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-   -   Deciding on further treatment (https://www.askmehelpdesk.com/showthread.php?t=178256)

  • Jan 29, 2008, 07:16 PM
    froggy7
    Deciding on further treatment
    And now for the update on Trink:

    Mixed news. The neurologist seems to think that the problem is in Trink's neck. She apparently showed signs of pain when it was manipulated. The x-rays are beautiful, which is pretty much what we expected, which means the likely culprits are a disc problem, a tumor, or some sort of irritation of the spinal cord lining or demyelization.

    So now I am facing two options:
    1. Continue with the cage rest, anti-inflammatories, and pain killers, and hope that this resolves on its own. The problem is that if it was going to get better this way, it probably would have by now. On the other hand, there is the possibility that the situation may just stabilize at this level. (Somewhere between 1 and 2 on a 5 scale, with 1 being pain, 2 being ataxia, and 5 being complete paralysis.)
    2. Do more extensive diagnostics (i.e. MRI) to determine what the actual cause of the problem is. The advantages of this is that it will determine whether the cause is a bulging disc (which seems to be the most likely cause), tumor, inflammation of the meninges, etc. And based upon those results, we can determine whether there is anything that can be done surgically. The disadvantages are that it's not cheap (roughly 5k, including the surgery), there's the possibility that the surgery actually causes more damage (you are mucking around close to the spinal cord, plus there's all the standard surgical risks), and, given that the symptoms are mild, it's possible that the MRI will show several mild abnormalities, any of which could be the cause, which makes it a bit of a guessing game when you do the surgery.

    Right now I am taking some time to consider the options, since the possibility of suddenly getting worse is not that likely. It would, in some sense, be easier if her condition was worse. If she wasn't walking, then I'd be much more likely to do the MRI and surgery. On the other hand, if I hold off and try the medical management route, and she does get worse, well... the worse she gets the longer the recovery from the surgery is going to take, and the more likely it is that she doesn't make a full recovery.

    So how do people decide when to do the more extreme testing? What should I be considering?

    (And, just an fyi, a greyhound's heart is HUGE! They did a chest x-ray, because if it was a tumor it might have spread there, and it's relatively easy to take chest and neck at the same time. And there is just the big splotch in the middle of the rib cage, with some very large blood vessles through the lungs. It was impressive to see!)
  • Jan 29, 2008, 07:50 PM
    simoneaugie
    froggy7,
    Trink is your child (canine or not.) I'd try the MRI. At least then you will have a better idea what she is facing.
    Simone

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