atlantoaxial instability
 

Does anyone have any experience with this? Our Millie has been diagnosed after three episodes of severe (scared us to death) pain in her neck. It is a congenital malformation of the first two cervical vertebrae which can cause pain, paralysis, and death. Surgery is recommended, and we are willing to go there, but the surgeon's report also mentions an open fontanel and possible Chiari-like malformation, which in simple terms is that the brain is too large for the skull. That would put the whole situation over the top--surgery for the Chiari problem is incredibly expensive and I understand that results are iffy. The vet is following up with us on Tuesday with more definitive info about the "ifs."

Millie is eight months old now, and if possible, any orthopedic surgery needs to be delayed until she is a little older for growth plates to close.

For any of you who are on here routinely, you may recall that our other baby, Gracie, has had two significant surgeries before she was one (LP and liver biopsy with diagnosis of MVD). I cannot believe that we have another new dog with significant health issues. Just did not expect this. The breeder has offered to return what we paid for her to help with the medical expenses, and if it is just the one, we are totally game. I just can't hang in there if the little sweetie has two life-threatening issues--we would probably just love her as long as she is comfortable.


I hope this makes sense--we have come at this slowly, with a diagnosis taking several weeks. Now we have the two girls totally separated to protect Millie's neck.

Thanks for anything you know. . . we love these babies and just want them to be healthy and comfortable.

I am so sorry Millie is having problems. I have no experience with AAI but have read a few other member's stories of it over the years. I don't know if those members are active now but I will try to find a few old threads about it.

I am sure member LadyJane will check in and see your post, and she will be a good resource for you.

I will try to put a couple links here that discuss it. Or, you can do a search for atlanto (don't use the whole name, it's too long). Sorry these are old and random but may give you some info:

http://www.yorkietalk.com/forums/sic...bluxation.html

Dog Orthopedic: The Spine Center at VOSM

http://www.yorkietalk.com/forums/sic...i-surgery.html

I had an older pup with AAI but he also had multiple other neuro issues including chiari. He came to me as a senior (was a foster) and how he lived to be an old man baffled all the vets. We had him evaluated at Texas A&M and surgery was not an option.

There have been a few cases here on YT. I am going to message one person whose pup had successful surgery for AAI. Perhaps she will be a good person for you to communicate with. She lives in W Va and drove to NC to see a specialist. I believe you might be wanting to do a neurological consult. I know you mention ortho...but I would want a neuro weighing in on the case.

So sorry you have had such bad luck with breeders and sick pups.

Definitely I would go with a Neuro Consult, and I am not sure if you saw a board certified ortho surgeon or not when you were just dealing with AAI.

I am so sorry you are coping with this. Millie surely wound up in the hands of someone who will love and take care of her. I, too, have messaged a member who has a lot of experience with AAI. I hope there will be more members who are able to help you.

You guys are correct! We did see a neurologist, but my brain had moved to bones-ortho. . . Sometimes I just don't use my brain (also a neuro thing!).

Thank you for the advice on how to find threads about AAI here. I was finally able to read a couple. We are just concerned about the possibility of facing another life-threatening issue after spending thousands on this one.

We are lucky that she is neurologically intact-no paralysis or other issues. If you saw her with me on the couch or walking in the bathroom each morning you would have no clue there would be no hint of a problem. We want to make her well if it is possible.

Tomorrow I will get some answers about how serious the neurologist is about the possibility of Chiari or hydrocephalus. Are these just other possible diagnoses with similar symptoms, or is there a serious comorbidity factor? I don't know if I wish I understood more or am happy with my ignorance.

I will also read the suggested links/threads. This seemed somewhat clear cut until I received the written report, and then several more issues appeared. Wishing for easy decisions again.:confused:

With any serious diagnosis, there is the learning curve where you read and ask questions and try to understand it all, when it seems so foreign. It can seem overwhelming at first, but then you begin to get it, and form a treatment plan, and you will then feel empowered and somewhat in control.

I went through similar feelings when Tiki was thought to have a liver shunt, and when Meika got diabetes.

I spoke to the neurologist this afternoon and my fears are less. He says that he just wanted to mention all of the things that we could not rule out without an MRI, which I chose not to do because the radiograph was a clear diagnosis of the AAI.

We will do the surgery within the next month or so...just waiting for growth plates to close. She has been almost a month without an episode of pain since we are keeping her closely confined and away from Gracie. If that were the way we usually lived, I would consider longer delay, but we have another dog and small grandchildren--quiet is not happening here long term!

Thanks for the feedback and information--it all helped! I will post about the actual surgery when it happens--I am hoping that no one else has to research this problem soon, but more information is better with something so odd.

Thanks for the update and I wish all the best for your Millie. Do they sometimes use a neck brace of some sort to stabilize while waiting for surgery? I know they say treat them like very fine China, as they are so fragile. I have only read about it and not experienced any of it.

The neurologist we are seeing is reluctant to use a brace--he says that they do not typically tolerate them well and over the last couple of years his experience is that the dogs do just as well without them. I hope this remains the case.

We are limiting her in many ways. She is in a 2 x 4 pen when she is not in our laps, and probably because of her neck she never tries to climb or jump. We do allow her to walk around the bathroom when we are dressing.

She is still the sweetest baby around. Love her!

Hi,
I am one of the people ladyjane mentioned as having a pup with AAI. My name is Shellie and my baby girl is Cassie. She is 2 lbs and will be 8 years old in March.

I haven't been here for a very long time. I lost my precious Muffin a while ago in a tragic accident. About 6 months later Milo came into our lives, but then lots of other stuff happened too and was unable to post to YT.

Things recently calmed down and I decided now I had some time to post again to the YT community when yesterday we got a severe shock when we got the news that upon some routine exam it was discovered that Milo had a gigantic liver. He is only just 4 lbs and 16 months. We are very shaken and worried, so I decided to post to YT, but with less good news than I had hoped originally.

I saw your post and decided to respond. If you have any questions I can answer, PM me and I'll answer whatever I can.

I have not been able to contact Tena as yet. I see her on FB from time to time and Zhoie is doing well!
Anyway....here is the thread where her Zhoie was first diagnosed with AAI and where she went for surgery and how it all went.

http://www.yorkietalk.com/forums/yor...appt-tues.html

Thanks for the info! Shellie, I hope that Milo turns out to have only minor issues--it is just so incredibly scary to have sick little dogs--I get it now in ways I did not a year ago.

I will follow up on the reading--I know I will never understand more than the basics, but I want to be able to ask intelligent questions and make wise decisions for our little girls.

We had a lovely and unexpected respite over the last few months. When Millie reached the age for the surgery, we were dealing with other issues, and so we delayed seeing the surgeon until early summer. Because she was asymptomatic, he suggested watchful waiting in the hope that she would not have other issues. We were certainly not anxious to put her through such serious (and expensive!) surgery if she did not need it.

We were awakened from the dream Wednesday. Millie was in pain, so we gave her metacam, but she stopped eating, urinating, pooping. I took her to the hospital Wednesday night, and they put her on IV painkillers until they were able to get her pain under control enough to send her home with oral painkillers. The MRI done yesterday confirmed that her major issue is the AAI. The surgeon says that the other neuro things he sees on the scan are typical of dogs her size. Her surgery is tentatively scheduled for Tuesday, assuming the the tiny specialized parts that are needed will arrive on Monday.

Please just hold her little self in your thoughts over the next few days. I realize that this is not a real issue in comparison with the tragedy in Paris tonight, but I also know that the folks who read this love these silly little dogs who fill our hearts.

I will update when surgery is over.