This blog is for everyone who wanted to know what happened with our precious little Lily this weekend. (I warn you, it's LONG. We have been through a lot.)
Starting with Friday afternoon, Kevin got off work early and came home and took her over to his parents' house - she was running around like normal, playing, acting as she always has.
On Saturday morning, I woke up and realized that she could not see out of her left eye. I had set a small piece of a treat in front of her and she didn't see it and had to smell to find it. I tried again, with the same result, which worried me because it seemed to be overnight and I had never noticed the loss of vision before. I told Kevin I wanted to take her to the vet to get it checked out in case it was something serious since it had happened so fast.
So off we go to the vet. (Our vet is WONDERFUL and if anyone needs a referral, PLEASE ask me!) She looked in Lily's eyes and said the only thing she was noticing is that her pupils would not completely constrict. The most reasonable diagnosis she could give me was that she had gotten something in her eye and there may be some type of infection that could be cleared up with anti-inflammatory eye drops and an oral anti-inflammatory drug, which she gave me and assured me that if I did not see any improvement by Monday, she wanted to see her back in the office and contact a specialist who does "doggy opthamology". I had a haircut appt in Boone, so I left straight from the vet in Statesville to go to Boone.
On the way to Boone, I realized Lily was getting very anxious and that she might have to go to the bathroom. I let her out at a Walmart, she used the bathroom, and then I was going to go into Walmart so I decided to put her in a small carrier I have for going into stores. As I was putting her in the carrier, she started fighting me HARD to get out (which is not normal for her). It wasn't until about 4 seconds later I realized she was having a seizure. (Mom's dogs have had them before and I knew what the symptoms were.) I freaked out, called Kevin as soon as it was over, then called the vet. As I was on the phone with Kevin, she had a "after-tremor" (twitching ears and eyes blinking often). I was very very upset. Our vet told me it may be a fluke, but if she had another one I needed to take her to the emergency vet to get medication to stop the seizures. I went on to Boone, and she seemed fine.
On the way home from Boone, we stopped at Kevin's parents to see him and she acted normally there except for her vision. It was obvious that she was having trouble seeing.
I eventually got home with her and was resting with her on the couch, and about 5:05, she started seizing again. This one was much worse than the earlier one - she was convulsing, foaming/slobbering at the mouth profusely, twitching, and all other signs. I immediately called Kevin, and he rushed home so we could take her to the emer Vet. I also called a friend who is a Vet (not our vet) and she talked me through the seizure. She had actually worked at the emer Vet clinic several times and offered to call ahead and let them know we were on our way. She had stopped seizing by the time Kevin got home, and when she heard his truck in the driveway she got up and barked for him, and jumped down off the couch. She was very disoriented and almost fell after jumping down. When he came inside he picked her up and she immediately started seizing again. This one was not AS bad as the previous, but still obviously a seizure. We rushed to get her things together and went to the emer Vet. In the car on the way there, she had another seizure, so this meant she had had 3 within 20 minutes. We knew it was imperative to get her to the emer Vet and take care of the seizures ASAP before they did permanent damage.
We spent most of the night at the emer Vet, and the friend of mine that had recently worked there went above the call of duty and met us there. She stayed with us most of the time we were there to make sure they took care of us. She helped us understand exactly what was going on behind the scenes and made me feel better to have her there. I really appreciated her going that far for me!
Anyhow, we stayed at the emer Vet until about 9 that night, and they wanted to keep Lily overnight to monitor and make sure that she didn't have any more seizures. They also did not have the correct medication for us to bring her home, so they wanted to keep her most of the next day as well to make sure she got the medication she needed the rest of that day. We didn't end up going to get her until about 5pm the next day (Sunday) - and you can imagine how we were feeling at this point. Devastated! So when we went to get her that afternoon, the Dr. there seemed to be in high hopes that the seizure medication was going to control the seizures, but not hopeful that her sight would ever return to normal, which just crushed both of us. That was the thing I hated - her sight. The seizures I could deal with I knew, but the sight is what both of us were worried about.
So we took her home that night, and I slept with her on the couch. I was worried because she had very labored breathing and she had symptoms like "dry mouth" (licking the air, pale tongue) so I called the emer Vet at 3am to make sure we didn't need to rush her back over there. They said no, that we don't need to bring her back unless she is seizing again. Soooo ......
Monday morning we were due back at the regular vet for a follow-up checkup and Dr. B wanted to check on her eyes and see if there was any change from Saturday. I was there as soon as they opened Monday morning and Dr. B said she did see changes in Lily's eyes that did not look positive. She told me to just keep her on the phenobarb (seizure meds) and watch her over the next few days, and in the meantime, she wanted to contact a specialist in Charlotte who specialized in vision related issues in dogs, and that she would let me know if he wanted to see us or not. Basically, to go there was going to cost a lot, and they were most likely going to have to do an MRI which was mega bucks. I came home and was resting with Lily most of the day. Around 2pm, I got the phone call from Dr. B relaying the information from Charlotte, and it was a very bleak outlook. We were told that even if we went and did the MRI and were seen by the neurologist, there was a large possibility that they may not be able to fix whatever was wrong and she may not make it regardless of the specialist's work. It was a hard decision, but when I called Kevin with the news, we were both on the same page without even talking about it.
We rushed to Charlotte on Monday afternoon, to arrive at the specialist (Carolina Vet Specialists - CVS) around 4. They immediately took us into a room and took down the history of the weekend and her seizures and all of the other things that had happened. We sat in the exam room for about 45 minutes, praying (and of course I am just crying uncontrollably), not believing what is happening. We were waiting for the Dr. to come out of surgery on another animal, and to examine Lily. When he came in, he was very open and genuine when talking to us about what he thought was going on. He gave us several things he thought it might be, and then talked to us about options. Listed below are the things we were told:
Problem #1 that he suspected was a condition called GME (Granulomatous Meningoencephalitis) and was most likely our culprit. It is an inflammation of the brain, and depending on where the swelling occurs, it most likely caused the seizures and the loss of vision. This was the condition he was most confident that it was, and that was a big decisive factor in deciding to do what we did. For GME, the doctor wanted to take an MRI to confirm that was the right disease, and then take a spinal tap to make sure there was no inflammation in other areas of Lily's body. Both of these together would nail down that diagnosis and help us to quickly treat her and there was a 75% chance she would come through and possibly live longer. Without treatment, GME usually kills animals within a matter of weeks/months was what we were told.
The other problems he listed are insignificant now, but included cancer, something called necrotizing encephalitis (which is VERY similar to GME but affects more parts of the brain and is acutely FATAL soon after diagnosis - many times they cannot even diagnose this problem until an autopsy is done), and a couple of other possible problems. In the end, none of these were the problem.
We decided, after talking to the doctor and asking him what he would do if it was his animal, that we would let him scan her (MRI) and do the spinal tap, because we wanted to make sure that we had done everything in our power to help her/save her. My biggest issue was that she not suffer, no matter what we as her owners had to go through. We went ahead and ok'd the MRI, and he told us that what he needed to do was to keep her overnight, to ensure she came out of the anesthesia/MRI ok, and so that he could look over the results from the MRI and begin treatment first thing the next morning. We gave him the ok to do what he needed to, and they took her back. They were scheduled to do the MRI right away, and the spinal tap was to be done the next morning so that the fluid could be sent to the lab straight away and reviewed. He had to put her under twice, so of course I was worried about that too!
We went to my Mom and Dad's to spend the night since they live closer to Charlotte than us, and she and Daddy took such good care of us. Cooked us supper, let me sleep, (and boy did I get some good sleep!), moral supporters, and of course we were back and forth on the phone between the vets (both ours and the specialists). We had to make sure she had her phenobarb for the seizures and that she came out of the anesthesia ok. Basically, we called several times, and finally the Dr. there called us back to let us know the results. He was 99% sure that what she has is GME, and that there were other problems we needed to know about as well that were not as dire as the GME, of course.
She also has a condition (COMS/srinyx) that means that her skull in the back near her cerebellum is too small, so it has smashed the cerebellum, causing a small pocket of cerebrospinal fluid to form at the back of her skull. This also causes the spinal fluid not to flow to the spinal cord properly. He told us that she had probably had it since birth, and unless we saw it making a significant impact on her, it was something we may never have to worry about.
The last condition she has (the name escapes me - something about luxation) means that her top two vertebrae (near the skull) are not formed correctly, again causing neck pain and possibly some neurological issues, but she also has had this condition since birth and neither of these two other conditions play any part on the GME. The Doctor told us he would not be concerned with either of these at this time since she obviously has learned to deal with them over her lifetime.
The GME however, is a different story. After spending the night at Mom's, we called first thing that next morning and the doctor had already completed the spinal tap. He wanted us to wait until 11 to come in and get her #1 - because she was still asleep from the anesthesia, and #2 - because he wanted to be able to meet with us and talk us through everything and he had surgery before 11 and show us/explain the treatments.
Mom went up there with us. I needed the moral support, and she understands me better than anybody. Kevin was a huge help too, but I am sure you all can understand the support a mom can offer.
We all trooped over there, and as we sat in the room, I just had mixed emotions. I sat and listened to the doctor explain the MRI to us, show us all the images, and tell us that Lily has a very mild case compared to others he has seen. He did conclude that her vision loss was directly related to the GME and also that the seizures were almost positively related to the swelling as well. He was very confident of her ability to recover, although it is definitely going to take time and depend on her ability to deal with the treatments. He said that her survival depends completely on how well she reacts to the medications she would receive over the next year, and the next few weeks would be critical to knowing whether her reactions would ensure her survival or lead us to put her to sleep.
The treatments include the phenobarb, which is the seizure medication, and prednizone to reduce the swelling of the right side of her brain and in the occipital lobe (which controls her vision). She also will have to take chemotherapy for the next year once a month from our local vet. The chemo is to reduce the amount of white blood cells in her body so they will stop attacking her brain, which is what led to the GME to start with. The specialist at CVS was highly positive that she will come through this with no problem as long as her little body can handle the drugs that we are giving her. Over the last four days, she has had 3 injections of a drip of 65ml phenobarb (emer Vet), phenobarb orally (15mg per day - 7.5 in the a.m. and in the p.m.), two cases of anesthesia for the tests that were run on her, prednizone, and two chemo treatments. She is resting tonight, but her personality is still here. She has not lost her appetite, her thirst has gotten more pronounced on these drugs, and she is bathrooming regularly. She also went and picked up a bone tonight and wanted to play/chew on it which is completely normal for her.
She seems to be taking all of this well, but as I said, the next 2-3 weeks will be the telling factor in all of this. She goes back tomorrow for 2 more chemo treatments, then we go in a week for blood tests to make sure the chemo is doing it's job. After those blood test results return, she will take 2 sets of chemo back to back each month for a year, along with the phenobarb and prednizone daily until we know it is working, then we may be able to reduce/stop using those two as time permits. We are hoping for the best and praying with all we've got.
I wrote all this mostly to let our friends and family know what all we have gone through the last few days and to ask for LOTS OF PRAYER in the coming weeks/year. We don't know how long God will keep her with us, but we hope that this will go into remission and we have her for her entire life span. It is just so sad to us that she has been with us less than two years and she is having to go through all these problems already. We would MUCH appreciate the prayers of healing and for God to place his hand on her and all of the doctors who help us take care of her. I truly believe God has taken care of us thus far and He will continue, I just hope my little dog doesn't hurt. That's what I am the most concerned about.
I also wrote this to help other chihuahua owners understand our bout with GME. Hopefully it will help someone in the future to know what is wrong with their dog and QUICKLY get the help they need from the right people (neuro specialists). If anyone that reads this wants names of these wonderful veterinarians, or other advice on what I know, please don't hesitate to contact me via comment on this blog.
Lastly, thank you all in advance for your prayers and concerns. We hope little Lily will come through and be just fine. I will update when new information happens or we get more information re: GME and the other diseases that harm these innocent animals.
Thanks again ~ Lily's (Concerned) Mommy
Boy is she tired! Hehehe - all that eating wore her out!
