Dottie

Tonight, Dottie had her second consult with Dr DePompa, the Florida based neurologist.

This follows the MRI we went to Auckland to complete last week (18th May 2022), which was also sent to Dr DePompa.

It has been such a huge help to us to have an expert like Dr DePompa on Dottie’s case. We’ve learnt a lot and honestly, it’s given us so much peace of mind to have an expert who sees dogs like Dottie all the time advise us on what to do.

We really can’t stress enough how important it is, as pet owners to advocate for your pet and go in search of answers for them. Look outside your city, or even country if need be, to find someone who can guide you.

Consult:

Dr DePompa also went through all the images with us and explained a couple of things. We learnt.

* The prior MRI taken in Christchurch in 2021 can’t really be compared to the new one. Those images were poor quality and not focused on her brain/spinal cord, hence why we had to travel for this one. At the time - to be fair, the doctors had no idea she had CM or any other neurological issues and we’re just scanning her back to check for any painful areas. But in future - We will always go back to Auckland for the same quality MRI and neurologist present because it’s made all the difference.

* Dotties neck bones (C1-C2) are malformed and likely the cause of the issue in the first place. So the growth compressing her spinal cord is likely to be bone with a little touch of scar tissue. This could be a result of her dwarfism as that causes a lot of bone, joint and ligament abnormalities. Impossible to tell due to a lack of studies (and dwarf dogs available to study!)

* One concern is - Dottie’s bones are abnormal already and if we have the surgery done to remove the bony growth and decompress the spine, it could create another issue.  Surgery could create the serious neck instability issue we were concerned she had initially. We would be essentially just fixing one problem to create another. Dottie would then need two seperate, invasive and difficult neck surgeries. They can’t be completed together. That’s putting Dottie through a lot as the recoveries will be difficult too!

* Plus - if they do surgery to remove that growth that Dr DePompa suspects is bone now, it may regrow and quicker. If it is bone, it shouldn’t grow too fast. It may even stay as it is. But if this is removed, it could grow back and end up being mixture of bone and scar tissue, likely to regrow and grow back even larger and quicker than what she has.

* Dottie’s latest MRI doesn’t show any syrinx. This would indicate Dottie’s chiari like malformation (CM) has NOT progressed to syringomyelia (SM) (really good news!) When CM develops, it leads to this SM condition which also steps up the pain. Unfortunately, this neck compression issue can also create SM. So by regular MRI’s we’ll need to keep an eye on that and check for any progression.

* Best case scenario, Dottie was born with these abnormal bones in her neck and can live with them. The growth stays the way it is and doesn’t progress any larger. No SM develops and we can manage her on pain medications.

* It’s common in a lot of Brussels Griffons to have the enlarged ventricles. Hopefully, as Dottie is already 3 years now, she was born like that and it won’t progress. We can check that on a MRI in a year.

* Her brain cyst is also common for a lot of Griffons. The only thing is that her one is quite prominent as it’s pressing on the cerebellum slightly and flattening it. The fluid is pressing on the back of her brain. This is treated with omeprezole (which she is now on). Again, will compare with a new MRI in a year and hopefully it will be around the same size.

* Dottie has the bony indent indicating a diagnosis of CM but no SM present. Her case is mild.

* No great instability in her neck at present as far as they can tell from this MRI. That doesn’t mean it won’t develop in Dottie so it can be monitored with subsequent MRI’s.

What’s Next? Where to From Here?

* We have followed the advice of Dr Stewart and Dr DePompa and upped Dottie’s Gabapentin dose from 20mg twice per day, to three times. Dottie is also on Omeprazole. No Prednisone, Frusemide or Metacam anymore.

* Watch Dottie closely for any issues, particularly when it comes to her mobility. If there are any, we’ll need to seek a new MRI and help ASAP.

* In a years time and probably annually, we head back to Auckland for a repeat MRI. The best option at the moment is to hold off and collect more information to see if it progresses and how. Best case scenario - little to no progression!

* We should also be able to fly Dottie next time (using the ATR and in cabin dog hold). Because she will be hopefully a lot less fragile! Never will she be ok for the cargo hold (no dog should!) but not needing 100% oversight for that 1.5 hour trip.

* We will keep in touch with Dr DePompa and schedule a couple of consults yearly to discuss her annual MRI’s and any changes they show that we need to implement.

* Something Dr DePompa said that really resonated with me is that - there is no quick fix available for Dottie and we need to wait and collect more information. Also that, sometimes it’s hard, because of course, peoples natural inclination is to want to fix whatever they can see wrong, to make sure Dottie is OK and the issue removed. But we aren’t dealing with a normal dog here. Dottie’s little body is (and will always be) abnormal and so we have to be careful about fixing one issue only to create another. Watching, waiting and gaining more info on her progression rate is safest.

So, we feel more comfortable with a plan ahead, knowing that’s what Dr Stewart and Dr DePompa advise.