Re: New Member-Cushings treatment side effects
Just wanted to give an update. Sadly, we had to let Emmy go Monday night. She had another neurological episode on Sunday evening and lost function of her back legs. We took her to the ER and when she arrived she was completely unable to walk and was drooling excessively. She was immediately admitted and they gave her anti-nausea medication (said excessive drooling was due to extreme nausea) and wanted to run additional tests. She had a painful abdomen and an ultrasound revealed a gallbladder mucocele, but they weren’t sure if this was causing the nausea issues. Bloodwork was normal except for kidney values which were even higher than before we started Vetoryl, and high blood glucose. Her urinalysis also showed a elevated glucose. The ER doc on intake thought it looked like intervertebral disc disease (herniated disc), but said she was going to push for the neurology consult in the morning (we were scheduled for one on June 25). In the morning she was still unable to walk, and around lunchtime the neurologist examined her. She was completely paralyzed in her back legs and had no reflexes. Her front legs still had reflexes but showed signs of neurological damage. She also had no pain reflexes. What concerned the neurologist the most was that she was severely obtunded. I had never heard this term before, but it means she was completely oblivious to her surroundings-she slept through the entire examination. Because of the severe obtundation, the neurologist’s primary preliminary diagnosis was a malignant neoplasm in the brain that may or may not have metastasized to her spinal cord. The secondary was meningeloencephalitis. She said a herniated disc was extremely unlikely and her prognosis was grave. She said she needed an MRI to confirm the diagnosis, and if no tumor was found, she’d need a spinal tap. She would have to undergo general anesthesia for this. I never got to speak directly to the neurologist, but spoke with the ER doc on duty who spoke to the neurologist. She said that a brain tumor may or may not be treatable, and the meningeloencephalitis is treatable, but they could not guarantee she’d ever regain function in her legs. She also said she would still have the other conditions (Cushings, kidney failure and likely diabetes). We wanted to speak to her primary care vet for her opinion but she was out Monday. We spoke to two ER vets who said the MRI would be very hard on her (she may not even survive the anesthesia), and it would be of no use to her-it would tell us what was wrong but wouldn’t change the outcome. She was never going to have a good quality of life in their opinion and that we should let her go. We had pretty much decided that evening to end her suffering, but we wanted to see her for ourselves. She was really bad. The ER vet described her condition as “almost comatose” and that there were no drugs in her system that caused her to act that way. We knew immediately we had to let her go, and she died peacefully Monday night.
The next morning, I received a call from her primary care vet. She got the lab reports and knew she had died. She had not yet received the neurologist report. I filled her in and she was shocked and she said she just saw her Friday and she was acting normally. She did say that symptoms of neurological diseases are notorious for coming on fast and strong. She said we 100% did the right thing and that she would have done the same thing has it been her dog. This makes us feel better since she had treated Emmy for years. We are comfortable with our decision, but are struggling to make sense of it all-what/how/why this happened and why it came on so suddenly. And of course, we are feeling guilty that there was something different we could’ve done to result in a better outcome (did giving her Vetoryl cause the brain tumor to manifest itself, or would they have been able to do something if we had brought her in sooner for tests). The two ER vets didn’t think Vetoryl had anything to do with this, and that there was nothing we could’ve done differently. When asked what happened to her, one ER vet’s explanation was that dogs are experts at hiding diseases, and that, unlike humans, dogs can adapt to diseases for a long time, until they can adapt no more. She thinks that is what happened here. They may be right, but I would feel better if the neurologist said all of this as well. The primary care vet is going to consult with the neurologist (who incidentally was her neurology professor in veterinary school), and will try to get more detail. Hopefully we can get some additional information that will help us make sense of it all.
Needless to say, my husband and I are totally devastated. We thought worse case scenario was a herniated disc. A malignant brain tumor was never on our radar. For the first time in 15 years we are without a dog, and we are lost (we had to euthanize our other dog in January who suffered from severe arthritis and advanced canine cognitive disorder). We want to thank everyone on this forum who gave advice on Emmy’s behalf. We really do appreciate it.
Nicole
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