgery, but yes, this is a very specialized clinic that sees complex cases so it makes sense that regular clinics probably wouldn't come across this often. We have to imagine what life will be like for Sprite because we don't know anyone else whose pet has had this procedure. He also told us there are risks involved, mainly infection and blockage developing in the shunt, and of course the surgery itself. I'm feeling more optimistic today about Sprite's chances.

I'm so glad you're feeling a little better. I feel confident that you'll do what you believe is in her best interests - be it surgery or letting her go - and there is no right answer except the one you make!

[107barney]

I feel like I should add to this. That chihuahua didn't ultimately make it but I didn't know that when I posted the original story. He had a second shunt repair and then was adopted. He passed a few months later from a seizure. I am so sorry I didn't see this earlier and I don't want you to think he was some great success now that I found that. Every case is different and maybe there are success stories. I would ask your neurologist how many of these he has done and how the life was after and for how long. I spend a lot of my dogs, but I'm not sure I would do this surgery if they couldn't give me a good prognosis. I just don't know. I feel horrible for you having to make this decision and want to cry.

[ladyjane]

Try not to focus on one failure. It happens in everything. I am sure there are some amazing success stories with these surgeries. Hopefully the neuro can share the good and bad with you and give you some information that will make this decision easire. I too am so sad that you are faced with such a difficult decision. Always remember, that there is no right or wrong whichever way you go.

[ladyjane]

Originally Posted by kmarla

Thank you ladyjane and 107barney for the links. Little Sammy was such a precious angel with so many challenges but he was a fighter. I think the human description for COM Syndrome is Chiari Type 1, which it seems Sammy had also. I loved the video's. Little Sprite walks off balance like that just before and after her seizures. Normally she is quite coordinated, but sometimes she walks with the strangest little gait, like she is competing in a dressage competition. She lifts her little front legs high up one at a time like prancing. It was uplifting to read about the little chihuahua. Our neurologist seemed very confident about doing the surgery, but yes, this is a very specialized clinic that sees complex cases so it makes sense that regular clinics probably wouldn't come across this often. We have to imagine what life will be like for Sprite because we don't know anyone else whose pet has had this procedure. He also told us there are risks involved, mainly infection and blockage developing in the shunt, and of course the surgery itself. I'm feeling more optimistic today about Sprite's chances.

Yes, Sammy was indeed precious. It broke my heart when I had to let him go. I loved to watch him walk and play...oh how he loved his toys! I have such wonderful memories of him.

Would love to see pics of Sprite!

[megansmomma]

I just had a thought about a few questions to ask the neurologist.

What damage has already been done to the brain when you take into consideration that the left ventricle is 3Xs the size of the right.

What is the long term prognosis and the possibility of needing to repeat the shunt surgery. If the shunt is placed will follow up surgeries need to be done to ensure that the shunt working properly and if so how often will they need to be done.

[kmarla]

Thank you all for the support and the great suggestions about what to ask the neurologist. Her blood work results should be back today so hopefully we can have an opportunity to get some answers over the phone. Our follow-up appt is next week. I spent yesterday grooming Sprite and giving her a puppy cut...much needed as she had all these little shaved patches all over from all her tests. She looks so adorable. I'll try to post a couple of pics of Sprite later and will update after with any new info. I was saddened to read the update about the little chihuahua. That is exactly our concern about doing this procedure. Are we just prolonging the inevitable?

[ladyjane]

I like the commercial for the Cancer Center that says we don't have an expiration date stamped on our foot. I feel the same way about our pups. The inevitable is that we will outlive them (hopefully) and I try not to think of end results unless the odds are heavily stacked against. BUT...even with that sometimes there are amazing results in modern veterinary medicine. I have had pups die in ways I never expected. Sometimes the devil we know is better than the devil we don't.

[kmarla]

Update: I spoke to the neurologist this evening and Sprite's liver and cerebrospinal fluid tests are both normal, so she is a good candidate for the shunt. He explained that 75% of dogs who have the shunt procedure live normal lifespans and follow up is minimal. Having the shunt should eliminate the seizures and prevent brain damage, which we don't see any major signs of with Sprite at this point. We would just need to be observant for any negative changes, reoccurrence of seizures etc but she wouldn't need MRI's or other expensive tests. There is a 25% risk of problems after having the procedure however, and the vast majority occur within the first two months, so that is the danger period. The most common problems are death during the surgery, bleeding in the brain, infection and blockages in the shunt. So it's not all clear sailing in the beginning. She would be hospitalized two to three nights after the surgery. If we decide to have the procedure (which I think we will) then we will meet with the neurologist and he will go over all the risks/benefits in detail. We need to let him know within a couple of days. The palliative option would be to continue with her meds and monitor her carefully. When the seizures become more frequent/harmful then we deal with euthanasia. We don't know the timeline for her but it is limited. We want to give her a chance for a long life but I won' lie, that 25% risk is greater than I would like, but the other choice isn't good either. Thanks again for all the support!

[TxVicki]

Sending out prayers for Sprite.

[ladyjane]

Keeping Sprite and you in my thoughts and prayers...

[megansmomma]

It sounds like you had a great discussion with the Neurologist and need to weight out all you options for Sprite. Whatever your final decision is regarding her care you can know it was made with nothing short of love. In my book that's what really counts! I will keep you all in my thoughts and prayers.

[Buster Brown]

Sending out prayers for your sweet Sprite and support to you and your husband.

SPRITE

[107barney]

Originally Posted by kmarla

Update: I spoke to the neurologist this evening and Sprite's liver and cerebrospinal fluid tests are both normal, so she is a good candidate for the shunt. He explained that 75% of dogs who have the shunt procedure live normal lifespans and follow up is minimal. Having the shunt should eliminate the seizures and prevent brain damage, which we don't see any major signs of with Sprite at this point. We would just need to be observant for any negative changes, reoccurrence of seizures etc but she wouldn't need MRI's or other expensive tests. There is a 25% risk of problems after having the procedure however, and the vast majority occur within the first two months, so that is the danger period. The most common problems are death during the surgery, bleeding in the brain, infection and blockages in the shunt. So it's not all clear sailing in the beginning. She would be hospitalized two to three nights after the surgery. If we decide to have the procedure (which I think we will) then we will meet with the neurologist and he will go over all the risks/benefits in detail. We need to let him know within a couple of days. The palliative option would be to continue with her meds and monitor her carefully. When the seizures become more frequent/harmful then we deal with euthanasia. We don't know the timeline for her but it is limited. We want to give her a chance for a long life but I won' lie, that 25% risk is greater than I would like, but the other choice isn't good either. Thanks again for all the support!

I'm so glad the neurologist was able to give you some data about the procedure. We are definitely supporting you and Sprite!

[Rhetts_mama]

I have nothing to add other than sending good thoughts your and Sprite's way.