27 July 2014

On Thursday, July 24 we said goodbye to our dearest boy Milo.

Life had become very challenging for Milo as his mobility had decreased to the point where daily trips out to potty were becoming increasingly arduous for him and he needed assistance not only to rise, but to potty without collapsing.

While logically I know that quality of life over quantity of life is the best thing we can offer our beloved pets, it is a very different journey emotionally.  I wanted so much for him to rally and share more time with all of us, but he was existing and not living.

It was a terrible decision to have to make, but it was the kindest thing for him.

I was so grateful to our vet who helped us navigate through the many health issues and, for this final visit, allowed Milo to rest comfortably in the grass outside the clinic and drift off to sleep.  No stress from slippery tiles and medicinal rooms.

Milo was so very loved and so very missed by me and by the many who shared his journey.  

Sleep well my friend.  There have been many tears for you.  

Toe-ing the line

July 2, 2014

I have really lovely hardwood floors in my house. Very pretty unless you are a collie with mobility issues.

To help Milo navigate around the house we have the rubber bottomed mat super highway. Trimming the fuzzy in between spots of toes helps as well.

Last week this trimming ritual revealed that Milo had an injury to his right rear outside toe.  And that he had been licking it.  A lot.  I suspect that the culprit was the loading in/out of his wire crate in the car.  We've done some reconfiguring of crates so that Milo can have a super-sized crate to be more comfortable, but the angle of getting him in/out is a bit more challenging.   Milo loves to go along anywhere with the gang - even if it is just to hang out in the car.

Anyway, the toe was looking very sore and the nail bed looked infected so we went to the vet.  The nail was indeed infected and rubbing a sore into the soft tissue of the next toe making the area even more painful.

We were given two options in dealing with it.  The first was to remove the nail which would mean a lot of pain and bleeding.   (I didn't like that one.)

We chose the more conservative approach which is not without risk of needing to remove the nail anyway.
The vet cut away as much nail as possible right up to the quick and cleaned off the nail and surrounding area.  10 days of Cephalexin and several times daily nail/toe cleanings.  

I'm relieved to report that the wound area due to the rubbing has healed up nicely.  The nail itself seems better.   And Milo seems more comfortable.   Starting an antibiotic meant we needed to stop the herbs from Dr. Choi.

At the vet, we discussed the seemingly nebulous findings from the neurologist.  Since it was mentioned that we could try treating it as a disc issue my vet sent home a mild steroid in case we wanted to try it.  I contacted Dr. Choi to check on her thoughts and she thought it was worth a try.

We started the steroid last evening to see how he does with it over the weekend.

Neurology News

2 July 2014

From Milo's visit to the U of MN Neurologist.   As collies can tend to do, Milo was very stoic for his exam.
********

Today, Milo was referred for a neurologic evaluation from

the Complementary Medicine service due to slowly progressive hind limb weakness.

No notable findings were seen on physical exam except decreased muscle mass overall.

Summary of Neurologic Exam:

Examination of Milo's cranial nerves and fore limbs revealed no abnormalities. No pain was noted on

palpation of the back or neck, or on neck flexion. In the hind limbs, the conscious proprioception test

(flipping the feet over to see if Milo knows where his feet are) was decreased to absent on the left side but

normal on the right, leading to a diagnosis of left pelvic limb monoparesis. Patellar reflexes were normal in

both hind limbs.

At this time Milo's neurologic signs localize to spinal cord segments between the third thoracic vertebrae and

the third lumbar vertebrae. His signs are mild enough that the lower lumber can not be excluded. The

primary rule outs for him include:

1. Intervertebral disc protrusion: Material from the intervertebral disc protruding into the spinal canal causes

compression on the spinal cord and results and neurologic symptoms. Depending on the location of the disc

protrusion, one or both limbs could be affected, which fits Milo's presentation today.

2. Lumbosacral Stenosis: This disease has many causes, but all result in compression of the nerve roots in

the lower spine near the tail and pelvic area, or cauda equina. Symptoms seen at this disease are similar to

those shown by Milo.

3. Neoplasia (cancer): A tumor on or near the spinal cord or vertebral column could cause symptoms like the

ones seen with Milo today, however this is very unlikely given the length of time with out lots more weakness.

Treatment options:

We recommend that you continue treatment as previously discussed with the Complementary Medicine

service and contact us if his neurologic signs worsen. Further medical imaging such as MRI to localize

and/or diagnosis a causative lesion is a possibility, but is really only useful for guiding surgical decisions in

this situation. The treatment option chosen today was to continue with previous treatment and monitor for

 further signs.

******
At their request, I sent some video of Milo walking at home to demonstrate his challenges with walking at times and his slope backed stance.

Milo - video one

Milo - video two

Milo - video three

Seeking answers

22 June 2014

I realize that it has been a very long time since the last update about Milo which has a lot to do with too much work and a lot to do with the fact that he's been not doing very well physically with mobility.  Not sure why he's been declining but have been giving him supportive care with massage, chiropractic and acupuncture.

We are going to the U of MN Vet School tomorrow to see the neurologist and hopefully get some answers for our boy.

This is a photo from late May where Milo found a cool and picturesque spot to hang out in the shade.

Pain in the neck

7 May 2014

Milo's appointment today with Dr; Choi went really well. We discussed the concern over Milo's weak hind end including the fear of this being neurological. She also suggested the an MRI or CT scan might reveal disc problems. Several manual tests were performed at the start of the appointment. Turning over the toes on the hind feet was once of them. His response time to right the toes was very slow.

We also discussed his diet and Dr. Choi determined that the protein he's been on - fish - is not right for his disposition which is damp heat.; So we will add duck and turkey.

Then Milo was given acupuncture which he tolerates very well. He is always up for being touched. He had a bit of anxiety about 1/2 way when the electricity was added. Electroacupuncture provides a tiny current to the needles so they are more effective.

Following the acupuncture, Dr. Choi gave Milo some tui na massage. She determined through manipulation that Milo is having some neck problems and acupuncture may very well do the trick for him. She will also order more custom herbs for him.

 After the exam Milo rose much easier and the manual test with flipping his rear toes was again administered. His response time was immediate. It was really great to be able to help him. He looks more alert already. We have another appointment next week for more accupuncture and Dr. Choi feels that this may do the trick. We can hold off on MRI and CT for now.  Oh, and he immediately pooped when we went outside. I guess he really did feel good!

Back again

29 April 2014

On Sunday Milo, Sabrina and Leo visited our friend Kathy the canine massage therapist with Canine Massage For Movement.  Kathy has been instrumental in helping Milo and Sabrina with feeling more comfortable and able to move more freely and comfortably.

She worked on Milo first.  He was very happy to be touched and massaged.

Milo has had a pretty rough week. The relief he was receiving from the herbs prescribed by Dr. Choi at the U of MN was evident when they ran out and he was demonstrating a great deal of discomfort with standing and walking. He began having accidents in the house and found it too difficult to keep up with our strolls around the yard. He has been my little shadow since the day he arrived so this change in behavior was very startling.

After his massage therapist discovered that his sloped posture seemed to be generated from his caudal sacral area two vets suggested that an x-ray of the area would help diagnose the issue. Yesterday at the U of MN he was lightly sedated and given a pain injection for the imaging procedure. He had a really rough time with the drugs and could barely walk even into the late afternoon. Last evening he was still "drunk". I was relieved that by this morning he was back to himself.

The x-rays revealed that his pelvic skelton is normal. So... we know he is in pain but we don't yet know why. Dr. Choi wants to see him next week. In the meantime, I am giving him 81 mg baby aspirin AM and PM which seems to give him some relief. So frustrating.

Life's full of ups and downs

22 April 2014

Last week Milo accompanied Sabrina for a visit with Dr. Choi at the U of MN Vet School.  Milo was getting close to finishing his herbs and is still very weak in the hind end and doing a lot of "sloping" when standing.  More and more it has become difficult for him to keep up with us at the dog park and people have been asking if he is an old dog.

Dr. Choi had several sophomore veterinary students observing her appointments for the morning and both Milo and Sabrina took full advantage of their attention.

Milo's blood work shows that his monocytes although still in the normal range are at the very high end of normal and have risen significantly from his last test.   Dr. Choi did not like that he did not respond the way that she had hoped with the herbs to help his back.   Another round of herbs is being developed for Milo.