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Nicola O

Dog with mini stroke ?? (sorry - long post)

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Hello all.

 

Well after Norman the cats near death experience a couple of months ago we now have another problem. Millie, my 17 yr old Mini Poodle looks to have had a mini stroke. It happened last night and she has lost some use of her back-end. She is very wobbly and is worse on her left side, and sometimes leans on the furniture on that side to steady herself, or circles in that direction. On the plus side she still asked for, and ate, her dinner last night, has not lost control of bladder/bowels and is 'going' normally, and has even managed to jump on the sofa without help and gone up and down the stairs a couple of times (though I did have to come to her rescue on one occasion when she seemed stuck). Generally she seems her normal self, if a bit confused as to why her back end is not working properly.

 

Just come back from the vet who agrees that it's probably an age related mini stroke. Now this vet is very good (it was him who got Norman through his total renal failure) but I think he could do with improving his bedside manner. Without even examaning her he said we should consider euthenasia because of her age - he kept telling me that she was, after all, 17 yrs old. I told him that until last night she has been as fit as a fiddle, still running about like a 2 yr old, and has NO heart murmur (apparently most toy/min poodle over 10 yrs has some degree of heart murmur), gums are still nice and pink etc. He checked her over and was forced to agree with me that she is in very good shape - but he only looked at her on the table, he didn't ask to see her walking.

 

He has given her some tablets called VIVITONIN - 10 days worth, and we are going back on Monday night and he said if there in no improvement.......... But if it's his opinion that this decision should be made that quickly why has he perscribed 10 days worth of tablets, and I was disappointed when he said that because of Millie's age he would NOT be prepared to do any further investigations, even a simple blood test or an x ray, either she gets better now or it's curtains. Surely that decision should be MINE, not his, and providing she doesn't deteriorate I may perhaps seek a second opinion before the PTS decision is made.

 

Sorry to ramble on, just worried about Millie and a bit annoyed with the vets attitude, I felt that because Millie is old she is not worth bothering with :(

 

Nicola

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I think that is awful of your vet to be like that. Can you see another one? I think you should tell him, when you go back, as she is fit and well, and despite being old, you are not even considering that route. Unless of course it is what is kindest for her. Imagine if your dr said the same thing!

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How sad :( If you feel that she still has some years left in her I personally would seek a second opinion. Even if they say the same thing you have done all you could. Hope she improves

I know she is old and that her time is limited now, but as she has been as fit as a flea until this happened last night, I felt she would go on forever (silly I know).

I think that is awful of your vet to be like that. Can you see another one? I think you should tell him, when you go back, as she is fit and well, and despite being old, you are not even considering that route. Unless of course it is what is kindest for her. Imagine if your dr said the same thing!

I think some of the problem is that english is his second language (I think he is Dutch or something) and he was the same with Norman but as he got Norm through his crisis I 'forgave' the vet his attitde, and I know these subjects have to be broached but there are ways to say these things. Unfortunately, there is only this one vet at the surgery at the moment (there is normally two) so if a decide I need a second opinion I will take her to the other vets that the chooks go to (there is an avian specialist there and my local surgery won't see chooks).

 

I will take her back Monday but unless she deteriorates we will NOT put her to sleep. I will, of course, not let her suffer but I believe that any animal deserves treatment and time to recover.

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Me again

 

I've just been googling the tablets the vet perscribed and they seem quite good :-

 

"Vivitonin is a drug used to improve some of the signs of old age. It acts to increase blood flow to the heart, brain and muscle. It is used in dogs which are lacking in energy or seem vacant and unwilling to exercise or show interest in their surroundings. Although you cannot necessarily teach an old dog new tricks, many old dogs do show a distinct improvement in demeanour and activity levels. The effects of Vivitonin (which contains the drug propentofylline) include opening up airways and blood vessels, providing more oxygen to the brain, heart and muscles. Vivitonin is a safe drug which is very rarely associated with any side effects, and you can often help an old dog which seemed just to be "getting old".

 

If they help blood flow to the brain then that's what she needs after a stroke, isn't it ??

 

Millie knows something is wrong with her left hind leg, she lays on the floor and nudges it. But she has just got herself out the backdoor, up and down a couple of steps, managed a very wobbly curcuit of the garden, had a wee and got herself back in again :clap:

 

Nicola

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These episodes do usually show quite rapid improvement with good nursing and TLC. She should show an improvement over the next few days if she is going to. What your vet says, whilst maybe not delivered particularly sensitively is quite valid. What people call 'strokes' in dogs are usually actually Vestibular Syndrome They act like stroke victims and so people tend to refer to them as strokes. Further investigation won't really help to be honest and you may find incidental things on blood that don't actually relate to what is going on (age related liver or kidney disease). Good luck, give her lots of TLC but try not to move her too much as quite often they have balance issues in the early stages. You may have notices her eyes flickering (nystagmus) and a head tilt. They can feel motion sickness as a result so restricting movement will help her feel less sick.

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Thanks for that info on Vestibular Syndrome Chucky Mama, the article was very interesting. Millie doesn't have all the symptoms it mentions, her eyes are not flickering and she has not actually been sick, but has made a gagging noise a couple of times today. I have not been making her move about, just letting her potter about when she wants to, and she does seem to have the 'head tilt' as she does keep leaning to the left. She's due her dinner soon so we'll see if she still has her apetite.

 

I understand what you are saying about further tests perhaps not being worth it, but I think what upset me most what the vet's attitude of 'as she is an old dog I won't be bothering to do anything for her', he didn't explain that the test might not really help so it gave me the opinion that because Millie is old he felt she was not worth bothering with.

 

Again, thanks for the info.

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I have to say that I am shocked and surprised by your vets attitude. I'm not a dog owner, and can't offer any opinion on the treatment/prognosis, but I feel it is part of a vet's duty to have a good bedside manner. I totally agree that it would have been a different matter if your vet had explained his comments, you would have understood. I think there would be a lot of point (but I totally understand if you can't face it) telling him/the partners if he isn't one the effect his (seeming?) lack of compassion has had - he may not realise the effect his manner is having. This is not questioning his knowledge or diagnosis, but it is just like having a sympathetic or unsympathetic doctor - the experience you have makes a massive difference to your feelings of wellbeing and your ability to cope with whatever the situation ends up throwing at you. Good Luck to you and Millie :D

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Thank you everyone for you kind words.

 

I think Millie is a little better today (I hope I'm not just seeing what I want to see). she has been able to walk in a straight line, all be it a bit wobbly, without falling over, but she does still struggle with turning round or going round corners, and she is still leaning against the furniture to steady herself. She couldn't poo yesterday (sorry to be talking poo) as her back legs couldn't hold her in the required position, but today she has managed two quick poos :clap:.

 

She ate well last night when I sat next to her and held her bowl at head height as I noticed that when she bent down to the floor she toppled to the left.

 

If Millie is not showing signs of pain or distress, and you are in a position to spend the time she needs, then follow her and your instincts for a while?

Hugs from here.

 

She def. is not in pain or distress, and this episode does not seem to have affected her brain at all as she honestly is her normal happy self and her tail is constantly wagging as it always does, I think that she is just confused as her back end won't co-operate at the moment. It is def. more her rear left leg than the right as when she is standing still her right leg is more central underneath to support and steady her and her left leg is more out to the side. I've also tried the 'toe test', I dont know what it's proper term would be, when they are standing and you turn their toes upside down and see if they realise and correct their foot, and Millie is fine on the right side but not correcting on the left (yet :pray: )

 

I think I will cancel tomorrow nights vet visit (unless she deteriorates of course) as I think there is some improvement and there is nothing the vet can do tomorrow apart from going on about her being PTS - and I am NOT having that conversation yet - she needs more time for recovery and at least complete the course of meds the vet has given her.

 

Apoligies for the long post again but it does help to be able to talk to people.

 

Nicola

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I'm glad you're seeing a slight improvement. You know your dog best and are the best person to guage her quality of life so hang in there :) .

 

If Millie is not showing signs of pain or distress, and you are in a position to spend the time she needs, then follow her and your instincts for a while?

That is exactly what we did with Riley recently after one vet said that we'd probably have to have him PTS as amputation wasn't an option. He is absolutely fine now and goes on longer walks than some other dogs we know, with no ill effects.

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her eyes are not flickering and she has not actually been sick

This is only evident in the early hours.

 

What you describe today is absolutely normal for dogs recovering from a ''stroke' (Vestibular Attack) :) Stick with it and continue with your nursing. I agree regarding cancelling your vet's appointment. If she is making steady progress there is little point in stressing her with a journey to the vets. She should continue to progress each day. Some dogs are left with a slight head tilt, others recover completely. Some of course do not recover but if she has improved I would be quietly hopeful :pray: I have nursed many a dog following a ''stroke' (Vestibular Attack) and always found it very rewarding seeing them get back to health.

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Just posting to agree with what you and everyone else has said ... go with your own instincts ... you know Millie very much better than your vet does, it's all too easy sometimes for a vet to "write off" a dog he doesn't know, particularly at Millie's wonderful age.

I know when I first had Willow I took her to the vet and he wanted to cut her tail off (long, long story, won't bore you with it) but I felt he was wrong and cancelled the appointment for the operation the following day. Willow still has a tail that goes "all the way to the end" and more importantly a wonderful vet at a different practice who is interested to hear and listens to my views on treatment for whatever the problem happens to be. It's true, I think, that there are vets who are good with people but even those that aren't might still be brilliant vets (just need to work on their bedside manner), but I wouldn't hesitate to seek a second opinion, as others have said, even if it doesn't tell you anything you don't already know, at least you will know!!!!

Good luck little Millie!

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:dance::dance::dance::dance: I AM SO HAPPY :dance::dance::dance::dance:

 

Millie has improved so much, when I came in from work she tried jumping up at me. She is still swaying as she walks and stumbles as she turns round (and is still having moments when she seems quite bad again) but generally she is so much better than a couple of days ago. She even tried to play with Freda for a minute but stopped as her legs were all over the place :lol:. I've also done the 'toe test' again on her left foot and five times out of six she corrected it herself :clap: .

 

I have been thinking about the vets attitude all weekend and have decided to change surgeries. I phoned the other one in town and explained why I wanted to register with them and the receptionist was shocked when I told her what happened on Saturday. We have an appointment for Friday night as Millie will be almost out of meds then so we can get more if the new vet thinks she still needs them.

 

Here is my lovely, brave old girl (not a very good picture I'm afraid)

DSCN0715.jpg

 

Nicola

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What a sweet girl :) I am glad that Millie is picking up.

 

Chucky Mama has given excellent advice on vestibulars. A colleague's 12 year old GSD has had two vestibulars in the last year, both of which she has made a good recovery from. There was a similar thread recently on a dog forum that I go on, a couple of members had to have their dogs pts but the majority of member's dogs had made a good recovery.

 

Everything crossed :D

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Hi all. I warn you now - this is long - but wanted to update you as we have seen the new vet tonight and I have to say that he is FANTASTIC !!

 

He was SO thorough and asked so many questions about what happened - what legs seemed most affected, how did she stand, walk, how did she act when going in circles, the exact angle of her head tilt, and loads more that I can't remember now, and he concluded that she has not had a Vestibular attack (which happens further back in the brain) but a Cerebral Vascular attack (I think that was what he called it) which happens at the front of the brain. There was two other possibilities but he said they were highly unlikely as they would not allow for much, if any, recovery. He then examined her over really thoroughly and checked all her reactions and said that she was neorologically (spl?) sound and that if I hadn't said what had happened he would never be able to tell as there was no evidence of it now.

 

I had taken in a urine sample that he tested and it showed that the 'specific gravity' (?) was low so he was worried about her kidneys, so took bloods for further tests. Whilst typing this (sorry it's so long) the vet has just phoned to say that her kidney results were perfect but she had elevated Lipaze (spl?). Lipaze can come from the bowel or the pancreas, if it's from the bowel there is no problem but if it's from the pancreas that would indicate pancreatitus - but my answers to his questions about vomiting and bowel motions would not indicate a problem with the pancreas so he admitted being a little confused by the results at the moment. They will run a further test on the bloods specifically for pancreatic lipaze and I should get the results on Monday.

 

He has prescribed a drug called Aktivait which should help her brain and reduce the risk of this happening again.

 

So on one hand - excellent news on her recovery as she really seems back to normal now, but a little worry about the pancreas. I had to tell my tale of the previous vet to about four members of staff and all were horrified by his attitude, but have to say these guys seem lovely.

 

Sorry if this was all too much information :lol: , but wanted to share the news.

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